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Book Reviews   |    
Delirious

Delirious
by by Daniel Palmer.; New York, Kensington, 2011, 384 pages, $25

Reviewed by Jeffrey L. Geller, M.D., M.P.H.
Psychiatric Services 2011; doi: 10.1176/appi.ps.000621517
View Author and Article Information

The reviewer reports no competing interests.

Dr. Geller, who is the book review editor, is professor of psychiatry and director of public-sector psychiatry at the University of Massachusetts Medical School, Worcester.

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The book Delirious is author Daniel Palmer's debut novel, and perhaps we can attribute some of its problems to a maiden voyage. The book is not an illuminating addition to the growing list of fiction that focuses on psychopathology. In fact, it's a stigma breeder. Before examining this, let's look at some of Delirious' rough spots.

The novel is set in the greater Boston area. Palmer goes to great lengths to provide detailed accounts of geography, neighborhoods, and auto travel. An author of fiction can take all manner of liberties, such as creating fictional places or renaming real ones. In this book, the fictional psychiatric hospital clearly is McLean Hospital. If an author portrays places as they actually are, he or she needs to avoid inaccuracies. For example, specific driving routes are mentioned in the narrative, but the roads on these Massachusetts routes don't actually connect; exits on the Massachusetts Turnpike are misnumbered, and names are misspelled—Worchester for Worcester, for example. Such inaccuracies are distracting to those who know the region. Next time, Palmer should skip such details or pay closer attention to them.

In trying to write a psychological thriller, Palmer outwits himself. By the time one finishes reading the two-and-one-half-page prologue, one has a good idea “who did it,” and the evolving plot does little to dissuade the reader from his or her original thoughts. And concluding a thriller with a plethora of happy endings reads more like Hans Christian Andersen than Ian Fleming.

But the major difficulty with Delirious is its inaccurate portrayal of psychopathology and psychiatry. Again, a fiction writer can take liberties but should take care to avoid mistakes. The book is titled Delirious, but no character has a delirium. The terms “psychiatrist” and “psychologist” are confused. Descriptions of the procedures followed in Massachusetts civil commitment hearings are skewed. The interfaces between the criminal justice and mental health systems are not accurate. Hallucinations, delusions, and dissociation are not correctly distinguished. Most troubling: there are repeated implications that having a mental illness means you become only your mental illness, acutely losing all aspects of your former self. Boundaries are violated to the point that one man's long-term doctor, treating him for schizophrenia, knowingly becomes his brother's girlfriend. By the way, some of her training as a mental health professional is in handwriting analysis. “Mind control” leads to murder, the controlled person being devoid of any autonomy.

Delirious is bad for psychiatry. Let's hope it is not made into a movie, at least not as written. And let's hope Daniel Palmer uses this book as a learning experience for his second novel.

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