Some people are more frightened than others.
“You spent nearly two years in a loony bin! Why in the world were you in there? I can’t believe it!” Translation: If you’re crazy, then I’m crazy, and I’m not, so the whole thing must have been a mistake.
“You spent nearly two years in a loony bin? What was wrong with you?” Translation: I need to know the particulars of craziness so I can assure myself that I’m not crazy.
“You spent nearly two years in a loony bin? Hmmm. When was that, exactly?” Translation: Are you still contagious?
I stopped telling people. There was no advantage in telling people. The longer I didn’t say anything about it, the farther away it got, until the me who had been in the hospital was a tiny blur and the me who didn’t talk about it was big and strong and busy.
I began to feel revulsion too. Insane people: I had a good nose for them and I didn’t want to have anything to do with them. I still don’t. I can’t come up with reassuring answers to the terrible questions they raise.
Don’t ask me those questions! Don’t ask me what life means or how we know reality or why we have to suffer so much. Don’t talk about how nothing feels real, how everything is coated with gelatin and shining like oil in the sun. I don’t want to hear about the tiger in the corner or the Angel of Death or the phone calls from John the Baptist. He might give me a call too. But I’m not going to pick up the phone.
If I who was previously revolting am now this far from my crazy self, how much further are you who were never revolting, and how much deeper your revulsion?
New Frontiers in Dental Health
My one-and-a-half-year sentence was running out and it was time to plan my future. I was nearing twenty.
I’d had two jobs in my life: three months selling gourmet cookware, much of which I dropped and broke; and one week typing in the Harvard billing office, terrifying students by sending them term bills for $10,900 that were meant to read $1,900.
I made these mistakes because I was terrified by the supervisor. The supervisor was an elegant and attractive black man who roamed all day among the aisles of typists, watching us work. He smoked while doing this. When I lit a cigarette, he pounced on me.
“You can’t smoke,” he said.
“But you’re smoking.”
“Typists are not permitted to smoke.”
I looked around the room. All typists were women; all supervisors were men. All supervisors were smoking; all typists were not.
When break time came, at ten-fifteen, the bathroom was stuffed with smoking typists.
“Can’t we smoke in the hall?” I asked. There was an ashtray outside the bathroom.
But we couldn’t. We had to smoke in the bathroom.
The other problem was clothes.
“No miniskirts,” said the supervisor.
This put me in a pickle, as I had only miniskirts, and I had as yet no paycheck. “Why?” I asked.
“No miniskirts,” he repeated.
Smoking was Monday, miniskirts was Tuesday. Wednesday I wore a black miniskirt with black tights and hoped for the best.
“No miniskirts,” he said.
I scooted to the bathroom for a quick cigarette.
“No smoking except on break,” he muttered as he passed my desk on his next round.
This was when I began making my high-priced mistakes.
Thursday he beckoned me over to his desk, where he sat, smoking.
“Making some mistakes,” he said. “We can’t have that.”
“If I could smoke,” I said, “I wouldn’t make so many.”
He just shook his head.
Friday I didn’t go in. I didn’t call either. I lay in bed smoking and thinking about the office. The more I thought about it the more absurd it became. I couldn’t take all those rules seriously. I started to laugh, thinking of the typists jammed into the bathroom, smoking.
But it was my job. Not only that—I was the one person who had trouble with the rules. Everybody else accepted them.
Was this a mark of my madness?
All weekend I thought about it. Was I crazy or right? In 1967, this was a hard question to answer. Even twenty-five years later, it’s a hard question to answer.
Sexism! It was pure sexism—isn’t that the answer?
It’s true, it was sexism. But I’m still having trouble with rules about smoking. Now we’ve got smokism. It’s one of the reasons I became a writer: to be able to smoke in peace.
“A writer,” I said, when my social worker asked me what I planned to do when I got out of the hospital. “I’m going to be a writer.”
“That’s a nice hobby, but how are you going to earn a living?”
My social worker and I did not like each other. I didn’t like her because she didn’t understand that this was me, and I was going to be a writer; I was not going to type term bills or sell au gratin bowls or do any other stupid things. She didn’t like me because I was arrogant and uncooperative and probably still crazy for insisting on being a writer.
“A dental technician,” she said. “That’s the ticket. The training is only one year. I’m sure you’d be able to manage the responsibilities.”
“You don’t understand,” I said.
“No, you don’t understand,” she said.
“I hate the dentist.”
“It’s nice clean work. You have to be realistic.”
“Valerie,” I said, when I got back to the ward, “she wants me to be a dental technician. It’s impossible.”
“Oh?” Valerie didn’t seem to understand either. “It’s not bad. Nice clean work.”
Luckily, I got a marriage proposal and they let me out. In 1968, everybody could understand a marriage proposal.
Topography of the Future
Christmas in Cambridge. The Harvard students from New York and Oregon had switched places with the Columbia and Reed students from Cambridge: vacation musical chairs.
The brother of my friend who was going to die a violent death—but we didn’t know that yet; his death was nearly two years in the future—took me to the movies, where I met my husband-to-be. Our marriage as well was two years in the future.
