“Triggered: A Memoir of Obsessive-Compulsive Disorder” is for anyone who is or knows someone who is suffering from mental illness of any type.  While Wortmann wrestles with OCD, he is more than sympathetic regarding all types of mental illness. In addition to making us understand the problems and loss of so much of his life due to his problems, it’s important to him that mental health professionals try to understand things that they may not have personally experienced. If they can’t feel what the patient feels, it is important that they are careful when trying to help and not make light of things. (His well-meaning social worker decided to call his deepest depression “crumping” because she felt it would be easier for him to call it this when he had too much trouble asking for help.  This did not end well.)

Even as a boy, Wortmann tended to use irony in order to survive his disorder.  While it may seem better than complaining and constantly feeling unhappy with the help provided, to the reader it is obvious that this is exactly what kept Wortmann from really asking for help when needed most. 

His fixations — whether they be the perfection seemingly demanded by Jesus in his religion; his obsession with perfection in school and at home; or his very normal embarrassment by a parent picking him up from school — are not unfamiliar to the average person. But the OCD causes Wortmann to have an extreme, painful and almost fatal reaction to such things. 

It is difficult to judge this book because it is well-written by a man who could be writing fiction and making you laugh or cry depending on the moment.  He admits to trying to kill himself more than once. He can’t be sure that he won’t do so at some point in his life, because no matter how much help he gets, no one can take away what he’s been given — which seems to be an overabundance of guilt and worry. Think of the adolescent fear of dating. Then imagine the impossibility of setting this fear aside long enough to understand that a “no” isn’t the end of the world and asking is the only way to get a “yes.”  This is just a small portion of his life.

I think this book will bring many people to a new understanding of OCD because it is filled with interesting anecdotes and compelling sadness along with hopeful events.

To write anything negative about this book would be difficult since I have suffered my own type of mental illness.  I have suffered physical pain, as have most people at one time or another, but mental pain far surpasses this. Wortmann’s pain hurts me as he says “Does it sound embarrassing, trite, if I claim that I feel a kinship between us?”  This, I am sure, means everyone with mental pain.  It feels as though Wortmann “feels” too much, which is probably due to a lifetime of pain that is difficult to pinpoint and difficult for others to comprehend. It doesn’t sound embarrassing or trite to me, because feeling the pain I felt — and knowing there are people like Wortmann who will live with this pain forever and have never known real peace — is painful to me.

Triggered: A Memoir of Obsessive-Compulsive Disorder
By Fletcher Wortmann
Thomas Dunne Books: March 27, 2012
Hardcover, 272 pages
$24.99

At one point during the chat, I connected with a distraught young woman who had been seeing a therapist for quite some time, but her OCD was getting worse, not better. “Is the ERP therapy too difficult for you to do?” I asked her. “ERP therapy?” she responded. “What’s that?”

I was stunned, though in retrospect I’m not sure why. Our family had floundered and then fought our way through a disorienting maze of treatments and programs, desperately trying to find the best help possible for Dan. But I had thought Dan was the only one who had been steered in the wrong direction, sent to the wrong therapists, and put on the wrong medications. It was then and there that I became an advocate for OCD awareness.

Exposure Response Prevention Therapy (ERP therapy) is a type of cognitive-behavioral therapy (CBT) and, in my son’s case, a very effective treatment for OCD. In a nutshell, this therapy involves the person with OCD facing his or her fears and then refraining from ritualizing. This is extremely anxiety-provoking initially, but eventually the anxiety starts to wane and can sometimes even disappear. A concrete example of ERP therapy in action would involve someone with OCD who has issues with germs. They might be asked to touch a toilet seat and then refrain from washing their hands. Treating OCD with ERP therapy has even been the topic of some reality shows over the past few years. So why do so many therapists remain in the dark?

When Dan diagnosed himself (with the help of the Internet) at the age of 17, he was referred to a well-respected clinical psychologist in our area. This therapist employed traditional talk therapy, which included examining underlying issues. This form of therapy is usually ineffective in treating OCD. In fact, talk therapy often exacerbates OCD. Repeatedly talking about their fears and reassuring OCD sufferers only adds fuel to the fire. OCD is not something rational that can be discussed. It is a neurologically-based anxiety disorder. In fact, a study done in 2007 showed that OCD sufferers had less gray matter in the areas of the brain associated with suppressing responses. Telling someone with OCD not to worry is like telling someone with asthma to stop having trouble breathing. It isn’t possible.

And so Dan spent months in therapy, getting worse. He ended up spending nine weeks at a world-renowned residential program for OCD, and that was his, and our, first introduction to ERP therapy.

You don’t have to go to a residential program to get the right help for OCD, but you do need to find a properly trained therapist who specializes in the disorder. What works for one OCD sufferer may not always work for another. You and your therapist will work together to find the right balance of therapy, medications, and stress management techniques that will give you the best chance of success. The best resource out there for finding these competent therapists is the International OCD Foundation. Not only do they list health care providers by state, they give you tips on what questions to ask when interviewing a prospective therapist.

ERP therapy is difficult, but with hard work the OCD sufferer can improve dramatically. Three years ago Dan was so debilitated by severe OCD that he could not even eat. ERP therapy literally saved his life and today he is a rising senior in college with a wonderful life ahead of him. ERP therapy often is very effective for those with OCD. Having OCD is tough — getting the right help shouldn’t be.

Through its holistic, compassionate approach, this valuable guide empowers with knowledge, instills with confidence and gives women a direction for finding doctors who are truly knowledgeable about their disorders and able to treat their pain.  As is read in its introduction, “This book is the product of our passionate belief that all women with sexual pain need both physical and emotional support.” 

Deborah Coady and Nancy Fish provide a detailed, empathic guide that that offers a wealth of physical and emotional suppport. I highly recommend Healing Painful Sex: A Woman’s Guide to Confronting, Diagnosing, and Treating Sexual Pain.

Millions of women suffer from sexual and pelvic pain in America today, yet it is frequently misdiagnosed or not diagnosed at all.  Because of the multidisciplinary nature of sexual pain, which falls between the disciplines of experts, women have often been told that pain is “all in your head”  or that nothing can be done to help them.  As Coady and Fish point out, “We’re here to tell you that none of that is true.  Sexual pain is almost always caused by an identifiable, verifiable medical condition; it can be treated and is not in your head.” 

Nancy Fish had suffered from severe pelvic pain and had seen seven specialists before visiting Deborah Coady.  Coady, while having years of experience with women suffering from sexual pain, nonetheless took some time to uncover all of Fish’s difficulties.  Fish, like most women suffering from sexual pain, through inadequate treatment had several conditions that had compounded and spread.  A licensed certified social worker specializing in chronic illness, Fish found great hope in Coady’s insistence that she never give up on herself. She was inspired to form a partnership with Coady to help those with the chronic illness of sexual pain. 

