Agnes's Jacket: A Psychologist's Search for the Meanings of Madness [Hardcover]

Gail Hornstein PhD (Author)

Book Description

Publication Date: March 17, 2009

In a Victorian-era German asylum, seamstress Agnes Richter painstakingly stitched a mysterious autobiographical text into every inch of the jacket she created from her institutional uniform. Despite every attempt to silence them, hundreds of other patients have managed to get their stories out, at least in disguised form. Today, in a vibrant underground net-work of “psychiatric survivor groups” all over the world, patients work together to unravel the mysteries of madness and help one another re-cover. Optimistic, courageous, and surprising, Agnes’s Jacket takes us from a code-cracking bunker during World War II to the church basements and treatment centers where a whole new way of understanding the mind has begun to take form.
A vast gulf exists between the way medicine explains psychiatric illness and the experiences of those who suffer. Hornstein’s luminous work helps us bridge that gulf, guiding us through the inner lives of those diagnosed with schizophrenia, bipolar illness, depression, and paranoia and emerging with nothing less than a new model for understanding one another and ourselves.

Editorial Reviews

From Publishers Weekly

Hornstein, a professor of psychology at Mount Holyoke, investigates personal testimonies of madness for what they can teach us about mental illness and its treatment. The author spent several years attending meetings of survivors'  groups, such as the Hearing Voices Network in the U.K., whose members hear voices but reject the notion that they are mentally ill. In addition to these stories, Hornstein presents many forms of personal expression by those suffering from mental illnesses, including archived video recordings, writings through history and the artwork of the Prinzhorn collection (of which the eponymous jacket is an example), the basis for the modern understanding of outsider art. Hornstein concludes that mental illness is primarily based in trauma, as opposed to the dominant view of biological and hereditary origins. Behind the psychiatric profession's attachment to such views she sees, as do other psychiatric dissidents, the profiteering influence of prescription drug companies. A wealth of compelling characters includes the eccentric and the heartbreakingly resilient. Despite some repetition of narrative detail, the fascinating avenues Hornstein pursues and the humanity and thoroughness of this exploration make a serious contribution to critiques of contemporary psychiatry. (Apr.)
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From Booklist

Fed up with medical professionals who overmedicate and don’t listen to patients diagnosed as mentally ill because they hear voices, voice hearers are prominent in the psychiatric survivor movement. Hornstein, with 30 years’ experience as a psychologist and a fascination with the movement and other efforts by the mentally ill to speak for themselves, here offers a totally engrossing look at their testimony. She switches between accounts of developments in Britain, with its Mental Health Testimony Project, and incipient efforts in the U.S. She is candid in noting that these are not case studies but individual portraits. Hornstein intersperses historical accounts of voice hearers trying to communicate their experiences, including Agnes Richter, a German woman who stitched messages all over a jacket she wore, messages that were considered indecipherable. Hornstein argues for the need to try to decipher or listen to the narratives of people who are considered mad. She challenges treatments, including psychiatric drugs, that assume mental illness is a matter of “chemical imbalance.” Readers will appreciate this highly accessible and amazing look at mental illness. --Vanessa Bush

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Product Details

• Hardcover: 304 pages
• Publisher: Rodale Books (March 17, 2009)
• Language: English
• ISBN-10: 1594865442
• ISBN-13: 978-1594865442
• Product Dimensions: 9.2 x 6.6 x 1.2 inches
• Shipping Weight: 1.2 pounds (View shipping rates and policies)
• Average Customer Review: 4.2 out of 5 stars  See all reviews (4 customer reviews)
• Amazon Best Sellers Rank: #21,980 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

11 of 15 people found the following review helpful:

3.0 out of 5 stars Very interesting, but not entirely convincing, August 11, 2009

By 

Elizabeth A. Root (Laurel, MD USA) - See all my reviews
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This review is from: Agnes's Jacket: A Psychologist's Search for the Meanings of Madness (Hardcover)

I found Agnes's Jacket to be a very uneven work. On one hand, I was very moved by the possibility that self-help groups can be a valuable resource. Hornstein spends time in England where the mentally ill are often considered by to be "experts by experience" able to assist one another and insist that the psychiatric professions truly listen to them about the nature of insanity. They exchange ideas on dealing with symptoms that they cannot get rid of; I would think that this might be limited to the higher functioning insane. Others might not be sufficiently articulate, but perhaps different types of groups could help different people.

Hornstein comments that people who hear voices can often help one another cope. That seems very plausible and promising to me. But surely one's underlying attitude toward the voices makes a difference: the person who genuinely believes that there is a radio transmitter in his/her head might not see how practicing yoga would be to the point. I would think that they would feel more in need of a surgeon to remove the transmitter. Still, if self-help is effective, I support it. At least they could be offered the support of people who understand and sympathize with their problems. Unlike Hornstein, I don't think it necessarily follows that there are not underlying chemical bases for some mental illnesses.

