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Book Reviews   |    
There Aren't Any Kitchens in Heaven
Reviewed by Anita Everett
Psychiatric Services 2006; doi:
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by Claudia M. Jones, Ph.D.; First Books Library, 2003, 136 pages, $11.45 softcover

Dr. Everett is senior medical advisor for the Substance Abuse and Mental Health Services Administration in Rockville, Maryland.

Are you looking for a good reference for the family of a person with a diagnosis of schizophrenia? There Aren't Any Kitchens in Heaven just might be the recommendation you are looking for. This work provides accounts of life with Paul, his paranoid schizophrenia, and his associated drug abuse. The first part of the book, "Paul's Story" is told from the perspective of his younger sister, who is also the author, Claudia Jones. An additional perspective is provided in Part 2, "A Mother's Story," a series of entries from a diary maintained by Paul's mother. Part 3 includes the evaluations of several professionals who were involved in conducting forensic evaluations of Paul.

Many of the events recounted in the book include the type of tragic and seemingly senseless experiences that a family with a member who has schizophrenia might encounter. Paul slashes the tires on a neighbor's car when he senses the neighbors are out to get him. He goes through a period of obsessive, vigorous hand washing throughout each meal for unclear reasons and intermittently experiences a variety of auditory hallucinations of varying intensity. At one point, Paul exposes the ventilation system in his mother's house by creating six foot holes in the plaster ceilings so that insect bombs could be placed throughout the system to eliminate the voices that reside there and threaten him. The story includes multiple hospitalizations and complications with intermittent drug abuse. He brutally attacks his mother while under the influence of crack and psychosis. There are triumphs as well, but these are the more ordinary and modest triumphs of everyday living with a serious and active mental illness.

Although Paul has a unique set of circumstances and manifestations associated with his illness, the types of situations described in this book are likely to be familiar to many families who live with a member who has a mental illness.

What is extremely remarkable about this book is the very neutral, unassuming, and accepting way these dramatic events are presented by Dr. Jones. Throughout the book there is a tone of nonjudgmental acceptance of Paul, his mental illness, his substance abuse, the treatment system, and the law enforcement system. Although it must have been challenging not to explore potential greater meanings or rationalizations of the events in the course of Paul's life and illness, the work remains neutral throughout. Serious mental illness is not romanticized; nor does the book present a dark and hopeless outlook. Rather it provides a relatively objective perspective from which the reader can develop his or her own interpretations and understandings. Paul's mother and Dr. Jones regard Paul with respect and dignity. Throughout the writing, Dr. Jones models an attitude of acceptance in living with the realities of her older brother's mental illness and drug abuse. Perhaps with the acceptance there is a bit of adaptive or protective distancing; however, a clear sense of love and concern for the well-being of her brother is consistently conveyed throughout the book.

From my perspective as a community psychiatrist, it is disappointing that no treatment provider or system was central in mitigating the experience of Paul or his family. Paul had no rescue. Unfortunately, this is likely to be a realistic reflection of the experience of many families who far too often are not included in the active treatment of an individual.

This book would be useful for family members, particularly those near the outset of experiencing mental illness in their family. It would provide validation of some of the experiences family members may have encountered. It is easy to read, moves at a good pace, and, at only 121 pages, is accessible even for those who are reluctant readers. This book would be useful in a teaching forum as a discussion springboard to enhance sensitivity to the lived experiences of family members. For seasoned professionals and peers, the book is likely to serve as a reminder of the intensity of the experience of family members. In a best-case scenario, it could even enhance motivation to commit to greater efforts to more directly engage family members in the active treatment of individuals with schizophrenia.

Buy this book, read it, and put it on a shelf in your office to recommend to the families of the individuals you work with and treat. It is a gem.




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