The best books for rethinking the line between sanity and madness

Although Madhouse reads like a Stephen King novel, everything it recounts is actually true. At the turn of the twentieth century, Henry Cotton, a psychiatrist and the medical director of the New Jersey State Hospital at Trenton, thought he had found the solution to mental illness. His unconventional approach to treatment, however, left more people dead and disfigured than effectively cured. Andrew Scull’s deeply-researched narrative of Cotton’s medical interventions is a horrifying, yet entirely gripping, account of the lengths people have gone in the name of psychiatric treatment.

This classic account by a renowned sociologist is critical reading for those interested in the anti-psychiatry movement, a crusade that viewed psychiatry as more coercive than therapeutic and, in some cases, questioned the reality of mental illness itself. For one year, Goffman embedded himself in St. Elizabeth’s mental hospital in Washington, DC, where he ultimately concluded that the defining features of the asylum – similar to those of prisons and other “total institutions” – did more to shape the patient’s behavior than the supposed illness for which the patient had been admitted in the first place. Goffman’s observations left a significant impact on popular ideas about asylum care and helped contribute to widespread deinstitutionalization several decades later.

This is a quick read, but it’s one that will leave an impression. A young woman, suffering from a malady described as a “temporary nervous depression,” is instructed by her husband to get into bed – and stay there until she has recovered. This was the famous “rest cure” touted by early twentieth-century physicians as the solution to all manner of women’s psychological maladies. As Gilman skillfully narrates in this fictional tale, the rest cure was not all it was chalked up to be. By the end of the story, the protagonist isn’t sure what’s real and what she’s simply conjured up. It’s a tale that will make the reader question the boundaries between sanity and unreason, particularly for headstrong women living in a patriarchal world.

Fast food and popular culture aren’t the only things that Americans have exported overseas, journalist Ethan Watters claims in this fast-paced and easily readable book. Recently, the American mental health profession has also begun exporting its own understanding of mental illness. Through four case studies examining anorexia in Hong Kong, PTSD in Sri Lanka, schizophrenia in Zanzibar, and depression in Japan, Watters argues that the world is flattening through the global homogenization of mental disorders and their treatment. It’s a fascinating look into an overlooked aspect of the American psychiatric profession, one that will leave readers wondering if our own approach to mental illness is the best one out there – and if it’s perhaps creating more problems than it’s solving. 

Ever since the anti-psychiatry movement began in the 1960s, the asylum has gotten a pretty bad rap (think: One Flew Over the Cuckoo’s Nest, a book I would have recommended had I been given a sixth choice!). Barbara Taylor’s brave memoir brings an unexpectedly positive reassessment of an institution where she spent several years of her life: Friern Mental Hospital, also known as the Colney Hatch Lunatic Asylum. After experiencing severe anxiety, Taylor was admitted to Friern in 1988 where she found a meaningful community and therapeutic support network before the hospital was dismantled in the early 1990s. The ultimate erosion of the asylum system, Taylor contends, left patients like her with few places to turn for long-term care and support.