Deborah Coady, through her personally developed teams of colleagues in neurology, dermatology, orthopedics, pain management, gastroenterology, urology, peripheral nerve surgery, physical therapy and psychotherapists, demonstrates in Healing Painful Sex how fruitful their holistic approach can be. As they write, “Even in your most difficult situations, you can experience a significant reduction in your pain and can find help for reintroducing sex as a joyous and nourishing part of your life.  We promise:  Things can get better.”

The book is organized into three parts. Part 1: Naming the Problem begins with the difficult situation of talking about sexual pain.  It helps the reader learn how to share her situation with one or two other people who can then help make medical decisions.  The book then discusses the often arrogant, uninformed or downright abusive physicians who exist.  As stated in the book, “The degree of incompetence, insensitivity, and indifference among gynecologists, other specialists, and general practitioners is hard to overstate.”  Hoping to aid their emotional healing along the way to ending their sexual pain, Coady and Fish outline the ways in which the reader can understand what to do when the doctors get it wrong. 

The first section of the book ends with a chapter dedicated to finding a doctor who will offer effective treatment and provides a detailed holistic guide on beginning one’s healing by following guidelines on pain, sleep hygiene, diet and supplements, exercise and relaxation techniques and learning of how to be gentle with oneself.

Part 2: Understanding the Problem, provides the reader nine chapters of detailed information covering the symptoms and conditions of pelvic floor dysfunction, vulvodynia, pudendal nerve pain, clitorodynia, pelvic organ problems, endometriosis, painful bladder, and irritable bowel syndrome, skin disorders, such as lichen sclerosis, and hormonal, surgical, and post-cancer causes of pain.  Interwoven with detailed explanations of the causes of sexual pain, the book contains full-page anatomical illustrations, checklists for particular disorders, and details on the types of tests needed as well as lists of the common misdiagnoses given for a disorder and ways to rule it out.  It contains details on how the various conditions can co-occur and affect one another.  It tells the potential patient of what to expect during an examination and offers guidance based on the doctor’s performance and recommendations.

Part 3: Overcoming the Problem presents valuable information and guidance devoted to fulfilling one’s life with the joys often taken away in sexual pain.  Coady and Fish hope to return libido, desire, partner intimacy, healthy relationships with friends and families to women undergoing sexual pain.  Their many personal case studies validate and underscore the valuable guidance they provide.  The book closes with excellent resources, including recommended books, helpful websites, psychotherapists, as well as relevant organizations and associations.

Healing Painful Sex: A Woman’s Guide to Confronting, Diagnosing, and Treating Sexual Pain
By Deborah Coady, MD & Nancy Fish, MSW, MPH
Seal Press: November 1, 2011
Paperback, 400 pages
$18

David Stringer has a well-written account  of how a family member can feel about their mentally ill, substance-abusing sibling and son.  In his first-person memoir the reader can’t help but empathize with David and his family but also feel strong emotions for David’s brother John who is riddled with problems. We can all see that John has made some very poor choices that affect everyone around him but David lets us know that he is a genuinely good-hearted person.  John’s affliction with schizophrenia and his substance abuse are similar, as far as I can tell, to the “chicken and egg” question.  Which came first, his schizophreni — leaving him wide open for self-medication — or drugs as a “party favor” and then his schizophrenia giving him an excuse?

On page 81 the author puts it well when he speaks of “disengagement-through the use of drugs…drug use was common, and drug abuse is sometimes a mask for schizophrenia.”  That makes me wonder how often this happens, and for how long, in other families.  It’s made clear to the reader that John had always been a gregarious, fun-loving guy, perhaps to the point of being a “party guy.”  I have to wonder whether his personality led to his drug abuse or if it was the mental illness that led him to have this type of personality.  Either way this was a tough road for John but then it also brought his family into this “hell” with him. 

On pg. 112 the author succinctly states how their mother, who feared losing John forever, would send him money even though she knew where it would probably go. But her fear overcame common sense and she felt she did what she had to in order to help him stay alive.

I found this book to be what I would consider an account of how James Frey’s family must have felt like in “A Million Little Pieces.” It made me realize that while this man was obviously hurting that there was a whole family going through this with him.  I believe this book will bring a lot of insight to other families who are going through this same sort of hell and feel alone and as if they’ve done something wrong.  The book doesn’t pull any punches and goes straight to the situation as it is.  Where John’s friend, Reingold, says “life is fragile, puny and temporary” on page 69 I believe he sums up the reasons why we should “know” the ones we love while we still can.

The concept of not “knowing” a loved one until after something terrible happens is one that I believe goes on too often. Really getting to know someone, especially someone with obvious problems, is very difficult and we all have our own problems to deal with but as the author pointed out, it can be well worth the effort it takes!

I found it interesting that the author states that “John reminded me of Dean in Kerouac’s “On the Road” because that’s one of my favorite books and I had already been making the same comparison.  There are definite parallels, one of which is that John wanted to see and do all that he could in the time given to him.  Though this can be a good trait, it can also be a curse, especially for a man already battling his own demons.  I’ve dealt with this feeling of unrest and the wonder of what I’m missing “out there” to the point of having lived in four different states and at least seven different cities in the past twenty years, never settling down and meeting several “John Stringers” during this time.  Though I don’t think that these people had the same problems as John, they were clearly fighting their own demons, both internally and externally, and that also brings one back to the “knowing” people.

I think this book would be very helpful to anyone dealing with similar circumstances, whether in their own family or the family of friends and loved ones.  People in this line of work, helping the mentally ill or the addicted, would get a great deal of insight as to the impact the people they are trying to help have on their families.

The author also does a good job of explaining and trying to remove the stigma put on homeless people who are probably just not equipped or don’t have the family who’s equipped to help them realize and fight the problems that have forced them into this lifestyle.  Too often these people are treated as sub-human, animals or invisible rather than normal human beings with afflictions we are lucky enough to have escaped.

I found the book to be entertaining, easy to read and well-written.  If the author’s plan was to help the general public understand at least a little of the life of the “John Stringers” in our lives he did a great job, But as far as I’m concerned he also wrote something that would help the caretakers of such afflicted people to really understand the impact of these poor souls on their families and loved ones. This, I believe, is a great learning tool.  I’m left thinking of what the author states on page 298, “John has helped me see more people as my brothers.”  That can’t be a bad thing!

The Lonely Screams, by Sean Seepersad, presents a curated collection of essays contributed to Seepersad’s website, Web of Loneliness. The stories are often wrenching and sad, and Seepersad follows each essay with his thoughts about the origin of and solution to the writer’s loneliness.  Aside from his clinical and academic interest in the subject, Seepersad has a personal interest; the final chapter is his own essay about his experiences of loneliness.

