Review of "Madness"

By Marya Hornbacher
Houghton Mifflin, 2008
Review by Christian Perring on May 20th 2008

Marya Hornbacher published Wasted, her chronicle of her messed up childhood and her eating disorder, in 1998. Now, ten years later, she follows it up with Madness, a chronicle of her messed up adult life, her alcoholism and bipolar disorder.  Each chapter is devoted to a specific time in her life, so the book is a collection of episodes with gaps between them.  This heightens a sense of disconnection and fragmentation, which Hornbacher apparently feels herself.  She starts the book dramatically, in a standard memoir ploy, with a dramatic scene from 1994, and then goes back to the start of the story with her childhood in 1978, when she was 4.  The rest of the book goes in fits and starts up to Summer 2007.  Readers wanting to check on her latest progress can read her blog

Her story includes recurrent self-destructive behavior, some self-mutilations that border on suicide-attempts, a failed marriage, many visits with various psychotherapists and psychiatrists, many AA meetings, several relapses, 7 hospitalizations, and a gradual sense of her getting more control over her life and learning how to cope with her illness.  Although Hornbacher's diagnoses have been bipolar disorder, substance abuse, and eating disorders, these don't neatly separate out in her story, and she doesn't seem like a typical case of any particular disorder, if there is such a thing.  She does do a good job of conveying racing thoughts, and indeed it seems that a good portion of the book was written when she was at least slightly manic.  Most of the book gives the reader some sense of what it is to feel crazy, and to justify one's actions with ridiculous rationalizations.  

Addiction memoirs can be hard to read, because they always have repeated self-deception, self-destruction, and failed pledges to stop.  While Madness is about much more than addiction, it still has that feature -- (listening to the unabridged audiobook makes it easier to get through).  It is also a difficult because of the jumps in the story.  Hornbacher is often surprised to find herself in a new situation, doing something she hadn't expected, undertaking a project or in a relationship she hadn't planned on.  She often finds her own behavior completely surprising, or doesn't know how she ended up in the situation she finds herself.  It must be a difficult experience for her, and readers will share some of that experience in reading the book. 

So Madness is strong on provoking emotions in the reader and possibly on conveying Hornbacher's experience.  It also does a good job at showing how coping with mental illness is a lifelong project that is enormously confusing at first, because it can take doctors and psychiatrists so long to settle on a diagnosis, and for sufferer to work out what treatments work best.  The book is much less strong on making clear which symptoms are associated with which illnesses, and despite the subtitle "A Bipolar Life," it doesn't give a clear sense of the cycling of moods associated with bipolar.  It would not be at all surprising if Hornbacher received other diagnoses later on, or if those reading the book felt that she should have received other diagnoses.  Many, probably most, people with serious mental illness don't fit neatly into the standard diagnostic categories, so it isn't surprising if Hornbacher does not.  It does mean that readers should be careful in thinking that her story is will resemble that of most people diagnosed with bipolar disorder. 

Link: Author website

© 2008 Christian Perring

Christian Perring, Associate Professor of Philosophy, Dowling College, New York.

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