STARRED Book Review: Home for the Bewildered

Reviewed by Erin Britton | Content warnings: Childhood sexual abuse

Who heals the healer?

A powerful and poignant novel that examines the deleterious consequences of societal pressures and expectations, Michelle Tobin’s Home for the Bewildered addresses the stigma that was—and sometimes still is—attached to mental health struggles. It considers how both patients and physicians must bear the burdens associated with a lack of understanding, like the desire to keep “unpleasantness” hidden from public gaze. 

Through an unflinching portrayal of a multitude of traumas and misconceptions, Tobin reveals precious moments of hope and the unexpected strength of the human spirit.

While Dr. Dorothy Morrissey has no desire to be the “half-hearted nonconformist” that her boyfriend Kenneth half-jokingly accuses her of being, she has to admit that the accusation is not entirely unfounded. Raised in a large, working-class Catholic family but having now clandestinely moved in with Kenneth prior to marriage, she knows that her benign rebellion would be, to say the least, frowned upon. But while she’s bold enough to cohabit, she still can’t countenance the idea of sex before marriage.

She’s much more firm in her convictions regarding her professional life, however, serving as the first female psychologist at the St. Lawrence Asylum in Lansing, Michigan. Sadly, the achievement is yet another thing her family doesn’t approve of. “Her parents had barely acknowledged, let alone celebrated, Dorothy’s accomplishments. Since she had yet to snag a rich Catholic husband, she might as well have done nothing.” And even though 1974 has just dawned, her professional success is met with a good deal of sexism from others too.

While such issues irritate Dorothy, she ensures they won’t interfere with her work with her patients. She has a clear-eyed perception of the state of mental health care in the United States in the mid-1970s—“People did not schedule their psychotic breaks. The policy made the situation that much more traumatizing for both the patient and the doctor.”—but she’s also certain that people can be helped if given the correct treatment, and so she follows policy to make sure she’s available to provide that help. 

In Home for the Bewildered, Michelle Tobin focuses on Dorothy’s interactions with four particular patients—Thomas Perfect, George Eavey, Ruth Fitzgerald Johnson, and Marcella Mafoud—largely over the course of 1974–1975. The four have a variety of symptoms, behaviors, possible triggers, and potential diagnoses, with the latter ranging from post-partum psychosis to bipolar disorder to personality disorder and more. As Dorothy learns about her patients’ histories, she begins to connect with them, which has repercussions for both their treatment and her personal life. 

A dedicated physician whose compassion for her patients contrasts strongly with how harshly she judges herself, Dorothy is a complex and compelling character. She has great insight into other people—“Dorothy was psychologically astute, a good listener, and had a way of intuiting the secrets of other people without realizing it. This was a valuable skill in a therapist, creating a safe place for patients to confide in her because they ‘just knew’ she understood them.”—but she’s not so insightful when it comes to her own desires, fears, and motivations. 

Similar to her patients, Dorothy’s difficulty with self-acceptance starts with her past. Much of her difficulty can be laid at the door of her family and her religious upbringing. Indeed, as Tobin makes clear, the long shadows of the injustices of childhood lie over them all. Even though Dorothy is at the St. Lawrence Asylum in a professional capacity rather than as a patient, she is also being held back in life by unaddressed traumas and the inability to shake off the weight of other people’s expectations.

In particular, Tobin mentions the impact caused by the abusive & oppressive Catholic Church. Tobin really brings out the pernicious and insidious nature of the sexual discrimination and hypocrisy of both Church doctrine and the actions of individual members of the Church. For instance, thinking back on the messages that were conveyed to young girls at her Catholic school, Dorothy observes: “What was a girl supposed to do? The only conclusion to young Dorothy’s mind was that her choices were ugly but smart, liked but slutty, or uptight and marriageable until the wedding night at which time, she could let loose without being a slut.”

Sadly, the treatment that Dorothy received wasn’t the only kind of abuse being doled out by the Catholic Church at the time. As is now well known—and perhaps was even well known back in the 1970s—sexual abuse of children was rife, and the long-term psychological damage of such abuse is having a profound impact on one of Dorothy’s patients. “Dorothy sat down to write her note. She was suddenly overwhelmed by emotion. She felt like she was overcome by the emotions George was refusing to allow.” Tobin relates George’s experiences in a non-sensational way, but it’s still very disturbing.

In addition to the devastating impacts that mental, physical, and sexual abuse (and other kinds of abuses, too) has for those who experience it, Tobin also highlights the fact that the victims of abuse—not the abusers—are often left to shoulder all the blame and guilt. Both Dorothy and her patients have been largely let down by those around them, particularly by their families. As such, Home for the Bewildered can be a very upsetting and distressing read, and it can prompt great anger about the abuse that the characters have been subject to.

It is also a surprisingly hopeful book with Tobin elucidating the connections that develop between Dorothy and her patients, both in the patients themselves and other unexpected directions. Hope can be found in the most surprising of places, and there’s always a possibility of change. 

What’s more, there are moments of humor to be found throughout the story, even in relation to the darkest of subjects, especially through the words and exploits of Thomas: “Suicidal Ideation—been there, done that, don’t want to do it again.”

While presenting an unflinching portrayal of the difficulties and uncertainties of mental health care in the 1970s, Home for the Bewildered never loses sight of the fact that Dorothy’s patients are people, not diagnoses. Although the “suffering of the mentally ill did not register for a moment” with many, especially those in power, it certainly registers with readers, as does the dedication and commitment of physicians such as Dorothy. 

This is a highly emotive book that conveys a vital message about the importance of tolerance and understanding.

Thank you for reading Erin Britton’s book review of Home for the Bewildered by Michelle Tobin! If you liked what you read, please spend some more time with us at the links below.

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