Two-thirds of the contributors to this book are women, and most describe feeling lonely for as long as they can remember. The contributors tell personal stories of loss, betrayal, childhood bullying, parental abuse and abandonment, romantic relationships gone awry, and of opportunities missed or simply not available in their lives. Most writers try to understand why they experience chronic loneliness, and they often point to events from their childhood that set the pattern in motion. Jack, for instance, writes “From my earliest memories I have always felt alone and not totally accepted. I have learned that when I was a baby, out of frustration my mother would hit me to stop me crying.” He concludes his essay hopelessly: “Loneliness kills potential. I can see no future for myself. I will give myself a few years, though. I would not ever kill myself, no matter how much of a failure I become.” In his analysis, Seepersad comments on Jack’s resignation and notes that Jack responded to his childhood loneliness by becoming a chameleon, “changing himself to fit the world around him,” and this kind of separation results in the loss of the hurt child within. Seepersad’s solution for Jack is to “get in touch with his true self, realize his true desires, and pursue his own dreams.”

The Web of Loneliness project is not set up with a rigorous experimental design, run within the auspices of a university lab; it’s a website, and anyone who wishes to contribute his or her story is welcome to do so. Contributors frequently comment on their gratitude for being heard, for being able to give voice to the experience of loneliness. At the end of each essay in the book, a URL is provided so the reader can go online and leave comments about the essays, and read comments others have left.

Although the stories were indeed sad, and sometimes difficult to read, they were actually stories of a great many more conditions than loneliness. Many writers were clearly experiencing profound clinical depression, and some experienced suicidality. Of course, depression and loneliness make sorrowful bedfellows, and each contributes to the other in a dynamic way. I wanted Seepersad to focus the book more closely on loneliness. With a public website inviting contributions, I wondered why he chose the particular essays he selected for this book.

My greatest disappointment with this book was in Seepersad’s commentary after each essay. He structured his response in two directions: what he saw as the origin of the individual’s loneliness, and his advice to the writer. Without exception, both halves were shallower than I expected. Seepersad is a clinical psychologist, and I’d anticipated reading more insightful commentary about the origins, and less glib advice.

Additionally, his thoughts about the origins are often contradictory. For one writer, who sought close relationships despite expressing a concern about intimacy, Seepersad wondered why she sought relationships, if she was afraid of intimacy? To a later essay, he commented that the need for belonging is a basic human need, like hunger.  As a psychologist with access to (if not familiarity with) the literature, he could have presented a more in-depth examination of the conflict between a basic human need, like belonging, and the anxiety associated with fear of intimacy. Such an explanation needn’t be heavily academic — given the book’s audience, which is probably people who feel lonely, he could have presented more complex information in an accessible way.

With a stated goal of offering each writer advice about what they might do to change their circumstances, Seepersad takes on a big job, especially for a slim book of this type. The answers are certainly complex, given the lifelong patterns these lonely people describe, but Seepersad resorts to an essentially light, hand-waving response, as he offered at the end of Pat’s story: “If you are suffering from this inner loneliness as well, it may well mean you need to undergo your own deep, transformational process as well.” With such a shallow answer (pointing to an enormous and difficult task), he would have been better off formulating a different structure for his responses to the essays. Had he organized his responses with a tighter focus on illuminating the source of each writer’s loneliness, he could have gone into greater depth and made his contribution more valuable.

In the end, reading this book felt like reading a public website, and I did not come away with a greater understanding of “the complex world of the lonely,” as the book’s subtitle promised. Seepersad has access to such rich material, I hope his next effort takes the questions a little more seriously.

The Lonely Screams: Understanding the Complex World of the Lonely
By Sean S. Seepersad
CreateSpace: May 18, 2011
Paperback, 186 pages
$8.99

We children of schizophrenics are the great secret-keepers, the ones who don’t want you to think anything is wrong (p. 5).

Author Mira Bartok has encapsulated in this statement her life as the daughter of mentally ill musical prodigy Norma Herr.  The Memory Palace describes Ms. Bartok’s journey from scared child to haunted college student to free adult and finally back again to scared child, sitting at her mother’s bedside as she succumbs to the effects of a lifetime of poor (mostly homeless) living.  It is a moving, evocative story, relating Norma’s schizophrenic mind to Mira’s later experience with traumatic brain injury, and how this helped them to reconcile after 30 years of estrangement.  A difficult read at times due to the subject matter, The Memory Palace is nonetheless a valuable addition to the narrative of mental illness in our society and in our families.

The book begins at the end, so to speak, as Ms. Bartok’s mother is fading away in a Cleveland hospital.  She happens to find some keys among her possessions, one of which is to a storage unit containing vast stacks of old photos, diaries, and mementos that serve to open the floodgates of the author’s memory.  She then decides to create a “memory palace” to sort and categorize these intense experiences based on a method created by Matteo Ricci, a Jesuit priest with incredible mnemonic abilities.  Each subsequent chapter is opened with a painting that Ms. Bartok has created to symbolize a specific room in her palace, accompanied by selections from her mother’s letters and diaries that allow the reader to experience her descent firsthand.

From here, we return to the author’s childhood years.  She and her sister suffered at the hands of her steadily declining mother after her father essentially disappeared.  The family lived with her grandparents, who weren’t much better in terms of providing any sort of parental support.  There are many vivid and graphic examples of the type of abuse Ms. Bartok endured, among them the following excerpt of a bedtime conversation with her mother:

“‘I have to tell you something important,’ she says.

‘What?’

‘Don’t drink milk before going to bed.’

‘Why not?’

‘Because rats like milk.’

‘What?’

‘A rat will eat your face off if it smells milk. And Myra?’

‘What?’

‘You girls are my most precious possessions.’” (p. 54)

In order to cope with the instability and tension, Ms. Bartok escaped into the worlds of writing and art, activities that later became her career.  Her mother, in the meantime, became increasingly uncontrollable and even violent.  After Ms. Bartok and her sister left for college, Ms. Herr would call them incessantly, show up unannounced, and threaten them and their friends.  Once she attacked them for suggesting that she needed treatment, they jointly decided to break off all contact with her and change their names.  Myra Herr is now Mira Bartok.

Over the next seventeen years, during which time the only contact mother and daughter had was through a P.O. box, the author achieved a level of professional and personal success, albeit not without some difficulty.  She spent time travelling abroad in Europe, the Middle East, and Scandinavia, exhibiting at art shows and publishing articles and books under her new name.  In what she eventually recognizes as a repetition of living with her mother, Ms. Bartok marries William, who we gradually learn is seriously mentally ill as well.  It takes her some time to realize she can, and indeed needs, to break free, but she does and goes on to meet and marry Doug.  They are still married, and he allows her to have a healthy and stable life.

