Kate Millett, The Loony Bin Trip (first published in the USA by Simon and Schuster, 1990), Virago Press Ltd, London, 1991, pp. 322, £6.99 (paperback), ISBN 1-85381-326-5

This is no simple, heat of the moment, narrative either of madness or of psychiatric abuse. According to the acknowledgements at the end "eight years went into writing and rewriting", before Millett's editor reduced "the vast pile of manuscript" by half, and gave it "what strength and coherence it has": a statement raising considerable questions about narrative, form, and authorship.

Millett, artist, writer, political activist, is perhaps still best known for the impersonal academic study, Sexual Politics (1969), one of the ovarian (surely not seminal) texts of the "second wave" of twentieth century feminism. However, more satisfying, in my opinion, is Flying (1974), a freewheeling confessional account of being a "Women's Lib" superstar in those heady early days. In Sita (1977) this confessional mode, exhilarating when applied to the head-on clashes of personal and political, was focused into a powerful if claustrophobic study of emotional obsession. Millett's fascination for extremes and the hazy borderline between "normal" and "abnormal" was further manifested in The Basement (1979: USA only), a study of the real-life torture-murder of an adolescent girl in Indianapolis.

Millett, a committed advocate of the civil rights of mental patients, underwent psychiatric incarceration some years before the "real time" of The Loony Bin Trip, described in flashback. Suicidal depression following this experience led to the prescription of lithium. Millett's decision early in the 1980s to go off a drug causing her obvious (as well as unseen but feared) side-effects precipitated the events she narrates, which demonstrate, that, as she points out, though "depression is the victim's dread" (for reasons all too harrowingly revealed in her account of it), it is the manic phase of this bipolar disorder which others fear; in depression "you are quiet and you suffer", giving others no bother.

The situation within the women artists' community at her farm is depicted strictly from Millett's contemporary perspective, though she attempts to understand and sympathise with what increasingly come to seem her tormentors. Few writers can match Millett in writing from this apparently solipsistic angle. There is a welcome lack of "poor little me" or "how exquisitely sensitive I am" about her tone as she portrays herself struggling with demons, trying to come to terms with them--rather than presenting herself in a charming light or revenging herself on persecutors. The negative feedback loop of suspicions of madness reflected in increasingly defensive, "irrational", behaviour becomes "Gaslight" revisited, with Millett's lover Sophie in the Charles Boyer role, constantly undermining Millett's ability to sustain non-chemically-supported sanity.

Only obliquely does the reader sense fears of madness within the community being projected into the "mad one". The group dynamics strongly reminded me of Joanna Russ's 1980 essay on "Power and Helplessness in the Women's Movement" (collected in Magic Mommas, Trembling Sisters, Puritans and Perverts, The Crossing Press, 1985). It seems probable that the famous feminist Millett had been alloted the "Magic Momma" role: strong, serene, all-nurturing, a 70s feminist version of Virginia Woolf's "Angel in the House". Her vulnerability would thus have come as betrayal.

Madness is not a country that an individual might with impunity, if subjected to sufficient stress, visit once or twice: having been incarcerated is a lasting stigma, its repetition a constant threat. It would appear that the distinction between insanity and mental deficiency which we are told now exists is not so clear in the minds of many, even mental health professionals. A episode of mental trouble becomes a permanently defining trait, while (from Millett's account) she was constantly treated as mentally subnormal rather than (perhaps) disturbed. Millett herself maintains intriguing ambivalence on the "reality" of madness, though it is clear that if there is an "objective state" of insanity the institutions she experienced were good neither to "cure" nor to care, but merely contained.

I would contest her suggestion that in physical, unlike psychiatric, medicine "the prevailing attitude is compassion and respect". Only so much, one could hazard, as will preserve the doctor from a malpractice suit. What about women unnecessarily hysterectomised, the terminally ill with inadequate pain relief, sufferers from stigmatised diseases? The same issues of authority, power, and powerlessness apply.

This book is a painful read: the beautifully described moments of epiphany never seem sufficiently strong or occur often enough to balance the pain and anguish. It is a honest attempt to describe an experience of which something, ultimately, in spite of or because of all the labour taken, remains indescribable.

Lesley Hall

Wellcome Institute for the History of Medicine