"There is no such thing as magic," Porsena said. "But if the patient wishes to act as if the entry methods are magical, we don't discourage that. Whatever works is OK with us. But we don't want the patients either in remission or cured to still believe that there is such a thing as magic when they are through with the therapy. Please don't tell this to any patient who hasn't progressed as yet to your stage."
When the time came for Jim to leave, he stood up, and they shook hands.
"I'm not really leaving you since I'll be seeing you once or twice a week," Jim said. "But this is kind of a farewell."
He walked to the door, then turned around before he opened it.
"I encountered many mysteries in the Lords' worlds," he said. "Most of these I solved or at least had a good explanation for. But I haven't penetrated The Mystery."
"Which is what?" Porsena said.
"If all universes except for one, the original, were created by the Lords, who created the original? And why?"
"Only the young concern themselves seriously with matters such as ultimate origins and the reasons for them. When you get old enough to know that such questions have no answers, you'll quit asking."
"I hope I never get that old," Jim said.
Porsena smiled. He supposed that the smile looked to Jim like The Sphinx's inscrutable expression. Perhaps Jim thought that his doctor was concealing the wisdom of the ages behind the smirk of the stone-headed Egyptian statue.
He was. He knew what The Sphinx knew about the ultimate mysteries. That is, nothing.
The Mysteries were unassailable in this world and in all worlds.
The most that any human being could do was to try to solve the "little" mysteries. Those were huge enough.
AFTERWORD
A. James Giannini, M.D.
I
On an otherwise unremarkable English afternoon, a remarkable English girl named Alice walked through a looking glass. On the other side, she found a land of fantasy and distortion. Her ability was unusual because she could enter a fantasy created by someone else and then return to the alternative "real" world. Schizophrenics and other psychotics inhabit their own world of delusion and also have difficulty reentering the real world -- that common interface that humanity shares. Children can also inhabit a secret place of fantasy. While they seldom have trouble skipping across the twin planes of fantasy and reality, they do not have the ability to transport adults into their secret worlds.
It is the lack of Alice's gift that makes the practice of psychiatry so difficult. Each delusional patient is truly a master of his own universe. This universe is an entity unique to the individual. It has its own terrain, its own memory-base and its own symbolic language. The understanding of each of these worlds provides the therapist with the ability to discover the root trauma and modify the results. Unfortunately, the patient retains the ability and prerogative to alter his personal reality at any time. For some, alterations occur in a chaotic fashion, while for others it seems to occur whenever a breakthrough is imminent.
The great English therapist, R. D. Laing, developed a school of thought in which a schizophrenic's psychosis would be considered an alternative valid reality. For the initial therapeutic phase, as least, this school provided a useful model. In trying to understand the patient's psychosis, however, one had to consume a large amount of professional resources. Many times, this expenditure was wasted. The patient was sole master of his delusional scheme; he controlled its access and could alter its form.
Frustration with these inherent limitations causes many psychiatrists to rely solely on a specific class of medication, the "neuroleptics," to reduce and control their patient's psychoses. This has always seemed to me a solution to one-half of the physician's classic problem. Dependence upon neuroleptics alone resolves the symptoms but does not remove the cause of the disorder. With the resolution of the delusional symptoms may come the disappearance of the very key that might provide insight into the damage that begat the delusion.
Alice was able to pass unhindered through an alternative universe. This was a universe of some stability. While such characters as the Duchess' child could change their shape, the underlying form of the chessboard-mirror world was stable. It is the accessibility and stability of this world that makes it an attractive alternative to the locked-off morass of each patient's separate delusional subreality. A therapeutic anodyne would then be a world with fixed reference points and a door that permits universal ingress and egress.
While completing my psychiatric residency at Yale University, I encountered many patients whose worlds were closed off to me. Their personal fears and my neuroleptic medications seemed to function as twin seals forever removing me from the dreadful fears that pushed them away from reality. It was at Yale that I conceived using science fiction or fantasy novels as the source of an alternative reality that the patient and I could explore together.