Back in America, Ms. Bartok was in a horrible car accident at age 40, which resulted in a traumatic brain injury.  She lost much of her ability and memory, and while she was able to improve, everyday life remains difficult.  Through the process of experiencing the world shifting in and out of focus, needing to expend a lot of energy to simply make it through the day, along with a need to reconnect to her now-unreliable memories, the author makes the decision to reach out to her mother:

I’ve already lost her once, and have, at least for a time, lost myself.  I don’t want to lose her again. But I decide I can only see her if she is in some kind of supervised setting.  Otherwise, she’ll try to come home with me.  I contact the social worker and we begin the long process of finding my mother a permanent home.  Which, in the end, turns out to be a quiet dark room in a hospice ward. (p. 267)

She discovers that her mother is terminally ill and flies to see her.  Eventually, her sister joins them, and they begin the process of understanding and ultimately reconciliation.

The first reaction inspired by The Memory Palace is to the effects of the deinstitutionalization of the mentally ill, instigated by President Kennedy.  In 1974, the plan was to “…replace our backward state hospital system with newer and better narcoleptic drugs and free comprehensive community care (p. 107).”  The only real effect on Ms. Bartok, however, was that each time she and her sister were forced to commit their mother to the hospital, she was released after a shorter and shorter stay. 

“The miracle drugs… don’t help at all.  As for the comprehensive community care, we’re still waiting for it to arrive,” writes the author.  Her family received no social assistance, and even during the violent episodes when police were called, they just sent Ms. Herr to the emergency room, had her drugged up, and released her to start the cycle over again.  Ms. Bartok writes compellingly on why this should not have been allowed to happen—and is clearly very angry at lack of effort from society and public policy to successfully treat schizophrenics.

It would have been nice to see this level of detail when reading about the author’s brain injury and the results thereof.  She does provide a medical explanation, but this reader wanted to learn more about its specific effects, which are detailed in the author’s Q and A at the back of the book (but not within the text, other than a broad overview).  It would have helped tie Ms. Bartok’s mental decline with that of her mother’s, although even as is, this connection is movingly presented:

…although my condition has improved it’s clear that there are many problems that will never go away.  Weeks blur into months and years.  I’ve lost the order of things.  To the outside world, however, I show a different face that the one I show with Doug at home.  Children of the mentally ill learn early on how not to be a bother, especially if they grew up with neglect. (p. 266)

The original paintings that begin each chapter are beautiful and evocative, and the journal entries provide first-person view of the perspective of a schizophrenic mind.  There are some timeline jumps within chapters that can be jarring, but overall the book is organized and laid out well, in such a way as to evoke the most understanding of the main narrative.

It is difficult to say whether Ms. Bartok and her sister did enough with the situation and acted correctly in their relationship with their mother, but that’s not the point of the book.  The Memory Palace serves as a window of understanding into the complicated, judgmental, and often misunderstood world of mental illness, allowing those of us who have been lucky enough to not grow up under the thumb of schizophrenia the opportunity to expand our view.  Well-written and emotionally wrenching, this book is testament to the achievement of Ms. Bartok in overcoming her childhood, the tragedy of her mother, and finally her traumatic brain injury.

The Memory Palace: A Memoir
By Mira Bartok
Free Press: January 11, 2011
Hardcover, 320 pages
$16.50

The book is divided into an introduction and four chapters, but there is no table of contents—likely, in my opinion, because Butler wants his reader to follow him through his story, step by step.  The introduction sets the stage for how the book operates overall: weaving seamlessly between intimate experience and observations of the larger human network. He gives us the encyclopedic definition of sleep as well as some insight into his own issues with sleep, beginning as a child suffering from sleep terrors.  Perhaps the most creative section of the book, though Butler’s creativity shines throughout, he mimics the way the mind falls asleep to end his introduction.  He meticulously takes us through a list of outside influences (lights and noises) as well as inside processes that loop through our mind as we begin to sleep.  He beautifully captures and intertwines both his large philosophical thoughts and trivial matter.

Butler then leads the reader on a path of the history, science and culture (if you will) of sleeplessness that only a true sufferer could shed light on. In the first chapter (his title chapter), he maintains his balance of personal, reflective thought and scientific fact. He explains the types of insomnia and most notably points out primary and secondary insomnia.  (Primary insomnia is caused by mental disorders or a medical condition and secondary insomnia is related to more extrinsic factors.)  He balances these facts with a personal twist and writes his own discovery that sleeplessness “seems a hypersensitivity to the condition of being alive.” This shows his acute attention to detail and his intimate knowledge of the life of an insomniac.

The second half of this chapter echoes and explains the way the brain “clings” to ideas as tiredness sets in—he calls this section “Uncontrollable Reflection” and comically includes footnotes throughout that allude to different tangents his mind took while writing the section. 

The second chapter gives a deep history of insomnia and theories on sleep in general.  He includes quotes and ideas from a range of people across history; almost everyone from Aristotle to Edison and beyond.  Again, he draws a parallel between history and his own personal experience,  explaining a recurring ‘dream’ he would have when he was awake for multiple nights and struggling with his insomnia.

Chapter three begins to get more desperate—similar to how a person may become more desperate for sleep as they watch the hours of the night pass by.  He explains here that he began eating large amounts of food in order to help himself fall asleep.  Unfortunately, he began gaining weight and realized that there was a large amount of scientific data to support the fact that as you increase your BMI, the quality of your sleep declines.  He describes his dreams again here and the pain and anger begin to surface in them. 

Then, in the last chapter, he falls into the inevitable feeling of acceptance, tinged with defeat and resignation.  He delves into both the scientific issues as well as his personal issues he has had with sleeping pills.  To conclude the book, he writes a type of dialogue with himself and seems to find that the solution (for him) is writing.  While he is not the type to preach, I believe this is a message he is sending to his fellow insomniacs.  Certainly, it is not a cure, but perhaps it can be a comfort and a way of coping.

I enjoyed the book overall, but was especially drawn to Butler’s writing. This book is covered with praise for another book of his, There Is No Year, and I plan on reading that soon because of how much I liked his voice.  Butler has an extremely creative mind and his descriptions are gorgeous.  He is also able to condense and explain research and historical fact in a way that is approachable and intriguing.  I do not suffer from insomnia, but do have a particular interest in sleep and dreams and so I found this book very satisfying.  I would encourage you to read the book entirely, as it will make his experimental and creative sections more approachable.  He often likes to lead his readers down a dream-like path, so don’t get startled if things begin to feel unreal; that is, I believe, his intention.  He seems to be playing with the state of insomnia itself, still very much awake, but constantly on the verge of dreams.

Nothing: A Portrait of Insomnia
By Blake Butler
Harper Perennial: October 11, 2011
Paperback, 336 pages
$14.99

In my current position as a rehabilitation counselor at a psychiatric center (as well as in my previous employment), I have worked with numerous people who have been diagnosed with schizophrenia. I have witnessed how devastating the illness can be not only for those who are diagnosed, but for their family members as well. Schizophrenia is a commonly misunderstood diagnosis. The term “schizophrenic” is used all too often in horror movies and news stories alike with the intent of scaring people. In reality, the scary thing is not people who suffer from this illness, but how many people never get the help they need because of the stigma associated with the diagnosis. With this book, Margaret Hawkins helps to shed some light on this reality.

