Falling into the Fire

April 15, 2013
In describing her own experiences and providing a survey of both the history and the current state of the field, practicing psychiatrist and Brown University assistant professor Montross (Body of Work) tackles the professional, ethical, and moral difficulties of diagnosing and treating mental illnesses. By focusing on several galling case studies—such as that of Anna, an otherwise caring and compassionate mother plagued by obsessive thoughts of killing her young child—Montross exposes and explores the challenging, sometimes paradoxical role of psychiatric professionals. It becomes abundantly clear that in the field there are rarely simple solutions: it is often difficult to untangle a patient’s symptoms from environmental factors, and what some might consider destructive behavior may provide the patient with genuine relief. On top of all that, Montross must also contend with wearying anxiety, uncertainty, and doubts regarding the efficacy of her aid. “Try as we might,” she writes, “we simply cannot predict which of our patients... will leave the hospital healed, never to return.” Her accounts of the complexities of mental illnesses encountered in the field stand in stark contrast to the tidy descriptions of those illnesses presented in the Diagnostic and Statistical Manual of Mental Disorders, and her intriguing analysis is anchored by the humble and empathetic voice of a psychiatrist working in a field wherein “every diagnosis is an act of faith.” Agent: Kristine Dahl, ICM.