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Book Review: Still Missing by Chevy Stevens

September 19, 2014 7 comments

A woman's jawline and neck are viewed through a shattered glass.Summary:
Annie O’Sullivan extremely forcefully declares in her first therapy session that she doesn’t want her therapist to talk back to her; she just wants her to listen.  And so, through multiple sessions, she slowly finds a safe space to recount her horrible abduction from an open house she was running as an up-and-rising realtor, her year spent as the prisoner of her abductor, and of her struggles both to deal with her PTSD now that she’s free again and to deal with the investigation into her abduction.

Review:
I was intrigued by the concept of this book.  Yes, it’s another abduction story, but wrapping it in the therapy sessions after she escapes was an idea I had not seen before.  So when I saw this on sale for the kindle, I snatched it up.  I’m glad I did, because this is a surprisingly edge-of-your-seat thriller.

Stevens deals with the potential issue of back-and-forth with the therapist by having Annie say in her first session that in order to feel safe talking about what happened to her, she needs the therapist to say very little back to her.  It is acknowledged that the therapist says some things to Annie, but it appears that she waits to talk until the end of the session when Annie is done talking.  What the therapist says isn’t recorded but Annie does sometimes respond to what she suggested in later sessions.  This set-up has the potential to be clunky, but Stevens handled it quite eloquently.  It always reads smoothly.

The plot itself starts out as a basic abducted/escaped one, with most of the thriller aspects of the first half of the book coming from slowly finding out everything that happened to Annie when she was abducted.  The second half is where the plot really blew me away, though.  The investigation into her kidnapping turns extremely exciting and terrifying.  I don’t want to give too much away.  Suffice to say that I wasn’t expecting most of the thrills to come from the investigation after the kidnapping and yet they did.

Annie is well-developed. Her PTSD is written with a deep understanding of it.  For instance, she both needs human connection and is (understandably) terrified of it, so she pushes people away.  Stevens shows Annie’s PTSD in every way, from how she talks to her therapist to how she behaves now to subtle comparisons to how she used to be before she was traumatized.

Other characters are well-rounded enough to seem like real people, including her abductor, yet it also never seems like Annie is describing them with more information than she would logically have.

I do want to take just a moment to let potential readers know that there are graphic, realistic descriptions of rape.  Similarly, the end of the book may be triggering for some.  I cannot say why without revealing what happens but suffice to say that if triggers are an issue for you in your recovery from trauma, you may want to wait until you are further along in your recovery and feel strong enough to handle potentially upsetting realistic descriptions of trauma.

Overall, this is a strong thriller with a creative story-telling structure.  Those who enjoy abduction themed thrillers will find this one unique enough to keep them on the edge of their seat.  Those with an interest in PTSD depicted in literature will find this one quite realistic and appreciate the inclusion of therapy sessions in the presentation.

5 out of 5 stars

Source: Amazon

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Book Review: January First: A Child’s Descent into Madness and Her Father’s Struggle to Save Her by Michael Schofield

August 8, 2012 2 comments

Blonde girl running with the words "January First" imposed over her.Summary:
Michael and Susan thought their daughter, January’s, high energy levels and vivid imagination were the result of her high IQ, but when she turned five her imaginary friends started to tell her to do bad things like hit her baby brother or throw herself out of windows.  Soon it became apparent that her imaginary friends were actually hallucinations.  What followed was a harrowing struggle to get their daughter diagnosed and treated.

Review:
It’s rare to see a memoir by a father.  There are a ton of memoirs by mothers but not a lot by fathers, particularly not by fathers of daughters.  Put this together with the fact that Jani (her parents’ nickname for her) has childhood-onset schizophrenia, and you have one unique book.

This is an excellently told memoir.  It opens with Michael speaking about having his daughter’s diagnosis now and struggling with all the barriers toward a normal life presented not just by her illness but by the world we live in.  He talks about how some people argue that it’s impossible to diagnose a child with a mental illness, let alone schizophrenia, and of course some people even suggest that Jani is possessed by demons.  He gets the denial.  It’s scary to see a child consumed by an illness that is completely arbitrary in choosing its victims.  But he says,

Denial is not going to help Jani or any of the other mentally ill and schizophrenic children I have come to know. What they need is acceptance. What they need is for us to be telling them “your illness does not define you.” We cannot go inside their minds and “fix” them. But we can fix the world so they can live in it.  (location 90)

That speaks very strongly toward the whole reason I created the Mental Illness Advocacy Reading Challenge, and I knew then that this was going to be not just a unique read, but a challenging and good one.

