A Review of A Kind of Mirraculus Paradise: A True Story About Schizophrenia

Let me make something clear from the start: Sandra Allen’s A Kind of Mirraculus Paradise: A True Story About Schizophrenia really is a piece of anti-psychiatry propaganda. 

The book opens with the author recalling how their estranged uncle, “crazy” Bob, had contacted them shortly after Allen had enrolled a graduate writing program. Upon learning that Allen is a writer, Bob calls them to say, “Hey, I wrote a book, man. I wrote the story of my life.” Not too long after that, Allen receives a bizarre manuscript from Bob in the mail, along with a note apologizing for its “messiness” and an offer to pay for Allen’s services. Of Bob’s typewritten transcript, Allen writes that it was “hideous to look at, even from a distance,” describing a “wall of text” in “almost exclusively capital letters, with no paragraph breaks” and “colons everywhere.” Allen thought it “stank like cigarettes.” Upon reading through several pages, Allen considered the possibility that Bob’s story might be a product of delusion or a calculated lie. Allen continued to read Bob’s manuscript, but when some of the language became “explicitly racist,” Allen chose to disengage. As Allen tells it: “I wanted to ignore it the way you ignore a urine-soaked pile of coats on a sidewalk or a man on a park bench screaming obscenities.”

AKOMP is not about schizophrenia, but about feeling toward schizophrenia. It’s is an experimental and contentious narrative, elegant in its execution and almost deficient in every other way. The author, Allen, an accomplished journalist and editor, takes on the topic of schizophrenia from an unconventional and experimental angle. The book oscillates between these two different narratives written in different fonts. In the first narrative, Allen tells Bob’s story. In the second narrative, Allen attempts to address larger issues pertaining to mental illness by investigating the conceptual and diagnostic meaning of schizophrenia, as well as the changing ways American psychiatry has treated madness. “I am no expert in so many of the complicated topics at hand,” Allen concedes early in the book. While Allen promises to vows to “compensate” by learning as much as possible, it quickly becomes painfully apparent that Allen hasn’t put in the research.

Allen’s own “reportage” on mental illness is dismal, unrigorous and tinged with a distinct moralizing anti-psychiatry ethos that bodes ill for the rest of the project. The book contains significant errors. The author’s reliance on several single-minded, simplistic talking-points mar what is otherwise an eloquent and entertaining experimental illness autobiography.

The first page of Bob’s manuscript, his own writing (in lowercase): “this is a true story of a boy brought up in berkeley california durring the sixties and seventies who was unable to identify with reality and there for labeled as a psychotic paranoid schizophrenic for the rest of his life.”

This theme of truth and veracity is invoked and reinvoked throughout the book. Allen recounts, somewhat regrettably, conducting a meticulous, fact-checking of her uncle’s story, including interviewing family and “comparing Bob’s facts with what I could confirm elsewhere in letters, report cards, resumes, and the accounts that people were giving me.” Allen’s investigation of the world around Bob strikes at the core theme of the book.

Allen seems to fear the delusion of Bob’s account of reality. And yet, Bob’s narrative is not where the careful reader should cast their suspicions. It’s Allen’s so-called “journalism” that has more in common with a Washington Post op-ed or Mad In America blog or Tom Friedman column than anything that is verifiable, fact-checked, and deeply committed to accuracy.

There are errors in AKOMP and they are chiefly mischaracterizations of medical treatment. Case in point, in a passage occurring about halfway through the book, Allen claims that psychiatric medications such as antidepressants and antipsychotics medication are “addictive” because “some” patients who “choose” to stop taking them often experience withdrawal symptoms.

Some people who’ve chosen to quit neuroleptics often find that comes with an excruciating period of withdrawal. Some feel that the addictiveness of these drugs isn’t sufficiently studied or communicated to patients.

In the passage above, Allen hopes you will conflate drug dependence and drug withdrawal with drug addiction and accept this unsubstantiated claim, which is a prominent talking point in anti-psychiatric circles, then assume that withdrawal from prescribed neuroleptic medication is just as harmful as someone withdrawing from heroin or opioids.

