book review Impulse by Ellen Hopkins

I just finished reading the well known book Impulse by Ellen Hopkins.

When you search for mental illness in young adult fiction or ask about any books in this category this book is top of the list.

Like all Ellen Hopkins works it’s a novel in verse.

It centers around three different teenagers from different walks of life/ situations and who have different mental illnesses.

Venessa lives with her Grandmother. Her father is away in the military often. Her mother had bipolar and Venessa witnessed her suicide.

For years Venessa has been depressed and cutting. In an attempt to end her life she cut too deep.

She made it out ok physically with only the scars, and found herself in Aspen Springs psychiatric hospital.

Tony doesn’t really have a family. He was severely molested by his mother’s boyfriend. He got sent to lockup for killing the boyfriend. His fondest relationship was with a man Phillip who died of AIDS. He comes into the story believing he’s gay. He really doesn’t know where his life will go from here as he spent years in lockup and then was a drug user.

Conner comes from a wealthy family. He is a twin and is in the shadow of his “perfect” sister. He is constantly pushed to be the best in football and grades and overall quality. No one understands him or has ever truly unconditionally loved him. It was all about the image. It is revealed that Conner was molested at 12 by his babysitter. Ever since then he’s been attracted to older women. . He had a sexual relationship with a teacher and when things fell apart inevitably he shot himself.

These totally different teenagers are thrown together in Aspen Springs.

I have some issues with Aspen Springs as someone who has been hospitalized, read other books about residential treatment and has friends who have been hospitalized. The therapists and staff there don’t seem at all to me to be developed characters. You never get a sense of them as separate people. There’s Dr. Boston who conner calls (Dr. B) and Dr. Starr who Conner calls The Bulldog.

There are also other psych techs Paul and Kates and other “house mother” staff. Again they really seem to be not a main part of the story. The therapists will prompt a character to talk about family life what brought them there ETC, but it will just turn into them explaining more of their story rather than much of a dialogue.

Whenever there is dialogue universally it felt to me like the therapist would say things that were not very sympathetic to the teens, like telling them to understand their familie’s point of view, follow their rules ETC. While this is true, empathy is a two way street. The guy who molested Tony doesn’t deserve empathy in my book. It just seemed like all I heard out of either therapist was preaching on what to do rather than building a relationship with the teenagers.

The core of relationships in the story is between the three teenagers. Vanessa is noticed by the two boys right away as good looking and a compassionate kind person. She strikes up a friendship with both Conner and Tony. They also notice her cutting. But neither want to “tell on her,” a theme in the book that leads to a tragic end.

At first Conner feels more attracted to Vanessa. Tony feels attracted to Coner. Though Coner is kind of a mystery. Flirting with the therapists, acting very tough and in control. Tony is warm and friendly.

Seeing the three interact in group therapy the rec room, on outings ETC friendship deepens and attractions change up. Tony becomes clearer on his sexuality.Vanessa, as she understands more about bipolar disorder and is on the right medication, is able to sort out her past with more clarity. Conner slips further into himself as no matter how he tries his parents just don’t understand him. In fact on his visit home his mother demands he not take meds for the whole weekend. Which is unrealistic and shocking!

Some other things that stood out to me were the use of “takedowns” by staff, something that is rarely used in hospitals now. Restraint is always a last resort and I feel by having this depicted in the book, the use of rough bodily force to solve crisis it would make readers believe this is the norm. On top of this whenever a crisis happens dinner and meds are delayed. It seems like the staff don’t really know how to handle a crisis without physical restraint and things go into chaos quickly with life on the unit interrupted. To me this is the mark of a very negative experience on a unit. That while it does happen, you would think the author would want to show the most positive side of the running of a psych unit. This could be the only thing someone reads about the mental health system. So they’ll go around like “why would I ever want to be hospitalized. In Impulse you get knocked down for getting angry and then if you’re just trying to go with the flow you have to witness this violence and have your routine disrupted.”

This actually puts a bad stigma on a psychiatric hospital experience I feel as one who has been hospitalized. Now what’s written unfortunately does exist in some form. I just wish the more helpful aspects were depicted, (I.E) staff standing out as very supportive characters one feels a connection to, staff holding a calm sense of leadership with boundaries ETC.

