Sunday, January 2, 2022

 

Book Review

Powers, Ron. “No One Cares About Crazy People. The Chaos and Heartbreak of Mental Health in America.” New York:  Hatchette Books, 2017.

Ron Powers promised his wife, Honoree Fleming, he would not write this book.

But ten years after his guitar prodigy son Kevin hanged himself in their basement a week before his twenty-first birthday in July 2005, after struggling with schizophrenia for three years; and then a few years later his older son Dean started experiencing the symptoms of schizophrenia and had a psychotic break --- Ron Powers changed his mind.

Powers started to reconsider his promise when he read the hateful words, “No One Cares About Crazy People,” in an email from Kelly Rindfleisch, who was Governor Scott Walker’s Deputy Chief of Staff in 2010 uncovered by the Milwaukee Journal Sentinel, mocking the horrible treatment of psychiatric patients in the Milwaukee County Mental Health Complex, he was shocked and angered. Patients treated for bipolar disorder and schizophrenia were starved, raped, impregnated, and walked around naked.

Powers hopes you will not enjoy his memoir and trenchant review of the history of mental health treatment in America.  He wants you to be wounded by his book --- wounded enough to do something about the state of help for the severely mentally ill in America.

Born in Hannibal, Missouri, Mark Twain’s hometown, Powers’ works include “Mark Twain: A Life.” With James Bradley, he co-wrote the 2000 number one New York Times Bestseller “Flags of Our Fathers,” made into a movie by Clint Eastwood. Powers was the first television critic to win the Pulitzer Prize.

Powers’ writing tears at your guts with his vast knowledge of our treatment of severe mental maladies, his intimate understanding of schizophrenia, and his heart-wrenching story of his two sons.

About his two sons, Powers says, “There is no greater feeling of helplessness than to watch two beloved sons deteriorate before your eyes, not knowing what to do to bring them back.”

Powers tells us that both of his sons suffered from schizophrenia and anosognosia. The latter is an inability to understand or have insight into your mental illness. Despite hallucinations, delusions, paranoia, you think you are mentally healthy.

Anyone who reads the history of our treatment of the severely mentally ill in America will feel nauseous, sad and angry. For example, “Life” magazine ran a story in 1946 with horrid  pictures of Pennsylvanias Philadelphia State Hospital at Byberry and Ohios Cleveland State Hospital. Movies such as “The Snake Pit,” in 1948 showed the hideous treatment of patients in mental hospitals.  

Powers recounts the “good intentions” of President Kennedy’s 1963 legislation that sought to provide more humane care for patients in psychiatric institutions. This transfer of patients to the community was prompted by the discovery of “miracle” drugs like the anti-psychotic Thorazine, aimed to cure schizophrenia. An aim that worked like a powerful rifle that misses the target.

With the consensus of political liberals and conservatives – for different reasons, we went from a nationwide peak of around 560,000 beds in 1955, to about 35,000 today --- half of what we need. Without these beds, we have about one-third of the homeless consisting of the mentally ill; more psychiatric patients in prisons than in hospitals; the mentally ill clogging emergency rooms and warehoused in the nursing homes.

Powers reminds us how some psychiatrists --- Thomas Szasz, R.D. Laing, and cult leaders such as the science fiction writer L. Ron Hubbard, creator of Scientology, have poisoned the well of psychiatric treatments, claiming such nonsense that mental illness is a myth. Szasz’s widely read book “The Myth of Mental Illness” (1961) propelled the antipsychiatry movement. Szasz wrote:

“My argument was limited to the proposition that mental illness is a myth, whose function it is to disguise and thus render more palatable the bitter pill of moral conflicts in human relations.”

Powers tells how Szasz teamed up with L. Ron Hubbard of Scientology fame backed by millions of Scientology member dollars to create the Citizens Commission on Human Rights (CCHR) established in 1969 headquartered in Los Angeles, California. Its stated mission --- and CCHR continues to this day – is to “eradicate abuses committed under the guise of mental health and enact patient and consumer protection.” On the CCHR website, they write:  PSYCHIATRY: AN INDUSTRY OF DEATH. Some protection.

There is some good news about progress in treating mental illness. For example, Congress has authorized 1.1 billion dollars to do an eight-state demonstration program . Mental Health Act introduced by our Democratic senator Debbie Stabenow which became law in 2014 and detailed criteria for treatment centers to become certified community behavioral health clinics. In 2016 Republican senator Roy Blunt of Missouri introduced a bill to add funding to 24 states to expand the demonstration program.

In 2008 the National Institute for Mental Health launched the Recovery after an Initial Schizophrenia Episode project. The NIMH just completed its first trials of the project in 2015 and finds much value in aggressive intervention for first-episode psychosis (1).

We have a long road to travel to bring the research and treatment of severe mental illness out from under the stigma of treatment and into the mainstream of competent care.

Perhaps the stigma and humiliation of mental illness will lessen as we discover the biological etiologies of psychiatric maladies and provide reliable and valid measures of illnesses of the mind.

 

(1)  Satel, Sally & Torrey, E. Fuller Torrey. “A Prescription for Mental-Health Policy.” “National Affairs, Number 31, Spring 2017.

Saturday, January 1, 2022

 

BOOK REVIEW:  Mankoff, Robert.  “How About Never? Is Never Good For You? My Life in Cartoons.” New York: Henry Holt and Co. 2014.

Haec enim ridentur vel sola vel
maxime quae notant et designant
turpitudinem aliquam non turpiter.

