SciELO - Scientific Electronic Library Online

vol.52 issue1Informal caregivers for stroke survivors: what does occupational therapy offer? author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand



Related links

  • On index processCited by Google
  • On index processSimilars in Google


South African Journal of Occupational Therapy

On-line version ISSN 2310-3833
Print version ISSN 0038-2337

S. Afr. j. occup. ther. vol.52 n.1 Pretoria Apr. 2022 



Madness. Stories of Uncertainty and Hope




Author: Sean Baumann

Dr Sean Baumann is a psychiatrist. At Cape Town's Valkenberg Psychiatric Hospital, Dr Baumann worked as a consultant in the Male Acute Service unit. This short-stay, high care, closed ward, in-patient unit hosts a wide variety of psychiatric and neuropsychiatric illnesses that are too severe to be managed at a clinic or in other hospital settings. He is also a senior lecturer at UCT's Department of Psychiatry and Mental health and the editor of a widely used textbook prescribed to undergraduate students in medicine, occupational therapy, and nursing.

Information on the book

Published: 2020

Publisher: Johnathan Ball Publishers, Jeppestown, Johannesburg, RSA

ISBN number: 978-1-77619-013-3

Available in: Paperback - ZARR280.00 and E-book - ZAR R 179.99

Number of pages: 348 pages




The book follows a cantata by Dr Baumann called Madness, Songs of Hope and Despair that was first performed in 2016 at the World Psychiatric Conference in Cape Town, and subsequently ran for several seasons at the Baxter Theatre in the same city. In the introduction, Dr Baumann explains his reasons for writing the book as "an attempt to make some sense of the experiences I have gained working as a psychiatrist in an admission unit of a public hospital for over 25years." Based on these experiences, he concludes that "a strictly biomedical approach has led to significant advances but is limited by a reductive position". Dr Baumann's empathy and compassion for his patients permeate the book and are embodied in the aim: "to change our harmful ways of thinking about mental illness... to pay tribute to those who live with these mysteriously altered states of mind and ways of being in our shared world." (Page 8)

Dr Baumann writes well, making the book easy to read. The prose has none of the third-person objective staidness of academic writing. The headings of the 41 chapters illustrate the point: The notion of madness, The need for the other, The frontier: A historical context, Living with uncertainly, The boundaries of mental illness and the problems of living, The confounding limits of science, The biology of madness, Medication and madness, Traditional healers, Freud, Jung and other interpreters, Coercion, Violence, Unreason, Wonder, Shame, The dream of the community, The status of disability and its complications, It's all in the mind, At least it's not going to kill you, The cliché of the madness of the world, Madness is not a metaphor, The romance of madness, Madness and the theatre, Art and madness: Madness and machines, Psychopathy and psychosis, Fear, Anxiety, psychiatry in disarray and a celebrity circus, The problem with depression, The illusory thrill of mania, The allure of intoxication, Madness as a disorder of consciousness, Madness as a disorder of self, Bring back my son, I can't go on like this, Odd ideas, and rarely a strange beauty, Hearing voices, or listening, A family aghast, Suicide and its aftermath, HIV and madness, Huntington's disease, syphilis and other tragedies of a damaged brain, Meaning and madness.

Throughout these chapters, the author uses actual clinical encounters to make and describe a point.

Antjie Krog, one of South Africa's internationally renowned poets, writes the set-up blurb and sums up the content of the book and the reading experience best: 'This book has irrevocably changed my understanding of madness. Through succinct and often poetic accounts, Baumann carefully mediates access to glimpses of the brave, fearful, lonely, and vulnerable humanities of those suffering from psychiatric disorders, especially schizophrenia. The text, illuminated by extraordinary artwork, compels one to believe that beyond all the distress and despair, there is, and always should be, hope."

Occupational therapy and occupational therapists are mentioned several times in the book. Each time in authentic and well recognised scenarios, showing Dr Baumann's experience of having worked with occupational therapists and his understanding and appreciation of our role. Some such scenarios (Pages 89 - 90) had me laughing out loud and I still smile every time I recall them. A highly appreciated aspect of the book, for me, was the contextual relevance to our South African realities that permeate it. Many of the author's insights and experiences will transfer well to other African countries with similar mental health resources, intervention strategies, and cultural views.

This has been one of the best books I read in 2021, and I highly recommend it to all occupational therapists, not only those working - but teaching also - or interested in mental health. The last sentence of the book epitomises the reason why I am an occupational therapist. It describes what I personally have had to hold on to, to go to work, when working with broken, hurt people gets too much. It is also a mindset I have admired and appreciated in so many of my patients: "Beyond hopelessness and reason and madness, there is only hope." (Page 347)

Reviewer: Dr Hester M van Biljon, B Occ Ther (UFS), M Occ Ther (UFS) PhD (Wits).

Declaration of bias: The reviewer has no bias to declare. She has no affiliation with UCT, Valkenberg Hospital, the publisher, or the author.

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License