The Lives They Left Behind: Suitcases from a State Hospital Attic

#234
Title: The Lives They Left Behind: Suitcases from a State Hospital Attic
Authors: Darby Penney, Peter Stastny, Lisa Rinzler (photographer)
Publishers: Bellevue Literary Press
Year: 2008
205 pages

Terribly disappointing because it could have been wonderful, but instead suffers from repetitive, barely-restrained vitriol. The book's ostensible focus is on reconstructing, from suitcases left in the attic, the lives of people who were patients at a residential psychiatric hospital. This is an interesting proposition, but it is not pursued hermeneutically or adequately. The problem is not that the authors have a point to make and use the case studies to support it. Rather, they are not sufficiently up-front about their agenda and present a veneer of scientific inquiry to convey their neutrality. However, they are not neutral, and their thesis is ill-served by not being explicitly described.

An otherwise-interesting topic is marred by heavy negative over-generalization, failure to stick to the topic it proposes to present, and failure to separate the issue of type and quality of care from the question of what to do when a person is unable to manage in society. Making the book worse is poor editing, both in terms of sometimes-confusing organization and flow, and unclear and repetitive statements. Some important information and explanation are also missing (for example, whose hands are holding the people's possessions in the photos, and is it journalistically suspect to have used hands that appear to match the person's demographics?). Another area that seems deceptive and detracts significantly is the authors' contradictory attitude about the patients' privacy. On the publishing information page, they report that they would have used patients' names but for privacy laws. I can understand this regret; my dissertation study participants wanted me to use their names and I was not permitted to do so. However, the authors' desire to use names stems from their own wishes, not their subjects', as their subjects are dead. Presumably if the patients' relatives had given permission, the authors could have used the patients' names (since the survivors hold the decedents' privilege). It is possible that the patients would not have wanted their names used. In this light, the authors' use of people's first names, full-face photos, and potentially identifying information seems both coy and unethical, as well as unnecessary and provocative. Who is it who was stripped of their autonomy and used for other people's ends by the bad legal/medical/psychiatric abusers? And whose privacy is abrogated by the authors, for their own purposes? Hmm.

I support the authors' contentions that psychiatry has been used as an instrument of social control and management, that patients were and are pathologized and disbelieved, and that they often receive inadequate care, especially in public institutions. This is widely documented and more effectively demonstrated elsewhere, though it bears repeating. The authors could have used this book more effectively for this purpose had they constrained their editorializing and not engaged in multiple instances of extreme and overgeneralized assertions. For example, they don't give any examples of people who they think need any kind of psychiatric intervention, yet also condemn the state and psychiatric/medical profession for not providing other services. Perhaps most egregiously problematic, they condemn the objectification of the patients and the loss of their complexity and humanity, yet by only portraying the parts of  patients' histories that support the authors' perspective, they also treat the patients as objects that serve the authors' ends.