... the book feels at once crafted, its prose full of calibrated grace, and startlingly unmediated. No brush (with obscurity) is necessary to buff its surface ... Howland seems reluctant to reinscribe the cruelties of these categories: sick and well, normal and abnormal. Suspicious of the ways in which they are delineated, she proceeds according to a simpler binary. Those who suffer are patients. Those who don’t are not ... The choice for Howland thus becomes one between the vulnerability of the inmate and the brusque, fatuous bullying of the keeper ... Her tone, recounting the stampede toward the doors, feels slightly mocking. She’s no longer present in the anguish of the moment, but she isn’t explaining it to us from without, either. Instead, she seems to be ironically reconstructing a flood of feelings that has already subsided, serving them up as a wry, self-conscious simulation: 'We’re being forced, that’s what it is!' There’s the nauseating sense that Howland is veering ever closer to a real, claustrophobic horror—one that even now lunges toward her, out of the past—but, thank God, the doors are sliding shut ... Howland holds her life at arm’s length; recounting a nurse’s rudeness or a fellow-inmate’s aggression, she sounds grateful for the good material ... It all feels like an attempt to overwrite, or perhaps just write away from, the present tense of suffering—which, for Howland, is akin to madness. Similes, any device that transforms a thing into what it is not, become helpmeets: if Howland’s mother suggests a glamorous animal, then the patients appear as beautiful aliens ... When people write about their rendezvous with mental illness, there are often a few false notes scattered among the true ones, places where the meaning of the thing feels not fully absorbed. Howland’s book struck me as remarkably perceptive and wise, but there was one passage, toward the end, that protruded as an exception .. This may not be the smug sentimentality of the memoir’s psychiatrists, who are eager to congratulate Howland for submitting to their expert care. But it does seem to contain the felt truth of someone who parted from her life and then returned. No one is going to rediscover you. You have to rediscover yourself.

This is not a story of mere neglect but of a writer’s collusion with invisibility, with a lifelong ambivalence toward selfhood and its burdens ... The onus of personality, the weight of the past, crop up often in Howland’s work ... As that first paragraph portended, this is a story about her neighbor’s heart, not her own — an anthology of the lives she encounters in the ward known as W-3 ... here’s a refusal to romanticize sickness or health. Her suffering doesn’t make her unique or interesting; instead it folds her into a common experience. Her insistence is on telling the story of a collective with blunt clarity, and sidestepping the genre’s potential for sentimentality or sensationalism. She brings the particularities of the world to life, how hair care was a miserable problem for the women of the ward; everyone just gave up and resorted to wearing towels like turbans ... It’s what hooked me — the temperature of the prose, its cool watchfulness. The narration isn’t distant, but it isn’t intimate either. Howland isn’t interested in redemption or instruction — but something more elusive ... It’s that quality of depiction that Howland seems to pursue — the clarity that allows readers to feel as if we are encountering the ward itself, Zelma herself, and not the narrator’s projections, not her own need.

... a slim, witty and uncompromising memoir ... Structured less as a self-portrait and more as a mosaic, Howland tells the stories of her fellow patients with astuteness and empathy. She contextualizes the late 1960s milieu—with its ubiquitous racism and misogyny—in which she and her peers had become ill and were now attempting to get well. Calmly, coolly, she recounts the astonishing sexism of the medical profession that had dismissed her troubles ... With its incisive humor and unsparing descriptions, W-3 refuses a tidy resolution, instead showing how all the 'clumsy, good intentions' in the world can't always provide a cure for the horror and tedium of losing one's mind.

Howland’s story is not so much the description of her inner experience as it is a kind of group portrait of the ward ... personalities and many others whirl by somewhat quickly, observed by a wry narrator who’s attentive to manner and mood, but doesn’t get to know her fellow patients deeply and dares not take too many liberties imagining their inner lives ... Howland is committed to a kind of first-person plural perspective, stressing the we of the ward rather than her personal experience, as if trying to translate the effective therapeutic process into an aesthetic principle. After the first few chapters, she stops reflecting on her pre-institutional life, no longer dipping back into her past to flesh out the story of her recovery. Nor does she tell us much about her ongoing relationships with people in or out of the hospital ... There is a kind of self-effacing blankness at the center of the book.

... brilliantly observant ... Howland loves a good curiosity; her business, in W-3 and throughout her oeuvre, is with the odd detail and the odd person out. Drawn to the eccentrics who populate Chicago—and her family in particular—she vividly renders the social worlds within the movie theater, the public library, the courtroom and the living room, attending to the essential strangeness of each person she describes ... Some of her most personal moments depict her reluctance to get personal ... She tends to lavish attention on her wonderful weirdos while devoting significantly less space to herself. Then again, authors reveal themselves in what they choose to reveal about others.