But let’s read this more closely and think about what is going on here. Allen is trying to convince us that prescribed neuroleptic withdrawal constitutes an “addiction” for those who choose to stop taking these drugs. Yet, drug dependency and withdrawal occur with many prescribed and legal nonprescription substances, sometimes resulting in “an excruciating period of withdrawal” for “some people.” Furthermore, if we understand the concept of addiction to involve some element of pleasure or positive reinforcement that leads a person to misuse or abuse a substance, it becomes even less compelling to argue that antidepressants or antipsychotic drugs are “addictive.” That’s not to discount the seriousness of withdrawal, which can certainly be “excruciating,” but they hardly fulfill addiction criteria. If I were to guess, however, I’d say that Allen is trying to push an anti-medication agenda, while appearing to offer a “critical” and “balanced” account of a complex topic. With the neat phrase “some people,” these words are divorced from their author and neutralized of their intent. It’s an incredibly irresponsible approach that Allen adopts throughout the project.

In another example, Allen unsubstantiated claim that “electroshock therapy” can cause comas should stick out like a thousand sore thumbs.

[Agnes] recalled hearing he had undergone electroshock therapy at Herrick Hospital. Gene wasn’t sure whether that was the case; Bob made no mention of it in his manuscript. (The controversial therapy can cause memory loss and comas.)

The parenthetical is key. A citation or example would go along way here. But Allen provides no evidence whatsoever, even anecdotally, that comas are a side effect of ECT. Probably because there isn’t any. While a cursory Google search on the topic came up empty, a colleague managed to find a single article from the Journal of Clinical Psychiatry reporting a case of coma occurring in a psychotically depressed man. But it wasn’t the ECT. Rather, the source of coma was reportedly due to the IV administration of droperidol during post-operative recovery. This article contains 9 citations and none of them lead to another relevant case.

It would be one thing if these two instances of unsupported and questionable examples of bullshit claims masquerading as facts were honest mistakes in an otherwise “true account of schizophrenia.” But, of course, they’re not. Other mistakes fall into two overlapping categories: poorly researching the issues and rhetorical strategies.

As Allen explained in one interview, an additional goal of this book is to successfully address bigger questions concerning mental illness, such as: “What is schizophrenia, what is mental illness? What is known about a category like schizophrenia and what is not known?” Compounding my discomfort with this book is the author’s superficial treatment of this topic.

Repeatedly, Allen writes of “some people” as if they are a meaningful metric. “Some people.” Who are they? No one knows. How many of them are there? Some. How many is “some”? 5? 20? 100? No one knows.

Some people feel that no amount of research will ever yield answers to basic questions about schizophrenia because the word ‘schizophrenia’ doesn’t refer to any actual disease. They argue that psychiatric diagnoses only reflect the biases of those giving them, whether individual or social. They point to antique diagnoses that, in hindsight, betray this phenomenon completely.

Certainly, the existence of multifarious reactions to the etiology of schizophrenia, the validity of the diagnosis itself, and the potential for research to find answers need no citation, but by offering zero studies, data, examples or empirical basis for such a claim, Allen’s statement is useless. Why is Allen writing any of this? What is the point? What exactly are we talking about here?

In my experience, people who’ve been psychiatrically diagnosed feel a variety of ways about their diagnosis and about the field of psychiatry itself. Some who’ve been told they have schizophrenia agree with the diagnoses, and some feel that psychiatric medication has saved their lives. Others of the opposite persuasion champion for the abolition of psychiatry entirely.

Allen engages in a false dichotomy, presenting the experience of diagnosis and of the psychiatric discipline as either cheerleaders of the life-saving benefits of psychiatry and, notably, psychotropic medication, or the opposing “critical” anti-psychiatry anarchists, who’ve read the writing on the wall, and seek to burn the psychiatric establishment to the ground. It’s an argument that don’t really need to “proven” or justified with evidence since it’s nearly impossible to argue with.

No two people I’ve interviewed or resources I’ve read about mental health care in America have felt the same way about what the right treatment should look like. But most everyone who follows these issues agree that the situation at present is quite grim.

