We Ve Been Too Patient

25 unflinching stories and essays from the front lines of the radical mental health movement Overmedication, police brutality, electroconvulsive therapy, involuntary hospitalization, traumas that lead to intense altered states and suicidal thoughts: these are the struggles of those labeled “mentally ill.” While much has been written about the systemic problems of our mental-health care system, this book gives voice to those with personal experience of psychiatric miscare often excluded from the discussion, like people of color and LGBTQ+ communities. It is dedicated to finding working alternatives to the “Mental Health Industrial Complex” and shifting the conversation from mental illness to mental health.

**THE INSTANT #1 NEW YORK TIMES BESTSELLER** "An unforgettable—and Hollywood-bound—new thriller... A mix of Hitchcockian suspense, Agatha Christie plotting, and Greek tragedy." —Entertainment Weekly The Silent Patient is a shocking psychological thriller of a woman’s act of violence against her husband—and of the therapist obsessed with uncovering her motive. Alicia Berenson’s life is seemingly perfect. A famous painter married to an in-demand fashion photographer, she lives in a grand house with big windows overlooking a park in one of London’s most desirable areas. One evening her husband Gabriel returns home late from a fashion shoot, and Alicia shoots him five times in the face, and then never speaks another word. Alicia’s refusal to talk, or give any kind of explanation, turns a domestic tragedy into something far grander, a mystery that captures the public imagination and casts Alicia into notoriety. The price of her art skyrockets, and she, the silent patient, is hidden away from the tabloids and spotlight at the Grove, a secure forensic unit in North London. Theo Faber is a criminal psychotherapist who has waited a long time for the opportunity to work with Alicia. His determination to get her to talk and unravel the mystery of why she shot her husband takes him down a twisting path into his own motivations—a search for the truth that threatens to consume him....

“Gary Greenberg has become the Dante of our psychiatric age, and the DSM-5 is his Inferno.” —Errol Morris Since its debut in 1952, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has set down the “official” view on what constitutes mental illness. Homosexuality, for instance, was a mental illness until 1973. Each revision has created controversy, but the DSM-5 has taken fire for encouraging doctors to diagnose more illnesses—and to prescribe sometimes unnecessary or harmful medications. Respected author and practicing psychotherapist Gary Greenberg embedded himself in the war that broke out over the fifth edition, and returned with an unsettling tale. Exposing the deeply flawed process behind the DSM-5’s compilation, The Book of Woe reveals how the manual turns suffering into a commodity—and made the APA its own biggest beneficiary.

“A gorgeously written primer for anyone who has ever been (or ever will be) a patient . . . The book soars.” —The San Diego Union-Tribune Jamie Weisman was a patient long before she was a doctor. She was born with a rare defect in her immune system that leaves her prey to a range of ailments and crises and that, because it is treatable but not curable, will keep her a patient for life. In this probing and inspiring book, she brings her sojourns on both sides of the doctor-patient divide to bear on the issues of the flesh that preoccupy us all. It is a worthy addition to the best that has been written about our physical selves, a meditation on our extraordinary powers of healing and the limitations that leave intact the miracle and tragedy of being.

The Silent Patient by way of Stephen King: Parker, a young, overconfident psychiatrist new to his job at a mental asylum, miscalculates catastrophically when he undertakes curing a mysterious and profoundly dangerous patient. In a series of online posts, Parker H., a young psychiatrist, chronicles the harrowing account of his time working at a dreary mental hospital in New England. Through this internet message board, Parker hopes to communicate with the world his effort to cure one bewildering patient. We learn, as Parker did on his first day at the hospital, of the facility's most difficult, profoundly dangerous case--a forty-year-old man who was originally admitted to the hospital at age six. This patient has no known diagnosis. His symptoms seem to evolve over time. Every person who has attempted to treat him has been driven to madness or suicide. Desperate and fearful, the hospital's directors keep him strictly confined and allow minimal contact with staff for their own safety, convinced that releasing him would unleash catastrophe on the outside world. Parker, brilliant and overconfident, takes it upon himself to discover what ails this mystery patient and finally cure him. But from his first encounter with the mystery patient, things spiral out of control, and, facing a possibility beyond his wildest imaginings, Parker is forced to question everything he thought he knew. Fans of Sarah Pinborough's Behind Her Eyes and Paul Tremblay's The Cabin at the End of the World will be riveted by Jasper DeWitt's astonishing debut.

