The Burden of Sympathy – How Families Cope With Mental Illness

    By David A Karp.

    Oxford University Press

    Price: £19.99

    ISBN: 0 19 512315 8

    “The hardest part of caregiving is not knowing whether what you
    are doing is right or wrong”. So says one of the many caregivers
    quoted in this book, giving a flavour of the difficulties
    elucidated within.

    David Karp is an American professor of sociology who has turned
    his attention to the dilemmas of family caregivers where there is
    mental illness in the family, especially schizophrenia and manic or
    severe depression.

    The core questions in this book concern the moral obligations
    that family members may feel, including what we may owe each other;
    what the moral boundaries of family relationships are; and what are
    the limits of sympathy. Through a series of interviews he addresses
    the issue of how people come to understand the nature of their
    obligations, and the responses provide a very moving account of the

    Through reading this work it became clearer than ever how
    care-givers are faced with the task of constructing their own
    understanding of mental illness, and formulate an understanding of
    how it comes about. This includes that most difficult of
    quandaries: “Am I in some way responsible for this person’s mental

    Karp classifies family responses into four sections which he
    calls “the four Cs” namely cause, cure, control and coping. In each
    section we see how the affect of mental illness on a family is a
    process that has deep ramifications all round.

    The last two chapters are called “Surviving the System” and
    “Caring in Post Modern America”. These reveal how very American
    this book is, but the themes are applicable to a British

    The way in which Karp combines analysis with empathy makes this
    a difficult story told with great respect. This is a compassionate
    book and should be read by all those touched by mental illness
    within the family.

    Ged Smith is senior mental health practitioner, Royal
    Liverpool NHS Trust.




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