There is so much good in this book, Powers' warts and all sharing of his life, his struggles with two schizophrenic sons, including the suicide of one of those boys just days before his 21st birthday, is beautiful, and brave, and does so much to humanize mental illness. In this historical moment when we demonize the mentally ill because of the acts of a few we need to raise understanding of what mental illness is and isn't. I could not be more grateful to Powers for shedding light on the reality of this plague that has affected, sometimes even taken, people I love. Powers also presents a compelling history of mental illness, some of which was new to me and was fascinating.

For me this book was unsuccessful in 2 areas. The first of those areas was totally understandable. Powers spent SO much time talking about his sons' music. Duplicative stories of gigs that did nothing to advance the reader's understanding or the narrative. I know Powers wanted to show that his son was important and more than his illness. That said, I don't think he needed to try so hard and I don't think many readers would have a real interest in where his 17 year old played what. Certainly the truth of his status as a musical prodigy could be told with just a few of those tales, and the fact of his admission to the esteemed programs at Interlochen and Berklee. These many (many!) digressions were simply boring and frequently led me to put down the book. Ditto on the letters home from both sons. A few of them had red flags to be sure, but mostly they were 100% unremarkable letters from well-educated high school and college aged boys to anyone they felt compelled to write. Powers tries hard to stress their extraordinary insight, but I have an 18-year old, and a lot of the observations sound like things he would say or write to me. The most remarkable thing was how little emotion was to be found in the "sane" letters. Maybe Powers left that out? From what was there the relationship seemed very distant without trust or love. These were simply reports on things going on.

My second issue with the book was more serious. Powers makes an argument that it is wrong that parents cannot commit their adult children as a matter of course. Shame on him. The mentally ill adult is an adult who needs to be allowed to make his own decisions. We don't routinely infantilize adults under our laws because it would be morally, ethically and constitutionally wrong to do so. In those instances where it is necessary because a person is not competent, the law allows for conservatorship. Is it difficult to get to conservatorship? Yep. And is should be. Powers tells the story of a person who had a psychotic break the day after his 18th birthday attempting to show that this is a ridiculous line being drawn. But guess what. All lines are somewhat arbitrary. All of us reach our legal majority at the same age though we are at different levels of development. All of us can collect Social Security and Medicare at the same age though many of us are healthy enough to work, and some people need those programs years earlier and cannot access them. A line is drawn based upon averages, means and medians, and traditions. Mentally ill people have the right to live by those same rules unless a threat to themselves or others (at which time there are remedies.) I found this argument offensive and cruel and dangerous, and it made the rest of the book suspect in my eyes. I cannot imagine what Powers' surviving son, Dean, thought of that thesis. I am sad and angry for him. That is not to say Powers didn't love his sons. He clearly adored them. But his desire for the law to make them perpetual children to ease his care-taking is spectacularly arrogant.

This book is just heartbreaking, as it details the writer's sons descent into mental illness (schizophrenia to be specific). There's lots of interesting history, background, and research into schizophrenia and mental illness, including how Western cultures treat the mentally ill, the history and mistake of de-institutionalization (which I recall vividly in my college town when a nearby mental institution was closed and suddenly there were many clearly mentally ill homeless suddenly wandering the town). At times, there was too much information, and some of it seemed disconnected from the family story (i.e.,the history of lobotomies -- a great book about this is "Patient H.M." by Luke Dittrich, grandson of the man who performed the most lobotomies in the U.S.). Most affecting in this book was the portrait of the sons, the younger son specifically, who took his own life. A brave, courageous, well-written, important book about the challenges of mental illness, from a personal and cultural perspective.

Painful read.

I wanted to read this book because I have two children who suffer from depression but also because I had a brother who was a paranoid schizophrenic who killed himself 27 years ago. My brother who was diagnosed as suicidal after years of psychosis was institutionalized and given an antipsychotic medication that caused him to "see things clearly" and prompted him to kill himself.

