Excerpt from The Great Pretender by Susannah Cahalan, plus links to reviews, author biography & more

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The Great Pretender by Susannah Cahalan

The Great Pretender

The Undercover Mission That Changed Our Understanding of Madness

by Susannah Cahalan
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  • First Published:
  • Nov 5, 2019, 400 pages
  • Paperback:
  • Jul 2020, 400 pages
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Print Excerpt


One email I received was from the father of a thirty- six- year- old man who had struggled for two decades with debilitating psychosis. He told me how little modern medicine had been able to offer. "They seem to blame my son for his 'psychiatric illness' on the basis that he has no 'physical illness' that they can heal," he wrote. The drugs, the only treatment offered, had not helped, but actually made him worse. Despite his family's pleas for other options, the response was, "Take the drugs—or we'll force him to take them."

The father recognized his family's plight in my own story and had been inspired by my parents' successful pushback against the medical system. My recovery bolstered his determination to continue searching for more meaningful answers for his son. But something I'd said subsequently had troubled him. In his email he included a YouTube link to an event where I'd spoken at the release of the memoir's paperback edition. As I watched the clip, I felt like I was being slapped in the face by my own palm. He quoted my words back to me: "My illness appeared as if it was a psychiatric condition, but it was not a psychiatric condition—it was a physical condition."

This father felt betrayed hearing me utter the same unfair distinction that he so often heard from his son's doctors. "The brain is a physical organ and physical disease occurs within the brain. Why does that make it a 'psychiatric condition' instead of a physical 'disease'?" he wrote. "What am I missing?"

He was right, of course. How had I so wholeheartedly embraced the same unproven dichotomy that could have confined me to a psychiatric ward, or even killed me? Was it my need to believe that, because I had a physical disorder, I had been "cured" in a way that set me apart from people with psychiatric conditions? What else had I—had we—accepted as fact that may have been dangerously reductive? How many fallacies about the mind and brain have we all just been taking for granted? Where did the divide lie between brain illness and mental illness, and why do we try to differentiate between them at all? Have we been looking at mental illness all wrong?

To answer this, I had to heed the advice that my favorite doctor, my own Dr. House, neurologist Dr. Souhel Najjar, often gives his residents: "You have to look backward to see the future."

Excerpted from The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness. Copyright © 2019 by Susannah Cahalan, LLC. Reprinted with permission of Grand Central Publishing. All rights reserved.

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