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Nobody's Normal: How Culture Created the Stigma of Mental Illness

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For centuries, scientists and society cast moral judgments on anyone deemed mentally ill, confining many to asylums. In Nobody’s Normal, anthropologist Roy Richard Grinker chronicles the progress and setbacks in the struggle against mental-illness stigma—from the eighteenth century, through America’s major wars, and into today’s high-tech economy. Grinker infuses the book w For centuries, scientists and society cast moral judgments on anyone deemed mentally ill, confining many to asylums. In Nobody’s Normal, anthropologist Roy Richard Grinker chronicles the progress and setbacks in the struggle against mental-illness stigma—from the eighteenth century, through America’s major wars, and into today’s high-tech economy. Grinker infuses the book with the personal history of his family’s four generations of involvement in psychiatry, including his grandfather’s analysis with Sigmund Freud, his own daughter’s experience with autism, and culminating in his research on neurodiversity. Drawing on cutting-edge science, historical archives, and cross-cultural research in Africa and Asia, Nobody’s Normal explains how we are transforming mental illness and offers a path to end the shadow of stigma. The preeminent historian of medicine, Sander Gilman, calls Nobody’s Normal “the most important work on stigma in more than half a century.”


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For centuries, scientists and society cast moral judgments on anyone deemed mentally ill, confining many to asylums. In Nobody’s Normal, anthropologist Roy Richard Grinker chronicles the progress and setbacks in the struggle against mental-illness stigma—from the eighteenth century, through America’s major wars, and into today’s high-tech economy. Grinker infuses the book w For centuries, scientists and society cast moral judgments on anyone deemed mentally ill, confining many to asylums. In Nobody’s Normal, anthropologist Roy Richard Grinker chronicles the progress and setbacks in the struggle against mental-illness stigma—from the eighteenth century, through America’s major wars, and into today’s high-tech economy. Grinker infuses the book with the personal history of his family’s four generations of involvement in psychiatry, including his grandfather’s analysis with Sigmund Freud, his own daughter’s experience with autism, and culminating in his research on neurodiversity. Drawing on cutting-edge science, historical archives, and cross-cultural research in Africa and Asia, Nobody’s Normal explains how we are transforming mental illness and offers a path to end the shadow of stigma. The preeminent historian of medicine, Sander Gilman, calls Nobody’s Normal “the most important work on stigma in more than half a century.”

30 review for Nobody's Normal: How Culture Created the Stigma of Mental Illness

  1. 4 out of 5

    Dramatika

    You might have noticed that despite the many claims of the author the stigma of mental illness became less and less prevalent today. Moreover, seemingly ordinary behavior that was thought just typical stages of every day life, like irritability, anger, or mood things suddenly could be explained by not being ordinary life human being but by a number of (always ready at hand) psych disorders straight out of the DSM-5. There was even a certain honor of not dealing or improving one's own behavior, a You might have noticed that despite the many claims of the author the stigma of mental illness became less and less prevalent today. Moreover, seemingly ordinary behavior that was thought just typical stages of every day life, like irritability, anger, or mood things suddenly could be explained by not being ordinary life human being but by a number of (always ready at hand) psych disorders straight out of the DSM-5. There was even a certain honor of not dealing or improving one's own behavior, as this is beyond control of the individual who is alas can't help but be his sick psych self. Nevertheless, there are certain behaviors more readily suitable for fashionable psych disorders than others. Bipolar is in, psychosis and all kind of chemical addictions definitely out! This is no to belittle any real sufferings of the people with such disorders, but I know many perfectly stable people with good jobs, families and active social life who claim to be bipolar all of a sudden. Clearly many don't realize the true severity of this disease. I remember the time when borderline personality was all the rage, another very serious and very disabling disorder. There is fashion for mental disorders too! On the other hand, many people suffering from the complications of horrible Covid 19, for instance, emphasize the neuro biological component of their psych symptoms as if to suddenly succumb to normal PTSD of the real psychotic episode we all live through right now is to show weakness. I believe both biological and actual collective psychosis factors are at play here. The book is heavily emphasized on psychoanalytic approach as the author's father and grandfather specialized in psychoanalysis. It is the one view through which lenses we look at different descriptions of mental health in different cultures. And yet we come back to the definition of normal in all its varieties. It might be a spectrum and the less clear boundaries, but time and again throughout the book we still can't completely ignore the marks on this continuum specifying the boundaries of normal definition. We might change the language and use neurotypical and neurodiverse but still define the scale and it measures. One thing that the author didn't emphasize enough is the enormous burden many people with mental health disorders place on their families. With the reduced funding for mental health facilities many dangerous to themselves and others are left at home to be cared by their strained families. Schizophrenia is a very prevalent disorder that many people are treating successfully but still require hospitalization from time to time. With the approach of less stigmatization and normalization of mental illness sometimes result in disastrous consequences for the mental health facilities so desperately needed by the people in urgent situations. In other words, the actual stigma for mental health issues exist, yet it doesn't mean that the mental health diseases are not real, however one might define them. I think that the disease manifestations are cultural and yet even that is changing due to globalization. ADD wasn't diagnosed when I was growing up, yet most of the kids somehow made it though school despite the horrors of the rigid education system. What worries me now is medicalization of the previously normal human experiences of grief and suffering and yes sadness. I refuse to be positive and cheerful all day long. I'm gloomy and pessimistic and find life truly miserable and its everyday struggles. Yet this is real me without the support of medication. The fakeness of all American smile is what many Europeans notice the most (I bet ppl in US disagree). This false cheerfulness must be observed at all times, with the help of medication if necessary. I wonder what the author thinks of that.