Hornstein also quotes an author know as John Custance who suffered from mental illness and wrote books on the subject. (She is very disappointed to find out that his son does not remember life with father fondly.) Custance argued that if a lunatic tells his doctor that he sees a devil, the doctor should regard the devil as being as actual as the lunatic and investigate what kind of devil he has seen. Certainly talking to the lunatic about an imaginary devil may reveal more about the patient's mind, but if the devil is actual, than the lunatic is wasting his time seeing a psychprofessional--he/she should be seeing an exorcist.

I am also not convinced by Hornstein's rejection of insanity, or some of it, as chemical imbalances. If, as she says, professional opinion shifts every forty years or so, I would assume that neither physical nor life history explanations are adequate. It may be that insanity, like blindness, can have a variety of sources and histories. Not all of her examples support her premise. "Peter, from Jesus", for example, had no history of known traumas underlying his sudden breakdown, and found talk therapy irrelevant. If one has read popular works (and I would presume professional literature) about mental illness, one has also read about people who found talk therapy useless and drugs like Prozac a miracle cure, so perhaps the message is that there aren't simple answers. Mental patients, like all patients, need to be listened to. Agnes's jacket, the central symbol of the book, is ambiguous in this regard. It may be a statement from Agnes's point of view, but it is incomprehensible to the rest of the world, even to those who try earnestly to understand it.

Hornstein rejects the chemical imbalance theory because she does not like the assumption that the imbalance is incurable, although it can be treated. It doesn't matter what she doesn't like, it matters what it true. She does not offer any evidence that her preferred support groups cure the condition, and it is ironic that such groups, especially those in the twelve step tradition, has also been severely criticized for arguing that the problem will be life-long.

She also criticizes the chemical treatments because there are problems with side effects. That is very true, and not inconsequential, but it is also true with diseases that are generally agreed to be physical. I stopped taking the medicine I was given for migraines because I hated the side effects, but other people successfully use the same medicine. It really isn't evidence against the chemical imbalance theory, just against carelessness in the use of medication.

On the balance, self-help and guidance from mental patients sounds like it might be promising, but I am not convinced that insanity may not be, in some cases, chemical, and that drugs cannot be helpful.

4 of 5 people found the following review helpful:

5.0 out of 5 stars Fascinating, insightful, enlightening book, May 19, 2010

By 

K. L. Haworth "Kevin" (Amsterdam, the Netherlands) - See all my reviews
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This review is from: Agnes's Jacket: A Psychologist's Search for the Meanings of Madness (Hardcover)

I just finished reading this book and am finding it difficult to express how wonderful I think it is. But I think it has the potential to be a life-changing book for many people, so I will add a few words of praise to the eloquent reviews I read above (or below, depending on where this review gets posted).

The information and insights in this book have fundamentally changed the way I look at "madness" and the way I feel and think about those around me who are dealing with mental health issues. After reading this book, I hope I can be a better and more supportive friend to those in my social circle who are living with schizophrenia and depression. And I know for certain that I will look differently (with more caring and understanding, I hope) at strangers I come across in my daily life who appear to be mad.

Thank you, Gail Hornstein, for writing this book and for sharing the stories of some truly amazing and inspiring individuals and groups.

6 of 8 people found the following review helpful:

5.0 out of 5 stars Thought provoking and accessible to the lay person, June 5, 2009

By 

Margaret Pyle "Love to read" (New York, NY) - See all my reviews
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This review is from: Agnes's Jacket: A Psychologist's Search for the Meanings of Madness (Hardcover)

I thoroughly enjoyed reading Agnes's Jacket. Being that Ms. Hornstein is a Mount Holyoke college professor, I was concerned that it might be quite technical and dry, but it was anything but that. Agnes's Jacket is a thought provoking analysis of the lives of people who hear voices, suffer from depression and a variety of other devastating psychological problems and how they have been treated medically in the US versus the UK. Ms. Hornstein makes a convincing case that in the UK, where self-help groups are more prevalent and medication is less prescribed, the ill seem to have a safer place to manage their illnesses and therefore have better, and even more normal lives.
As I read the book, I kept on thinking of different people in my life who would benefit from reading it. Agnes's Jacket also made me think of all of the people who I see daily (I work in NYC)who may be suffering from some of these afflictions, and it makes me think about the hardships in their lives.
Agnes's Jacket was a really wonderful book to read and I would highly recommend it to anyone. I've already passed it on at work to have others read it. It would be a great book to read and discuss in a book club.