A Bibliography of Mental Patients’ Autobiographies: An Update and Classification System

Autobiographies written by individuals diagnosed as mentally ill are available in the English language going back at least as far as the fifteenth century. The formats of these books range from privately printed tracts with little or no editing to books issued by major publishers. Several accounts, such as those by Schreber (1) and Beers (2), have become classics in mental health education, while others remain largely unknown. There are at least 25 published bibliographies and anthologies (3-27), the latter often meant to be used as corollary readings in psychopathology classes. These anthologies have brought the books to the attention of a wide audience of students, practitioners, and the public. Several of the autobiographies have been made into feature films.

Other types of books about individuals with mental disorders, such as biographies, case studies, and fictionalized accounts, can be useful data sources and teaching tools; however, we have chosen to focus on autobiographies for several reasons. First-person narratives provide a valuable archival record of the phenomenology of mental disorder and the changes that have occurred in diagnosis, treatment, and public response over several centuries. This genre views mental disorder from the inside looking out, drawing upon the human capacity for self-description and self-analysis. In this way, memoirs complement research and case studies performed from the outside looking in. The accounts are written in the person’s own words and emphasize issues that the writer, as distinct from a clinician, deems important. The books are interesting to read as narratives with a strong story line. Some authors are celebrities for whom a large amount of biographical information is available, permitting comparison of multiple data sources. The accounts show the disorder in its family and environmental context. The books span different centuries and cultures and include women and men of different ages, occupations, socioeconomic classes, and education, representing a multitude of diagnostic categories and treatment procedures. One can find personal descriptions of exorcism, purging, leeches, insulin coma therapy, ECT, pharmacological treatments from ancient to modern times, various types of psychotherapy, and self-help groups.

In general, the accounts are independent of one another, in that the authors give little indication of having read other books in the same genre. This particularity increases the research value of the autobiographies. Memoirs represent an archival data source amenable to qualitative and quantitative analysis that can be used to test theories. As an example, a systematic tabulation of visual hallucinations described in the autobiographies found that the majority occurred under conditions of reduced sensory input, as when the person was in isolation and sometimes physically restrained (20). Finally, the autobiographies portray mundane aspects of mental hospital life not often discussed in the clinical literature, including clothing policies, noise levels, the palatability of hospital food, visiting regulations, and the general provision of privacy in treatment settings. Some authors are noted writers, poets, and artists capable of portraying in words and drawings, beyond the talents of most clinicians, the inner world of mental illness. The updated listings include novelist William Styron’s moving description of severe depression with its suicidal impulses and songwriter Dory Previn’s haunting lyrics that depict thought disorder in schizophrenia. Autobiographies have been included in the curriculum for training mental health professionals (28). Some cross-validation of accounts written by patients can be found in books and articles by nonpatients, including journalists, psychiatrists, and social scientists, who lived on mental hospital wards as participant observers (29-33).

Almost 40 years ago, the first author and his colleague Humphry Osmond began a systematic compilation of these published narratives (20-22). For a book to be included, it had to be a first-person narrative by someone who had been hospitalized for a mental disorder. This necessarily excluded fiction, biography, and case studies written by a second party. Collaborative works, such as a book co-authored by a patient and therapist, were acceptable if the patient was specifically listed as an author. At the time, we included only books by individuals who had been hospitalized for mental disorder, in order to avoid being overwhelmed by accounts of anxiety and distress with little basis for making qualitative or quantitative distinctions. In our view, the research value of the list was increased by consistent use of these criteria, even at the cost of excluding sensitive portrayals of mental disorder and treatment, such as Ward’s The Snake Pit (34) and Plath’s The Bell Jar (35), which were technically classified as fiction. A parallel literature exists of first-person accounts by family members that is beyond the scope of this article. Because there are literally hundreds of first-person accounts written by individuals hospitalized for a mental disorder, there seemed little reason to seek out and include marginal cases.

The present article is intended to update earlier lists and to provide a framework for classification and further analysis. As of this date, there have been few attempts to classify the books according to factors other than diagnosis. This is understandable, since previous bibliographies were prepared before widespread use of electronic data processing. The capacity to locate autobiographies written by individuals in specific occupations or social categories and with a particular disorder, e.g., an artist or writer with schizophrenia or a therapist with bipolar disorder, would increase the usefulness of these books for patients and family members. Earlier bibliographies and especially Peterson’s list (16), which is based on his 1977 dissertation, include very few titles published after 1980, so we will use that as our starting date. Because outpatient treatment has become a more feasible option, the updated list waives hospitalization as a criterion in cases in which an individual has been diagnosed with or treated for a major mental disorder or both. Several titles are new editions or reissues of earlier books that had been out of print. In these cases, the earlier publication date is given in parentheses following the date of the current edition.