Trying to raise my kids the best I can

Friday, March 05, 2010

Voluntary Madness


I just read this book "Voluntary Madness" by Norah Vincent. She's a great writer, and as a wanna be psychiatric nurse practitioner I find the subject matter interesting. It's about her experience in mental illness wards- partly as a writing experiment when she was healthy, and partly as treatment for the very real bipolar depression she experienced.


I vehemently disagree with her disdain towards medication, and for that reason I hesitate to recommend it. It is two steps backwards in the battle for mental illness treatment and understanding. I agree with her repugnance towards pharmaceutical companies and frustration with the side effects and the scientist's lack of full-understanding of the medications, but none of those are a reason to deny the advances we've made toward mental illness treatment.

That aside, there are gems in the book; some of which I'll quote here:

Moral vanity being that great middle-class indulgence that makes us write checks to charities and do the right thing for the less fortunate, because doing so reinforces our fiercely guarded belief that we are good people. But when the less fortunate come banging on your door and your heart in real time, up close, blowing their not so fresh breath in your face, wanting to be a person instead of a project or a write-off, then your cherished little antibacterial ideals turn all squeamish and stuttery, saying "well, but,..." "Yeah, but,..." and finally showing themselves outright to be as vaporous and self-serving as they always were.

How can we treat [the brain] the way we treat, for example, a kidney? There is the brain, whose business is thought and feeling and judgment and even mystical experience. And then there is the kidney, whose business is piss.

When you're not depressed, it's really hard to remember exactly what it felt like when you were depressed. You can remember it as an idea. You can describe it analytically. You know you felt terrible, and you know you don't want to feel that way again. But you don't remember the details, the quality of the suffering.

I was grateful St. Luke's didn't use wristbands. To patients they are indicative of anonymity and neglect, and the doctors who own St. Luke's seemed keyed into that, or so I imagine, understanding on some level that being tagged is a gross insult to your dignity. It makes you feel like property, or a corpse, a body not a person, the implications of the tag-maybe the need for it- being that if you passed out in the hall they'd know who the hell you were.

She knew enough about the course of her condition to know when she was losing touch with reality, and she had a very helpful circle of psychotic friends with whom she had what she called regular "reality checks." This meant that, because their delusions were all different, she could call one of them and say, "I think the CIA is watching me," and they'd be able to set her straight, confirming that, in fact, no, no one was lurking in the bushes outside her house or listening to her phone calls. Similarly, when they called her to ask if aliens were landing in the park down the street or check whether the computer chip in their molar was actually picking up signals from police radios, she could assure them that they were, in all likelihood, mistaken..."I was sitting in one of those meetings and I said, 'Am I God?' and everyone shouted "Nooooo". Now there's a reality check for you."

[Laughing is] like the happy version of vomiting, or the less profane version of coming, depending on your point of view.

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