>Call Me Crazy: Stories From the Mad Movement, by Irit Shimrat, Press Gang,
>167 pages. $18.95
>
>Review by Paula Caplan
>
>[COPYRIGHT The Globe and Mail, July 26, 1997]
>
>Irit Shimrat's Call Me Crazy:Stories From the Mad Movement is a compelling
>and important antidote to the torrent of popular and professional books,
>and the thousands of scholarly journal articles, in which people suffering
>emotional torment are slapped with skyrocketing numbers of labels branding
>them as medically ill, and the major focus is on the use of mood-altering
>drugs.
>
>Shimrat--who says she "went mad" three times--survived the psychiatric
>system, and was the editor of Phoenix Rising, the magazine of the
>"psychiatrized,"from 1986 to 1990. Call Me Crazy is a blend of persosnal
>anecdote, self-help advice and the history of psychiatry and its
>patients--she would say victims--with interviews and contributions from a
>wide range of other psychiatric survivors and advocates.
>
>The writings of people who, like Shimrat, belong to what is variously
>called mental patients' liberation, psychiatric survivors' organizations
>and the mad movement, are typically ignored by mainstream mental health
>professionals and media. Perhaps that is because former patients and their
>advocates lack political, social and economic power. Perhaps it is because
>their stories vigorously agitate our notions of what truly helps them.
>Perhaps both factors are at play.
>
>The movement has also been called "antipsychiatry," but Shimrat and the
>other organizers she quotes take care to point out that some therapists
>from the several mental health disciplines have been helpful to people
>classified as mentally ill. The book's most important contribution is to
>convey the perspectives of those who have been on the inside, rather than
>the better-known ones of those who inspect, diagnose and 'treat' them.
>
>Psychiatric survivors' groups promote and publicize the rights of "mental;
>patients," as well as providing education that the mental health
>establishment rarely offers about diagnosis, drugs and electroshock
>therapy. Call Me Crazy is chock-full of invaluable, highly specific
>information about what's wrong with establishment treatments, and
>suggestions about ways to help people when they are, in Shhimrat's words,
>"freaking out."
>
>Some of the dangers Shimrat recports about contemporary treatments are
>well known: careless prescription and overprescription of drugs, overuse
>of electroshock treatments, and failure to inform patients and their
>families about the unwanted effects of treatments, all of which happen
>more commonly to women and members of other relatively powerless groups.
>
>But Shimrat and the "mad movement" people she interviews also vividly
>describe behaviour to which people labelled mentally ill are regularly
>subjected, but which most people would assume was confined to psychiatry's
>early, more naive days or even the insane asylum's sordid past. These
>include the gratuitous, and counterproductive, use of physical force and
>even rape by staff, justified by the view that patients are not fully
>human, plus dismissal of patients' claims of abuse on the grounds that
>they hallucinated it; labelling individuals mentally ill because they are
>"different" (outspoken, disabled, First Nations people, for instance); the
>hospitalizing of an older woman by her adult children, who were angry that
>she was spending money she might have left to them, with therapists paving
>the way by calling her shopping a symptom of manic-depressive disorder;
>and the use of the court system in Canada to equate "crazy" with
>dangerous, despite research suggesting thsat people diagnosed with serious
>mental disorders are far less likely to be dangerous than, for instance,
>wife-beaters.
>
>Bearing witness, former patients tell their stories. One whose respected
>Toronto psychiatrist silently stared at her for most of each appointment:
>"I entertained myself by trying to see if I could keep from blinking
>longer than he could"--no wonder OHIP goes broke. One who told her doctor
>shat she "howled" while grieving her
>
>father's death, and was told that he hadn't realized she was still
>psychotic. One who reports the large number of patients who committed
>suicide while on medication (the disturbing "other side" of medications
>that are sometimes useful in some doses for some people). Respected lawyer
>and psychiatric survivor Carla McKague observes that it is legal to force
>people to take ":horrendous drugs like Haldol," which frequently cause the
>permanent muscle twitches of "tardive dyskinesia," but illegal for people to
>choose to smoke marijuana.
>
>The constantly expanding official list of alleged mental disorders
>(ensconced in the massive psychiatric "bible" the Diagnostic and
>Statistical Manual of Mental Disorders) now numbers 374, including
>stuttering, nicotine dependency disorder and major depressive disorder
>(which fits a person who is still grieving a loved one's death a few weeks
>later). No one presenting himself or herself as troubled or frightened can
>be certain of avoiding all those labels. We are all at risk, when branded
>as sick, of losing legal rights and social, political and economic power
>and respectability. This makes the enormously helpful, concrete advice
>from Shimrast and her colleagues--to treat the anguished of this world
>with humanity, kindness, respect and truthfulness--all the more
>compelling.
>
>Shimrat says a nurse who helped her into the shower when she was too
>drugged to move well was the only staff member who treated her as a human
>being, and it moved her to tears, thus putting her in danger of being
>classified as hysterical and manipulative. It is no coincidence that the
>therapists who have the greatest success with people considered severely
>disturbed are those who treat with large doses of humanity and love. But
>their numbers are too few. Activist David Cohen suggests that patients,
>noticing their own reactions to psychiatric drugs, should perhaps be
>allowed to choose their medications themselves. His statement that they
>would be much less damaged than by psychiatrists prescribing them will
>infuriate many in the mental health establishment, but is at least as
>worthy of serious debate as the notion that allergy doctors should listen
>to their patients' reports of adverse reactions to antihistamines.
>
>It is less painful for the professionasl to see troubled people in brief,
>emotionally distant
>sessions, and hand them prescriptions for drugs, than to listen to their
>grief and fear and offer them care, respect and helpful perspectives. But
>a public's numb acceptance of therapists' justifications of dehumanizing,
>overcontrolling "treatments" decreases the amount of humanity in
>therapists, in patients, and in us all.
>
>It would have been nice to see the many people whose words form
>substantial sections of the book cited as contributors, and the book could
>have used a good editor to integrate its many fragments. But its general
>themes and specific recommendations are sensible, caring, and worthy of
>our attention
>
>-------------
>
>Paula J. Caplan is a psychologist and author of They Say You're Crazy: How
>the World's Most Powerful Psychiatrists Decide Who's Normal and,
>coincidentally, the play Call Me Crazy.