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Feb
14
Book Review: Voluntary Madness by Norah Vincent
2009 at 12pm Posted by Rebecca Joines Schinsky
Recently published December, 2008 by Viking (a division of Penguin)
I loved Norah Vincent’s first book Self-Made Man, in which she dressed, acted, and lived like a man for a year-and-a-half in order to penetrate traditionally male parts of society and better understand what life is like for American men. That book was compelling, insightful, and hard to put down, so I had high hopes for Vincent’s second foray into her trademark “immersion journalism,” Voluntary Madness: My Year Lost and Found in the Loony Bin. Unfortunately, Voluntary Madness left me feeling more than a little bit “meh,” so in lieu of writing a summary, I’ll share this synopsis from the publisher:
Norah Vincent’s New York Times bestselling book, Self-Made Man, ended on a harrowing note. Suffering from severe depression after her eighteen months living disguised as a man, Vincent felt she was a danger to herself. On the advice of her psychologist she committed herself to a mental institution. Out of this raw and overwhelming experience came the idea for her next book. She decided to get healthy and to study the effect of treatment on the depressed and insane “in the bin,” as she calls it.
Vincent’s journey takes her from a big city hospital to a facility in the Midwest and finally to an upscale retreat down south, as she analyzes the impact of institutionalization on the unwell, the tyranny of drugs-as-treatment, and the dysfunctional dynamic between caregivers and patients. Vincent applies brilliant insight as she exposes her personal struggle with depression and explores the range of people, caregivers, and methodologies that guide these strange, often scary, and bizarre environments. Eye opening, emotionally wrenching, and at times very funny, Voluntary Madness is a riveting work that exposes the state of mental healthcare in America from the inside out.
My first big issue with this book is that the subtitle is a huge misnomer. Vincent spends a grand total of 34 days in three different facilities (two visits of ten days each and one of two weeks), and Voluntary Madness could more accurately be called “My Month in the Loony Bin.” Now, I’ve never been in a mental health facility, but I have the general impression that in order for an author to truly understand the experience of being immersed in any situation or group would require more than ten days. Vincent writes about the people she met on the wards as if she spent years with them, when, in reality, she was in each place for little more than a week. I just had to question the depth and accuracy of the impressions she gleaned from such short visits.
It also irritated me that Vincent was not entering the situation as an objective observer. Having previously spent time “in the bin” for real treatment, Vincent went into the project with already formed opinions about public health care facilities, and the first third of the book, in which she gets herself admitted into the mental health unit of a large public hospital in New York City by falsely reporting symptoms of severe depression, is a seething indictment of the facility, its staff, and the medical model approach to mental health care treatment. The fact that she is receiving treatment and working through her own problems as she studies the environment seems to hinder rather than enhance her account. Because her ten days in the facility lead her back into depression, Vincent accuses the system of creating self-fulfilling prophecies that doom the patients to futures in which they will never get better but instead will become the chronically ill and ostracized people their caregivers expect them to become.
Some time after her release, Vincent attempts to wean off of the anti-depressants she has been taking for years, and she quickly spirals back into depression, just in time to check into the second facility, a private “bin” in a small, rural mid-western town. This facility is nicer, its staff is more experienced, and Vincent experiences positive results from her ten days of treatment, providing illustration of the difference in quality between public and private treatment facilities, which Vincent likens to the differences between the service at the United States Post Office and FedEx. As her treatment and her symptoms improve, Vincent warms up to the idea that “the bin” might not be all bad, and she softens in her critique.
At this point, the book turns into more of a memoir of Vincent’s personal journey back to mental health. When she visits the third and final facility, a higher-end private center that takes a holistic and more than slightly new age approach, Vincent discovers the form of treatment that works best for her. She encounters psychiatrists and therapists that restore some of her faith in the profession, and she makes important breakthroughs in her own recovery. In this last third of the book, Vincent makes several personal revelations that make the book much more interesting and compelling.
I really enjoyed the memoir-ish aspects of Voluntary Madness, but Vincent’s attempts to expose “the state of mental healthcare in America” fall flat because they are nothing new. Readers who are entirely unfamiliar with mental health treatment will surely learn something from Vincent’s experience, but for readers who have taken even an introductory psychology course, the ideas presented in Voluntary Madness will be nothing new.
When Vincent opens up and really writes about her experiences with depression and the past traumas that have led to her self-destructive thoughts and behaviors, she is captivating. But when she lapses into pseudo-philosophical ruminations on the role of the will in mental illness and re-creates her downwardly spiraling thought patterns, she loses me. Voluntary Madness has its moments of greatness, but they are too few and far between to make this a great read. An interesting read, it is, but it left me unsatisfied and a bit frustrated. This is just one woman’s perspective, and, thankfully, Vincent is honest enough to admit that.
Redeemed by the more personal and emotional sections, Voluntary Madness falls into the “good but not great” category. This would be a decent selection for readers who are interested in learning about one person’s experiences with mental health treatment, but even Vincent tells us that it should not be taken as a representative account, and there are better memoirs of mental health treatment—and more powerful indictments of the system’s failures—out there. 3 out of 5.
Visit the author’s website to learn more.
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The Self-Made Man sounds great…this is not the first lukewarm review I’ve read of this one, though.
This sounds like a good concept that wasn’t implemented very well.
Too bad, it sounds disappointing. I do still want to read Self-Made Man, though.
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I’ve been very interested in reading this book. Your review was great and I’m sure it will be helpful for me that my expectations will not be too high.
I’m most upset by the time difference from title to story – not very well-thought out I’d say. Also knowing that she did go through these experiences during a mentally unstable time will be useful to reading this as a memoir rather than a serious look at mental health care – because surely a person can’t make a solid judgment when their own state of mind is off. Not to say that the author’s opinion doesn’t count, but more that it can’t be taken as irrefutable.
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I read your comments about Voluntary Madness with interest. I am writng on a similar topic and can’t figure out how to gauge whether it is worth trying to make into a book. It would be very helpful if you could give me your thoughts. Thanks.
In my preceding post asking for your thoughts, the link to what I have written appears not to have show up: http://suzycreamcheesegoesinpatient.blogspot.com/
It reads best if you start with the oldest post (March 10, 2010) and read forward.
I’ll do my best to take a look soon.