In After Schizophrenia, Margaret Hawkins tells us the story of her sister, Barbara, who suffered from schizophrenia for years without receiving any type of treatment. Hawkins begins by giving the reader some background about her sister. According to the author, Barbara was a “stunning and self-aware young woman” through high school and college. She was very successful both socially and academically. There were subtle signs that something might be wrong while Barbara was in college; however, she was able to complete her degree. She met a man with whom she fell in love and soon after completing college, Barbara got married and moved with her husband to Iraq. For the most part, it seemed as if all was going well.

However, as Barbara’s letters home began to change, the author realized that something did not seem right. Her sister slowly began to sound like a different person, and it was not clear what was happening. Eventually, Barbara’s marriage fell apart and she moved back with her parents. Like so many people who have been diagnosed with schizophrenia, Barbara’s symptoms started to take shape in her early adulthood and escalated rather quickly. Unfortunately, as is also too often the case, neither Barbara nor her family really understood the types of treatment that were available at the time or how to go about getting help.

As the title suggests, After Schizophrenia’s second half focuses on how Barbara was able to get treatment and become “reawakened” after about 30 years of experiencing symptoms. For anyone who has either suffered from schizophrenia or knows someone who has, this part of the book may be especially moving. While reading about the author’s first coherent conversations with her sister after years of attempts, I was reminded of many of my own interactions with clients after they had begun to participate in their own treatment. I imagine anyone with similar experiences will also have similar feelings reading about Margaret Hawkins and her sister’s journey.

One thing that should be pointed out is that the title of this book might be misleading to some people. The author does not suggest within the book that her sister is somehow completely “cured” of schizophrenia by the book’s end. Rather, the title is meant to convey that through obtaining treatment, Barbara was able to overcome some of the more debilitating symptoms that came along with her diagnosis. In the final chapters, the reader sees the slow return of the “stunning,” “self-aware” woman we are introduced to in the beginning of the book.

As someone who works with people diagnosed with schizophrenia on a daily basis, I know that the saga of Barbara and her mental illness is one that is very similar to that of many others. I hope that through books such as this, Margaret Hawkins and other authors will help bring schizophrenia out of the shadows of misunderstanding. I am a supporter of any work that helps bring to light the fact that with the proper treatment, people with schizophrenia and other similar diagnoses can live fulfilling, meaningful lives. This book certainly manages that feat in addition to being an emotionally powerful family chronicle. If you or someone you know is currently suffering from schizophrenia, After Schizophrenia will definitely be an inspiration.

After Schizophrenia
By Margaret Hawkins
Conari Press: October 1, 2011
Paperback, 256 pages
$16.95

The reader readily forms an alliance with the author, as we witness her difficulties with medication, her loving but sometimes strained relationship with very caring parents, her finite marriage and her battle to feel accepted in life.  Dr. Dobbins gently guides us along the ups and downs she has faced as if this part of her were an actual client (Jane) coming to see her for sessions of psychotherapy, which provides us with the details that make up this fascinating history and also allows the reader to witness her very adept perspective as a trained clinician. 

“Jane stops talking.  Venturing further, I ask Jane if there is anything I can possibly do to make her life better today.  Help me find my home.  My God, I’m realizing, she just wants to belong” (page 37).

Perhaps this format leads the author to a more compassionate telling of her own story.  Or perhaps it makes it easier for a talented but humble person to speak about her myriad accomplishments (obtaining her doctoral degree from Vanderbilt University and being chosen for a very competitive clinical fellowship during her graduate training).  Whatever the reason behind this enjoyable storytelling design, it lends itself to a seemingly nonjudgmental rendition of a true account full of peaks and valleys.

As a thirty-something female scientist who has actively sought my own best mental health practices over the years, whether yoga or meditation, I truly enjoyed this book on many levels.  Having just read a personal account of a high-level female executive living with schizoaffective disorder in The New York Times (Oct. 22, 2011), I found this book similarly very effective in encouraging the reader to challenge certain antiquated limitations put on those dealing with mental illness.  Dr. Dobbins urges her audience to become more familiar with the specific challenges brought on by a loss of contact with reality (psychosis) and mood problems that are typical of this ailment, while illustrating the remarkable potential and gifts those with mental health diagnoses may share with the world at large.

In this uplifting, if sometimes saccharine, tale of one person’s triumph in managing a potentially very difficult condition, I found myself rooting for the author until the very last page.  Her manner of writing is very easy to digest and on occasion it was easy to imagine sitting across from her in some café while she disclosed the details of her life to date.  Her genuine concern for others and warm heart come across clearly throughout this entire body of work, which makes it quite easy to get behind what seems to be one of the author’s major objectives:  to better understand those living with mental illness.

“The stigma is worse than the illness.  I am guessing that my toughest battle has yet to be fought.  It’s going to be very hard having a lot of people know, if things go that way.  It’s human nature for people to see only ‘mental illness’ in a person when you tell someone you have one.  And the fear from not understanding makes us all crazy.  That’s why we need to unite” (page 146).

I cheer Dr. Dobbins for having the courage to reveal such trying details from her past, including arrests, in order to inspire further empathy and kindness to everyone we come in contact with in life. As we peer into this complicated, but flourishing therapist’s life, it’s hard not to believe in the strength that comes from self-awareness and perseverance.  As a biographer, Dr. Dobbins does not seem particularly interested in blame or pointing out the many errors that have been made in her years of treatment (particularly with medication), although these mishaps are included in the fibers of the story, but spends more time offering accolades to those who have provided meaningful support and exemplary treatment along the way (in the academic arena as well as within her varied treatment settings).

Overall, I found this book both very enjoyable and educational,  all the way through the “facts” section found in the end, where the author shares a handful of realities meant to dispel many errors commonly believed concerning mental illness. The author’s positive attitude and quest for self-knowledge are remarkable and by the close of the story, both she and her dog seem like a warm neighbor down the way; certainly a neighbor I would enjoy waving to every day.  I look forward to the possibility of more work from this author.

What a Life Can Be:  One Therapist’s Take on Schizo-Affective Disorder
Carolyn Dobbins, PhD
Bridgecross Communications: October 16, 2011
Softcover, 226 pages
$19.95

Wait a minute, how can anything positive come from being shot by a stranger in the chest with a .38 caliber pistol?  Well, as Pennington points out, he was lucky. He didn’t die. The bullet missed his heart. In the ambulance to the hospital, he focused on breathing, relaxing, reassuring himself, and thinking positively.

Subsequently he realized that a series of very fortunate coincidences prevented him from being killed, which left him enlightened: “Why should I be in a miserable situation and be unhappy? Being in a miserable situation is bad enough.”

As Pennington points out, life is inevitably sad and full of unexpected tragedies. So rather than wallowing in misery, why not look for whatever good you can find and turn misfortune into benefit?

