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Summer 2009 | Vol 12 No 4

Review

Cheryl Peever

Voluntary madness: A questionable commitment to fighting stigma

For Norah Vincent, who lived as a man for her book Self-Made Man, her latest foray into immersion journalism takes her into three mental health and addiction facilities posing as a client. Unfortunately, she called her book Voluntary Madness: My Year Lost and Found in the Loony Bin. One would hope that after Vincent’s experiences, her language would change. Not so. She uses stigmatizing terms like “the bin,” “zombie parlor,” “insanitarium” “and asylum.” Clients are “mad,” “insane,” “psychotics” and “society’s rejects,” never just people.

Immersion journalism allows the public a glimpse into the private domain through lived experience. Although the writer/observer also becomes subject, yielding a certain amount of subjectivity, this is still meant to be journalism. But Vincent offers a story without investigation, sorely lacking in objectivity. She describes her desire to “inform” and “entertain,” but what she exposes are her own biases, stereotypes and grudges.

Anyone who has worked in or sought help through the mental health system knows it has problems. Seeing the system through the lens of a client can offer a fresh perspective and a critical analysis that professionals cannot provide. However, Vincent’s criticisms seem more like the ravings of a petulant child than the insights of someone interested in reform.

Vincent admits herself to a large public hospital with an acute population; a small, private hospital in a rural setting with a less acute population; and a private alternative treatment facility. From the outset, she states her goal to expose and ridicule the system. She is predisposed to not like staff, calling them “lazy mindless bureaucrats” and “paper pilers.” She resents the nurses who follow orders and enforce rules, but saves most of her vitriol for psychiatrists, who are arrogant and entitled – “a prick on a power trip,” a “pug jailer with and advanced degree.” So she is surprised when one doctor agrees with her decision to not use medication and grants her request for community passes. Vincent is able to recognize that not everyone in the system is the enemy, but only those who meet her needs.

It is noteworthy that Vincent herself has a diagnosis and during one of her admissions had gone off meds and became depressed. But she does not identify with her fellow patients, seeing herself on a different plane of existence. Her intention to promote social justice and defend her co-patients turns to “visceral disgust and hatred,” particularly for those who are psychotic. Although she hates that medication is used liberally, she believes client are “mildly more acceptable when tranquilized or debilitated.”

Vincent struggles with her diagnosis and whether her depression is biological, or whether medication has produced a chemical imbalance. She questions the role of “the will” in depression and whether depression is just a “bratty rebellion” in the face of adversity. She describes herself and her fellow patients as consuming their depression, “rolled in it like pigs” and “reclining in the arms of a disease.” It is unfortunate that her own internalized stigma and denial lays blame on her fellow patients. She judges them, most of whom she sees as unwilling to change, even when given compassion, understanding and freedom.

Aside from the obvious – that offering respect, programming and outpatient resources improve chances of recovery – Voluntary Madness fails to offer insights into how to improve the system or better respond to client needs. It reads more like a self-indulgent blog that contributes to, rather than challenges, stereotypes and prejudice.

Voluntary Madness: My Year Lost and Found in the Loony Bin. Norah Vincent. Viking Adult, New York, 2008, 304 pp., $25.95US.

Cheryl Peever is manager of the Women’s Program at the Centre for Addiction and Mental Health in Toronto.