The Man Who Wasn't There: Investigations into the Strange New Science of the Self (13 page)

When I returned the next day, the IV and the urine bag were gone. A pair of crutches lay next to David’s bed; he had already crutched to the bathroom and back, just as the surgeon had said he would. He smiled and laughed easily as we spoke. The tension that had lined his face all the time I had known him was gone. I sensed relief, happiness.

Months later, I exchanged emails with David. He said he had no regrets. It was as if for the first time in his life, David was
whole.

TELL ME I’M HERE

WHEN YOUR ACTIONS DON’T FEEL LIKE YOUR OWN AND WHAT IT DOES TO THE SELF

What gives me the right to speak of an “I,” and even of an “I” as cause, and finally of an “I” as cause of thought? . . . A thought comes when “it” wants, not when “I” want.

—Friedrich Nietzsche

For any true grasp of delusion, it is most important to free ourselves from this prejudice that there has to be some poverty of intelligence at the root of it.

—Karl Jaspers

M
arch 10, 2013. It was a bitterly cold day in Bristol, England, much colder than it was in London, which is a two-hour train ride due east and from where I had just arrived.
I met Laurie and her husband, Peter, at the Bristol train station. We were to go and see the parking garage where Laurie had tried to jump and end her life on a similarly cold day in November 2008.

Peter drove us to the garage and up the ramp that spiraled steeply to the terrace of the eight-story building. “You are not going anywhere near the edge,” Peter said to Laurie. “You are not going to tempt fate.” Laurie seemed far less concerned. She exclaimed, “Wheeeeee!” like a kid on a roller coaster as Peter climbed the ramp at a fair clip.

We parked on the seventh floor and climbed up to the terrace. The wind stung. For a few minutes, Laurie struggled to find the spot she had intended to leap off of. Nothing looked familiar. Even the parapet was too high. “This is impossible for me to climb,” she said. “I think they changed it, to make it less easy to climb.” But the concrete parapet looked uniformly old, nothing seemed added on. We kept searching.

We found the place. It was near the very top of the same spiral ramp we had driven up. The ramp had inner and outer parapet walls. That fateful November day, Laurie had first peered into the inside of the ramp. The ground below had been muddy (it was filled with gravel today) and she had decided it would be too soft to kill her. She then walked over to the chest-high, foot-wide outer parapet and somehow climbed onto it. Had she jumped, she would have landed on concrete.

Today, when you stand at the wall, you see a modernistic fifty-foot-high sculpture in front, a column clad in slate, with an umbrella-like disk of solar panels near the top, above which are twin, twisting vertical blades of a wind turbine. “I remember looking at that,” Laurie told me. “They were building that in 2008.”

The sculpture stands in the middle of a long traffic island. On the far side are multistory brick buildings, beyond which you can see the tiered tower of St. Paul’s Church, known in Bristol as the Wedding Cake Church. Even with suicide on her mind, Laurie had stood admiring the view. It had also given her pause to ponder the jump. Would it kill her or just paralyze her? As she contemplated the outcome, a man
saw her from below and called out: “Are you all right?” Laurie did not answer. “I guess he called the police,” she told me. The police came up and rescued her. They took her to the nearby police station, where she was sectioned under the UK’s Mental Health Act—in a holding cell for twenty-four hours.

To this day, Laurie thinks it wasn’t her decision to attempt suicide. “I was under the influence . . . of some force,” she said. “I wasn’t the one making that decision. Someone was trying to push me off the edge.”

Soon after that incident, Laurie was diagnosed as suffering from schizophrenia. But the knowledge hasn’t changed her sense of how she felt the day she tried to jump. Sitting in a Starbucks inside the shopping center next to the parking garage, she continued to voice skepticism that the thoughts that told her to jump were her own. “I still wonder if it is outside of me,” she said.

About a month later, I was attending a conference on “Hearing Voices” at Stanford University. The first speaker had finished her talk on musical hallucinations, and was taking questions. An audience member read out a question that someone named Sophie had posted on Twitter (the talk was being streamed over the Internet). Suddenly, a woman sitting near the front put up her hand. As the puzzled speaker looked at her, the woman said, “
Sorry, I’m Sophie.” The audience dissolved into laughter.

I had a more complicated reaction than that of the audience. I had come to the conference to meet Sophie (who is from Chicago), so the fact that she was posting on Twitter had dismayed me. Was she watching the talks remotely? Hadn’t she turned up at Stanford? Seeing her sitting in the room was a big relief.

I first learned about Sophie from Louis Sass, a professor of clinical psychology and a schizophrenia expert at Rutgers University in New Jersey. “She’s the most articulate person with schizophrenia I have ever met,” Sass told me. Years ago, before her own tryst with schizophrenia, Sophie contacted Sass because she had found his work interesting. Sass has been arguing for decades that schizophrenia should be viewed as a complex disturbance of the self and self-consciousness, and the view resonated with Sophie, whose mother had suffered from schizophrenia. Then, one day, Sass received an email from Sophie, which he recollects as saying, “Gee, funny thing happened . . .” Sophie, it turned out, had had a psychotic breakdown herself.

Sophie grew up with a mother who suffered from psychosis (a condition in which one’s sense of reality is profoundly altered). With the hindsight of maturity and training in psychology and philosophy, Sophie can see her mother’s paranoia and erotomania (“she was convinced people were in love with her”) for what it was: the outcome of severe schizophrenia. But as a four-year-old, Sophie knew no better. Her mother would drive Sophie and her brother to grocery stores but would refuse to go in herself. Instead, she would send the children to get the groceries and even pay for them. “When you are a four- or five-year-old child, getting a whole cartful of groceries and paying for them with a check that your parent has pre-signed was very strange,” Sophie told me. “But at the same time, I thought, Oh, that’s just how she is.”