That is the general premise of this book and one that provokes knee-jerk cynicism as it brings to mind the many trite phrases mothers harped at us for years: look for a silver lining; look at the glass as half full; make lemons out of lemonade.  Yeah, yeah, all of these truisms were pretty annoying as a kid, but as you approach the age when your mother uttered these phrases, you’re hit by the truth: Mom was right.

In this very short, quick-read book, Pennington tells eight personal stories of experiences that could have shattered his physical, financial, and mental health. Yet he never let misfortune drag him down. He not only beat his problems, but pushed past all of the hurt and disappointment to better himself.  Each of these stories ends with a sort of parable—a lesson that readers can apply to their daily lives. 

Pennington strategically leaves his wife’s illness to the very end, because, as he admits, it is the hardest lesson. “I know it sounds insensitive and selfish for me to say this,” he writes. “But I have no doubt that I am a better man because of what I learned by living through the illness that took her life.” His wife, Claire, suffered from multiple sclerosis, and in light of her suffering, he came to realize that his problems were minuscule. In caring for her, Pennington learned to give freely and without expectations.

“If we can respond to others’ needs without expecting a reward in return, it is possible for us to receive a gift for our giving,” he writes. “We may find ourselves feeling an increased sense of usefulness or pride in a job well done.” It’s the Golden Rule.  As Mother might have said, Do unto others as you wish they’d do unto you. What gives this and other old homilies some relevance is that Pennington has actually lived through some fairly horrible times and recovered by using these principles.

On the other hand, it’s worth noting that Pennington was an executive coach and motivational speaker long before he wrote this book. In fact, immediately after he was shot (which occurred early in his career), he thought, this would make a great “signature story”–a story to spice up his lectures and grab the crowd’s attention. 

For this reason and more, this book largely feels as if Pennington packaged his lecture notes as another point of sale in the back of the lecture hall. The bullet points, the call-out boxes, the bold-faced lessons are dead giveaways. 

However, just because you know this, does it diminish Pennington’s overarching lesson? Well, I don’t think so. The author helps readers put tragedies and so-called tragedies into perspective and gives readers strategies to build a better life. “Whatever your next step might be, it doesn’t have to be earth shattering,” he writes. “It may not produce a dramatic change right away. But if you don’t take it, you will have missed new opportunities that you would not have discovered otherwise.”  Pennington’s words do seem wise—and if Mother were listening, she’d no doubt give a self-satisfied nod in agreement.

Find the Upside of the Down Times
By Dr. Rob Pennington
Resource International: May 20, 2011
Paperback, 125 pages
$17.95

We’re kick-starting a 10-question series, “Clinicians on the Couch,” which will appear each month here on Psych Central. We’ll interview a new therapist about everything from the biggest myth about therapy to the biggest obstacle for clients to the best advice for a meaningful life.

This month, we spoke with psychotherapist Julie Hanks, LCSW, the director of Wasatch Family Therapy and author of the popular Psych Central blog Private Practice Toolbox. Hanks also is a writer, media consultant and singer/songwriter! You can learn more about her at her website.

1. What’s surprised you the most about being a therapist?

I am always amazed at how well people function considering the emotional and relational baggage or mental illness that they’re dealing with. Humans are amazingly resilient, and as a parent myself, I find that particularly reassuring.

2. What’s the latest and greatest book you’ve read related to mental health, psychology or psychotherapy?

I’m in the process of completing my certification as an Emotionally Focused Couples Therapist (EFT) so I’ve really been digging into the work of Dr. Sue Johnson: The Practice of Emotionally Focused Couple Therapy: Creating Connection, and Hold Me Tight: 7 Conversations For A Lifetime of Love.

I LOVE this model and it speaks to how I already frame my own life and relationships and how I conceptualize my clinical work. Coming from a large, close-knit family, I’ve always been curious about the impact of family relationships, and I naturally frame my life — past and present — in terms of emotions, relationships, attachment styles. By nature, I am an emotion-focused and expressive person so becoming an emotionally focused therapist was a natural fit.

3. What’s the biggest myth about therapy?

The biggest therapy myth is that going to therapy is a sign of personal weakness or it means that you’re “crazy.” Well, we’re all a little “crazy,” aren’t we?

Everyone has emotional baggage from childhood and other wounds along the way that a therapist can help you sort through. I sincerely believe that everyone can benefit from talking to someone “outside” of their real life during times of transition, confusion, or emotional difficulty.

4. What seems to be the biggest obstacle for clients in therapy?

The biggest obstacle for clients in therapy is resisting taking responsibility for their own life, and progress. It’s painful to shift from feeling like your life happens to you, to the understanding that you are a powerful creator of your own life.

That doesn’t mean you dictate every event, but you understand the power you have to decide what meaning you’ll give to your experiences and what you’ll do with them.

For example, I’ve worked with clients who were horrifically abused in the past who have courageously worked through their painful experiences and come to a place of freedom to create a fulfilling and meaningful life. I am so inspired by the bravery of my clients.

“Everything happens for you, not to you.” – Byron Katie

5. What’s the most challenging part about being a therapist?

The most challenging part of being a therapist is feeling drained sometimes by absorbing others’ emotions. While it’s an honor to “sit” with clients in their most painful experiences, fears, wounds, it’s also tiring.

My emotional sensitivity is a double-edged sword. It’s why I’m effective in my clinical work, and yet it is also difficult to turn off that sensitivity. I have learned to prioritize alone time so I can feel my own feelings without emotional interference from others.

6. What do you love about being a therapist?

I love helping people find their voice, their passions, their gifts, their mission, and provide guidance to resolve the events, emotions, patterns or beliefs that keep them from fully expressing their best self in their lives and relationships.

I see the good and the worth in every human being and reflect that back to my clients until they can fully experience their worth and potential for themselves.

7. What’s the best advice you can offer to readers on leading a meaningful life?

Learn to love, respect, and accept yourself, so you can share your best self in your relationships, and with the world. Reach out and be willing to be emotionally vulnerable in your relationships. Let others know how much you love them and how much you value them.

8. If you had your schooling and career choice to do all over again, would you choose the same professional path? If not, what would you do differently and why?

Definitely! I have never regretted my path. Not one minute of it.

9. If there’s one thing you wished your clients or patients knew about treatment or mental illness, what would it be?

Clients tend to feel like they’re the only ones suffering. I wished they understood that they are not alone.

10. What personally do you do to cope with stress in your life?

My best stress coping strategy is to be fully engaged with the people I love, and in the things that I love. I really value what I feel “called” in my heart to do and I value what I want to do. That may sound simple, but if something doesn’t interest me, I generally don’t do it. I don’t want to spend energy and time resenting or resisting my life. I don’t have time for things that don’t sound energizing.

My relationships help me cope with stress. As an external processor, I need to talk things through with someone else to make sense of my experience and to get comfort and support so I value spending time connecting with my family and friends. The older I get, the more I appreciate having eight amazing siblings who really “know where I’m coming from” and who have enough shared DNA that they “get” my idiosyncrasies.