W-3 is a debut and, as debuts go, it’s very fine, at moments dazzlingly and daringly written. In the early 70s, it was not beholden on a writer to tip-toe around the subject of mental illness, to worry about terminology or stereotyping; it is a ruthlessly straightforward, almost impudent book and all the better and wiser for it. Its author captures quite brilliantly the comical competitiveness of her fellow patients ... she is excellent, too, at delineating what we might call the secret life of the institution ... But Howland’s technique in this memoir is to stare at others, not herself; her breakdown and its causes (men, money, something horrible that happened when she was a child) are touched on only intermittently and always at an angle. In the main, she is painfully absent from the text, an omnipotent narrator who also seems to be standing with one leg on either side of a gaping void. W-3 is more or less shapeless, its tone unvarying, the camera permanently fixed at the same distance from the action, its end oddly peremptory. While this may be an important part of the book’s design—its relentlessness mirrors both her illness and the unpunctuated days of hospital life—it’s also utterly exhausting. W-3 is not a locked ward, but the reader, held prisoner too long, leaves it with an overwhelming sense of relief.

W-3 is not a recognizable form. What does one expect from a memoir about being institutionalized in a psychiatric ward? If there is a singular confession, it is cleverly eased over: yes, a suicide attempt, yes, a note on the method, yes, an insight into the machinery that kicks into action once you survive an attempt in 1960s urban America. But it is not a memoir that confesses to an intimate or spectacular inhabitation of neuroses ... Howland writes around herself: she is ever-present, but more in her steely observations, less so in the facts of her life. She narrates the slow passage of time in the ward, her friendships with the others who live there too, and their wardrobes, moods, families, objections and exits. She is a mesmerizing writer about institutions in general; a quality that is also tended to in the narrative voice she develops in her fiction. She observes life in institutions telescopically, harboring a wryness towards bureaucratic structures and a deep fondness for the people having to navigate them ... Bette Howland’s prose is unsparing, and in her memoir, this manifests as a trick of form ... the memoir, as Howland shows us, need not be instructive. The radicality of W-3 lies there: it is imaginative, as a form, because it is a narrative about the banal, moving contradictions of people who experience madness, and how they experience them.

The voice is cool and the gaze is clear: Howland doesn’t 'indulge' in reflections on her trauma or make any attempts to romanticise her illness—instead her focus is outwards, onto the ward and her fellow patients. It is a startlingly frank account of mental illness, and the contradictions and humiliations of life as a patient. In fact, the least modern thing about it might be that frankness—Howland is plainly unhampered by the need to watch her language ... It goes on. Perhaps for too long. We shuffle from one character to another, in a relentless—even exhausting—litany of minute detail. The compound effect Howland achieves of all this individual strangeness is that it begins to look ordinary. Before long the reader is thoroughly accustomed to the institutional life that the author experienced ... Howland, meanwhile, remains shadowy: there is no exploration of her inner world, no prism through which our view is filtered. The book has no narrative shape to speak of. It takes some time to work out what she is doing ... But Howland is right to suspect that it is in the small particulars that real insights emerge ... As you near the end the mystery of her absence from the pages begins to solve itself: she views her treatment, and the chronicling of it, as a form of self-escape. When she does give us details, it is as a kind of exorcism.

... compelling and lucid ... Her memoir, clear-eyed, with an anthropological, sociological distance, is a brilliant attempt to document life on the ward with clinical detachment ... with an insightful introduction by Yiyun Li...Howland’s writing on mental distress and its consequent treatment through hospitalisation, is a wonder. Her prose is direct, unadorned, understated. Despite the horrors she endures she does not appeal for the reader’s sympathy, but rather seeks to be understood, to have her voice heard, and to have her vision of her story recounted and expressed ... Howland captures perfectly one of the existential contradictions of life on a psychiatric ward ... This account of mental distress and hospitalisation is never depressing, thanks to the compelling voice, full of wry, cool humour and clinical detachment that allows us to see not only the pain but also the absurdities of life on a psychiatric ward. This is Howland’s gift, to be able to be part of this life, and yet outside sufficiently to document it so compellingly.

... [Howland's] first book resurfaces with all its epigrammatic, disconcerting, and incandescent firepower intact ...[a] clinically observed yet compassionate, drolly and bravely matter-of-fact memoir ... The descriptions are breathtaking ... And how crisply she charts the desperate dramas, penetrating strangeness, mordant humor, and transcendent alliances. Among the many chronicles of depression and psych wards, Howland’s is uniquely arresting in its omniscient attention, radiant artistry, zealously pursued insights, and abiding respect for those who share her struggle.