We met in front of the Brattle Theatre. Les Enfants du Paradis was playing. And in the bright, dry December air, Cambridge seemed a sort of paradise that evening, busy with lights and Christmas shoppers and a fine dry snow. The snow fell on my future husband’s fine blond hair. They’d gone to high school together, my doomed friend’s brother and he. Now he was home from Reed for Christmas vacation.
I sat between them in the balcony, where we could smoke. Long before Baptiste lost Garance in the crowd, my future husband had taken my hand in his. He was still holding it when we came out of the theater, and my friend’s brother tactfully left us there, in the twirling snowy Cambridge night.
He wouldn’t let me go. We were infected by the movie, and Cambridge was beautiful that night, full of possibilities and life. We spent the night together, in an apartment he borrowed from a friend.
He went back to Reed; I went back to selling garlic presses and madeleine pans. Then the future started closing in on me and I forgot about him.
He didn’t forget about me. When he graduated that spring and returned to Cambridge, he tracked me down in the hospital. He was going to Paris for the summer, he said, but he would write to me. He wouldn’t forget to write, he said.
I paid no attention. He lived in a world with a future and I did not.
When he came back from Paris, things were bad: Torrey’s leaving, the question of my bones, the worry over how much time I’d lost in the dentist’s chair. I didn’t want to see him. I told the staff I was too upset.
“It’s impossible! I’m too upset.”
We talked on the phone instead. He was moving to Ann Arbor. That was fine with me.
He didn’t like Ann Arbor. Eight months later, he was back, wanting to visit again.
Things were not as bad. I had a lot of privileges. We
went to movies, we cooked dinner together in his apartment, we watched the body count for the day on the seven o’clock news. At eleven-thirty I’d call a taxi and go back to the hospital.
Late that summer my friend’s body was found at the bottom of an elevator shaft. It was a hot summer, and his body was partly decomposed. That was where his future ended, in a basement on a hot day.
One September night I got back to the hospital early, before eleven. Lisa was sitting with Georgina in our room.
“I got a marriage proposal tonight,” I said.
“What did you say?” Georgina asked.
“I got a marriage proposal,” I said. The second time I said it, I was more surprised by it.
“To him,” said Georgina. “What did you say to him?”
“I said Yes,” I said.
“You wanna marry him?” Lisa asked.
“Sure,” I said. I wasn’t completely sure, though.
“And then what?” said Georgina.
“What do you mean?”
“What’s going to happen then, after you’re married?”
“I don’t know,” I said. “I haven’t thought about it.”
“You better think about it,” said Lisa.
I tried. I closed my eyes and thought of us in the kitchen, chopping and stirring. I thought of my friend’s funeral. I thought of going to movies.
“Nothing,” I said. “It’s quiet. It’s like—I don’t know. It’s like falling off a cliff.” I laughed. “I guess my life will just stop when I get married.”
It didn’t. It wasn’t quiet either. And in the end, I lost him. I did it on purpose, the way Garance lost Baptiste in the crowd. I needed to be alone, I felt. I wanted to be going on alone to my future.
Mind vs. Brain
Whatever we call it—mind, character, soul—we like to think we possess something that is greater than the sum of our neurons and that “animates” us.
A lot of mind, though, is turning out to be brain. A memory is a particular pattern of cellular changes on particular spots in our heads. A mood is a compound of neurotransmitters. Too much acetylcholine, not enough serotonin, and you’ve got a depression.
So, what’s left of mind?
It’s a long way from not having enough serotonin to thinking the world is “stale, flat and unprofitable”; even further to writing a play about a man driven by that thought. That leaves a lot of mind room. Something is interpreting the clatter of neurological activity.
But is this interpreter necessarily metaphysical and unembodied? Isn’t it probably a number—an enormous number—of brain functions working in parallel? If the entire network of simultaneous tiny actions that constitute a thought were identified and mapped, then “mind” might be visible.
The interpreter is convinced it’s unmappable and invisible. “I’m your mind,” it claims. “You can’t parse me into dendrites and synapses.”
It’s full of claims and reasons. “You’re a little depressed because of all the stress at work,” it says. (It never says, “You’re a little depressed because your serotonin level has dropped”)
Sometimes its interpretations are not credible, as when you cut your finger and it starts yelling, “You’re gonna die!” Sometimes its claims are unlikely, as when it says, “Twenty-five chocolate chip cookies would be the perfect dinner.”
Often, then, it doesn’t know what it’s talking about. And when you decide it’s wrong, who or what is making that decision? A second, superior interpreter?
Why stop at two? That’s the problem with this model. It’s endless. Each interpreter needs a boss to report to.
But something about this model describes the essence of our experience of consciousness. There is thought, and then there is thinking about thoughts, and they don’t feel the same. They must reflect quite different aspects of brain function.
The point is, the brain talks to itself, and by talking to itself changes its perceptions. To make a new version of the not-entirely-false model, imagine the first interpreter as a foreign correspondent, reporting from the world. The world in this case means everything out- or inside our bodies, including serotonin levels in the brain. The second interpreter is a news analyst, who writes op-ed pieces. They read each other’s work. One needs data, the other needs an overview; they influence each other. They get dialogues going.