Her mother’s paranoia manifested in other ways. For instance, when strangers, or even the postal carrier, came to their house, the family would shut all the windows and hide. “I thought it was very normal,” said Sophie.

It was around the time that Sophie entered junior high that she realized her mother, and their family life, wasn’t normal. Her mother’s
paranoia had been exacerbated. She thought a recording device had been implanted in her uterus, and even in their dog, and that the whole house was wired. She would ask her kids to walk down a block, away from the house, before she would talk to them.

If that wasn’t difficult enough, Sophie’s family history of schizophrenia went further. Her mother’s first husband had had a schizophrenic breakdown when studying philosophy, and was institutionalized at a state hospital in California. “We grew up in fear of him,” recollected Sophie. “[My mother] thought that he was going to get out of the hospital that he had been committed to, and come and find us, and that he wanted to kill her. I have no idea if that was in any way grounded in reality. So we grew up in fear of him, but at the same she very strongly romanticized his brilliance, his genius. Our house was full of his philosophy books.”

Kant, Hegel, Heidegger, and Karl Jaspers filled the shelves. Sophie even got to read this man’s diaries, which documented his descent into madness.

Through all of this, Sophie negotiated her childhood just fine, developing an intellectual and academic bent of mind. She turned down a Cornell scholarship and went to Nepal to work with an NGO, and then spent a year and a half in Japan. She returned to the United States and went to the University of Oregon in Eugene to study continental philosophy. One of her advisers was John Lysaker, who has written extensively on schizophrenia, psychosis, and the self. During her senior year, still blissfully absent of any symptoms of psychosis herself, Sophie wrote to Louis Sass. She was intrigued by his ideas on schizophrenia, the attendant “madness,” and the parallels he saw in modernism.

“If you want to find a good analogy for many schizophrenic experiences and symptoms, an excellent place to look is in the avant-garde modernist and postmodernist art of the twentieth century,” Louis Sass told me. “That is not to say anything as silly as modernism is schizophrenic or that schizophrenia is modernist necessarily, but there’s a structural parallel which offers quite a different way of understanding, often in great detail, a lot of what is really going on in schizophrenia.”

An unusual confluence of life events led Sass to this view of schizophrenia and to
his 1992 book
Madness and Modernism.
One was his training in modernist literature. As an English major at Harvard in the late ’60s, he was drawn to modernism, wrote his thesis on Nabokov (“who was kind of a modernist”), and keenly studied the poetry of T. S. Eliot and Wallace Stevens. Schizophrenia was also a hot topic then. Scottish psychiatrist R. D. Laing had written a provocative book on the subject,
The Divided Self
. Sass took a course at Harvard for which Laing’s book was required reading. And around that time a close friend of his developed schizophrenia.

Almost four decades later, sitting at the kitchen table in his Brooklyn brownstone apartment, Sass recounted his friend’s descent into the cauldron of schizophrenia. There were signs even in high school that his friend was unusual. Those who develop schizophrenia typically go from being premorbid (before there are any clear indications of impending psychosis) to prodromal (at the cusp of psychosis) to full-blown psychosis. “His premorbid personality, to use the technical term—I certainly didn’t think of him that way, he was my friend—was in retrospect typical of a certain kind of person with schizophrenia,” said Sass.

His friend was unconventional and fiercely autonomous (an attribute that would prime Sass to question the standard view that mental
disorder always involves lessened autonomy). “We ‘normals’ were so incredibly conventional from his point of view,” said Sass. “So cowardly, in a way. . . . You wouldn’t dare stand on your head here in my house, for example. He would have, if he felt like it, as a manner of speaking. He would do things that were outrageous. He wasn’t afraid of anything.”

Once, in a school cafeteria, his friend picked up the fish from his plate and lobbed it high into the air and clear across the hall toward the teachers’ table. All this could be described as behavior “motivated by a certain kind of oppositionality, contrarianism, insistence on autonomy, contempt for the normal,” said Sass. Not entirely unusual for adolescent boys of his age, perhaps. But “there was something different about my friend’s way of manifesting it . . . so extreme that one has to call it, whatever the word means, ‘insane’ in a way.”

His friend eventually became psychotic. “My sense of what it was from knowing him and knowing him very well, from before he became psychotic and after, didn’t fit with the common images [of schizophrenia],” said Sass.

Schizophrenia was originally called dementia praecox, a term coined in the 1890s by the German psychiatrist Emil Kraepelin. It was Swiss psychiatrist Eugen Bleuler who renamed it schizophrenia in 1908. Dementia praecox, or premature dementia, posits, among other things, intellectual disability. Another now out-of-favor psychoanalytic view of schizophrenia was one in which the person regressed to an infantile state, robbed of the maturity of an adult. Yet another stereotype, popularized by the antipsychiatry movement and some of the literary avant-garde, was of the schizophrenic as a romanticized wild man, in touch with his deepest desires and instincts.

Sass and his friend went to different colleges. Sass went to
Harvard, and would go on to do his PhD in psychology at the University of California, Berkeley, and his internship in clinical psychology at the Cornell University Medical Center–New York Hospital. Meanwhile, his friend’s schizophrenia worsened. He dropped out of college, and eventually committed suicide. The experience marked Sass.

Back in his apartment, Sass cast his mind back to when he had gone to see his friend after he had had psychotic breakdowns. On one occasion, Sass found him obsessed with dancing on one foot—something he had been working on for many weeks—now demonstrating his talent inside his mother’s garage. But there seemed to be no further purpose to his endeavor, no desire to impress anyone, no desire for personal gain or any usual sort of narcissistic satisfaction.