You certainly don’t have to cite your own experience, but statements as abstract as this require context and elaboration. It should be easy to name one person among series of “no two people” and “most everyone.”

As some alternatives have taken root in this country in recent decades, others have worked to oppose them.

That’s great. But what alternatives are you talking about? Rhetorically, these “both sides” statements feel good on their face, even though they are intellectually vacuous. The problem is that Allen seems untroubled by and uninterested in the question of what, exactly, or how, or why this is occurring.

And, so, boringly, on. This book is full of silly arguments. If you’re sensitive to language, your eye and ear will snag on these statements. Their persuasive ability comes from their ability to sound plausible and intelligent and to be quickly forgotten about. It’s a manipulative way to write.

It’s sad because this book has moments of genuine eloquence. To be sure, the book is very personal, very well-written, but it’s also not very exciting. It’s actually quite dull. It’s worth asking yourself: what is Allen telling us here that we don’t already know? What have we learned?

Why should this matter? Because the value in Allen’s “true story about schizophrenia” comes from its power to nurture critical thinking and promote empathy among readers. Allen’s lack of rigor, care, and self-reflection betray an authorial intent that seems fueled by self-interest and exploitation rather than curiosity and care for people with severe mental illness. In this way, Allen’s project undermines both our understanding of schizophrenia and our ability to foster genuine empathy for people deemed to be a less-than-fully human threat to society.

If AKOMP had focused on Bob’s story alone, it would be have been an excellent contribution to the understanding of schizophrenia. So why did Allen step out of their zone of expertise to profile the meaning of schizophrenia itself?

It’s not my place to question the author’s emotional life, and it’s entirely possible that the mistakes made by the author are the result of misinformed or poor research, so let’s skip to another question concerning fact-checking: if this book was fact-checked, why are there so many errors? One answer is that Allen was intent on shoring up a conclusion they had reached well before they began their reporting for this book.

As it happens, Allen considers the kind of pre-mature conclusion bias in the context of making sense of Bob’s life story:

Had I read Bob’s manuscript only up to the description of his first stay at Herrick Hospital, I might have supposed it was a screed against psychiatry as a whole. Or that he disputed the idea that there was something going on inside his brain, something that made it hard for him sometimes. But his manuscript didn’t dispute this; perhaps it’s what he meant when he wrote on his manuscript’s cover page that he was unable to identify with reality.

Indeed, a troubling consequence of the author’s apparent anti-medication position is how it seems to be at odds with the reality of Bob’s life. By all accounts, Bob seems to have embraced medication and psychiatric care, even after experiencing violent and traumatic hospitalization. There’s no doubt about the horrifying description of Bob’s early hospitalization, where he was forcibly medicated and abused by staff. Still, he kept taking his medications, even despite the awful side effects. For instance, at the age of 55, Bob writes: “IM STILL ON MEDS, AS LONG AS THE GOV. PAYS FOR THIS SHIT, ILL KEEP TAKING IT.”

In another example, Allen lumps Bob in with “many people” who “call the diagnosis [of schizophrenia] itself as ‘label,’ a tool used to discriminate against, confine, discredit, and silence.”

Surely, as is clear from context, neither Bob nor Gene defined “label” as “a tool used to discriminate against, confine, discredit, and silence.” Indeed, I would argue that the average person (even “most people”) would understand “label” to indicate a name or category or classification that is someone attached or assigned to a person. This may not seem like a big deal, but I would argue that by overlooking this and letting it slide, the implication is that Allen is a better source, having already provided the word with a specific meaning—one that the reader is invited to fall back on. It doesn’t matter that Allen’s definition may be completely distinct from how Bob understands the term “label” – as a general name, classification, or category that is applied to something or someone, as is implied several pages later when Allen reports that Bob’s father, for whom the diagnostic category of schizophrenia carried little meaning, “also referred the diagnosis as a label.”

I find it oddly unsettling that Allen cannot – or will not – offer any satisfying explanation for writing Bob’s story. The most expansive answers come early in the book, when Allen expands on the process of translating or “covering” Bob’s manuscript:

I wrote my version of it, referencing his account as my guide. I kept going, really studying a chunk of his story and then writing it in a way that captured his spirit as vividly as I could.

