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Transforming Madness


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About the Author

Jay Neugeboren has published seven novels, two short story collections, and two memoirs, including 1997's acclaimed Imagining Robert, a New York Times Notable Book of the Year. His stories and essays have appeared in more than a hundred magazines and have been reprinted in more than fifty anthologies. He has won numerous awards for his work, as well as fellowships from the National Endowment for the Arts and the Guggenheim Foundation. He is a professor and writer-in-residence at the University of Massachusetts, Amherst.


A quiet revolution is taking place in the care and treatment of the mentally ill, observes Neugeboren in this invaluable state-of-the-art report. Within the last five to 10 years, antipsychotic medications have become much more effective and their side effects less debilitating. Just as important, he notes, is the emergence of recovery programs, peer support centers and community treatment facilities that make it possible for the severely mentally ill to go to college, hold down jobs, marry and raise childrenÄeven without being fully cured. There is a downside, though: general hospitals, now the primary providers of inpatient psychiatric care in the U.S., are as dreadful as they were a quarter-century ago, the author opines. In his moving 1997 memoir, Imagining Robert, Neugeboren, who is also a novelist (The Stolen Jew) and teaches at UMassÄAmherst, discussed his brother's three decades of breakdowns and hospitalizations. This deep personal involvement with psychiatric illness propels the present book, an open-ended odyssey in which the author astutely probes a profession deeply divided between psychotherapeutic and pharmacological approaches. While acknowledging the value of drugs, Neugeboren makes a strong case for psychotherapy in the treatment of schizophrenia, other psychoses and mood disorders. Though the narrative at times feels padded, the searing profiles of people who have recovered and built new lives, often after having been pronounced medically hopeless, along with Neugeboren's selective evaluations of treatment programs, will make his journey enlightening to patients, their families and caregivers, as well as to general readers. Author tour. Agent, Richard Parks. (May)

"Hope, Neugeboren notes, 'can prove to be a genuine and quite solid element--a palpable force in a person's life and being.' The hope is not for a 'cure, ' necessarily, but for programs and modes of thought that help people work, love and play--even if symptoms of mania or hallucinations or depression persist."--Joshua Wolf Shine, "Washington Post Book World"

"Drugs are not enough" might telegraph the message of this major survey of our mental health system, its virtues and sins, and its patients, therapists, and managers. Neugeboren, a novelist, guardian/biographer of his mentally ill brother (Imagining Robert, LJ 11/1/96), and teacher (Univ. of Massachusetts), brings out the possibilities for life afterÄand withÄserious mental illness. He tells the stories of many individuals who are living well despite terrible psychiatric histories, thanks to programs that include good psychotherapy and social support along with psychiatric medication. Unfortunately, many programs lack an essential human element, and the drive for pharmaceutical research to make psychosis medically curable just like other illnesses leaves psychotherapy, rehabilitation, and follow-up care in the shadows. Neugeboren provides a literate, lively guide, rich in history, biography, and economics as well as psychology and neurochemistry. This should be on the short list of books on mental health that can be called great. Recommended for all libraries.ÄE. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC Copyright 1999 Cahners Business Information.

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