Friday, 1 December 2017

Book Review: Another Kind of Madness

“There are times that I wish I had cancer.”

It is difficult to imagine that anyone would wish for cancer. But through the eyes of someone diagnosed with a mental illness, this statement may make more sense. The cultural perception that cancer is a “real” illness and mental health challenges are weaknesses or character flaws is just one example of why efforts to reduce stigma are needed.

In Another Kind of Madness, Stephen Hinshaw shares his story of growing up with the unexplained absences of his father. It wasn’t until his father shared information about his bipolar diagnosis while Hinshaw was in college that he was able to better understand the absences.

Hinshaw compares the stigma around mental illness to other marginalized groups throughout history, such as the LGBTQ community. Attitudes about gay marriage have changed over the years, but we have not seen that same progression with mental illness. When other groups experience stigma or discrimination, there tends to be solidarity and positive identification with members of the affected group, which provides protection. Whether it’s sexual or racial minorities, the members of these groups can support each other. But who wants to self-identify with a group that’s considered “crazy”? This stigma makes it challenging for people with mental illness. In many cases, they don’t have the support system that’s available to other marginalized groups.

While understanding the facts helps people recover and should increase understanding, it can also promote stereotypes.

“Facts promote stereotypes, while the information that needs to be conveyed is the great potential for coping and recovery if treatment is made available,” writes Hinshaw.

Many families face the challenge of needing to share what’s happening to get treatment, while at the same time feeling unable to share what’s happening due to fears about how others will respond.

Throughout the book, Hinshaw provides an honest portrayal of the stigma involved with having a family member with a mental illness.

“The famed Berkeley sociologist Erving Goffman coined the term courtesy stigma to signify society’s strong tendency to degrade anyone associated with a stigmatized individual or group,” writes Hinshaw. He also talks about anticipated stigma, “the fear of what might happen if the world were to know” about a mental illness.

Stigma is not a simple problem with a simple definition. There isn’t only stigma involved when people learn about their own illness, but when others find out about it, when a family member is suffering, when seeking treatment, when getting out of treatment, and the list goes on. Left unchecked, it can be a vicious cycle. Throughout the book, Hinshaw shares vivid examples of the multiple ways stigma can be experienced.

Hinshaw has both personal family experience as well as professional training in both psychology and psychiatry. But he admits that what we know in these fields is just a small amount of what still needs to be learned. I appreciate his invitation for people to adopt humility and learn what they can about mental health.

“Those who bask in their supreme knowledge are deluding themselves, their patients, and the scientific community,” writes Hinshaw.

Hinshaw’s hope is that telling his story will move the needle ever so slightly on the battle to reduce stigma. As people continue to tell their stories, the reduction of stigma is possible, but there is a very long way to go.

Mental health professionals who have never experienced mental illness personally or in their families should read this book. It’s written by someone who works in the field and knows the clinical nature of mental illness. But perhaps more valuable is Hinshaw’s ability to speak about mental illness as someone who’s lived it. It’s powerful for mental health professionals to see, through Hinshaw’s eyes, exactly how much a family is impacted by mental health.

One of the important takeaways is that it’s not only individuals who suffer with a mental health diagnosis, it’s also often those they come in touch with. Hopefully one day, people diagnosed with a mental illness will not wish for cancer. Until then, we can continue educating ourselves and treating everyone with compassion and kindness.

Another Kind of Madness: A Journey Through the Stigma and Hope of Mental Illness
Stephen P. Hinshaw
St Martin’s Press, June 2017
Hardback, 267 pages



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