The science of psychology is abundant with well-developed theories that ascribe great importance to social influences and consider development as mainly culturally determined. Vygotsky’s cultural-historical theory is probably the best possible example, but one may also include all the varieties of modern interactionist and social-constructivist approaches.

Furthermore, one can very often find many standpoints, all different in their specific objectives, their conceptual apparatus, and empirical foundations of their data (and ranging from Georges Canguilhem’s philosophical approach to Thomas J. Scheff’s sociological theory to the social psychiatry movement, to name but the few), which try to explain the etiology of mental illnesses as determined interactionally and/or mainly by social factors.

In this tradition, there are numerous scientists whose object is to provide empirical corroboration for various above-mentioned theoretical edifices. One of them is certainly the author of the book Media Madness. Public Images of Mental Illness. Dr. Otto F. Wahl is a clinical psychologist and a professor at George Mason University, Fairfax, Virginia. During his career of almost thirty years, he has written two books, more than 30 papers, and more than 20 educational articles. And, as he declared on his home-page, after he started dealing with the problem of stigmatization of persons with mental illness in 1980, his "major area of research interest is in public perceptions of mental illness, mental illness stigma, and mass media depictions of mental illness."

As to the style, the book is clearly written, always concise, and very well documented. All chapters are extensively referenced and one cannot but admire how thoroughly Dr. Wahl investigated his topic. The illustrations are almost always to the point, and the bibliography and filmography included at the end of the book (which contain several dozens of books, TV shows, and films "about Mental Illness" released since 1985) are both a proof and inspiration for further research.

As to the contents, the author’s project is to describe and illustrate the ways mass media depict people with mental illnesses. After revealing many empirical data about extreme frequency of ‘media images of mental health,’ which show that an average US media consumer practically cannot evade being faced with them every day, he goes on to conclude that "overall, the mass media do a poor job of depicting mental illness, with misinformation frequently communicated, unfavorable stereotypes of people with mental illnesses predominating, and psychiatric terms used in inaccurate and offensive ways" (pp. 12-13).

Having established this fact, the author tries to analyze the stereotype of mental illness that media communicate to their wide audiences. He discovered that they portray persons with mental illness as remarkably different, as "a breed apart" (title of the third chapter), as if the aim of the media were to reassure the recipients that it could never happen to anyone among them.

How could one underline this difference between "us and them"? One way is to laugh at them. Another is often described and discussed distancing by projection. And so, apart from mere being different, the mentally ill persons are depicted as extremely violent, as if they were totally unpredictable, dangerous, and ferocious. Although various data show that truth is quite the opposite, Dr. Wahl provides numerous examples to corroborate the claim that "[a] trait of mentally ill characters in the mass media is that… they are tinged with evil. They are more than just criminals. They are morally tainted. They are bad people" (p. 75).

What follows is a discussion of the importance of this convincingly described situation. I believe that by now we all know how much and in which way the mass media mold our minds. But Dr. Wahl establishes a few more facts. The first among them is that "the public identifies the mass media as their primary source of information about mental illness" (pp. 87-88). Furthermore, people believe what they hear and see. One can easily draw a conclusion that public attitudes about mental illness are mostly influenced by the mass media’s inaccurate depiction. And last but not the least, "patients in psychiatric hospitals watch even more television on an average day than does the rest of heavy-viewing public" (p. 105). For them and those who care for them this is an insult, damage to self-esteem, and a cause for withdrawal.

Possibly the least elaborated part of the book is the author’s effort to provide the reasons for this situation. Although he offers six reasons for this kind of media images of mental illness, his efforts are rather superficial and not very convincing. Even when he starts in a good direction he ends in retelling and quoting. One gets the impression that the author probably decidedly avoided to scrutinize and discuss the relevant data and opinions. This part, I am afraid, cannot satisfy a professional. On the other hand, that could make the book all the more attractive for a lay public, which is its main target.

On the other hand, the book closes with the most inspirational part. Contrary to opinions of many important authors (very succinctly put by David Cohen: "In the mental health field, it seems that real ‘progress’ remains impossible since laypersons and professionals alike have not changed their thinking in over two centuries: they still misunderstand madness; they still desire to repress the mad because they fear them; and they are uninterested in policy, except during brief periods surrounding publicized incidents"), Dr. Wahl presents his efforts as a part of an ever-growing front. The list of activities performed by people and various organizations dedicated to struggle against stigma is not only impressively long and wide-ranging, but provokes strong inspiration as well. It is not only the dedication that is impressive, but first of all the fact that the work is well designed and properly aimed, without inappropriate aggression toward media workers. Most encouraging of all is the author’s emphasis on the importance and value of individual actions. Therefore, this is the part of the book that can be strongly recommended to anyone interested in psychological prevention.

And, at the same time, this part removes any possible dilemma as to whether this book deserves our attention. Namely, despite being theoretically and conceptually somehow superficial, it is very important for practical work since it contains both a strong corroboration and justification, and encouragement and inspiration for further work in the troubled fields of psychological prevention and mental health care.

Aleksandar Dimitrijevic teaches Mental hygiene and Psychological Prevention at Belgrade University, Yugoslavia. His main research interests include: definitions of mental health and/or normal/pathological; connections between neonatology and developmental psychology; Kohut’s self psychology; psychoanalytically informed studies of the arts.

Categories: MentalHealth, Philosophical