Twilight of American Sanity

  • by Allen Frances
  • Narrated by Christopher Grove
  • 12 hrs and 39 mins
  • Unabridged Audiobook

Publisher's Summary

A landmark book from "one of the world's most prominent psychiatrists" (The Atlantic, June 2017): Eminent psychiatrist Allen Frances analyzes the national psyche, viewing the rise of Donald J. Trump as darkly symptomatic of a deeper societal distress. Equally challenging and profound, Twilight of American Sanity makes sense of our time and charts the way forward.
It is comforting to see President Donald Trump as a crazy man, a one-off, an exception - not a reflection on us or our democracy. But in ways I never anticipated, his rise was absolutely predictable and a mirror on our soul.... What does it say about us, that we elected someone so manifestly unfit and unprepared to determine mankind's future? Trump is a symptom of a world in distress, not its sole cause. Blaming him for all our troubles misses the deeper, underlying societal sickness that made possible his unlikely ascent. Calling Trump crazy allows us to avoid confronting the craziness in our society - if we want to get sane, we must first gain insight about ourselves. Simply put: Trump isn't crazy, but our society is. (from Twilight of American Sanity)
More than three years in the making: the world's leading expert on psychiatric diagnosis, past leader of the American Psychiatric Association's DSM ("the bible of psychology"), and author of the influential international best seller on the medicalization of ordinary life, Saving Normal, draws upon his vast experience to deliver a powerful critique of modern American society's collective slide away from sanity and offers an urgently needed prescription for reclaiming our bearings.
Widely cited in recent months as the man who quite literally wrote the diagnostic criteria for narcissism, Allen Frances, MD, has been at the center of the debate surrounding President Trump's mental state - quoted in Evan Osnos' May 2017 New Yorker article ("How Trump Could Get Fired") and publishing a much-shared opinion letter in the New York Times ("An Eminent Psychiatrist Demurs on Trump's Mental State"). Frances argues that Trump is "bad not mad" - that the real question to wrestle with is how we as a country could have chosen him as our leader. To answer this, Frances looks deeply at the American past and present. Twilight of American Sanity is an essential work for understanding our national crisis.

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Psych angle confers platform, some wisdom, but ...

The situation is familiar. I think of Einstein, Jonas Salk, and others who made breakthroughs and conferred great value upon society in a particular field. This confers to them an opportunity, a platform, to hold forth to a broad public on most any other subject. All of us might wish such a platform, and these geniuses can't resist issuing spiels on everything from public policy to dog breeding. As often happens, the great gifts in the original field translate, if at all, unevenly into brilliance or wisdom to the other subjects. Often these geniuses have grown up in (or reached) very individualized, nonstandard, often coddled worlds where their idealism grows like a hothouse flower, far past their discipline to learn some messy nuts and bolts of real-world pragmatism. And so they play their lofty tunes of how the world could be fixed if only people would be civilized and reasonable and smart (which everyone could do, and would do, if in their shoes), and most of all, behave according to these wise folks' canons, and stop being such fools.
This book in this regard is better than some fiascos. I agree with most of this author's ideals. Never mind this is at its core a clear, if undistinguished, comprehensive restatement of the blue-state world view. I heard not a single idea here I hadn't arrived at (or heard) elsewhere, myself, ever since my days in the beautiful sheltered coastal redwoods in the UC system. So, would I like everybody to read this and adhere to its wonderful ideals? I suppose. It probably would be a best approach, at least bringing relative common sense and limits to a now cartoonishly delusional population (decades too late admittedly: we faced a world of these limits the day the bomb fell on Hiroshima, but only intensified the orgy of materialist-expansionist overconfidence, ever since, and it's getting pretty ugly out there. Here I sound somewhat like the author). But I can't say that with complete confidence, because the world and its people and devilishly complex new circumstances constantly go sideways on us. Maybe following these precepts would turn us into the vulnerable flower children (thanks H.G. Wells) too sweet to resiliently withstand the next nasty surprise the universe (and not merely Trump and his eternal rabble-rousing ilk) may bring upon us. The assumptions here are not unpacked and visibly hedged with enough discipline to suit me. They are presented too much as an unvarnished correct "reality testing," as if there was one reality rather than an array of crazy (and crazily unpredictable) contingencies. But I don't pretend to have a corner on reality testing (a psych phrase much-used here). Kudos to the author for trying to bring some humility to a USA population desperately in need of it So I'm aligned with some of this basic restatement of the blue-state view. .
My big problem here is this guy indulging his desire to make his big spiel of the theory of everything and how it can be fixed (and BTW I greatly respect and agree with many of his other writings, including his last popular book), and dressing up his personal philosophy, reasonable as it may be, as "reality " in some implied "I am the wise man of psychiatry" sense (I mean, look at the title: psychiatrist ... analyzes ...). I think the psychiatric disciplines (and yes I've had psych classes and read the DSM manual and used it all professionally, in law) like other sciences with large social/fuzzy elements, law included, sit uneasily with philosophy and politics. Expertise in one can easily be mistaken for expertise in others. Real governance and public policy is hard and messy and costly and like shooting in the dark. Yes, wise folks can lend an overarching structure. But maybe USA's people are trying and missing not as much as an idealist would want, given the hard unforeseen edges of reality. The boundaries between these fuzzy social-human disciplines, and their claims on some sort of ultimate "reality," seem always tenuous and conditional and often their best proclamations fizzle in fairly short time-horizons as the world and its people keep doing what they have done from the first moment: shift duck and dodge and react and cheat and evolve and defy best intentions. Yes, it would always be wonderful if people could be humane, and not in a state of panic-driven aggression, and husband (an old world, please relax you linguistic hysterics) the resources of earth well. Has that ever happened? No. Generations of idealists from platonists to Christians have seen their nose bloodied in the face of another reality: the world will not settle down and sit still in a harmonious condition of sweet reason. Ever, except for freakish exceptional fleeting intervals. The certitudes of this author's "reality testing" may seem prescient and then quaint, I think, in a shockingly short span of years. Then maybe prescient again. What will not happen, and has never happened, even pre-human, is a sweetly regulated world of the sort he envisions. That is at the heart of sentimentalist narrative fallacy. This place and every denizen in it, jumps all over crazily. We can still try our best, but best get used to this nasty little eternal fact. I hope many will listen, particularly if they have been in the silo of junk media swamping us in fresh waves in an era of technologically cheap talk. On the other hand, don';t be too disappointed if yet another of this sort of person's grand opus of wisdom doesn't work out like this at all.
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- Phil O.

Required Reading

This is a very thoughtful analysis of our current political predicament. Although Dr. Frances is a psychiatrist, the breadth of his analysis reveals much more than just psychiatric wisdom. He has a solid understanding of history, ethics, biology, and mans place in nature. If there were a national book club, this should be on the reading list. Perhaps it won't change the hearts or minds of the 40% of Americans who would be willing to take a bullet from Trump on 5th Ave, but it might inspire some of the remaining 60% into action. Very well narrated, also.
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- Douglas

Book Details

  • Release Date: 09-05-2017
  • Publisher: Harper Audio