The other thing that bothered me was that patients were endangering themselves without staff even knowing. Vanessa managed to track down several good cutting tools which she had in her room and used to her hearts content. Tony would pretend to take his pills only to hide them so he could take more at whatever time he felt like. While again this can happen I would hope it’s not the norm. I would have liked for this to come up but then show it being firmly corrected by staff and explored. Especially the cutting part with Vanessa. For all her growth in regards to her bipolar disorder and relationship with her family her cutting is yet to be really dealt with. Though by the end she doesn’t have any incidents with it on the last level of the program, she makes a comment to Tony that she’ll never stop cutting.

This is very triggering for anyone dealing with self harm issues as so many feel this way. For the book to end with this sentiment is disturbing. I feel there had to be a way to really address the cutting through a solid therapy relationship in group therapy ETC.

The program is based on levels and basically having good behavior. To me this is only skimming the surface as someone could be fooling everyone saying their fine pass through the program and still have a ton of issues. Being teenagers they’re not jumping for joy to improve themselves. They’re ambivalent as expected, sometimes cooperating in therapy and other times not. Some confessions of secrets at the end of the book reveal huge areas not yet even touched by therapy which to me would definitely lead to setbacks. Especially as there is no talk of anything after the program like continued therapy or even medication. By the end of the book one character was actually no longer taking medication at all. Again something the other patients knew but didn’t want to tell staff.

This is common for us who have friends suffering with tough issues. Not wanting to “ tell on them” and make them mad. However for a book centered on mental health recovery I feel the issues should have been handled better. Either the person told on the other who was making bad choices, and the other person after some initial anger understood. Or no one told but staff found out and made it plain the dangers of doing this. For treatment staff they didn’t seem at all very perceptive or careful. Not knowing about anything to do with hoarding/ not taking meds, the whole cutting thing and just in general. Again the message seems to be that the teens depend on each other for the healing they receive and not so much the staff or program.

The last part of the program is challenge camp. Where two counselors take them out into the desert. This part interested me as the use of hiking and otherwise in the wilderness being therapeutic. I did see how it forced them to all work as a team, even getting the three to get along with other patients they previously didn’t associate with. This is where bonds are solidified between the teens. I wish there had been group process or other therapeutic intervention at this stage to discuss the relationship dynamics, or the teens issues. But of course there wasn’t.

The final scene of the book is chilling as one teen ends up committing suicide. Which again could be super triggering for many readers.

It does tell a harsh lesson that if someone is really bent on killing themselves and truly feels there is no hope they’ll withdraw into themselves and do it. However there was no processing of this by the staff or other patients. Besides everyone blaming themselves. I wish the book hadn’t ended so abruptly with no resolution on what treatment would be available to the teens once released and the huge impact of the committed suicide.

I guess I can see why the average person with no experience or knowledge of mental illness, the inpatient treatment system or therapy would find this book appealing. It could be their first glance into mental disorders and their effects. They wouldn’t know to question anything about how therapy was portrayed. And perhaps what attracts teen readers is the fact that the heart of the book is the peer relationships that bring healing. And that anyone, no matter their mental illness, level of trauma suffered ETC is capable of love and acceptance. This message shines through in the story. And in that it’s worth the read. If someone can pick up this book and see that no matter what they’ve been through there can be change in their life, whether through therapy or something else, then it’s done its job.

So despites the parts I really did not like I would recommend the book. Only because as I said I suppose for a first book on mental illness it does have its upsides. It could definitely start good conversations about the topics mentioned: abuse (physical, sexual, emotional), sexuality, abortion, cutting, depression, suicide. But the person facilitating needs to be prepared for what the discussion can bring up. Because so much of this triggering material is just kind of out there, with no one handling it in a professional sympathetic way, as in good quality therapy depicted, many readers could feel plain overwhelmed. Parents and teachers who aren’t professionals may then feel lost. Unless the author wrote a whole separate “how to discuss this book” book.

I welcome all comments. This is an extremely popular book so am hoping to get some good discussion going. n

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