After the introduction, Michael tells the story in a linear fashion.  He does a good job remembering how he felt in the early days.  His immense pride at his daughter’s high IQ and creative mind coupled with a determination to help her succeed and be herself.  It’s fascinating to see, as an outsider, how early there were warning signs that something was not quite right with Jani but that Michael and Susan (her mother) attributed to a positive cause.  I think that’s typical of parents and indeed of anyone who loves someone.  They were looking for the best.  Believing in the best for their daughter.  They may be that moderately annoying couple on the play date who just insist their daughter with inappropriate behavior is gifted, but seeing it from Michael’s perspective makes that make sense.  Most people (with the exception of parents with Munchausen by Proxy Syndrome) don’t want to believe that their child is sick.  So of course you exhaust every other option first.

This of course makes Jani’s move toward violent behavior at the age of five that much more heart-breaking to read.  I’ve heard and read stories and documentaries of how difficult it is for parents of young adults who become schizophrenic but at least they are adults.  To have this happening to your five year old is completely terrifying.  How do you control a child for whom no punishments seem to work?  Who is more concerned with appeasing her hallucinations than with obeying her parents?

I certainly don’t agree with all the parenting choices the Schofields made in the first five years of her life (and for the record, neither do all of the psychiatrists), but none of their choices would create schizophrenia.  Being overly lenient with your kids won’t make them hallucinate and become this violent at the age of five.  This is one of those occasions where you don’t always agree with the choices the memoirist made, but you’re also not right in the heat of the battle.  It’s far easier to say, “oh, you should have done this,” when it’s not your child who’s being lost to a mental illness right before your eyes.

That’s the thing about this memoir.  Michael is so obviously completely honest.  He tells things that happened that don’t present him in the best light.  He is completely forthcoming in his own shortcomings, but he reiterates over and over how much he loves his daughter and wants to keep his family together.  This combination does for this memoir what a lot of memoirs don’t have: it lends a complete sense of validity to the story as a whole.  Michael is so honest about the emotional struggle of it all that even though you may not like him as a person, you respect him as a father.

This level of honesty combined with his writing ability make this memoir a strong call.  A call to parents of children who are other-abled (whether mentally or physically) that they are not alone.  It’s also a call to the rest of us who are not one of these parents to take a moment to think how difficult it must be and go easier on the parents and the child.  I know I for one might think the next time I see a kid throwing an epic tantrum, “Maybe that child has an illness” instead of “Sheesh, do a better job, parents.”

Overall, this is a well-written memoir presenting the unique perspective of a father caring for a daughter with a mental illness.  It also provides one of the few accounts of childhood-onset schizophrenia.  Highly recommended to parents with special needs children, as well as to anyone who enjoys memoirs and the different perspectives reading them can bring.

4 out of 5 stars

Source: Netgalley

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The Neuroscience of Autism and Learning Disabilities (Science Librarian Boot Camp 2012 Tufts University)

Instead of inundating you with my notes from yet another professional development session, I decided to select out my favorite part to share with you all.  Out of everything I did in the Science Librarian Boot Camp, I enjoyed the Neuroscience presentations the most.  So, here they are. Enjoy!

