Abstract
In the book, Surrounded by Madness, Dr. Rachel Pruchno, an established professional and successful scientist, presents a clear picture of her life as the mother and daughter of loved ones with mental illness. She also reveals that having a scientific background does not protect her from the pain and feelings of helplessness when both her mother and daughter present behaviors that break her heart.
Pruchno attempts to be a voice in advocating for her daughter with a mental health system that is disjointed and lacking in support. The author shares her disbelief that the same system that failed her mother is now failing her daughter decades later. While Dr. Pruchno describes herself as having a voice and empowerment in her professional role, this book is her personal narrative and not an academic text. Dr. Pruchno’s relational voice is seldom heard by the medical mental health system or the criminal justice system that is unable to protect her daughter from an online predator.
Pruchno’s role as the researcher and mother move back and forth as she attempts to understand her daughter’s challenging behaviors by researching the literature on her daughter’s most recent diagnosis, reaching out to professionals and attempting to understand what is going on. Yet, as a mother, her voice is still relatively quiet as she struggles to “fix” her daughter’s problems. Is her stress and self-judgment harsher because society expects mothers to solve problems?
The relationship between daughters and mothers runs through the book. As her daughter’s behaviors become more serious, she questions whether she is a good mother. Were her limitations a result of being mothered by a woman with mental illness? She continues to struggle with society’s expectations that she be a “good mother.”
As she describes the day-to-day challenges of her life with her daughter, the reader empathizes with her exhaustion and her despair. It appears her exhaustion related to coping with daily struggles prevents her from joining with others to advocate for changes. Only after her daughter leaves the house does she seem to find the energy to reach out to others for emotional support. Pruchno’s goal in writing the book was to no longer keep hidden the secrets of mental illness in her life. She indicates that she regrets not asking for more support from others.
This book offers the reader a personal story of the pain and shame of mental illness in a family. Dr. Pruchno states that she needed to share a story where, sadly, there was no happy ending. She reminds readers that many of the large systems in the United States, such as health care, educational, and criminal justice, oppress women as they attempt to care for their families and themselves. She offers detailed examples of how these systems failed her daughter, her mother, and, by their lack of support, her. Social work students and women are reminded that the advocacy needed to improve these systems to support caregivers and families remains unfinished. Discussion questions are offered at the end of the book to expand on these topics.
Women continue to be the primary caregivers within the family, and for those women caring for someone with mental illness, this book validates their struggles with nonsupportive systems. Policy makers would benefit from reading this book to remind them of the real challenges family members face when someone they love has a mental illness. Do policies support the rights of those with a mental illness while also balancing their inability to make safe decisions? Policy makers are urged to listen to the voices of those caring for the person with mental illness to assist them in answering this question.