I prioritize self-care by taking a hot bath nightly to unwind, journaling weekly, and exercising regularly. Oh, and according to my kids I’m also a “professional napper.”

From all outward appearances, Kitty looked like the girl who had it all: a straight-A student; an accomplished gymnast; and a happy, well-liked teen who loved reading, horses, and even cooking.  By sixth grade, however, she began counting calories and maintaining what appeared to be a healthy diet. However, Kitty’s dieting grew to an out-of-control obsession. Crisis hit at age 14 when Kitty woke up in the night and told her mother that her heart “felt funny.”  In the hospital’s intensive care unit, Kitty was discovered to be underweight by 20 pounds and with a heart rate of only 42 beats a minute (normal is 60 to 80). She could have died from a heart attack. 

Brown’s crusade to save her daughter taught her many things, including some facts that terrify her: “most people with anorexia bounce in and out of hospitals, recovering and relapsing. That anorexia is the deadliest psychiatric illness; close to 20 percent of anorexics die, about half from starvation and the other half from suicide. Nearly one-fifth of all anorexics try suicide; many succeed.”  She also learns that recovery time is painfully slow — on average five to seven years.

In fact, Kitty was in and out of hospitals and did not recover quickly. Brown looked for help wherever she could, through a support group, books, and different kinds of therapy. As expenses for hospitalizations and treatments escalated, Brown fought with the insurance company over costs. When Kitty was home, Brown concocted high-calorie drinks and snacks and spoon-fed Kitty just to make sure she was eating.

No step of this was easy. As Brown describes it, Kitty was often Not Kitty–someone who appeared almost demon-possessed. “I know my daughter’s face far better than I know my own. I’ve stared at it, examined it, admired it, loved it…,” writes Brown. “But I’ve never seen this face before. Her eyes have gone blank; her mouth turns downward in almost a caricature of a pout. Her tongue pokes out, and…I realize with horror that it’s flicking like a snake’s forked tongue.”

It’s an image that makes any parent cringe, and yet any parent who has dealt with a teen’s mental illness can immediately relate.  Without a doubt, Brown’s sincerity is one of this book’s strengths. Brown writes honestly as a parent who is admittedly flawed and yet who remains vigilant in her quest. She tells readers that she ignored the signs of Kitty’s anorexia in its early stages. She admits to being exasperated and tired in feeding Kitty/Not Kitty. All the way, Brown relays how she navigated the system, what she learned, and how she kept her family together.

Even though this is a memoir, Brown, a journalist who writes for O, Redbook, and Psychology Today, skillfully weaves research into her narrative. She brings in lesser-known facts about anorexia, some of which explain why this disease seems to strike certain individuals, why it’s so hard for Kitty to gain weight, and even why this disease can actually appear to be a “demon.”

Certainly this is an engaging book–well-written and driven by a compassionate voice. Even so, I longed for Brown to push a little harder with her narrative scenes. For instance, I would liked for Brown to bring me to her dinner table so I could actually hear Not Kitty and see how family members reacted to her. Rather, Brown often glossed over the drama and summarized what happens. Because of this, Brave Girl , at least in my mind, is not on par with some of the top tier mental health memoirs, such as Lucky, The Unquiet Mind, and Girl, Interrupted.

Still, this book has a great deal to offer.  Any parent who has a child with an eating disorder will appreciate its helpful advice, interesting facts, and attempts at comfort. In the midst of crisis, it’s nice to know others have been this way before.

Brave Girl Eating: A Family’s Struggle with Anorexia
By Harriet Brown
Harper Collins: September 13, 2011
Paperback, 270 pages
$14.99

Dinnerstein isn’t afraid to admit unbecoming things and, perhaps because of this, she seems to be more self-aware than most.  She openly accepts her tendency to collect clutter and often finds humorous and creative ways to show this to the reader.  She explains in her introduction that the clutter can inspire her, as it is a collection of aspects of her life, but also seems to block her road toward enlightenment. 

This is by no means, as Dinnerstein reiterates, a book to help you organize or declutter your life.  It is instead a memoir-like account of how Dinnerstein began to realize that the very thing she didn’t want to deal with was exactly what she needed to look at the whole time.  She explains how she often looked at the piles of paper on her desk or the clutter packed in her closet and decided to ignore it because she was on a bigger search for spiritual guidance.  Unfortunately, the more she ignored her clutter, the more it dominated her life and the farther she was from her spiritual goal.

This book is a journey and Dinnerstein is a faithful guide who does not close off any part of her life to her readers.  Most important, while she is aware this is a journey, she is also aware that ‘moving forward’ doesn’t necessarily mean moving in a straight line.  She accepts help, support and guidance from a variety of people and lets their ideas permeate her own and change the course of her journey.  In fact, she first comes to the realization that her clutter may be blocking her path toward God through bumping into an old acquaintance she wasn’t even fond of. 

Dinnerstein’s ability to remain open is refreshing and realistic because it is true to the natural paths our lives take; she does not force a logical order on her process and that meant a lot to me as a reader.  She writes at the end of her book that “originally [she] set out to write a book about [her] relationship with clutter.  That soon evolved into an exploration of [her] search for a deeper spiritual connection.  However, in the end, the book has turned out to be as much about [her] friendship…” Through these words, she shows how she allowed the universe to have a hand in guiding her.  She did not set out to bulldoze a direct path toward enlightenment; she understands that a journey often points you in a variety of directions that were never planned on.

The biggest question she wrestles with throughout is a “chicken-and-egg issue between [her] Higher Power and [her] clutter.”  She wonders, “did [her] clutter get in the way of [her] relationship with God, or [she] create all that clutter to avoid the relationship?” She worries that she has unconsciously been thwarting her own efforts throughout her lifetime. This question also addresses a larger idea about the connection between the physical aspects of life and the spiritual. 

While I am not personally as much of a clutter-bug as Dinnerstein, it made me think about how seemingly small aspects of the physical life can reflect and restrict emotional progress.  I understand what she means when she says that she often was not ready to let go of items, though she no longer needed them.  While it may seem like junk to someone else, it is a physical representation of the past and that relationship will invariably affect your future. 

As said before, Dinnerstein does not pretend this is a straight journey.  She responds to outside influences and takes her time, which allows you as a reader to do the same.  Throughout the book, she relies mainly on her friendships, but also delves into psychological ideas, a 12-step program, a trip to Israel, and finally, the Kaballah.

I enjoyed accompanying Dinnerstein on her journey and felt connected to the way she viewed the world.  She is a woman of the real world, with dirty laundry piling up, house payments, deep friendships and a serious concern for a world beyond this one.  I liked that I could see all the parts of her life and that she was so open both to her readers and to accepting help in her own life.  I found, however, that some parts were almost too detailed, though.  I’m sure this was amazingly therapeutic for her to write and found that some parts seemed more for herself than for me as a reader.  This was nothing that completely soured me on the book, though, and I would still recommend it to others. Her story inspired me to begin thinking about my own ideas on spirituality and how I may be standing in my own way.