  2. 4 out of 5

    Chris Boutté

    I'm a recovering drug addict with over 8 years sober, and one of the reasons I self-medicated with substances was due to the stigma around mental illness. Since getting clean, I've become an advocate for mental health, and decreasing the stigma is one of my main goals. So, when I heard this book was coming out, I had to grab a copy. This book from Richard Grinker has a great, thorough history of how we treat the mentally ill around the world and what the stigma does to people. He even dives into I'm a recovering drug addict with over 8 years sober, and one of the reasons I self-medicated with substances was due to the stigma around mental illness. Since getting clean, I've become an advocate for mental health, and decreasing the stigma is one of my main goals. So, when I heard this book was coming out, I had to grab a copy. This book from Richard Grinker has a great, thorough history of how we treat the mentally ill around the world and what the stigma does to people. He even dives into the mistreatment of those with disabilities or those who are neurodiverse, which makes the book even more well-rounded.  Although this is an incredible book that I really think more people can read, the structure of the book felt a little off and seemed to drag a bit. For example, in the first half of the book, Grinker spends a few chapters talking about mental illness in the military, which is extremely important for understanding the history, but it really slowed the book down. Maybe it's because I'm already familiar with the subject, so that may just be my opinion. Regardless, this is an excellent book that I really hope gets the attention it deserves.

  3. 5 out of 5

    Cecilia Cicone

    This book was amazing and I am so grateful it exists. From detailing how capitalism and our sense of the importance of productivity has stigmatized mental illness to encouraging openness and suggesting how to be honest and adaptable with these struggles, I have so much to think and pray about.

  4. 5 out of 5

    Edward Sullivan

    An interesting, insightful chronicle of how mental illness became stigmatized and examination of how attitudes are gradually evolving. Grinker writes compassionately about the subject and infuses the narrative with the personal history of his family’s four generations of involvement in psychiatry.

  5. 5 out of 5

    Rennie

    Interesting and mostly very readable history of psychiatry. My interest did flag a bit eventually though. But the last chapter or so covering some of the progress that’s been made very recently in being more understanding and accommodating of people with neurodiversities, like even in major corporations’ hiring practices (and Berlin brothels!) was great. The looks at how mental illnesses manifest and are interpreted in different cultures was a highlight throughout.