INTERPRETER ONE: Pain in the left foot, back of heel.
INTERPRETER TWO: I believe that’s because the shoe is too tight.
INTERPRETER ONE: Checked that. Took off the shoe. Foot still hurts.
INTERPRETER TWO: Did you look at it?
INTERPRETER ONE: Looking. It’s red.
INTERPRETER TWO: No blood?
INTERPRETER ONE: Nope.
INTERPRETER TWO: Forget about it.
INTERPRETER ONE: Okay.
A minute later, though, there’s another report.
INTERPRETER ONE: Pain in the left foot, back of heel.
INTERPRETER TWO: I know that already.
INTERPRETER ONE: Still hurts. Now it’s puffed up.
INTERPRETER TWO: It’s just a blister. Forget about it.
INTERPRETER ONE: Okay.
Two minutes later.
INTERPRETER TWO: Don’t pick it!
INTERPRETER ONE: It’ll feel better if I pop it.
INTERPRETER TWO: That’s what you think. Leave it alone.
INTERPRETER ONE: Okay. Still hurts, though.
Mental illness seems to be a communication problem between interpreters one and two.
An exemplary piece of confusion:
INTERPRETER ONE: There’s a tiger in the corner.
INTERPRETER TWO: No, that’s not a tiger—that’s a bureau.
INTERPRETER ONE: It’s a tiger, it’s a tiger!
INTERPRETER TWO: Don’t be ridiculous. Let’s go look at it.
Then all the dendrites and neurons and serotonin levels and interpreters collect themselves and trot over to the corner.
If you are not crazy, the second interpreter’s assertion, that this is a bureau, will be acceptable to the first inter-prêter. If you are crazy, the first interpreter’s viewpoint, the tiger theory, will prevail.
The trouble here is that the first interpreter actually sees a tiger. The messages sent between neurons are incorrect somehow. The chemicals triggered are the wrong chemicals, or the impulses are going to the wrong connections. Apparently, this happens often, but the second interpreter jumps in to straighten things out.
Think of being in a train, next to another train, in a station. When the other train starts moving, you are convinced that your train is moving. The rattle of the other train feels like the rattle of your train, and you see your train leaving that other train behind. It can take a while—maybe even half a minute—before the second interpreter sorts through the first interpreter’s claim of movement and corrects it. That’s because it’s hard to counteract the validity of sensory impressions. We are designed to believe in them.
The train situation is not the same as an optical illusion. An optical illusion does contain two realities. It’s not that the vase is wrong and the faces are right; both are right, and the brain moves between two existing patterns that it recognizes as different. Although you can make yourself dizzy going from vase to faces and back again, you can’t undermine your sense of reality in quite such a visceral way as you can with the train.
Sometimes, when you’ve realized that your train is not really moving, you can spend another half a minute suspended between two realms of consciousness: the one that knows you aren’t moving and the one that feels you are. You can flit back and forth between these perceptions and experience a sort of mental vertigo. And if you do this, you are treading on the ground of craziness—a place where false impressions have all the hallmarks of reality.
Freud said psychotics were unanalyzable because they couldn’t distinguish between fantasy and reality (tiger vs. bureau), and analysis works on precisely that distinction. The patient must lay out t
he often fantastic assertions of the first interpreter and scrutinize them with the second. The hope is that the second interpreter has, or will learn to have, the wit and insight to disprove some of the ridiculous claims the first interpreter has made over the years.
You can see why doubting one’s own craziness is considered a good sign: It’s a sort of flailing response by the second interpreter. What’s happening? the second interpreter is saying. He tells me it’s a tiger but I’m not convinced; maybe there’s something wrong with me. Enough doubt is in there to give “reality” a toehold.
No doubt, no analysis. Somebody who comes in chatting about tigers is going to be offered Thorazine, not the couch.
At that moment, when the doctor suggests Thorazine, what’s happening to that doctor’s mental map of mental illness? Earlier in the day, the doctor had a map divided into superego, ego, and id, with all kinds of squiggly, perhaps broken, lines running among those three areas. The doctor was treating something he or she calls a psyche or mind. All of a sudden the doctor is preparing to treat a brain. This brain doesn’t have a psychelike arrangement, or if it does, that’s not where its problem is. This brain has problems that are chemical and electrical.
“It’s the reality-testing function,” says the doctor. “This brain is bollixed up about reality and I can’t analyze it. Those other brains—minds—weren’t.”
Something’s wrong here. You can’t call a piece of fruit an apple when you want to eat it and a dandelion when you don’t want to eat it. It’s the same sort of fruit no matter what your intentions toward it. And how strong is the case for a categorical distinction between brains that know reality and brains that don’t? Is a non-reality-recognizing brain truly as different from a reality-recognizing brain as a foot, say, is from a brain? This seems unlikely. Recognizing the agreed-upon version of reality is only one of billions of brain jobs.
Girl, Interrupted Page 9
