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Voluntary Madness: My Year Lost and Found in the Loony Bin - Norah Vincent - Google книги

Voluntary Madness is journalist Norah Vincent's account of her visits to three mental health facilities in America. The first is an urban, public hospital that houses mainly homeless, psychotic patients, many of whom are addicted to drugs. In this hospital, the doctors are overworked and jaded and medication is always the answer.

Soon, the author finds that her latent depression which led her to do the book in the first place is returning. The process of being institutionalised breaks her sense of self-worth down astonishingly fast.

Indeed, she suggests that it is the lack of autonomy in institutional life, even for those patients who voluntarily commit themselves, that makes it so hard for them to rebuild independent lives when they finally leave the institution. The second place Vincent visits is a private, rural clinic that caters principally to middle-class depressives and addicts.

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Here, she is given more autonomy - the freedom to make snacks and take regular breaks for fresh air. Her wrist isn't tagged and she has a room of her own. It's interesting to see how these small concessions to humanity have an effect on her state of mind but, overall, her experience still seems to be that sitting around with a load of whining, self-indulgent depressives is counter-productive. The third place Vincent stays is a more progressive facility, keen on individualised therapy as well as exercise and arts and crafts.

And it's here that she comes to her own, personal resolution.

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The originality of Voluntary Madness lies in the fact that Vincent is reporting from inside the system at its three cardinal levels: a hard-core public institution, a more congenial private equivalent, and an intensively personalised therapeutic realm. As near as is possible in a single account, this presents the full spectrum of psychiatry in operation. Vincent's observations veer between the insightful and the trite, but in a field dominated by antagonistic professional specialisms of brain and mind, it can take an informed and experienced generalist to see the big picture.

She is at her best when exposing the contradictions of public and private healthcare and bristling with the uncomfortable ironies of the position she has put herself in. Curiously, though, her examinations of her own psychology are less gripping than her acerbic social and psychiatric commentaries. She reveals a history of childhood sexual abuse in a spirit of blunt self-exposure, but the most obvious enigma which her books present to her readers - why the desire to adopt disguises - is left unexplored.

Voluntary Madness

She says a lot about sex but little about sexuality. Her therapeutic resolution turns out to be a sensible but limited philosophy of individual responsibility. There's nothing essentially wrong with this, only the light she points at the system is more glaring than the one she directs at herself. Topics Society books The Observer.

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Mental health Depression reviews. 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.