October 2, 2011

Sisters in Sanity: Guest Review

Ashley from Books from Bleh to Basically Amazing is back with another awesome guest review for Psychtember! This time it's for Sisters in Sanity by Gayle Forman.

Sisters in Sanity by Gayle Forman is a story that can be read on several different levels and it brought a lot of things to mind for me while I was reading.

Brit is 16, plays in a band and is trying to cope with the fact that her family changed forever when her mom started manifesting signs of Schizophrenia. Her dad couldn't bring himself to commit her to a mental institution, and she eventually walked out and started living on the streets. Several years later, her father remarried and Brit now feels displaced, like her dad is far happier with his 'new' family- the step-monster and their baby.

Her dad tells her that they are going to take a vacation to the Grand Canyon as a family. She's initially resistant, because her band has a really big gig that she would have to miss, and it's not like she's really been having a good time at home lately. But then, her dad tells her it will just be the two of them driving, because the drive is too long for the baby and she's hopeful that it's going to feel like old times with her and her dad, back when they were really close.

My heart legitimately broke for her when her dad pulls up to Red Rock, a center for rebellious teens that 'rehabilitates' them. Large men grab her from the car and drag her inside the center. She's completely confused, a little bit scared and a lot a bit pissed off. 

The center is an absolutely horrid place. None of the staff members have the credentials or education to be successful in their jobs, and these are the people who are there supposedly offering therapy and guidance to give these kids better futures. But their idea of therapy is moving cement blocks in the sweltering hot sun for hours, or 'confrontational therapy' where one girl stands in the middle of the rest and they all yell out horrible and degrading things (you're fat/ugly/a slut/trash/unlovable etc) until the girl in the center breaks down and then the 'healing can begin'. Let me tell you something you probably already know- the idea of confrontational therapy being anything even remotely resembling therapeutic is bullshit. It's a form of bullying. And it's not going to help them.

I read on Gayle Forman's blog that she actually wrote this book because of places like Red Rock. Places that claim to be correctional and healing centers for teens but are really absolutely terrible horrible places that crush souls. She wrote this book to bring attention to what these centers were really doing to kids which I think is important. I can't imagine a parent making the decision to send their child to a facility like this without at least checking the staff credentials. Seriously.

There are a few things that really bothered me about this book. First, is that Forman gave Brit's mother Schizophrenia. The mom didn't really get a lot of face time in the story, but her absence is critical, both to some of the stuff Brit is dealing with, and how her dad reacts to it and to her. The actual references to the mom were done well, and I thought were a fairly accurate portrayal. However, Schizophrenia is a mental illness that generally manifests itself in youth. I'm talking teenage years to early 20s. It never specifies how old the mom was when she started displaying symptoms, and it does sometimes manifest later in women, but I feel like, if Forman was going to use a mental illness that has such a specific onset period, she should have addressed that it was atypical for symptoms to manifest so old. Brit was decently old when it started happening, (between 9 and 11, I think) which means her mom couldn't have been younger than 29. That's really late for Schizophrenia.

The other annoyance I had is something that annoys me every time I see it. I hate when people use religion to make a joke. Any and all religious cracks are distasteful to me, and it grates on my nerves every single time I see it, no matter who it's directed at. And, Red Rock is in Utah. Which means there were lots of Mormon jokes. After the 5th or 6th time, I was really annoyed and disappointed that the book felt the need to go there. I promise, it's possible to write a book without making a joke at a religion. Thank you... Let's move on.

Anyway- One of the things that really struck me when reading this book is the idea of over-diagnoses. On page 9, Brit is given her 'diagnosis' from her 'therapist' and she's diagnosed with ODD- Oppositional Defiance Disorder and the definition the book gives is "Often loses temper, often argues with adults, actively defies or refuses to comply with adults' requests or rules, deliberately annoys people, blames others for his or her mistakes or misbehavior, is often angry and resentful, is often spiteful and vindictive..."

I'm not that far from my teenage years. My 5 year high school reunion just passed. And I remember, very well, what it's like to be a teenager, and I spend a lot of time around them now. I have yet to meet a single teen, ever, who doesn't fit this diagnosis. Seriously. It's a part of being a teenager. There are teens who struggle more than others, who could benefit from an ODD diagnosis and the therapy or help that would follow. Even if it's something as small as making the parents realize that there is other language that might reach their teen better. So, some people would most certainly benefit from a diagnosis like this. However, if you really wanted to, I'm pretty sure every single teenager could be given the same diagnosis and we should not be calling a normal developmental stage a mental illness. Seriously. Most people grow out of it. Some don't, some won't, and some just take a little longer than others. But almost everyone does and giving every single defiant, ornery and difficult teenager an ODD diagnosis isn't going to do anything good for anyone. 

Then that got me to thinking about other disorders that might be over-diagnosed. Kids have always been expected to be hyperactive. But now, any kid that has a hard time sitting still seems to have a potential ADD/ADHD diagnosis. And again- some of these kids legitimately do have the disorder. I've worked with kids (and adults) that legitimately have an attention disorder. But not every child needs to be given an attention disorder. But not every kid has one. Again- we should not be diagnosing mental illness for normal developmental stages.

I feel it important to add here that I am not an expert. This is nothing beyond my opinion, based on things I've seen, read and information I've gotten from professors and research. I'm not even kind of qualified to diagnose mental illness. But it's something that I feel has become too easy. It's easy to just decide your slightly challenging child has a disorder. That can be 'fixed'. It's how I felt Brit's dad reacted in this book. Easy solution- She has a disorder, so let the 'professionals' make her better.

The book itself is very well written (aside from the niggling annoyances I pointed out before) and I really connected to, really felt for the characters in the story. A lot of these girls, not just Brit are very well written and I found myself really drawn to these girls. And the members of Brit's band are legitimately amazing. Seriously some of the absolute best friends a girl could ask for. The secondary characters and their relationships were all so well done, so well brought together.

Really, this is a book that really needs to be read by more people. It's a shame that it gets so overlooked because it has so much to add, so much to offer.

Ashley has been fascinated by the mind since before she can remember and decided long before college that Psychology would be her field of study. She received a BS in Psychology and is currently deciding where it should take her next. Ashley would like it to be made clear that she is not an expert in the field, and that the thoughts and feelings expressed are hers derived from both academic and personal study and experience.  

Thanks very much for the detailed, thoughtful review, Ashley!

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