  6. 5 out of 5

    Ashley Peterson

    Nobody’s Normal: How Culture Created the Stigma of Mental Illness is written by Roy Richard Grinker, an anthropology professor at The George Washington University. Autism and cross-cultural psychiatry are listed as areas of expertise on his faculty page. He’s the father of an autistic daughter, who he refers to a number of times throughout the book. Culture The book revolves around the idea that mental illness is a product of culture and capitalism. The first section of the book looks back through Nobody’s Normal: How Culture Created the Stigma of Mental Illness is written by Roy Richard Grinker, an anthropology professor at The George Washington University. Autism and cross-cultural psychiatry are listed as areas of expertise on his faculty page. He’s the father of an autistic daughter, who he refers to a number of times throughout the book. Culture The book revolves around the idea that mental illness is a product of culture and capitalism. The first section of the book looks back through history, painting an oddly rosy picture of life for crazy folk back in the day. I spent much of this section being annoyed with what I was reading. There’s mention of a 15th century “asylum for the ‘insane'” in present-day Morocco, with the odd juxtaposition of them being frequently bound and whipped but also them being surround by fragrant plants and having reassuring conversations with doctors, as if the latter made the former just fine and dandy. Any takers on the whipping? The author says that in the early 1800s in western Europe, many ill people were kept in chains by their family members, but not because they had something their family members called “mental illness.” To me, that seems like saying people are having legs amputated because of gangrene, but they didn’t have something people recognized as being a thing called gangrene. Whether it’s crazy or rotting foot, not having a medical term to frame it in doesn’t make it less undesirable. The book opens with a story of someone from the Jun/oansi, a hunger-gatherer people in the Kalahari Desert in Namibia. Someone has schizophrenia-like symptoms, but it’s not seen as “mental illness”; it’s spirits sent by other people, and not the ill person’s fault, so it’s all just wonderful. That’s a nice thought, but the possession by spirits belief doesn’t necessarily translate into positive treatment. It can translate into people being chained to trees for years out of desperation because their family can’t manage them any other way. Speaking of which, Grinker criticizes a paper published in Nature with a photo showing a Somali girl chained to a tree. He argues that this “conceals the content of her life”, including family, politics, and religion. Yes, there’s content and context that’s not shown, but to suggest that the context is sufficiently enriching to make up for the poor kid being chained to a tree seems unnecessarily Kumbaya. The author later points out the problem of taking a Western approach to illness in non-Western countries, but, in my mind, he missed the mark with it. Psychosocial interventions like prayer can only do so much, and it doesn’t help the people with mental illness if we encourage more praying and then wash our hands of it all. Culturally appropriate and effective should be able to co-exist. Family ties The author’s grandfather and great-grandfather both make repeated appearances in the book. His great-grandfather, who migrated from Prussia to the U.S., became a neurologist. He attributed insanity to an inability to control impulses, especially the desire to shop. His grandfather did psychoanalysis with Freud as part of his psychiatric training, and in World War II used sodium pentothal (“truth serum”) to help soldiers access their trauma. The book also covers how mental conditions were viewed in WWI, the Korean War, Vietnam, Afghanistan, and Iraq, and how little seemed to be learned from one war to the next about how trauma affects people. Medicalization The author described medicalization as an integral component of capitalism, and called the “broken-brain model” an attempt to “give mental illnesses an objective reality apart from culture.” He gave electroconvulsive therapy (ECT) as an example of the problem with the broken-brain model; despite its high level of efficacy, it’s highly stigmatized because it’s rooted in that broken-brain model. He also discussed how medicalization relates to autism and the anti-vax arguments, as well as chronic fatigue syndrome. He argues that the biological model of CFS/ME is problematic because it gets in the way of psychological interventions that could potentially be helpful. There’s a valid point in there somewhere, but you may find yourself annoyed before he gets to it. Among the assorted points that I disagree with was Grinker’s argument that it’s actually a good thing that people are saying things like “a little OCD” or “a little bipolar,” as it validates that mental illnesses exist on a spectrum rather than being all or none, and decreases the stigma of those labels. I’m imagining some of my readers being rather unimpressed as they read this. The author isn’t so keen on the whole brain business, as “neuroscientific approaches to understanding and treating mental illnesses perpetuate stigma by reducing the complexity of illness experience, or our personalities, to the brain.” He then adds that he’s not suggesting that neuroscience can’t come up with new treatments, but it can’t reduce stigma. Sigh. This was one of many points in the book where there was a valid idea packaged up in a less than palatable way. For the first third of the book, I thought I disagreed with the author entirely, and it was only in the final third that I started to realize what he was actually getting at, and discovered I didn’t disagree with him as much as I thought. Presenting mental illness to the public as a brain disease is associated with increased stigma; that’s what the research on the matter clearly shows. However, Grinker seems to be implying that biology needs to be tossed out the window. I don’t think that’s actually where he’s trying to go, but he’s pointing a sign in that direction, perhaps inadvertently. My own theoretical perspective regarding culture tends to be along the more moderate lines of social constructionism; basically, the way we experience reality is socially constructed, and can never be fully separated from the social context. That’s not to say that mental illness doesn’t exist on an objective level, but the meanings attached to it and the way it’s interpreted are inextricably culture-bound. What Grinker was saying probably wasn’t too far off from where I stand, but with less of a space for mental illness on a realist level. Still, I found he was setting off my “this jerk doesn’t think mental illness is real” BS detector fairly regularly. I do think that’s more how he framed things than the essence of his ideas, but it was still there. The book concluded with Grinker saying he wants readers to take away that stigma can be a conversation starter, not ender. Now that, at least, is a message I can whole-heartedly agree with. I received a reviewer copy from the publisher through Netgalley.

