National Alliance on Mental Illness
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The Burden of Sympathy: How Families Cope with Mental Illness

by David A. Karp

Oxford University Press, 2000. 288 pages. Hardcover: $25.00
Review by David Seaman, NAMI Literature Committee

In this successor volume to his well-received Speaking of Sadness (1996), David Karp reports on a sociological study of mental-illness caregivers that is simultaneously interesting, informative, and somewhat frightening.

As in his prior book, Karp presents extended excerpts from transcripts of some 60 in-depth interviews with such caregivers-close relatives of severely ill persons with bipolar disorder, major depression, and schizophrenia-and then impressively analyzes and comments about them. The stories are both powerful and unsettling, and they reveal that the thankless caregiving task is very important, largely unappreciated, and frequently expensive, all-consuming, and lifelong. The ill too often deny their illnesses and fail to recover.

This sad commentary is viewed objectively by Karp, through scientific lenses, as a significant but rather hidden social phenomenon. The theoretical perspective guiding his analysis is called "symbolic interaction theory," which means that human beings, through communication with each other, define the meaning of what they are communicating about. Karp seeks "to illuminate the interpretive processes caregivers engage in as they define the character of their obligations to an ill parent, child, sibling, or spouse" (page 271).

Because of this somewhat detached approach, The Burden of Sympathy does not offer direct advice or present coping strategies; thus, some caregivers, reading it eagerly for immediate help, may be disappointed. Nevertheless, readers will learn that they are not alone in their anguish and that many others share their intense and complex love-hate feelings.

The general reader will learn that mental illness is still handled quite cruelly by our uncomprehending society and perhaps realize that major changes in the existing system are desperately needed. NAMI members already know that, but since the general public doesn't, solid books like this one can significantly help to spread the word