“Genetics of Neurodevelopmental Disorders,” Dr. Anthony Moncao, Tufts University

  • Genetics studies Genes. Neurodevelopment studies Proteins and Regulatory DNA. Imagining studies the Brain.  Psychiatry studies Behavior.
  • Genes aren’t determinative.  They interact with the environment.
  • There is very strong evidence that genetic factors increase risk.
  • Susceptibility genes–genes that with environmental factors increase risk for these diseases
  • How do we find susceptibility genes?
  • Identify a chromosomal translocator and neurodevelopmental disorder.
  • Copy number variants –> Deletion or addition/duplication of material.  We all have these in some variation but in some instances they hit important areas.  They are inherited or de novo (neither parent had it).
  • What is “strict” Autism?
  • Impairment in: verbal and nonverbal communication, reciprocal social interaction, repetitive and stereotyped patterns of interest (don’t ilke change)
  • Onset before 3 years
  • male to female ratio: 4 to 1
  • Autism Spectrum includes Asperger Syndrome, PDD-NOS (removed from DSM5)
  • Autism Spectrum has a combined incidence of about 1%
  • 5% of Autism Spectrum disorders are comorbid with Fragile X, Tuberous Sclerosis, Down’s, muscular dystrophy, and other Mandelian disorders.
  • What are the genetic factors in Autism?
  • heritability is about 85 to 92%
  • rate among siblings is 3 to 9%
  • It is one of the most strongly genetic of childhood-onset psychiatric disorders.
  • No evidence yet for genes with variants in all forms of Autism.
  • Hardly any two autistic kids are gonna be the same (genetically).
  • Many of these genes are important in synapses.
  • Cadherin 8 (CDH8) is probably the culprit in these microdeletions.
  • Variable expressivity –> a deleted gene can cause multiple different outcomes (autsim, learning disorder, etc…) so evidence is strong environment is a factor
  • Future prospects include: Cohorts, sequencing, translation, use of rare CNVs diagnostically, genetic counseling, early intervention for sibs, CNVs may help us predict the outcome.
  • Projected future difficulties include: CNVs are common, so we have to be sure the one we’re calling Autism really is.  Ethical issues of testing children before they have any symptoms.
  • Autism has very complex etiology.
  • Collaboration is important to make progress.
  • Specific Language Impairment.
  • Just as frequent as dyslexia/autism.
  • It is a difficulty acquiring expressive and/or receptive language despite adequate intelligence and no physical problems (ie deafness).  Problems in producing and comprehending speech, problems reading, normal nonverbal IQs.
  • It has an almost 100% heritability.
  • Inheritance is simple but complex phenotype.
  • The damaged gene –> FOXP2
  • A transcription factor.
  • Important in how the rest of the gene is regulated.  Kind of like a master switch.
  • Not the gene for speech (found in nonverbal species but important in vocalizations.  Mice won’t squeak properly.  Songbirds can’t learn songs if it is damaged.)
  • FOXP2 inhibits CNTNAP2 from being expressed (Sitting on it and not letting it make RNA).
  • Where is FOXP2 expressed in the brain? In the basal ganglia, phallus, cerebellum (motor centers).
  • Chimps are more similar to mice than humans in this gene.
  • FOXP2 is a regulatory gene.  Its downstream targets offer entrypoints into neural pathways involved in speech and language.
  • Developmental Dyslexia.
  • It is a diagnosis of exclusion.
  • 5% of schoolchildren have it.
  • Males are 3 to 4 times more effected than females.
  • Gene variant is two times as frequent in dyslexics as in controls.
  • Variants in KIAA0319 repress the expression of the gene.
  • These variants increase risk in reading problems in the general population.
  • May inhibit migration of neurons to the right are of the cortex.
  • ectopia–small bundles of neurons in the wrong area of the cortex
  • 4 dyslexia susceptibility genes have been found so far.
  • All 4 play a role in neuronal migration and/or axonal growth.
  • DNA is not determinative.  There are many other factors involved.

“Neuroimaging of Children’s Brains,” Dr. Jean Frazier, UMass Med

  • Goal: To explore how neuroimaging techniques provide insight into potential biomarkers for childhood onset neuropsychiatric disorders.
  • Basic principles of brain development: structures start small, get big, then get small again
  • 8 to 14 is an important age range.
  • They exuberate then prune, and it is the pruning that is important.
  • The more complicated a process is the more potential it could go awry.
  • Pruning is guided by “use it or lose it.”
  • The exact timing varies by structure.
  • birth to 3–time of rapid intellectual, emotional, and physical growth of brain and brain wiring
  • by age 6–95% of brain development completed
  • 8 to 13–2nd major brain growth spurt
  • 13 to 20s–pruning to organizing, especially in frontal cortex.
  • We can measure things that require energy using: PET, SPECT, fMRI, EEG, MEG
  • What MRI can tell us: structure, metabolites, blood flow, connectivity
  • MRS–noninvasive, analytic method to measure chemicals within body parts
  • If we are going to fully appreciate what is going wrong in brains, we have to fully understand what is going right in brains.
  • Whereas gray matter gets pruned, white matter increases.
  • Less gray matter, brain becomes more efficient.
  • But what happens in atypical development?
  • More blood flow in amygdala of depressed and anxious.
  • amygdala–governs ability to modulate our affect
  • Bipolars have abnormal connectivity in brain, especially in areas dealing with affect regulation and attentional capacity.
  • Application to Autism?
  • Recommends “Localization of white matter volume increase in autism and developmental language disorder” in Annals of Neurology by Herbert et al
  • Children with autism have more white matter.
  • Tracks most severely affected in Autism are growing/changing just after birth.
  • Biomarkers are a distinct characteristic that is an indicator of a particular biological condition or process.
  • Maybe the genetic risk factors are indicators of the dysfunction not the disorder.
  • Both schizophrenia and autism symptom is social withdrawal.
  • 1 in 54 boys and 1 in 252 girls (1 in 88 children) have Autism Spectrum, according to study from 2008
  • Inhibition of GABA and excitation of Glutamate are associated with autism.
  • Tuberous make too little of a certain protein. Fragile X makes too much.
  • Glutamate levels are higher in Autism.
  • Biomarkers could be used as predictors for treatment response.