An indecency decently put is the
Thing we laugh at hardest.

--- Cicero

If you like to laugh – and think, this is the book for you.

Imagine two guys looking up at a big sign that says STOP AND THINK. One fellow says to the other: “Sorta makes you STOP AND THINK.” The reaction of these two fellows is exactly what the cartoons in The New Yorker Magazine make you do – cartoons that are better described as life drawings requiring you to think about life’s predicaments and ambiguities, facing the dangers and excitements of being alive.

Bob Mankoff, cartoon editor for The New Yorker (TNY), has written a memoir about his life in cartoons. The topics of TNY cartoons draw on humor from sex, love, death, parenting, marriage, family, cruelty, fear, jealousy, envy, hate, identity, character, conscience, desire, mourning and more --- the same topics that psychologists are up to their ears in.

Mankoff left psychology graduate school to seek his fortune in drawing cartoons. He started selling cartoons in 1977, and started working for TNY in 1980. He says he knows all about rejection, being booted out of psychology graduate school, and submitting thousands of cartoons to TNY before getting his first cartoon published.
He became the cartoon editor in 1997, about 20 years after selling his first cartoon. As editor of the magazine, he evaluates more than 500 cartoons every week, selecting about 10 - 15 for each magazine issue

Mankoff is most famous for creating the cartoon bank, and for the following best-selling cartoon:

An executive is at his desk, on the phone, and looking at his calendar says, “No, Thursday’s out. How about never?” Is never good for you?”

His title of his memoir is taken from what might be the most popular cartoon in the history of TNY. Mankoff remembers how he got the idea for this cartoon. He was trying to get on the phone with a friend who he wanted to see. That friend kept saying, “Can we meet this time? Could we do it that time?” And finally Mankoff says to his so-called friend, “How about never? Is never good for you?”

Mankoff traces this snotty retort back to his Queens and Bronx New York Jewish background. The Chapter 1 title is: “I’m Not Arguing, I’m Jewish.” During childhood, whenever he complained to his mother he was bored, she told him to bang his head against the wall, Mankoff quips. She taught him boredom was a luxury.

He describes his never-boring cartoon editor job as evaluating humor, a much different process from enjoying humor. He gives an example of a cartoon with 10 possible captions --- and this is the format of the cartoon caption contest that runs every week in TNY. The readers submit captions to a cartoon on the page, and the winners of the caption contest are printed. His editing job consists of picking cartoons with the best captions.

To evaluate cartoons, Mankoff reports that he is faced with the paradox of choice, which automatically brings the interference of the judgment process, short-circuiting the laugh response. So instead of laughing at the cartoon, he has to judge it.

In analyzing humor, Mankoff comments about what comics call “the magic of three.” He says you need a sequence for surprise to make a narrative funny.

Here is an example of a cartoon with the element of triplets in humor --- a one, two, and then boom.

A woman is saying, “I started my vegetarianism for moral reasons, then for health concerns, and now it’s just to annoy people.”

The cartoons in TNY, show the very widespread humor taking place in New York, the circus of the world. Humor makes fun of what’s in the public mind.

Here are two examples of cartoons about same-sex marriage:

A couple is looking at TV, and the guy is saying, “Gays and lesbians are getting married. Haven’t they suffered enough?”

A couple is in bed, and the guy is saying to the woman, “What’s your opinion of some-sex marriage?”

Mankoff appreciates humor that is benign, not speaking truth to power, but humor directed back at the people who are reading the magazine.

He describes a theory of humor he calls, “Just the Right Amount of Wrong.” He says this view emphasizes that humor is different in different contexts. He says that the mother’s milk of humor is anything that’s embarrassing, guilt- or anxiety-filled. Mankoff has learned that humor comes in almost endless varieties: humor based on reality, observational humor, silliness, and playful incongruity or absurdity.

An example of an absurd cartoon is:

It’s a cowboy at a desk. The person sitting in front of him is a cow, and he’s reading his resume. And the cowboy is saying, “Very impressive. I’d like to find 5,000 more like you.”

One cartoon, apparently not for everybody’s taste, shows a rodent in a cage, and then another picture of a rodent who hung himself. The caption is: “Discouraging data on the antidepressant.” Mankoff tells about readers who send in letters saying they don’t like cartoons where animals suffer. Mankoff’s response: “We use anesthetic ink.” A wise-guy he is.

Some people are hypersensitive to humor, and some people have little or no humor. I make it a rule never to use humor with people I don’t like ---- it is hard to keep my unconscious slips from showing.

Mankoff notes there have been many cartoons in TNY about the Grim Reaper because humor is an important way we cope with death, anxiety, suffering and illness.

An example of Grim Reaper humor:

The Grim Reaper is taking away her husband, and the wife is at the apartment door, and she is saying, “Relax, Harry. Change is good.”

Cartoons about marriage are another staple of TNY cartoons. Mankoff mentions he is happily married to his third wife (the magic of three). He says humor is essential in our attempts to understand our partners and for our partners to understand us.

He cites a cartoon on marriage:

A man is talking to a woman in the living room and he says, “Believe me, Janet, I consider you an important part of our marriage.

Mankoff focuses on the links between creativity and humor. He mentions Arthur Koestler’s book, “The Act of Creation,” in which he connects humor, science and art.

Life without a sense of humor is life without any sense of proportion or perspective.
Where laughter stops, so does common sense.

As the psychologist William James noted, “Common sense and a sense of humor are the same thing, moving at different speeds. A sense of humor is just common sense, dancing.”

5 people found this helpful