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Book Review   |    
Curtis Adams
Psychiatric Services 2009; doi:
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by Ginnah Howard; New York, Houghton Mifflin Company, 2009, 304 pages, $24 hardcover, $13.95 softcover

Dr. Adams is assistant professor, Department of Psychiatry, University of Maryland, Baltimore.

The book Night Navigation is a journey into the murky present and a dark past. The reader follows an anxious mother named Del and her 37-year-old son Mark, who has a dual diagnosis of mental illness and substance dependence, through a year-long slice of their chaotic lives. Both characters reflect on their very difficult pasts to determine why their lives are on hold. The reader eavesdrops on their thoughts and discussions as they grapple with the two-headed tyrant of mental illness and substance dependence. Mark's illness is a dark bully: clandestine, stealthy, relentless, unforgiving, and domineering. Both characters attempt to conquer it, but they struggle. If Del micromanages Mark's life just so, can she avoid a repeat of past disasters? Will she maintain her boundaries, or will she retreat, as her boyfriend predicts? Will Mark get clean, and if so, will he stay clean?

While watching Del's failed efforts to change the course of Mark's life, the reader is treated to her many anxious cognitions and her unalloyed, wishful thoughts. Some of her struggles will make the reader laugh out loud. At the same time, one can empathize with her as she bypasses the many opportunities for a broader, fuller life. She has a grasp of the "love" element of the tough-love dyad but not the "tough" part.

Ginnah Howard has facility with addiction lingo. Using Mark to think and blurt out addiction and recovery catch phrases suggests that she has either done a great deal of homework or has had first-hand experience with addiction and its meandering course. To Howard's credit, Mark's words are not forced, overdone, or grotesque. They are often ironic and at times funny. What is less convincing is her depiction of Mark's manic and psychotic processes.

Thankfully, Mark and Del's tale doesn't end with all of its loose ends accounted for. After all, the characters don't live uncluttered lives. Instead, Ginnah Howard gives us an entertaining and worthwhile true-to-life story about complicated people grappling with vexing problems.

The reviewer reports no competing interests.

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