Book Review: Norah Vincent’s Voluntary Madness

In Self-Made Man, journalist, out lesbian, and daredevil Norah Vincent chronicled the year and half she spent disguised as a man and occupied with typically masculine activities.  Now, in Voluntary Madness, Vincent investigates another world through immersion in it—the inpatient psychiatric ward.  In this book, Vincent’s relationship to the social sphere she examines is ambivalent.  As a long-time sufferer of depression, Vincent’s first trip to a psych ward is brought on by a mental crisis and instigated by her therapist.  The three following trips that occupy the book are taken for the purpose of research, but the depression she continues to struggle with throughout the narrative is real.

Vincent spends time in a city public hospital, a privately owned hospital in the Midwest, and an experimental facility, also private.  At the beginning of the book, she is skeptical of inpatient treatment, psychiatric diagnoses and the use of psychiatric medication.  This basic skepticism lasts through her journey.  However, experience of her fellow patients leads her to acknowledge that some people experience mental distress that makes daily functioning impossible and that medication can help alleviate pain.  By the end, she tries to reconcile her own use of meds with the self-directed spiritual practice she develops in the last facility.

Throughout the work, Vincent’s libertarian perspective leads her to reject forcefully the role of victim. While at times her emphasis on individual agency is inspiring, at other times this stance distorts the reality of her situation.  For instance, throughout most of the book, she avoids discussion of how her sexuality and gender make her vulnerable.  Then, at the end, she reveals crucial information about both dimensions of her identity that changes how the reader views her depression.  Finally, her preference for private over public treatment centers sidesteps a pressing question: how can America best help those impoverished, uninsured, and in mental distress?  Vincent’s on-the-ground powers of observation make for an informative and engaging book, but in the case of social justice, her work raises more questions than it answers.