Another thing in this book that strikes me is its portrayal of a woman with OCD, obsessive compulsive disorder. She is so afraid of dirt that she washes and washes her hands, to the point where her hands are red and dry and cracked. This part of the book takes place many years ago, before the development of some of the modern anti-depressant and anti-obsessive drugs such as SSRI's (Prozac, etc.) and is a reminder of how truly horrible mental illness can be. I remember case reports in my medical school psychiatry readings about people who would wash their hands an entire afternoon, unable to stop. Can you imagine what that must be like, wanting to stop doing something repetitively but unable to do so because of some weird inner compulsion that won't let you quit? It would drive you, well, crazy.
I can only imagine what it must have been like with no medications for the more severe mental illnesses such as schizophrenia. Even with meds nowadays we still don't always do so well with them; with no meds it must have been a nightmare. No wonder Freud and his contemporaries had to come up with such detailed theories of the psyche; they were powerless to treat mental illness by any other way but psychotherapy. Modern psychiatric medicine isn't perfect, but it has undoubtedly helped many people.
P.S. If you want to read an excellent post about what it means to be a mother of a special needs child, read The Surreal Life by Dreammom.