  7. 5 out of 5

    Kristine

    Nobody's Normal by Roy Richard Grinker is a free NetGalley ebook that I read in early December. Grinker uses research from Africa and Asia (among many other sources and qualitative studies of those who lived with and among mental illness) to shine a scrutinous, yet ease-giving light on its stigma and that there is no normal, no sense of perfection that can be completely embodied or obtained. He also goes into the concept of physically and spiritually drawing out someone's inner demons, early form Nobody's Normal by Roy Richard Grinker is a free NetGalley ebook that I read in early December. Grinker uses research from Africa and Asia (among many other sources and qualitative studies of those who lived with and among mental illness) to shine a scrutinous, yet ease-giving light on its stigma and that there is no normal, no sense of perfection that can be completely embodied or obtained. He also goes into the concept of physically and spiritually drawing out someone's inner demons, early forms of labelling, sequestering, diagnosis, therapy, and treatment with issues such as PTSD, mania, autism, and gender diversity, as well as mental healthcare undergoing a massive overhaul.

  8. 4 out of 5

    JH

    An interesting book that covers a lot of history I was fortunate enough to learn in residency. The cultural perspective had some new information and the stories about the doctors in Nepal really made his points clear. I’m not sure he fully brought his premise home in the end but I found the book interesting and well researched.

  9. 4 out of 5

    Channa

    RTC!

  10. 4 out of 5

    Andréa

    Note: I accessed a digital review copy of this book through Edelweiss.

