From the mid-nineteenth century to the early twentieth, over 250 institutions for the insane were built throughout the United States; by 1948, they housed more than a half million patients. The blueprint for these hospitals was set by Pennsylvania hospital superintendent Thomas Story Kirkbride: a central administration building flanked symmetrically by pavilions and surrounded by lavish grounds with pastoral vistas. Kirkbride and others believed that well-designed buildings and grounds, a peaceful environment, a regimen of fresh air, and places for work, exercise, and cultural activities would heal mental illness. But in the second half of the twentieth century, after the introduction of psychotropic drugs and policy shifts toward community-based care, patient populations declined dramatically, leaving many of these beautiful, massive buildings--and the patients who lived in them--neglected and abandoned. Architect and photographer Christopher Payne spent six years documenting the decay of state mental hospitals like these, visiting seventy institutions in thirty states. Through his lens we see splendid, palatial exteriors (some designed by such prominent architects as H. H. Richardson and Samuel Sloan) and crumbling interiors--chairs stacked against walls with peeling paint in a grand hallway; brightly colored toothbrushes still hanging on a rack; stacks of suitcases, never packed for the trip home. Accompanying Payne's striking and powerful photographs is an essay by Oliver Sacks (who described his own experience working at a state mental hospital in his book Awakenings). Sacks pays tribute to Payne's photographs and to the lives once lived in these places, "where one could be both mad and safe."

    This book is not for them. Digging Out is for the concerned and frustrated friends and family members of people who do not fully accept the magnitude of their hoarding problem and refuse help from others. If you have a friend or loved one with a hoarding problem and are seeking a way to guide him or her to a healthier, safer way of life, this book is for you.In Digging Out, you will find a complete guide to helping your loved one with a hoarding problem live safely and comfortably in his or her home or apartment. Included are realistic harm reduction strategies that you can use to help your loved one manage health and safety hazards, avoid eviction, and motivate him or her to make long-term lifestyle changes. You'll learn how to handle a roommate or spouse with a hoarding problem, identify and work through special considerations that may arise when the person who hoards is frail and elderly, and receive guidance for healing strained relationships between people who hoard and their friends and family. Take heart. With this book as a guide, you can help your loved one live more comfortably and safely, salvage your damaged relationship, and restore your peace of mind.

    These powerful tools go far in helping clients connect with their values and give them the motivation needed to make a real, conscious commitment to change. Unfortunately, many of the metaphors that clinicians use have become stale and ineffective. That’s why you need fresh, new resources for your professional library.In this breakthrough book, two ACT researchers provide an essential A-Z resource guide that includes tons of new metaphors and experiential exercises to help promote client acceptance, defusion from troubling thoughts, and values-based action. The book also includes scripts tailored to different client populations, and special metaphors and exercises that address unique problems that may sometimes arise in your therapy sessions. Several ACT texts and workbooks have been published for the treatment of a variety of psychological problems. However, no one resource exists where you can find an exhaustive list of metaphors and experiential exercises geared toward the six core elements of ACT. Whether you are treating a client with anxiety, depression, trauma, or an eating disorder, this book will provide you with the skills needed to improve lives, one exercise at a time.With a special foreword by ACT cofounder Steven C. Hayes, PhD, this book is a must-have for any ACT Practitioner.

    Warnings that depressive disorder is a leading cause of worldwide disability have been accompanied by a massive upsurge in the consumption of antidepressant medication, widespread screening for depression in clinics and schools, and a push to diagnose depression early, on the basis of just a few symptoms, in order to prevent more severe conditions from developing.In The Loss of Sadness, Allan V. Horwitz and Jerome C. Wakefield argue that, while depressive disorder certainly exists and can be a devastating condition warranting medical attention, the apparent epidemic in fact reflects the way the psychiatric profession has understood and reclassified normal human sadness as largely an abnormal experience. With the 1980 publication of the landmark third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), mental health professionals began diagnosing depression based on symptoms—such as depressed mood, loss of appetite, and fatigue—that lasted for at least two weeks. This system is fundamentally flawed, the authors maintain, because it fails to take into account the context in which the symptoms occur. They stress the importance of distinguishing between abnormal reactions due to internal dysfunction and normal sadness brought on by external circumstances. Under the current DSM classification system, however, this distinction is impossible to make, so the expected emotional distress caused by upsetting events—for example, the loss of a job or the end of a relationship—could lead to a mistaken diagnosis of depressive disorder. Indeed, it is this very mistake that lies at the root of the presumed epidemic of major depression in our midst.

    In Victoria Costello's family mental illness had been given many names over at least four generations until this inherited conspiracy of silence finally endangered the youngest members of the family, her children.In this riveting story--part memoir, detective story, and scientific investigation--in the tradition of the story of Henrietta Lacks, Costello recounts how the mental unraveling of her seventeen-year-old son Alex compelled her to look back into family history for clues to his condition. Eventually she tied Alex's descent into hallucinations and months of shoeless wandering on the streets of Los Angeles to his great grandfather's suicide on a New York City railroad track in 1913.But this insight brought no quick relief. Within two years of Alex's diagnosis of paranoid schizophrenia, both she and her youngest son succumbed to two different mental disorders: major depression and anxiety disorder. Costello depicts her struggle to get the best possible mental health care for her sons and herself, treatment that ultimately brings each of them to full recovery. In the process, she discovers startling new neuroscience and genetic findings that explain how clusters of mental illness traverse family generations.The author closes by translating what she's learned into a set of ground rules for "New, New Parenting," advice to help individuals and families recover from addictions and mental disorders, and prevent their return in future generations.