Voluntary Madness: My Year Lost and Found in the Loony Bin (30 page)

You are not part of it. You are the touched other. Touched by damage, by madness, disease. For shame.

I began to cry again. I curled up on the bed, as in the tub, fetally, and sobbed.

In therapy with Carol the next morning I knew I would be able to map out the previous night’s mood. I wasn’t scheduled to see Carol that day, but this was one of the great luxuries of Mobius. You could walk in first thing in the morning, go to your therapist, and say, “I had a really rough night. I need to talk,” and she’d make time for you right then and there while it was fresh. In fact, Carol had made it clear that I could call her anytime during my stay. The previous night I hadn’t made use of the phone number she’d given me, because it had felt too intrusive to do so, and I suppose I’d felt too unworthy to deserve help. But after a night’s sleep, I felt ready to talk, and I burst through Carol’s open office door asking if she had time for me.

Therapy on demand wasn’t really just a luxury of Mobius, though it’s true that Dr. Franklin had fostered the creation of a flexible responsive atmosphere and had chosen to hire staff whose therapeutic styles could accommodate these needs. But each therapist formed his or her own relationship with each client.

Carol brought a tremendous amount of dedication and self-sacrifice to her work, and if you opened yourself to her, she would open herself to you in matching style. She was the antithesis of clinically detached. When you did therapy with her, you felt as though you were talking to a very insightful and selfless old friend, and while this might not have been an approach that worked for everyone, it was exactly what I needed. I’d had my share of intellectualized, rubber-gloved sessions with doctors, and I found them sorely lacking when it came to plunging deep into the muck of my emotional catastrophe. Even the best psychiatrists I’ve seen have always been too categorical for my taste, too trained in scientific method to follow the twisted routes of the battered human heart.

In my experience, going to a psychiatrist to get at your feelings had always been a bit like going to a gynecologist expecting to make love, and always with the same unsatisfying result. It wasn’t that nothing useful could ever be gained from the encounter, but you were far more likely to be talking pathology than anything else. A quick poke and your anatomy would check out fine, but your culture would read abnormal, and you’d leave with a prescription in hand. If you talked, you talked abstractly, with the doc standing back making notes, or umm-humming while you fought off the devil on the floor.

Mobius’s staff psychiatrist and I had had a joke about this very thing, in fact. He came in once a week, and I’d seen him for maybe fifteen minutes the previous day, per Mobius intake procedure. He’d asked me all the usual doctorly questions about psychiatric history, family medical history, which medications I was taking, and which ones I might be inclined to need while at Mobius.

“You know,” I’d said, “I could be dying right now, riddled with disease, and you’d never know it. I could keel over right here and you wouldn’t even notice.”

“I know,” he laughed. “I’d be too busy taking notes.”

I respected him for that. He appreciated both the absurdity and the necessity of his position. Pharmaceutical gatekeeper.

The business of real therapy was for Carol and Sam and Josie. Josie was the third therapist on staff, a social worker who came in two days a week.

For them it was a form of art, especially for Josie, who was the most intuitively gifted of the three, and the best at removing her ego from the therapeutic encounter. She was alive with expectation, but only in the sense of wanting very much to know you, and for you to know yourself, as the person that you were. She had no categories. Guiding principles, yes. A practiced way of being in the world, certainly. But she was more interested in following your lead than imposing her vision. She listened more actively than anyone I have ever met, not straining to show interest (which is always so obvious in professionals), but rather genuinely wanting to know what you were going to say next. She was in the business of emotional suffering. She saw it every day and faced it anew in each person. In her healing, she observed no precedent, consulted no patented manual that told her what your symptoms meant, or junked you in with like and likely minds that were not like you at all.

There was no one like you. That was the point. Of course this didn’t mean that we weren’t all human, all facing similar fears and pains, joys and temptations, all processing experience with similar equipment, and therefore all likely to benefit from the application of a few tried-and-true coping skills that had helped many people of various constitutions and experience along the way.

Josie taught me one especially important skill for dealing with what often felt like the overwhelming intensity of my emotional life. She taught all of us this same skill, emphasizing it and reemphasizing it in subtly different ways until we began to take it in, each in our own time and apply it to our experience as it was happening.

The idea was this: emotional experience tends to feel repetitive and cumulative. This had certainly often been my experience with depression. My bouts of despondency had usually felt huge and insurmountable and vastly out of proportion to whatever was happening in my life at the time, and that is what had made them so puzzling and seemingly unconquerable. It was as if my brain didn’t see what was happening as an isolated incident, but rather as an incident very like something it had seen before, in fact, many times before, and so it rolled the new experience in with all the others not just in kind but in quantity.

I was always asking myself why. Why am I feeling this? Thinking that if I knew the cause I could find the cure. But of course there was no reasonable why, at least not in the present. I was awash in an accumulation of past feelings and future dreads, all similar, at least as far as my brain was concerned, and so, lumped together as one. But nobody can handle a lifetime of experience in one moment. That’s why depression crushes you.

So Josie taught me, and all of us, to stop trying to figure it out or account for it, to stop letting it seep into the past and the future. She taught us not to get lost in our brain’s deceptive shorthand, in the accumulation. She taught us to stop asking the question why, and instead to ask what. “What am I feeling?” The idea was to stay with the feeling as it was happening, not to analyze it, but to experience it, to look at its contours, the way you would look at the contours of a landscape, to take it in with your senses, not your critical mind.

She would say, “Put a light around it, and separate it from the past and the future. From cause and effect. Just let it be what it is now, which is all that it really is anyway—the rest is an illusion.”

