AGNES’S JACKET

Compelling narratives of the experience of mental illness marred by a self-centered narrator.

In psychology’s ongoing struggle to define itself—it’s still a relatively new field, after all—one tediously recurring battle pits biological against environmental explanations for mental illness. As in most ideological struggles, extremists on either side exert the most energy, grab the most attention and make the most exaggerated claims. Hornstein (Psychology/Mount Holyoke Coll.; To Redeem One Person Is to Redeem the World: The Life of Frieda Fromm-Reichmann, 2000) takes an extreme anti-biology stance, portraying herself as a courageous, solitary holdout in a world of therapists so preoccupied by genetic explanations that they are often unwilling to listen to what patients tell them. While it is true that the advances in the understanding of the biological bases of mental illness have been overstated and cannot alone explain the many forms that emotions, experiences and life histories take, it is just as extreme and misleading to say that biology plays no part in people’s experiences in the world. This is essentially the author’s position, and it intrudes repeatedly, detracting from the pleasure of her meticulous research and the striking narratives she collects from people who have passed with varying degrees of success through the mental health-care system. Hornstein opens with the strange story of the seamstress Agnes Richter, a 19th-century mental patient who painstakingly embroidered story after story onto her jacket, using it as an example of how countless patients’ stories have been lost through the years. The author then introduces successful individuals and groups—like the fascinating Hearing Voices Network—that have carved out paths to wellness, or at least some degree of acceptance, outside the medical and psychiatric mainstream. Yet these informative descriptions are too often derailed by the author’s scientific prejudices.

Despite Hornstein’s assurance that she wants “real debates about mental illness, not just ideological grandstanding,” the latter is precisely what we get.