“Oliver Sacks meets Stephen King”* in this propulsive, haunting journey into the life of the most studied human research subject of all time, the amnesic known as Patient H.M. For readers of The Immortal Life of Henrietta Lacks comes a story that has much to teach us about our relentless pursuit of knowledge. Winner of the PEN/E.O. Wilson Literary Science Writing Award • Los Angeles Times Book Prize Winner NAMED ONE OF THE BEST BOOKS OF THE YEAR BY The Washington Post • New York Post • NPR • The Economist • New York • Wired • Kirkus Reviews • BookPage In 1953, a twenty-seven-year-old factory worker named Henry Molaison—who suffered from severe epilepsy—received a radical new version of the then-common lobotomy, targeting the most mysterious structures in the brain. The operation failed to eliminate Henry’s seizures, but it did have an unintended effect: Henry was left profoundly amnesic, unable to create long-term memories. Over the next sixty years, Patient H.M., as Henry was known, became the most studied individual in the history of neuroscience, a human guinea pig who would teach us much of what we know about memory today. Patient H.M. is, at times, a deeply personal journey. Dittrich’s grandfather was the brilliant, morally complex surgeon who operated on Molaison—and thousands of other patients. The author’s investigation into the dark roots of modern memory science ultimately forces him to confront unsettling secrets in his own family history, and to reveal the tragedy that fueled his grandfather’s relentless experimentation—experimentation that would revolutionize our understanding of ourselves. Dittrich uses the case of Patient H.M. as a starting point for a kaleidoscopic journey, one that moves from the first recorded brain surgeries in ancient Egypt to the cutting-edge laboratories of MIT. He takes readers inside the old asylums and operating theaters where psychosurgeons, as they called themselves, conducted their human experiments, and behind the scenes of a bitter custody battle over the ownership of the most important brain in the world. Patient H.M. combines the best of biography, memoir, and science journalism to create a haunting, endlessly fascinating story, one that reveals the wondrous and devastating things that can happen when hubris, ambition, and human imperfection collide. “An exciting, artful blend of family and medical history.”—The New York Times *Kirkus Reviews (starred review)

Why do some psychiatric patients fail to get better, even when in the care of competent clinicians? Treatment-refractory conditions are all too common in everyday clinical practice. Treatment resistance occurs across the full spectrum of psychiatric disorders, incurring enormous emotional, economic, and social costs. In the United States, treatment of depression alone costs more than $40 billion annually, and as many as 40% of patients with depression have a treatment-refractory form of the illness. This groundbreaking clinical guide starts where standard textbooks end, focusing on clinical strategies to be used after all basic treatment options, such as medication and psychotherapy, have failed. In this book expert contributors address the sequential clinical steps in treating difficult-to-treat psychiatric patients by offering a blend of evidence-based clinical recommendations, detailed case vignettes, treatment algorithms, and -- when necessary to go beyond the reach of evidence -- the clinical wisdom of leaders in the field. The chapters in this user-friendly, practical guide are organized by major disorder. Each chapter offers concrete recommendations on what to do when the usual first steps in therapy are ineffective, including evidence for biopsychosocial treatments alone versus in combination, generic versus specific therapies, and literature reviews and the latest expert wisdom. A sampling includes The management of the complex and often refractory bipolar disorder, which involves replacing or combining lithium treatment with anticonvulsants or atypical antipsychotic agents with adjuncts such as benzodiazepines, thyroid hormone, and electroconvulsive therapy, but also -- above all -- with careful attention to the therapeutic alliance. The importance of combined therapeutic modalities for patients with schizophrenia -- especially given managed care's cost-cutting strategies, which deprive many schizophrenic patients of effective treatment modalities such as family therapy or early use of an atypical antipsychotic. Combination treatments for anxiety, with medications adjusted over time as symptoms wax and wane, and early and appropriate interventions to mitigate internal and external environmental stressors. The emphasis on common sense, optimism, a sense of humor, and an iron constitution as the most important tools for clinicians wishing to work with the most severely ill patients with borderline personality disorder. The importance of individual differences in biological vulnerability, emotionality and expressiveness, cognitive schemas and beliefs, prior traumatic experience, resilience, and coping strategies for successful treatment of posttraumatic stress disorder. Packed with up-to-date information of immediate relevance, this volume will prove invaluable in both classroom and clinical practice, for everyone from beginning interns and residents to experienced psychiatric and medical practitioners and social workers.