Providentially, I discovered Philip José Farmer's World of Tiers series. It seemed to be a tool designed for the purpose of investigating and resolving psychotic disturbances. Its "Gates" provide the access mechanisms. Its characters were a Jungian delight; an entire panoply of archetypes were available for retrospective analysis. The variety of pocket universes presented a large but fixed number of multiple realities.
In the initial approaches with "Tiers-therapy," several patients with psychotic presentation were asked to read the series. Therapy then shifted from a review of the patients' activities to a discussion of the books. Gradually, these discussions became more focused so that the patient would gradually relate his experiences with those of Tiers characters. When stress would occur between therapy sessions and the patient would break down, the psychotic perceptions would gradually incorporate an ever-expanding fraction of the Tiers system. As an adapted Tiers universe replaced the highly idiosyncratic forms of alternative reality, I was able to enter each patient's private world. Finally, the metaphorical means were available to conduct work on-site. It was as if I were an astronomer, who, after gazing at Mars through a distorted mirror, was finally able to walk on that planet's red sands. Once the patient and I met on a common world, meaningful therapy proceeded quickly.
In this form of therapy, I noted that adolescents and younger adults had the best results. Those who were possessed of a love for books were the most eager. Therapy was quickly engaged if these young men and women felt themselves to be misfits who belonged in another age. Some had psychoses; others were addicted to their own fantasy world. When I moved to Ohio, I found a corps of willing patients (and supportive parents) who quickly accepted the tenets of Tiersian therapy. Since these patients were comfortable with expressing themselves, I was able to utilize the powerful tool of group therapy to project ourselves into a Tiersian model.
In standard group therapy, what is discussed ("content") is less important than the act of discussion ("process"). It is after all the flow of water rather than the nature of water that gives a river its special properties and attractions. Since every patient had a unique way of relating to the Tiers worlds, the de-emphasis on content worked well. Because all of our group members now shared the same basic symbols and archetypes, each patient could relate to another in a way that enhanced the process. By relating to each other, the group was able to resolve the earlier conflicts of its members and gradually reenter the real world. Using the Tiers series as a halfway house, they moved from private reality to shared reality to that reality which all humanity holds in common.
II
Farmer's re-creation of Tiersian therapy at Wellington Hospital captures the essence of this particular process. Tiersian therapy is currently undergoing a punctuated evolution. It has been discontinued and continued many times. Each manifestation has brought with it many refinements. As the strangely familiar Dr. Porsena emphasizes, the trick of the game is to ensure that Tiersian therapy becomes an entry into reality, not a substitute for it. Generally, our patients were able to distinguish their delusions or fantasies from rea
lity; they simply chose to avoid reality. Tiersian therapy is not yet applicable for the profoundly psychotic individual. Schizophrenics are not candidates for therapeutic systems that utilize evolving realities.
In reading the fictional re-creation of group process and the individual reaction to it, I felt I was an observer in my own therapeutic groups. Though Philip Farmer has never observed any of these sessions, he has reconstructed them accurately. While all persons and processes are totally fictional, any of my former patients and cotherapists should feel a sense of familiarity.
Future scientific papers on Tiersian therapy will analyze the components of this technique. It is to be hoped that my professional colleagues will then attempt to replicate the methods and results of this approach. Scientific papers, while a necessary part of the transmission of knowledge, lack the gestalt of the exploration: the experiment, the analysis, the therapeutic techniques. The novel, however, while short on absolutely accurate detail faithfully reproduces the sweat and fire of scientific enquiry. Red Orc's Rage carries on its pages the intuitive "feel" of psychotherapeutic treatment. In it, we can truly experience Jim's emergence into reality as he takes control of his own life.
III
Alice learned to run twice as fast and so became a queen. She then was able to walk through the nether side of the looking glass and reenter England.
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