Science & Research

Psychiatrist’s book seeks to demarginalize mentally ill

‘Falling into the Fire’ explores unusual cases of patients’ self-injurious behavior

Contributing Writer
Wednesday, October 9, 2013

A woman who swallows steak knives, a mother who constantly imagines injuring her child and a tunic-clad young man who fixates on the love radiating from his surroundings are all psychiatric patients featured in a new book written by Christine Montross, assistant professor of psychiatry and human behavior at the Alpert Medical School and a staff psychiatrist at Butler Hospital.

The book, “Falling into the Fire,” is a humanistic account of Montross’ encounters with psychiatric patients.

“There’s a tendency for people to marginalize the mentally ill or cast (them) as a population that is all very different from us,” Montross said. “It’s important to me to write about patients in a way that emphasizes their humanity, so that readers won’t view them as strange or peripheral.”

When selecting which stories to include in “Falling into the Fire,” Montross said she chose those she “could not stop thinking about.” Though the general public may know of psychiatric patients who inflict self-harm by cutting or burning themselves, Montross said the cases she describes in her book are more esoteric.

The case that has sparked the most public interest involves a woman who swallows dangerous objects again and again, Montross said. The patient — also featured in an earlier New York Times op-ed piece by Montross — makes frequent trips to the emergency room but cannot afford regular psychiatric care. The chapter that contains the patient’s case focuses on the complex emotions the woman evokes in the people who care for her, Monstross added.

Holding both a masters in poetry and a medical degree, Montross bridges the gap between the two often disparate fields of mental health and creative nonfiction.

In order to balance writing with her medical career and personal life, Montross said she has a very specific schedule that she “created by design.” She works weekends at the Butler Hospital and spends one to two half-days at the Med School. During the rest of the week, she can focus on being a mother and on writing.

Montross first became interested in psychiatry as a graduate student at the University of Michigan, when she encountered portrayals and themes of madness in her study of poetry. As she interacted with troubled teenagers during a stint as a high school English teacher, her interest intensified. After considering becoming a social worker or a clinical psychologist, Montross decided to go to medical school. Her first book, “Body of Work,” documents her experience as a student at the Med School.

During her psychiatry residency, Montross “was a keen observer, definitely extremely bright and focused,” said Steve Rasmussen ’74 MMS’77 MD’77 P’13 MD’17, chair of the psychiatry and human behavior department at Alpert and former medical director of Butler Hospital.

Though she writes nonfiction, Montross’ prose style has a lyrical quality, owing to her Master of Fine Arts in poetry, she said.

She said her poetry background has been helpful to her practice as a physician as well. “Poetry is looking closely at things and drawing conclusions — medicine is like that, also,” said Montross.

The book has been well-received, Montross and her colleagues said. She said both laypeople and other professionals in the psychiatric field have contacted Montross about “Falling into the Fire.”

Montross’ writing prompts readers to reflect on “familiar situations (they’ve)encountered in (their) lives that maybe (they) haven’t understood,” said Professor Emeritus Ted Goslow, who instructed Montross in anatomy at the Med School.

Montross said she hopes her book “gives people an appreciation for the vast capacity of the mind and the many ways that it can derail.”

She said she is in the beginning stages of a new book about mental health in prisons and “the confluence of mental health and the judicial system.”

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  1. HaroldAMaio says:

    —Psychiatrist’s book seeks to demarginalize
    mentally ill

    —“There’s a tendency for people to
    marginalize the mentally ill or cast (them) as a population that is all very
    different from us,” Montross said.;

    Apparently she does not know us. For a
    psychiatrist that is more than curious.

    We are about 20% of society, we earn to the
    million, hold every university degree, and every professional, white,
    and blue collar job. That does not sound like marginalized to me. I
    wonder how many students at Brown are dealing with a mental illness and are
    marginalized there.

    Harold A. Maio, retired Mental Health Editor

    • The people you speak of are not marginalized because they are petrified to tell anyone about their mental illness because they will then be marginalized by their colleagues, bosses, neighbors and friends. Mental illness is still not accepted as a real disease/condition by that other 80%. If they cannot see what is wrong with you, they cannot imagine how it feels. Therefore it doesn’t exist. How many mentally ill students, staff, or faculty have parents who refuse to discuss it with them? Or have children who don’t want their parents to meet their friends because the parent is mentally ill.

      As someone who was diagnosed with major depressive disorder, recurring, and has two bi-polar siblings, and one with borderline personality disorder, I know marginalized. Two of them cannot keep a job anymore, even though one was a teacher, and then later adjunct faculty with three master’s degrees and ABD.

      Two of us are in that 20% who are out there working in the real world, and we rarely talk about our illness because we are very used to how people behave, even in this bastion of liberal learning, when you tell someone just how ill you are and how you will never be able to survive without medication and therapy. They judge you, and find you lacking. The best, most interesting projects go to other people, because they are worried you can’t handle it. You take a couple of sick days and your boss wonders if you are sick or “just depressed”, like it isn’t really sick.

      So perhaps we should all read the book and then talk about the marginalized and the 20%.

      • HaroldAMaio says:

        … we rarely talk about our illness because we are very used to how people behave, even in this bastion of liberal learning
        The president of Brown needs to hear your statement. Please take that initiative.
        My experience was quite different.
        One evening in a night class my graduate school professor asked why I was so animated. I said, maybe it is the high following my suicide attempt this morning.
        Each of my German professors rallied around me. I got my Master’s Degree and a teaching assistantship.

        • I wasn’t necessarily talking about my current experience at Brown. I have a fabulous and understanding boss. Not everyone is so lucky.

    • Your post is distorted and you know it. She is talking about the seriously mentally ill not those with clinical depression, narcissism which you have plenty of, or other high functioning mentally ill people. Within the 20% you cite, there are a large percentage who are marginalized, untreated, homeless, and incarcerated. Try to post something Harold that is part of the solution and not just to hear yourself talk or read what you write in print.

      • HaroldAMaio says:

        “The” mentally ill is a distortion.
        I agree with you that there are people who are marginalized, defining them accurately is necessary to solutions.

        I disagree with you that among the 20% is a large percentage marginalized, It is a small and very significant percentage we are failing.

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