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Psychiatrist’s book seeks to demarginalize mentally ill

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

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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