  11. 5 out of 5

    Nicole Westen

    I loved this book, and found it rather timely. During the covid pandemic it had been in the news (and resurged again in England), that hospitals concerned with allocating resources, and even in setting where there is no strain on resources, those with mental disabilities have been given substandard care, or even in some cases out-right turned away. The most recent revelation in England, of doctors issuing blanket DNRs for anyone with a learning disability in their record is very upsetting. Most I loved this book, and found it rather timely. During the covid pandemic it had been in the news (and resurged again in England), that hospitals concerned with allocating resources, and even in setting where there is no strain on resources, those with mental disabilities have been given substandard care, or even in some cases out-right turned away. The most recent revelation in England, of doctors issuing blanket DNRs for anyone with a learning disability in their record is very upsetting. Most defend these decisions that those with mental disabilities and illness do not have 'quality of life'. They make this decision without even know the patient, but just assume that because their disability prevents them from fully integrating and participating in society on the same scale as neurotypical peers, these individuals must have miserable, empty existences. Which is absolutely not true at all, but it certainly goes a long way to show that the stigma of being 'not normal' is still alive and kicking... unfortunately. Grinker goes about mapping the history of western psychology and psychiatry, even if those terms had not been applied yet. He notes that the idea of the individual with a mental illness, whose condition prevented them from participating in a capitalist economy, as some how defective, deformed, or 'less evolved', is relatively recent. The enlightenment gave us many good things, this was not one of them. I think what I love the most is that in order to show how our perceptions of mental illness are cultural, Grinker compares an individual with what would, diagnostically, be the exact same condition, but in another part of the world, this condition (like schizophrenia or autism) is viewed in a completely different light, and not always as a personal failing or fault. In western society, as Grinker points out, we have this idea that everyone must be able to stand on their own and provide for all their own needs, without the aid of anyone else. Any person who cannot do this is shunned as not belonging in society. Which is quite an arbitrary metric, but it is one that fits in with industrialized capitalism that developed in the west. He also explains how in the Victorian era we began to define our concept of what was 'normal' and what was not, although the term 'normal' did not enter the english lexicon in it's current usage until the 1950's. Instead they tried to define, in a moral sense, what was 'right' and 'good' and what was not. Which led to the creation of a lot of the stigmatization that exists today around sex and gender and identity, and not merely mental illness. I love his phrasing, that the obsession with normalcy is 'an American neurosis'. Since the 1950's American society has been obsessed with defining 'normal', and then forcing all that does not naturally fall into that category into compliance. This is despite the fact that Grinker's father, a psychiatrist, tried to find actual 'normal' people, those who showed no clinical signs of any sort of disorder as in the DSM. He succeeded in finding a handful of individuals among college age men. And they were the most boring, unambitious, unimaginative, disinterested group of people. I really think this is a must read for anyone. This discusses how we came to perceive of mental illness as a society, and how that definition and our perception has changed as our society and our values have changed. Unfortunately, so far, those changes have not included one free of stigma. But there is hope we are progressing in the right direction, and trying to remove or at least minimize stigma where it exists. And one of the best ways, Grinker points out, is to go out and actually meet these people; and that while deinstitutionalization does bear the dark mark of shoving many mentally ill people with no social supports out into the street, it also put mentally ill people out in the community where they can see and be seen and forced society to reckon with how it understands these individuals and treats them. In the words of Mark Twain: "Travel is fatal to prejudice, bigotry, and narrow-mindedness..." If we want society to change these stigmatizing ideas of mental illness, then society must meet those they stigmatize and be forced to see them not just as an illness, but as the individuals that they are.

  12. 5 out of 5

    Elaine Ruth Boe

    While the premise of Grinker's book isn't anything I haven't heard in my reading on Disability Studies, I did enjoy his evidence. I hadn't ever approached the construction of mental illness from a military health point of view. I knew that military science has influenced many developments across the board for the lay population. That is especially true for how we understand mental health. The diagnosis of nonconforming individuals with "stigmatized" mental health conditions is a way to control a While the premise of Grinker's book isn't anything I haven't heard in my reading on Disability Studies, I did enjoy his evidence. I hadn't ever approached the construction of mental illness from a military health point of view. I knew that military science has influenced many developments across the board for the lay population. That is especially true for how we understand mental health. The diagnosis of nonconforming individuals with "stigmatized" mental health conditions is a way to control and police all of our behavior. I found anthropologist Ruth Benedict's words, quoted in the book, especially clarifying: “The concept of the normal is properly a variant of the concept of the good. It is that which society has approved.” On the other hand, medical professionals might feel pressure to diagnosis a patient with a certain condition the patient doesn't have in order to help the patient receive benefits or compensation or reduce stigma. There's also a lot of interesting discussion on how we understand the mind and body to be connected--or not connected, and how Western society can more easily process ailments of the body we can see. Another interesting discussion: how modern-day ECT (basically electro-shock therapy) has been honed to a much safer and effective degree than the horrors of the mid-20th century practice would lead me to expect. But the stigma trailing those earlier practitioners discourages those who might benefit from the practice from getting that help.

