by Jerry Waxler
After reading the memoir Surrounded by Madness by Rachel Pruchno, I pondered the lessons about life and about memoir writing. In this continuation of the series, I explore more of the lessons-about-life embedded in the book.
This is the third article in a series about Surrounded by Madness. For the first article, click here.
Psychology Lesson #3: Adolescent mental health care
When Rachel Pruchno’s daughter failed to follow the path of normal childhood development, the natural option was to look for help. Unfortunately, finding psychological help for her adolescent daughter required a complex and frustrating search.
She picked her way through complex insurance regulations and inadequate coverage, pleading and politicking with therapists who were not accepting new patients, trying to absorb each new diagnosis, leading to a new round of meds. When the problems continued, she had to start over, seeking the next round of help. Trying to help her daughter forced Rachel Pruchno into training, not based on an academic program but on real-world experience. The memoir passes this education along to readers, packed into a suspenseful high-pressure struggle for sanity.
Psychology Lesson #4: Inadequate response to broken minds. Unlimited response to broken laws.
When a child breaks the law, society steps in with full authority to remove all freedoms and place them in jail, usually without treatment. However, Pruchno’s daughter did not break laws, and so she was able to easily evade her parents’ desperate concerns, acting out at the very edge of sanity, and manipulating her way out of any attempts to rein her in.
The memoir, Surrounded by Madness, is in essence a cry for help, not just for one troubled girl but for the poor health of the mental health care system itself. Through Rachel Pruchno’s eyes, we experience the lack of supportive laws, lack of funding and research, and generally ineffective psychological response to children whose behavior reaches, but does not yet cross, the boundaries of the law.
The title could be construed as a double-entendre. Not only was Pruchno surrounded by the madness of trying to bring her daughter in line with social norms. She was also surrounded by the madness of a mental health care system that turns a blind eye toward insanity. Pruchno’s heart-wrenching story is both a good reading experience and a powerful cry for help from someone who has been under-served by the only institutional systems available in such situations. By sharing her story, Pruchno lets us feel the helplessness and insanity for ourselves.
For another tragic example of the maddening lack of social support for mental illness, see Leave the Hall Light On, in which Madeline Sharples’ son was able to sign himself out from treatment and commit suicide. Another example of a parent without institutional support is Live Through This by Debra Gwartney, in which two teenage girls cut school and eventually ran away leaving this single mom to find her own solutions.
Psychology Lesson #5: Health of the family versus the identified patient
The Pruchnos poured an extraordinary amount of energy into raising their disruptive daughter. Meanwhile their well-behaved son remained in the background, growing up in the midst of the drama caused by his sister’s erratic behavior.
The memoir, in addition to being about the daughter’s mental health, also demonstrates her impact on the health of the son and of the whole family unit. By showing the level of attention required to cope with the troubled child, Surrounded by Madness highlights the stress one sibling places on family dynamics.
The memoir doesn’t teach technical psychology lessons about these complex issues. Rather it leads the reader through the detailed personal experience of living through the situation. Books like Surrounded by Madness should be on the shelf of anyone who wants to learn how the psychological strength of the parents is crucial for the stability of the family.
For another memoir that shows the family’s response to a troubled child, see Freeways to Flipflops by Sonia Marsh. Read about it here.
Psychology Lesson #6: Nature versus Nurture: Unless Otherwise Demonstrated, It’s Probably Mom’s Fault
The contract of becoming a mother seems straightforward enough. Completely transform your life to become a caregiver, pour heart and soul into raising the child, and adapt every minute of at least the first eighteen years, no matter what the cost. As if this responsibility is not overwhelming enough, it is supercharged with a powerful threat of social stigma when the child does not meet society’s expectation.
In the 1950s, psychologists blamed mothers for causing schizophrenia. This cause for the horrifically disruptive mental disorder was discredited when inheritance patterns and medications demonstrated the disease’s biological roots. However, Personality Disorders resist such a straightforward biological model or treatment. As a result of this ambiguity, when a child persistently follows anti-social, self-destructive patterns, there is a tendency to wonder how parenting contributed to the problem.
To learn about the effects due to nature, scientists use magnetic resonance brain images and massive genetic surveys. To learn more about nurture, we need to observe the way these conditions unfold in real life.
Rachel Pruchno’s memoir is a fascinating case study that allows us to see into the dynamics of a family with a child who comes of age with this troubling mental condition. We watch the mother’s stunning persistence and intensity to guide the child, and the daughter’s equally persistent and intense determination to thwart those directives. The book offers no easy answers but raises these important questions in a detailed, careful exploration.
For this reason, this book is an important one to study when attempting to sort out the influence of nature and nurture on a child’s development.
In his book My Age of Anxiety, author Scott Stossel traces the complex relationship between genetic and environmental factors in pervasive anxiety. Stossel grew up with horrible, debilitating anxiety starting from an early age, so this quasi-memoir, quasi-textbook sheds light on the complex interaction between nature and nurture in severe pervasive anxiety.
For another memoir of Bipolar Disorder, see Tara Meissner’s Stress Fracture: A Memoir of Psychosis.
For brief descriptions and links to all the posts on Memory Writers Network, click here.
To order my step-by-step how-to guide to write your memoir, click here.