An intake psychiatrist once tried to tell me that “schizophrenics don’t get depressed.” That surprised me, since I had been in treatment for unipolar depression and schizophrenia for about ten years at the time. It also puzzled me, because I find schizophrenia pretty depressing in its own right, apart from and on top of other things that get me down.
He referred me to a neurologist who offered a differential diagnosis replacing both my psychiatric labels with the much simpler PTSD within the first 15 minutes of our time together. Needless to say, her offer didn’t carry much weight. I already knew I had PTSD, and I had learned the hard way what happens when I go off my antipsychotic and antidepressant for any length of time.
So I switched to a traditional couch-style counselor for a melange of symptoms ranging from breakthrough paranoias to lingering questions about my past. We talked very freely about big ideas in the history of psychiatry and clinical psychology, but when I brought up Freud the conversation went south pretty fast, so I dropped him, too.
Now I rely mostly on self-help books and peer reviewed journal articles for ideas about my mental health. Sometimes I get good leads on an angle from the cinema, too. Mad to Be Normal in particular introduced me to R. D. Laing’s penetrating insights into schizophrenese and the family dynamics of young adults who are on the verge of slipping into catatonic schizophrenia.
Although popularly considered part of the anti-psychiatry movement, Dr. Laing wasn’t against treating schizophrenics – he just found it counterproductive to keep them vegetative 24/7 in inpatient care. He distrusted the drugs that were available in his day because they were such overwhelmingly strong tranquilizers that they left most patients unable to cope with the simplest of interactions, making interventions like talk therapy virtually impossible. He recommended listening attentively to the content of schizophrenics’ delusions, and reading between the lines to decode the drivers of their descent into madness.
Although much has been gained over the years in terms of insight and compassion that has benefited patients, that sense of existential loss that comes with insight into having a mental illness is still a hallmark of patients’ experience with their initial diagnosis. And films like The Soloist, Mad to Be Normal, A Beautiful Mind, and Fathers and Daughters bring some of that anger to the screen in ways that are at once triggering and cathartic for me.
A 19th century social worker and theologian I’ve been reading lately named Bernard Bosanquet warns against succumbing to this kind of anger, popularized in the romance novels of his day, in a lecture series he gave at the University of Edinburgh from 1910-1912:
“There is hardly a morbid romance but founds its pessimism on … what it calls justice – some proportion .. between the given wants and fortunes of man .. the reiterated ‘Why’ – ‘Why should A be at a disadvantage when B is not?’ – and we feel it to be wholly discordant with the temper of stronger souls in whom we delight to recognize the ready welcome of differentiation and the insight that even the call for endurance is an opportunity. Justice as thus demanded is a principle of compensation for being what you are .. [as opposed to] accepting the whole involved in the differentiation, to transcend his apparent limits.”
That’s pretty stern medicine for our day and age. But I like the way he writes about the difference between our gut feelings and our best judgment, and I think that applies here, too: “You cannot anywhere, whether in life or in logic, find rest and salvation by withdrawing from the intercourse and implications of life; no more in the world of individual property and self-maintenance than in the world of international politics and economics; no more in the world of logical apprehension than in that of moral service and religious devotion. Everywhere to possess reality is an arduous task.”
I think it’s natural to get angry when we feel that we have failed ourselves, and mental illness frequently brings that feeling to bear on adults who find themselves falling far short of childhood expectations. When we fail, Bosanquet tells us, we confront the absolute head on. “It is only by the conjunction of what is quite beyond us with what is deep within us that the open secret of the Absolute confronts us in life, in love, and in death.”