Book Review: Abject Relations: Everyday Worlds of Anorexia by Megan Warin

Woman standing in waterSummary:
Warin, an anthropologist, takes an entirely new approach to anorexia, looking it from a purely cultural and anthropological perspective.  She spends a couple of years interviewing women with anorexia at various points in the life of the illness from early treatment to recovery to relapse.  In this way she analyzes not just the culture of women and men suffering from anorexia but also how anorexia is a response to the culture these people find themselves in.

Review:
This was my first read from the holdings of my new workplace.  The instant I saw the title and book cover, I knew I needed to read it.  The anthropology of anorexia? How fascinating!

It’s interesting that I feel I actually learned a bit more about anthropology than anorexia from this book, but perhaps that is because I am more familiar with the latter than the former.  From my work in psychiatry and as a mental illness advocate, I was already aware that people suffering from anorexia have their own culture.  I still highly valued seeing this presented in an academic fashion with a respect for the people involved.  I commend Warin for her ability to interact with these women and glean a sense of how they came to be who they are now with a respect for them as people that is all too rare to see in this type of work.

So what of the anthropology then?  What are abject relations?  Over the course of the book I learned that abject relations are ambiguous relations.

What is abject is in between, ambiguous, and composite. Abjection is thus contrary to dualist concepts because it undermines and threatens that which is separate. As such, abjection is fundamentally concerned with the complexities and contradictions of relatedness. (page 184)

Whereas most books about eating disorders attempt to say THIS definitively caused it, this book’s premise is that the etiology is entirely ambiguous.  What caused it, what makes it persist, what it is to suffer from anorexia.  Nothing about it is clear-cut.  That is the powerful statement of the book.  There are no easy answers to anorexia, but we can do much more to understand it both as its own culture and as an aspect of our own.

This focus on anorexia as a response to the mainstream culture and a formation of a new culture leads Warin to question a lot of the inpatient treatment techniques.   Warin sees anorexia as frequently about women attempting to assert a right to control over their own bodies that goes horribly awry, ripping the control out of society’s or tormentor’s hands, into their own, into ana’s hands, then into the hands of an authority figure again at treatment.  Warin sees value in helping people suffering from anorexia recover in the context of society.  Instead of feeding them alone in a single room have them cook and eat together in a group.  This reenforces the cultural and connecting aspect of eating that they have been denying for so long.

It is an interesting idea to look at anorexia as an abject cultural response, but I don’t think it’s one that is quite as unique or revolutionary as Warin seems to think.  Whereas there have always been those who think anorexia is the ultimate kowtowing to what society deems feminine, there have also been those who view it as women protecting themselves from being perceived as feminine, from having unwanted interactions with those who would objectify them.  Perhaps it is really both, which is what makes it so hard to treat.  I believe this is what Warin is trying to say, although she is often not as clear as she could be.  She gets caught up in academic jargon.  She is at her strongest when simply organizing her interactions with the women into themes and presenting them to the reader to do with what they will.

Overall, for an academic look at anorexia this is unique in that it is an anthropological study instead of a psychiatric one.  Looking at a group of people who are a group simply because they share the same illness and studying their anthropology is a truly fascinating concept.  The book is scientific, but it is social science and is thus easy enough for the mainstream reader to follow.  It provides the human aspect of anorexia without sensationalizing.  Anyone with an interest in eating disorders or anthropology will enjoy this book.

4 out of 5 stars

Source: Work Library

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Book Review: The Story of Beautiful Girl by Rachel Simon

February 23, 2012 2 comments

A woman in silhouetteSummary:
Martha, a retired, widowed schoolteacher, thought her life was pretty much over until one night when a young intellectually disabled white woman and a deaf black man show up on her doorstop in the rain holding a newborn baby.  Soon people from a nearby mental institution show up to take them back away.  The young woman, Linny, seems terrified and asks Martha to hide the baby.  The man, Homan, escapes.  Martha goes on the lam to keep the baby girl out of the institution, and Linny and Homan fight against all odds attempting to reunite their family.