  13. 5 out of 5

    Joséphine (Word Revel)

    Actual rating: 4.5 stars Initial thoughts: In his survey of attitudes towards mental health and treatments over the past decades, Grinker also included the impact of Western biases vis-à-vis non-Wester societies. He also included findings from a study he conducted in South Korea on autism, which I really appreciated. Overall, this book in greater depth things I had learnt during my studies of sociology and gave a broader overview at the same time. Really interesting how medical language has an im Actual rating: 4.5 stars Initial thoughts: In his survey of attitudes towards mental health and treatments over the past decades, Grinker also included the impact of Western biases vis-à-vis non-Wester societies. He also included findings from a study he conducted in South Korea on autism, which I really appreciated. Overall, this book in greater depth things I had learnt during my studies of sociology and gave a broader overview at the same time. Really interesting how medical language has an impact on whether or not illnesses get diagnosed in the first place.

  14. 4 out of 5

    Nate

    The author gives a great history of where/how mental illness “stigma” began and how our society and culture have propagated ideas of what makes someone normal vs. not. As the author says, we need to start thinking of mental illness as a spectrum that we are all on and that some individuals just fall on the more severe end of that spectrum. We should learn as a society to embrace these differences instead of trying to be “normal.”

  15. 4 out of 5

    Chet Taranowski

    Not bad. The author challenges the rather black and white concept of mental health diagnosis. We are all a bit dysfunctional. This isn't exactly a new idea. Nevertheless, the writer is pretty good at holding your attention when discussing history of psychiatry. He makes some good points, such as an examination of what does it mean to be a contributing citizen. Perhaps capitalism, in error, has made humans seem like simple commodities that should only be judged by their productivity. Not bad. The author challenges the rather black and white concept of mental health diagnosis. We are all a bit dysfunctional. This isn't exactly a new idea. Nevertheless, the writer is pretty good at holding your attention when discussing history of psychiatry. He makes some good points, such as an examination of what does it mean to be a contributing citizen. Perhaps capitalism, in error, has made humans seem like simple commodities that should only be judged by their productivity.

  16. 4 out of 5

    Lisa Konet

    A very good book about mental illness and how it is perceived by lay people and medical people. Very well researched and some good history about the subject. The author is obviously very passionate about the subject, A good fascinating read but not my favorite on the subject. Thanks to Netgalley, Roy Richard Grinker and WW Norton & Company for an ARC in exchange for an honest review. Available: 1/26/21

  17. 5 out of 5

    Keith Mankin

    Fascinating and entertaining examination of a complex subject of the changing perceptions of mental illness. Dr. Grinker weaves detailed research with the narrative of his family of prominent psychiatrists to produce a spell-binding story. He also raises important questions about the development and impact of societal norms.

  18. 4 out of 5

    RACHEL

    Brinker takes readers through the intersection of psychiatry, mental illness and cultural perceptions. Further, he broadens the perspective beyond the Western lens. All in all, a good look at the very complex and dynamic life of humanity. My copy was a gift through Goodreads First Reads.

  19. 5 out of 5

    Samantha

    One of the most important books I’ve ever read.

  20. 5 out of 5

    Stevie Smith

    Excellent history of what has been perceived as mental illness over the centuries. Look up "drapetomania" for a real horror. Excellent history of what has been perceived as mental illness over the centuries. Look up "drapetomania" for a real horror.

  21. 4 out of 5

    Dan

    A history of mental illness.

  22. 4 out of 5

    Jason Park

    Why is the stigma of mental illness declining? What can we do to make it go away faster? Roy Grinker looks at society and culture to answer that in his new book *Nobody's Normal: How Culture Created the Stigma of Mental Illness* My review: https://medium.com/park-recommendatio... Why is the stigma of mental illness declining? What can we do to make it go away faster? Roy Grinker looks at society and culture to answer that in his new book *Nobody's Normal: How Culture Created the Stigma of Mental Illness* My review: https://medium.com/park-recommendatio...

  23. 5 out of 5

    Emily

  24. 5 out of 5

    Josiane Stratis

  25. 5 out of 5

    Viivi

  26. 4 out of 5

    Carolyn

  27. 4 out of 5

    Sarah Johnson

  28. 4 out of 5

    Christopher Dart

  29. 5 out of 5

    Heather Hodgin

  30. 5 out of 5

    Dani

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