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by David A. Karp
Oxford University Press, 2001
Review by Courtney Young on Jan 10th 2002

The Burden of Sympathy

            Writing about mental illness in such a way that satisfies those who deal with it on a regular basis is a rather difficult task.  It is hard to know where to draw the line when writing about a problem that some see as a behavioral disorder related to how someone was raised, and others see clearly as a disease.  In either case caring for an ill family member can be tremendously difficult on the caregivers, and raises questions such as, what do we owe each other and how do we know when or where to draw the line when caring for family members?.  Questions such as these are raised in Karp’s book, but are never resolved. 

            Through conversations with caregivers he attempts to show how, “responsibility, duty, and love mix in different combinations to sustain family ties (p.16).  He also shows how these notions differ between men and women.  Although the book is well researched, written, and addresses many important topics, it seems lacking.  If you looking to find better ways to deal with sick family members, or the health care system, you will have to look elsewhere.  Admittedly, all cases of mental illness are unique, and perhaps it is impossible to offer advice on how to care for sick individuals.  However, it seems with a chapter entitled “Surviving the system” there would be some useful information rather than the continual criticism.  I’m not talking about something radical, but perhaps since everyone seems to be in agreement that the system needs to change, he could have included ways the public could address health care officials personally, pressuring some kind of change.  The current policies towards those afflicted with mental illness reflects society’s view of these people and their place in a capitalist society.  Karp provides an interesting analysis of this notion.

            Obviously this book is about people caring for those who suffer from manic depression, schizophrenia, clinical depression…etc, but we never hear the patients themselves.  The book gives the impression that they don’t care if they are hurting the ones caring for them, and I think including their voice would have lent a more complete analysis.  Throughout this book we see how caregivers themselves can become depressed, or how they struggle with difficult decisions to have their loved ones committed.  One sick person can affect an entire household, and we hear from mothers, daughters, brothers, sisters, husbands, and wives.  It is an interesting approach, and by giving the caregiver’s perspective we see mental illness itself in a different way.

            For those who are not familiar with mental illness and its severity The Burden of Sympathy is worth reading.  However, if you are a caregiver looking for help while you contemplate what your obligations are, or where your responsibilities lie; this book offers no answers or even advice on the matter.  This book does give the caregiver comfort in knowing that he/she is not the only one facing these ethical dilemmas, and raises important philosophical questions worth discussing.


© 2002 Courtney F. Young


Courtney Young recently graduated from Dowling College, Long Island, NY majoring in Fine Arts and minoring in Philosophy.  While planning her next step, she maintains her mental health by surfing.



Review of David Karp’s Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness