NOBODY'S NORMAL

A broad-ranging history of psychiatry, examining trends in how mental diseases are increasingly less stigmatized as we acknowledge that so often “the sufferer is innocent.”

Even today, English offers a rich lexicon of stigmatizing terms in the semantic domain of mental illness—one bit of evidence, writes cultural anthropologist Grinker, that “stigma isn’t in our biology; it’s in our culture.” Given its cultural locus, we can alter our behavior to use less alienating language, and, as the author illustrates, in some instances we have, especially regarding other illnesses. As we learned about HIV/AIDS, for example, “the fear and secretiveness…began to decrease,” even as obituaries now acknowledge the once-whispered term cancer and even suicide. Grinker, a professor of anthropology and international affairs, comes from a long line of psychiatrists and was brought up to believe that everyone suffers from some sort of mental illness at some point in life. Given its universality, the “discredited identity” that often accompanies mental illness is misplaced. The author offers an agile history of mental health and efforts to control it. For example, the Puritans of New England “believed that anyone without reason” needed to be controlled as if an animal, a category that included not just the mentally ill, but also babies. It was not until the 19th century that the realization became widespread that the mentally ill could be treated rather than merely punished. Interestingly, Grinker observes in his anecdotally rich narrative, many advances in psychiatric treatment came by way of military medicine, with so many soldiers shattered by the horrors of conflict. Indeed, it was the U.S. Army’s medical manual for mental disorders that formed the basis of the first DSM in 1952, a volume that represented “a marriage of military experience and psychoanalytical theory.”

A highly readable, thoughtful study of how we perceive and talk about mental illness—with luck, ever more respectfully.