A Cluttered Life: Searching for God, Serenity, and My Missing Keys
By Pesi Dinnerstein
Seal Press: August 23, 2011
Paperback, 312 pages
$17

The foreword is the only attempt Schubart makes at directly connecting the stories to one another.  Otherwise, each section is meant to stand on its own and represents a specific hardship of food addiction or obesity.  Since each story can function individually, it is easy to carry the book with you and read a section at a time.  In the foreword Schubart writes straight from his heart and explains his own struggle with eating habits and his weight.  He is charming, compassionate and first introduces himself as “a man of girth, overweight, fat… there I said it,” setting the scene for a brutally honest series of stories.

He is able to insert humor both in the foreword and in the stories without allowing that to saturate the fact that what he’s about to unfold is deeply sad. 

For the rest of the stories, though, he essentially removes himself and he resists any inclination you might expect from the author of a book like this to start giving dieting advice.  This makes the stories far more powerful, as the meanings and suffering in them are left to echo in your head.  He simply dedicates this book to “all those for whom food is a friend, an enemy, a compulsion, a joy.”

You should be warned, though, that despite how tender he is in writing, he makes no attempt to shield the reader from any of the hard-to-face truths.  Do not look to this book as a fast-track to comfort and inspiration. 

Eventually, this book can lead you there, but not in the way you may expect.  Instead of high-energy motivational speeches, Schubart examines the depths of a food addiction and all the infinite ways that it can become a part of a person’s life.  He does this solely though telling stories—and rarely steps out of the story to consciously instruct you.  He leaves the lessons up to you to reflect on and draw your own conclusions from.

I respect his approach to food addiction in this book because it mimics the way the addiction functions in the world.  Unlike other addictions, it can never be completely extracted from a person’s life or body, which makes the process of fighting it infinitely harder. It also makes it harder to identify the addiction because it is a necessary part of life.  It is far easier to notice that a drug is taking over your life, since it is not readily presented to you in café windows and served to you when you visit someone’s home. 

These stories are intricately intertwined with the story of a person’s life and Schubart focuses his attention there. Where other books would focus on the more regimented steps for getting help, this focuses on the stories of people who have suffered. 

The stories seemed disjointed at first—not because the ultimate connection isn’t obvious, but because Schubart writes beautiful prose that makes you deeply care about the characters and it is sad to see them not reappear in later chapters.  Once I accepted this, I was able to get into the rhythm of the book and liked how different the stories were. 

Some characters are presented upfront with their addiction and then Schubart takes you through the pain of living with it.  For example, one man’s story involves hiding his addiction from his wife and small child, who consistently worry about this health and try to monitor his eating habits.  Other characters’ stories begin with introductions that explain, and in many ways justifies, their resulting addictions, as Schubart leads you through histories of neglect and abuse.  One of his most compelling stories is a simple narration of the behaviors of an overweight woman he notices on a train.  His attention to her is so keen, only someone who has been in her shoes could truly capture the experience. 

He tells stories in both third person and first, of men and women, single and married, younger and older, but there is one common line: their suffering.  It is clear and poignant as a step on the road to recovery because it creates a safe environment for others to begin thinking about their own story.  In addition to this, it is a deserving piece of fiction and a heartbreaking collection anyone can connect with and learn a personal lesson from.

Fat People
By Bill Schubart
Magic Hill LLC: November 11, 2011
Paperback, 214 pages
$15

More than anything, Dan wanted to return to school in the fall, and so he was thrilled to be accepted into a world-renowned, intensive residential program for the summer. The staff there assured him that he would have plenty of time to get back on track and return to school. Dan was so excited; he couldn’t wait to go. You’d have thought we were sending him to summer camp.

At the residential program, Dan was the model client. He committed himself totally to his Exposure Response Prevention Therapy and though it provoked panic attacks, he forged ahead. He did everything that was asked of him and never complained. He took his meds. He bonded with his therapist and other staff members. Everyone loved him. He was one of the easiest clients (in terms of temperament) with severe OCD ever to walk through the clinic’s doors. In short, he was a pleasure to have around.

In fact, he was such a pleasure to have around, nobody wanted him to leave. Though Dan was making serious progress, we began to hear concerns from his psychiatrist and therapist at the clinic about him not being ready to return to school. If he stayed in the program longer, he could make that much more progress. At this point even Dan, heavily influenced by the staff that he had grown so close to, wanted to stay. He was comfortable there, surrounded by people who understood him. Never mind that he would not go back to college. Never mind that Dan’s school did not grant leaves of absence in his major. Never mind that by not going back, he would be giving up his almost lifelong dream. Better he should stay at the clinic and conquer that OCD.

What happened? How could it be that my son, who had insisted on completing his freshman year of college in the midst of severe OCD, was now saying he wasn’t well enough to return to school? He had chosen this program specifically so that he could return to college, and now he was telling us that school wasn’t that important to him. In terms of his OCD, he was in much better shape at this point than when he arrived at the clinic, but his frame of mind was worse. It’s as if he didn’t realize how sick he was until he entered the treatment program.

So how long should you stay in a residential program: until your OCD is totally under control, and there is not an obsession or compulsion to be found? Or should you get back into the world and live your life, all the while continuing to fight your OCD? One of Dan’s arguments for wanting to stay in the program was, “If I go back to school I won’t have time to concentrate on my OCD.” Hmm. Isn’t that a good thing?

As with most things related to OCD, there are no easy answers. But there are some things to keep in mind. In my opinion, the longer you stay, the harder it is to leave. Dan was at his residential program for nine weeks, and toward the end of his stay he was saying things such as, “I’m so comfortable here, I could stay forever.” And he meant it. Also, while there is no question that the staff at this clinic knew everything there is to know about OCD and its treatment, there is also no question that they did not know my son. Their interactions with him took place during the worst time of his life. They knew nothing about Dan’s passions, hopes, or dreams. They did a great job treating his OCD and I credit the ERP therapy for literally saving his life. But they did not treat Dan, the whole person. They failed to look at the big picture.

In my heart, I knew the right thing was for Dan to leave the program and go back to school. It was time for him to get back to his life, which included so much more than OCD. But when you have a psychiatrist, therapist and social worker telling you otherwise, it can be intimidating. Thankfully, the same friend who helped Dan get through those last weeks of his freshman year came to our rescue again. If he hadn’t said, “get him out of there,” my husband and I may very well have let him stay.

Dan returned to school and a tumultuous year followed. I second-guessed our decision many times. But if I ever doubt that we did the right thing, I just look at Dan now. His OCD is practically nonexistent and his passion for life has returned. And he is a senior in college, following his dreams.