Naturally, because all of us were experts at avoidance, none of us had actually tried this before. We’d always seen this seemingly huge tidal wave of feeling coming at us, and we’d run for the nearest distraction as soon as possible. But if you tried doing what Josie said, putting a light around it, or, if that was too airy-fairy a formulation for your taste, putting a fence around it, or a moat, or whatever worked, then you’d find that the feeling was more than likely manageable after all. Not only that, but rather than soaking you in misery for hours on end, it was likely to resolve itself quickly and drain away. Again, this was the idea that turning toward the thing that frightens you often diminishes it, the real and concrete being far less frightening than the imagined.

Sam explained this phenomenon in another way. His idea was that emotional discomfort was a kind of messenger. It was trying to tell you something, and if you turned away and didn’t listen, it would just keep trying to get your attention in more and more inventive ways, intruding on your distractions, or your highs, so that it would take higher and higher doses to shut out the sound of the messenger’s incessant knocking. Whereas, if you turned and listened, the way you might to an insistent child, the ruckus would die down quite quickly, and the message would come through in a manageable way. Of course this meant that you had to really listen, or as Josie had advised, pay attention to the what, to what was happening. But if you did, you often found that it was not nearly so bad, or huge, or terrifying as you had feared.

 

Carol and I did this in a less theoretical way in our one-on-one therapy together. The idea was the same. Break the emotion into its component parts, not just because it was snowballing and becoming far larger than it needed to be, but, per Dr. Franklin’s theory in process therapy, because it was part of a chain reaction. If you could break the chain, you could stop the reaction, stop the undesirable end result.

As I began to pull apart my emotional responses with Carol, I began to see in practice why Dr. Franklin’s method emphasized thought as well as feeling and behavior. The feeling and behavior parts made sense immediately, of course. The link between feelings and actions was clear. I feel bad, therefore I drink or I shoot up, or I cut myself, or I try to kill myself. But what hadn’t been so clear was the idea that thoughts lie behind feelings. Thoughts give rise to feelings or, in a sense, feelings are made up of thoughts. In fact, there can be no emotion without thought. So to get at the feeling, you must first get at the thought. To break the reaction you must start farther up the chain.

Most of us tend to think that emotions and thoughts are separate entities running on separate tracks. It often feels this way in life. For example, you may know in your mind, your thoughts may be telling you, that your boyfriend is a jerk who treats you badly, and therefore you should dump him. But your heart just doesn’t seem to get the message. You love him, and no amount of surety in your mind can seem to convince your heart that it’s mistaken. Why, in this case, doesn’t knowing something intellectually translate into feeling and then action? The thought is: My boyfriend is a jerk. Therefore the feeling should be; I hate him. And the behavior should be: I break up with him. Yet that’s not usually how it works.

But when you spend enough time dismantling your thoughts and feelings, you begin to see that they are not separate. It seems that way merely because the links between the thoughts and the feelings are very old and very buried. As Josie had reminded us, thoughts are really thought patterns, a way that your brain has learned to process your experience. Breaking those links, and rerouting a thought pattern takes a lot of effort and concentration. It’s a bit like learning a foreign language as an adult. Children pick up new languages effortlessly, organically, almost by osmosis, whereas adults have to do it the hard way, learning the grammar, memorizing the vocabulary, putting the sentences together word by word, or, as in my dream scenario, putting the house together brick by brick.

And that is what I did with Carol. I tore down my house brick by brick and rebuilt it again the same way. Or tried to. I can’t say that my house is entirely rebuilt even now, but let’s just say that I’m a lot more cognizant of the blueprints, so I know where the danger zones are. I know which walls are weak and likely to collapse, and I know which floorboards are loose and creaky.

I learned this by anatomizing my experience.

After spending the previous night curled up in a ball crying and contemplating hurting myself with one of the sharp knives in the kitchen, I went into Carol’s office that next morning and drew a map of my mood, a record of the chain of thoughts, feelings, and intended behaviors that had conglomerated the night before.

In the previous day’s therapy session I had reconnected with a familiar source, but in a more immediate way. The molestation. The fact of having been molested wasn’t news to me, of course. Nor, really, was the idea that it had profoundly affected my emotional life and the way that I process experience. But I had never before seen so clearly exactly how the molestation, as the source, could set a chain reaction in motion, how it led me, if I let it, inexorably down a self-abusive and destructive path. I hadn’t yet mapped the cycle on paper so that I could really see the process at work.

In the remote past, the molestation had triggered a sense of violation, unjust intrusion, and then, quite understandably and predictably, rage. That rage had persisted over the intervening years, and still lived very close to the surface, such that just speaking with Carol in one therapy session, having Carol ask the right open-ended questions and target the links between thought and feeling, had brought it up and out with a vengeance.

I had then carried that rage into rebirthing, and in the process of breathing and letting the emotional urgency come to the fore unfettered by my defenses, I had allowed myself to be consumed by it. I had visualized it as I had felt it coursing through me in the meditation. I had drawn the picture of it in the art room, the extreme close-up of my face, with the gritted teeth and bloodshot eyes, and the word “No” in place of a mouth. And finally, I had taken that feeling with me into the van.

Now, as I read back over my description of the ride home in the van, I can underline the words that serve as mile markers for the downward spiral of the mood from rage to self-harm. The word “rage” appears in the first sentence. “I went away full of the rage.” By the next paragraph the rage has become alienation. “I began to feel horribly alien sitting there.” By the end of the paragraph alienation becomes isolation. Then very quickly isolation becomes shame—the “taint.” Finally, as I had done in Carol’s office, in the face of the shame, I dissolve into a puddle and the description ends.

So the diagram looks like this:

 

Once the shame has taken hold, it’s a short step from there to self-blame. Shame is essentially self-blame. From self-blame it’s another short step to self-harm. You feel shame. You are, therefore, guilty. If you are guilty, then you must be punished. You must punish yourself. You must inflict pain, or perhaps even death. Obliterate the shame. Obliterate the self.