As a licensed marriage and family therapist and mental health writer, I am always interested in new books about mental health and the way we treat those with mental illnesses, so it was with interest that I picked up Marianne Richards’s self-published new book, Understanding Mental Illness: Comprehensive and Jargon Free 6th Edition. While Richards does give a comprehensive overview of the history of mental illness, the ways in which we as a society often treat it, and the defining characteristics of the most common diagnoses, I was left wondering just how this information might apply to someone who suffers from a mental illness or a professional treating this person.
Richards, who herself was diagnosed with Asperger’s years ago and experienced firsthand the stigma that those with mental illness often feel, begins with a historical look at mental illness. “Throughout history, individuals who have not conformed to the expectations of society (or their tribe) risked exclusion,” she writes. Much of this can be attributed to the difficulty society has in defining just what sanity is. While it is helpful to recognize non-conforming behavior, it is not helpful to act upon it irrationally, which is often referred to as “moral panic.”
Historically, this exclusion was most often in insane Asylums. “These were not only people with active mental illnesses but so-called social misfits whose only problem was eccentricity or minor social aberrations,” Richards writes. However, mental illness, rather than appearing in rigid categories, is better explained as existing upon a continuum, where no person remains neuro-typical throughout their life.
Much of what actually appears strange to us, Richards tells us, is not always the problem of the individual, but rather our own perception of that person. Yet because mental illness has so frequently been sensationalized, it has been given a negative image. And when those who are different experience this stigma, it often has an exponential effect. “Sometimes it’s not a matter of where you live but the society you are born into which determines your fate if you have a mental condition,” Richards writes.
It wasn’t until the Greek philosopher Hippocrates proclaimed that madness was “no more divine nor sacred than other diseases but has a natural cause,” that societal attitudes began to shift toward mental illness. The parallel is that while Hippocrates believed that mental illness was caused by imbalances in the vital fluids, psychiatrists now treat mental illness with medications to balance brain chemistry.
What also emerged out of the study of mental illness — which we can attribute to Carl Jung — was that many character constellations can be found across numerous cultures and generations. For example, the archetypes of the hero, wise man, mother, and fool have deep historical roots and are easily recognized in many different cultures. A second important finding was the value of the therapeutic relationship, which exists across the wide range of treatment modalities.
Adding to our understanding of mental illness, Richards takes a look at the Mental Health Act of 1983, which regulated the “reception, care, treatment of mentally disordered patients, the management of their property, and other related matters.” This regulation defined the ways in which patients could be removed from public places and admitted to treatment, and the need for their consent to do so, as well as the situations in which consent is overridden by concern for public safety.
Richards then explores the typical treatment modalities for mental illness and offers the following advice: “When selecting a therapist, there are two vital criteria. Therapists who have unresolved life problems will not help anyone. Therapists with a wide life experience are more likely to have a quality called empathy; good therapists possess this in spades.” However, while Richards explores both the psychotherapeutic and medical approaches to mental illness, I was left wondering how a patient with mental illness might know if their therapist has unresolved life problems.
Richards then provides “pen portraits” of therapists which I found interesting and engaging. For example, she describes Vera, a private practice counselor specializing in brief therapy, whose day consists of offering a distressed client practical problem solving skills, listening to an anxious client, helping an unhappily married man clarify his thoughts, and dealing with a passive aggressive co-worker.
Richards also explores some common mental conditions, their defining criteria, typical treatment approaches, and case histories, which again, I found interesting and informative. For example, Richards tells us that Obsessive Compulsive Disorder is often experienced as an inability to tolerate disorganization and a compulsion to make things orderly that are not under the person’s control.
Lastly, Richards offers eight keys to mental health, such as eating well, talking about feelings, learning new skills, and being creative. On the topic of stress, Richards reminds us that stress is a necessary part of life, but excessive stress results in unpleasant symptoms.
While Understanding Mental Illness is a clear and informative synopsis of the history of mental illness and the ways in which it has been treated, those who are looking for practical advice on just how to manage mental illness, or the stigma that often accompanies it, will need to look further.
Understanding Mental Illness: Comprehensive and Jargon Free 6th Edition
CreateSpace Independent Publishing Platform, September 2015
Paperback, 169 pages