Writing this way forced me to read his book closely, to try to understand every single phrase, no matter how seemingly unintelligible. Occasionally, I’d still decide that the way he’d put something was just too beautiful or funny or moving—or profane—to chance, and so I’d leave it his way. The capitalized words and phrases served as reminders, too, that this was someone else’s story.

Allen indicates that their they’ve “never had good answers” when asked what interested them about Bob’s story. It seems like an important question. Allen suggests that a “more interesting question” is why they kept writing, not why they began in the first place. It feels like a fatuous question designed intentionally bring about a particular kind of reading (or misreading). Put differently, Allen’s suggested question seems designed to protect the text from close reading. I could be wrong.

Allen also doesn’t reflect on the ethics of appropriation or their rights to claim authorial control over a story that’s not their own and without the permission of the original author. Allen doesn’t reflect on the representational politics of writing a story from a place of privilege about a topic which with they are self-admittedly (and demonstrably) have little to no expertise in. The utter lack of self-reflection combined with several other  things raises a profoundly important question: Is Allen the correct person to write this book? 

Here’s my question: why is Bob not included as a co-author to this book? The bulk of the book is his story (as told by Allen). What’s the justification for such a glaring oversight? Allen doesn’t offer any satisfying answers. The best we get is an early passage, where Allen describes writing their version of Bob’s story, “referencing his account as a guide,” with the added assurance that they wrote the book “in a way that captured his spirit as vividly as [they] could.” Yeah, but how? Allen offers nothing. 

Finally, did the following really happen?:

I am curious about one particular event from Bob’s life, which I must be honest, reads as being completely made-up. The event in question occurs during Bob’s awful hospitalization and comes after he describes a promise from his friend Bart that, when he was discharged, he would protest their treatment by “going to the press” and telling the world about the conditions of the hospital. The passage, which comes early in the book, didn’t raise red flags at the time since the reader accepts that some of what Bob autobiography entails may be fantasy given the nature of his state of mind. However, in light of Allen’s admission at the end of the book, where they expresses meticulous attention to the factual quality of Bob’s memoir by fact checking Bob’s life details, including his time in the military, where he went to schools, and even verifying his certificate in welding, and then following up all of that by comparing stories and notes with family, something about Allen’s acceptance of Bob’s story of watching television in the hospital dayroom only hours after Bart was discharged only to see his friend on the news, protesting the treatment at Herrick Hospital and speaking to a reporter. Specifically, Allen writes:

That evening Bob was sitting on the sofa in the dayroom. On the news, a big black guy surrounded by protestors was talking into a reporter’s microphone. It took Bob a moment to recognize Bart, in part because he was wearing fatigues, not pajamas.

What was Bart doing on TV?

He was flanked by about twenty-five people. They were holding signs; one said SHRINMKS KILL: Bart was yelling something.

It seems relatively easy to verify if it did since it was a televised segment. And given that Allen later describes investigating Bob’s dog to make sure it was real and jokingly attempting to verify Bob’s story about meeting Kenny Rogers as a patient in a psych ward and playing music with him Allen describes reaching out to Rogers, but not getting a response, which conveys some degree of incredulity on Allen’s part, although they do not come out and explicitly express disbelief. This doubt is not present anywhere in Allen’s telling of Bob seeing his friend on television the very day he was released, keeping his promise and whistleblowing on the hospital. In fact, Allen seems to double-down by offering some plausible explanation, perhaps sensing that the reader may harbor doubts, Allen points out that: “The first antipsychiatric protests were held around then, in Berkeley and a few other American cities—which perhaps explains what Bob saw Bart participating in on TV.” For me, the disbelief is based on the wild coincidence that a psychiatric patient would be discharged and able to contact appropriate media people that day and be taken seriously enough to be put on television and then Bob, while locked up in a very rundown and by all accounts abusive psychiatric institution would be watching that television news station that evening at the same time. It just all seems so implausible.