Review: 'The Great Pretender' by Susannah Cahalan

According to NAMI, 1 in 25 American adults experience serious mental illness each year. That's an enormous number and it's even more shocking when you consider the state of mental health treatment. I haven't done a lot of reading around this topic as it makes me sad, but I found that The Great Pretender was a great starter. I also once again owe thanks to LitHub for a great excerpt from and article about this book which brought it to my attention.
Thanks to Grand Central Publishing and NetGalley for providing me with a copy of this book in exchange for an honest review.

Pub. Date: 11/5/29019
Publisher: Grand Central Publishing

From "one of America's most courageous young journalists" (NPR) comes a propulsive narrative history investigating the 50-year-old mystery behind a dramatic experiment that changed the course of modern medicine.

For centuries, doctors have struggled to define mental illness-how do you diagnose it, how do you treat it, how do you even know what it is? In search of an answer, in the 1970s a Stanford psychologist named David Rosenhan and seven other people -- sane, normal, well-adjusted members of society -- went undercover into asylums around America to test the legitimacy of psychiatry's labels. Forced to remain inside until they'd "proven" themselves sane, all eight emerged with alarming diagnoses and even more troubling stories of their treatment. Rosenhan's watershed study broke open the field of psychiatry, closing down institutions and changing mental health diagnosis forever.

But, as Cahalan's explosive new research shows, very little in this saga is exactly as it seems. What really happened behind those closed asylum doors, and what does it mean for our understanding of mental illness today?

Over the past few years the conversation around mental health has changed drastically. Amongst my friends and peers, seeing a therapist is no longer something you need to hide or be ashamed off. Suffering from anxiety or depression is not just accepted, it is something friends will try to support you in as well. However, there is still a very long way to go when it comes to enough support and treatment being available. It means people are suffering with no recourse, especially in countries where healthcare doesn't receive enough funding. Books such as The Great Pretender, which dig into the history of psychiatry, the different forms it has taken and the studies that have shaken it up, is a great start to educate more people, while also sharing the deeply personal stories of those suffering from mental health stories.

Cahalan prefaces this book with her own story of hospitalization for encephalitis (She wrote her first book, Brain on Fire, about her experiences) and how the drastically the treatment she received changed once her diagnosis became physical rather than mental. She begins her research into why mental health issues are treated so differently from other physical ailments by looking into asylums and those, like Nellie Bly, who tried to expose them for their treatment in the 19th century. From there she discovers Rosenhan's study 'On Being Sane in Insane Places', a study that shook psychiatry and contirbuted to American institutions being closed and psychiatric diagnosis becoming more rigid and impersonal. As she digs in deeper and deeper, Cahalan frequently makes segues to explain more of the history of psychiatry in the USA. The story of Rosemary Kennedy absolutely broke my heart and the knowledge that what happened to her happened to countless of other people against their will is chilling. It is what makes the end of The Great Pretender very important. Towards the end, as she uncovers more and more oddities about Rosehan's study, Cahalan addresses both the revolutionary discoveries being made and the skepticism towards scientific studies that has grown more prevalent. She doesn't take the easy road and solely blame scientists, not at the end or at any point in the book. Rather, Cahalan uses her own experience and that of others to show how necessary medicine and good care is, while not shying away to show the darker spots where greed and complacency have wrecked lives. The Great Pretender is a read that packs a punch and that has had me thinking for a while now.

Susannah Cahalan is a great writer and her experience in journalism shines through in The Great Pretender. She ties all her research, her data and her conversations into a personal odyssey to find out everything she can about the study that had an enormous impact on her as well as the field of psychiatry. Cahalan manages to make this journey exciting, frustrating, eye-opening and truly emotional, which means that the 400-odd pages of The Great Pretender flew by for me. It's meticulously researched but written almost like a thriller novel. Cahalan's own frustration and pain is very clear, but so is her hope and trust in the improvement of the industry. I will definitely be reading Brain on Fire next and keep an eye out for furthering writing by Cahalan.

I give this book...

5 Universes!

The Great Pretender was a great read and one that has resulted in a big list of further reading. Cahalan's writing is engaging and her research detailed. I'd recommend this to anyone with an interest in psychiatry or looking for a good non-fiction read.