Review:
I received the audiobook version of this as a gift for one of the holiday swaps I participated in in December.  It was my first time reading the audiobook version of a modern story, as I’m a cheapskate and usually just get ones for free that are out of copyright.  It was thus an entirely different experience to be forced to slow down when reading this piece of historic fiction about a very dark secret in American history–mental institutions.  The amount of time that Linny and Homan are forced to spend simply waiting for their lives to get better.  Waiting for people to recognize their humanity.  It hit me much harder than if I had been able to read this in a couple of hours.  (Each disc is about 1 hour long, and there are 10 discs).  The wrongness of it all.  The amount of time and lives wasted simply because the able-minded and able-bodied didn’t seek to understand or to grant these people the basic human right of self-direction.

The story itself is told from multiple viewpoints–Linny, Homan, Martha, Kate (a caregiver at the institution), and later Julia (the baby daughter when she grows up).  Mostly Simon does a great job switching among the different voices, particularly representing Linny.  She does not overinflate her internal dialogue to be that of a person with an average IQ, but she still clearly represents Linny’s humanity.  I am a bit skeptical of the voice given to Homan though, mostly his tendency to give people bizarre nicknames like “roof giver.”  I know that neither
Simon nor I know a deaf person who is unable to communicate with those around him, so really it is all guess-work as to what his internal dialogue would be like.  But I can’t help but feel like it’s not quite there.  On the other hand, his confusion and frustration at people talking around him, over him, and treating him like he’s stupid just because he’s deaf is very well done.

In retrospect, I’m not quite sure why so much time was devoted to Martha and Julia when Julia was a baby.  Her story doesn’t end up being nearly as important as the Homan/Linny romance, so this focus feels a bit like a red herring.  I would definitely shorten those chapters.

The use of artwork and items of visual significance to the characters is gorgeous though.  Lighthouses are a central feature, and I don’t even like lighthouses myself, but I still found myself moved by how important the visual arts can be to people.  This is a book that, surprisingly, winds up being almost a battle cry for the arts.  For their value in helping us connect with each other and hold on to our humanity.  I think any artist or someone who is a fan of the arts would appreciate this book for that reason.

On the other hand, Simon is clearly a person of some sort of faith, with a belief in god and the tendency for things to all work out right in the end.  I’m…not that type of person.  So when characters wax eloquent about god or an overall plan or the ability of evil people to repent and turn good, well, it all feels a bit more like fantasy than historic fiction to me.  I probably would have been irritated by this less if I had had the ability to skim over those parts though.

In the end, though, I came away from this book appreciating its uniqueness and all the good qualities it had to offer.  It demonstrates through a beautiful story why it’s so important not to institutionalize the mentally ill or mentally challenged.  It shows the power of love to overcome race and disabilities.  It is the story of the power and beauty of resiliency.

Overall, I recommend this work of historic fiction to fans of historic and contemporary fiction, advocates of the mentally ill or mentally challenged, and those just simply looking for a unique love story.

4 out of 5 stars

Source: Gift

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Friday Fun! (Freelance Editing, Reading Projects, and United States of Tara)

January 27, 2012 8 comments

Hello my lovely readers!  Gosh, things have been hopping here this January, haven’t they?  I’m not sure why my reading has reached such a nice, steady rhythm, but I’m certainly enjoying it. 🙂

A quick announcement.  I’ve decided to start freelance editing.  If you’re at all interested, please check out the dedicated page for more details.  You all know that I’m a trustworthy, hard-working, smart gal, so I’d also appreciate it tons if you’d help spread the news.  Thanks!

I was super-pleased at the extent of conversation and interaction that the first book for the Diet for a New America Reading Project saw.  Thanks guys!  Next month is The China Study, and I do hope as many of you as can will join in with me.  This book is very much less about the US specifically and more about the best diet for human beings in general based on a ground-breaking scientific study.

Tomorrow is the discussion of the penultimate book in The Real Help Reading Project–Blanche on the Lam by Barbara Neely.  It’s hard to believe the project is almost over!  Time flies when you’re learning and growing with a friend. 🙂

On Wednesday I was home sick, and you know how sometimes when you’re sick you just don’t have the focus to read.  I therefore poked around my Netflix account and was pleased to see that the final season of United States of Tara was finally up on instant.  The United States of Tara is a Showtime half-hour show about a woman with Dissociative Identity Disorder (formerly known as Multiple Personality Disorder) trying to learn to cope with her disease without creativity-numbing medications so she can be free again to pursue her art.  I was very pleased with the first two seasons that showed the reality of coping with a mental disease, but that did not demonize Tara or bestow sainthood upon her family members.  I thus was really disappointed to see the third season take such a nosedive, and now I’m thinking I’m going to have to remove it from my recommended list.