The author traces the history of mental illness and treatment, not always in an entirely coherent pattern. But the gist is that historically there has been a split between compassionate and highly interventional care that helps and punitive care that either punishes the sufferer or pretends that there is nothing wrong or that the sufferer is entirely capable of making rational choices such as taking meds even when that person's judgment is without question compromised. Highly interventionist care has been proven to save lives.

I felt that the author was at his best describing the horrific process of deinstitutionalization -- the causes that led to it and the results that we see everyday on the streets and under the highway bypasses of every major city. If you want to see tragedy on a huge scale that breaks your heart, take a look at the underside of the highway bypasses in Austin, Texas. The author points out that California has the largest population of homeless mentally ill and the reasons for it. It was very helpful to read about what went wrong because you wonder as you walk around these people who are they and why are they there.

I don't know about the link between schizophrenia and high intelligence. I was surprised that the author, considering that both his sons ended up schizophrenic, didn't say more about genetic causes. He talks a great deal about stress as a trigger, but not enough about how it is a trigger for those predisposed to be fragile. I think that, as happened with my brother, there is always a tendency to try to find the cause. But often the stresses are things that normal life throws at you. My brother had trouble with socializing with others, as the author's sons seemed to. My brother had trouble with dating and relationships, as the author's sons seemed to. There was almost a spectrumish quality to the problems my brother had and I thought about that when the author described the laser like focus his son Kevin brought to playing the guitar. It sounded a little like Aspergers, not classically, but a little bit. I have wondered if in the end, when researchers delve more into the genetics, if they aren't going to find that these fragile people are in the highly functioning range of that autism spectrum. Just a thought.

I loved the author's suggestions for how to make everyone's lives easier. HIPAA absolutely needs to be reformed to take into account that many of the mentally ill have families who love and care them and need to able to help their relatives. My severely depressed son was denied psychiatric care because he had been to the therapist the same day. That is ridiculous. Fortunately he wasn't in crisis, so he was able to reschedule but what if he had been? No question that needs to be changed. We have found that disability services in various areas differ greatly in their ability to help people in crisis. Fortunately we live in Northern New Jersey with an awesome vocational rehabilitation program. Life saving.

I would much rather work with a child with depression than schizophrenia. Depressives, in my experience, want help and want to change. As the author points out, schizophrenics don't always recognize that the reality they have constructed for themselves does not match the external reality. My brother believed people on television and in the newspaper were talking to him. It is very hard to reason with someone and help them understand that the world is not the way they perceive it. Unfortunately, we all construct our own reality.

And I would end with Pink: Change the voices in your head. Make them like you instead. When my son was very young and under tremendous stress, he heard voices. I hear that song and especially that line and I tear up every time. I feel that our school system and our society is so hard on fragile people, as the author said life is suffering, and I'm not sure that we are doing right by our children by forcing them to try to be like everyone else, to fit in, just to survive. The wealthy have options -- boutique schools, boutique programs -- but my husband and I don't have a lot of money and we watched our children, especially our youngest son, suffer in a system that just didn't tolerate a lot of difference from the norm. The author was able to pull his children and put them in more specialized boutique environments and even that wasn't 100 percent successful. I think we need a lot more research and a lot more answers for these special people. Because Mr. Powers that allowing them to just die devastates and destroys families. My family has not recovered from my brother's death and never will. He haunts all of us.

A very moving book, part memoir and part reporting on the history of mental illness.

This is a book that is both non-fiction history of mental health care and treatment is the U. S. (and it's origins in the U.K.), as well as a memoir of the author's own personal experience with two schizophrenic sons. There were times in this book where the biases of being a dad of two schizophrenic sons overwhelmed the seemingly factual information being presented on the evolution of mental health care (or lack there of)- and that bias and incessant negative tone bothered me. I don't think the integration of the two forms truly worked. But still interesting food for thought.

Skip this, and read The Center Cannot Hold instead.