Falling into the Fire is the literary by-product of decades' worth of work in the psychiatric field. As a staff psychiatrist at Rhode Island's Butler Hospital, Dr Christine Montross puts forward real-life cases that baffle yet compel one’s continual engagement: there is the woman who causes herself intestinal ruptures by ingesting knives, bedsprings and curtain rods, the man who spends over $50,000 on dermatologic procedures to offset non-existent epidermal scars, and a mother who fantasizes every hour about killing her fifteen-month-old baby.
Reading this book helped me better understand the pressures and responsibilities of the medical establishment, as well as the thoughts that went with diagnoses and treatment decisions. I learned about the individual relationships between psychiatrists and patients too, and how often it’s fraught with humour, pain, and authenticity. Too frequently I found myself observing that psychiatrist-patient interactions resembled a romantic dance: testing each other upon first impression, and learning to trust each other over an extended number of sessions. The difference, of course, is that the psychiatrist is legally authorized to withhold from the patient the rights of freedom and autonomy.
At the heart of Falling into the Fire are questions more socio-political than psychological. It enquires into the validity and boundaries of sanity and normalcy; after all, ‘normal’ is normative. As Montross verifies, ‘every diagnosis is an act of faith’ (p. 132). What she speaks of, really, is a faith in normative society.