The thing that made US of Tara so appealing in the first two seasons was that, yes, sometimes Tara did bad things as the result of her illness, but she was fairly good at finding a balance.  She made mistakes like healthy people, just for different reasons.  In season three, though, Tara develops a new alter who is pure evil.  We’re talking stabby, Psycho sound effects, steals babies and tears her own teenage son’s room apart evil.  This alter is an abuser alter–an alter who takes on the whole personality of Tara’s abuser.  Now this is a real thing in DID (source) but the show handles it all wrong.  Yes, the new alter is scary and would be to all of the known alters, Tara, and her family.  However, having the alter kill all of Tara’s other alters then Tara kill the abuser alter is the exact opposite of how healthy healing from DID works.  Healthy healing is either learning to cope with having alters or integration.  Killing your alters and then proceeding to run off to therapy after the fact shrieks of writers who didn’t get their facts straight.  For a show that started off so strongly and well-supported by the Mental Illness Alliance community, I was really disappointed in this.

The other bad message in season three that really bothers me as an advocate is the change in Tara’s family and how they handle things.  Tara basically becomes too much for them to handle, and they all want to ship her off and lock her up.  Ok, some people do need in-patient treatment, and I definitely would have re-entered Tara into real therapy much sooner than her family does to prevent all this drama in the first place, but essentially the family comes to say that Tara isn’t worth it.  Tara is too much to handle.  They’re just gonna go do their thing now.  They even judge Max, Tara’s husband, for refusing to not continue to stick by her.  He insists repeatedly that he’s neither a stupid person nor a saint.  He just loves Tara.  Yet, in the end, the whole family is torn apart, leaving just Max and Tara.

While it is, unfortunately, very true that a lot of people abandon loved ones with a mental illness, one of the positive aspects of this show was that it let people with a mental illness believe that in an enlightened family unit, it doesn’t have to be that way.  Season three kills all that.  The only one who truly loves and advocates for Tara is Max, and everyone else feels pity for him because of it.  Sad stuff.  Definitely not advocate stuff.

Book Review: Emotional Geology by Linda Gillard

November 29, 2011 8 comments

Mountain in the distance with water in the foreground.Summary:
Rose is a textile artist with bipolar disorder who for years found her medication dulled her ability to work.  After a stunning betrayal that landed her in a mental hospital, she has moved to a quiet, extraordinarily rural island in Scotland in an attempt to control her illness with as little medication as possible so she may still create her art.  Her life isn’t quite as quiet as she imagined it would be, though, with a warm neighbor, Shona, who introduces her to her brother, a teacher and poet.

Review:
A rural island setting combined with art, romance, and mental illness–I knew this book and I would be fast friends before I even started reading it.  What I discovered was a book that addresses multiple universal issues–grief, betrayal, loss, family ties–in a glorious setting that left me dying to visit Scotland, if only to discover what peat smoke smells like.

The style of this book is unique.  Gillard easily transitions between perspectives, points in the time-line of Rose’s life, and even poetry versus prose.  I was astounded to discover that I enjoyed the poetry portions creeping up in the book.  They tend to happen at points of high emotion and exquisitely express the high highs and low lows someone with bipolar disorder goes through.  The changing of perspectives and time-lines could sometimes feel a bit jarring; that could have been smoother done, but I appreciate the style and vibe Gillard is going for.  It almost mimics the jarring highs and lows of bipolar disorder.

More importantly, though, the book exquisitely, gently shows that people with mental illness are just people like everyone else.  They may feel things slightly more strongly or need to work harder to stay balanced, but the mentally healthy have emotions too.  The mentally healthy can be thrown just as badly by life’s experiences.  If I could sum up the book’s point, it would be that we all have scars.

So you see, Rose, if you would just step outside your own fucking head for a few moments, you’d see you’re not the only one with scars. In any case the worst ones, the most disfiguring are never visible to the naked eye.” He zips up his fly. “I can probably live with yours. Can you live with mine?” (location 3816)

This is an emotional, challenging, touching book to read.  I recommend it to fans of contemporary fiction with a heart.

4 out of 5 stars

Source:  Kindle copy from author in exchange for my honest review

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