The Center Cannot Hold: My Journey Through Madness (15 page)

One afternoon on the unit, one of the patients, Henry—suddenly
and without apparent provocation—jumped full-body on another
patient, screaming wildly as he did so. Staff and some other patients
pulled him off and away, taking him to a different part of the unit,
where he sat and calmed himself. An hour or so later, a doctor came in
and sat with Henry, quietly telling him that what he'd done wasn't
appropriate and couldn't happen again. There was no punishment for
Henry's infraction, no beefy orderlies standing ready to mete out some
kind of response, and no physical restraints. No straitjacket, no
leather straps to hold Henry in his bed or on a chair. In fact (and in
sharp contrast to most American hospitals, even now), British
hospitals rarely use any kind of mechanical restraint, and have not for
over two hundred years. Save for a small percentage of extreme cases,
there was rarely anything dramatic that happened after the kind of
scene Henry had just created other than a simple, humane, and clear
response, with the basic message addressing the inappropriateness of
the behavior, instead of the damaged mental capacity of the patient.

In spite of being perceived by the patients as some sort of authority
figure—"on the other side of the medication counter," so to speak—I
usually empathized more with them than with the hospital staff. In
truth, I sometimes felt oddly competitive with the patients, weighing
in my mind which of us was sicker, they or I. After all, I was seeing
Mrs. Jones every day, and I was having ongoing psychotic thoughts.
Yet here I was, operating autonomously, seemingly in perfect control
and perfectly qualified to operate in the "outside"—that is,
sane—world. Yes, part of me was proud of being a caregiver, but
another part of me wanted to be taken care of, as the patients were.
Their moods and emotions were all over the place, all the time, and
the hospital accommodated that. I, on the other hand, was expected to
stay focused, disciplined, and measured in my behavior, in spite of the
soundtrack in my head that told me I was evil and potentially
catastrophic. It occurred to me each time I left the hospital that I was
something of a serious fraud.

And yet I did my job there conscientiously and well, and took a lot
of satisfaction from it. After all these years of being buried in books, or
being enmeshed inside my own head, connecting like this to other
people gave me a purpose. I was doing something worthwhile, and I
knew it. It wasn't arrogance I felt, it was pride, as much pride as I'd
ever had bringing home a report card of As to my parents. And when,
inevitably, it was time for me to leave Littlemore, the patients there
made a farewell card for me, which each of them signed. Many wrote
small notes thanking me for spending time with them. In my room
later that night, I turned the card over and over in my hand, reading
their words and marveling that it was me they were writing to, and not
the other way around.

Partway into that third year of analysis with Mrs. Jones, I noticed,
somewhat to my dismay, that I was becoming something of a
hypochondriac. Nearly everything that happened to me physically—a
cold, a paper cut, a headache, a stubbed toe—became an immediate
cause for serious concern, a reason to go see the doctor, a potentially
fatal illness. One day, I was riding along on my moped when a car cut
me off sharply, and I fell to the street, hitting my head. I was knocked
unconscious, and the hospital where I was later examined insisted on
keeping me overnight for observation. I was nervous about all the bad
scenarios that a head injury presented (death, amnesia, blindness,
brain damage, seizures...) but also, oddly, exhilarated that I'd survived
at all. Overall, the hospital environment—the smells, the sounds, the
overhead lights that never go out, the faceless, uniformed people
walking around and talking to one another in a code only they could
understand—completely unnerved me. All I could think of was that I
had to get out of there, before something else happened.

Well, now, this is pretty interesting,
I thought.
If I fear dying so
much, maybe that means that I don't want to die anymore. Maybe it
means that I actually want to stay alive, and find out what happens
next.

Near the end of my third year with Mrs. Jones, my former college
housemate, Patrick, was to be married, in Manchester. A small group
of us traveled together in one car to the wedding. I don't quite
remember how I ended up with this group, since I didn't know
them—it was probably a result of one of those you-call-so-and-so and
somebody's-putting-a-group-together kind of things.

I don't think I spoke more than ten words on the entire trip; I was
completely in my head, lost in one fantasy after another about Mrs.
Jones, and how to keep from leaving her. Mrs. Jones and I had agreed
that it was time for me to go back to the States, to get on with my life
there. We had agreed that our work together was coming to a logical
end. And yet the mere contemplation of that "end" had started my
mind and my anxieties on a collision course with each other.

In the car, everyone else was chatting merrily—on the drive up to
Manchester, it was with anticipation for the wedding and the
celebration, on the way back, it was retelling various moments and
events of the day—but I was completely silent. That was my way.
When the fantasies took over, I could see only them. And while lost in
them, I would exert as much of my will as I could summon to keep
anyone from knowing what was going on.

The ceremony, in a beautiful old church, was somewhat more
religious than I'd expected, and I was surprised to find myself in tears
as the bride and groom exchanged their vows. Not tears for myself,
but for Patrick, who had always been quite dear to me, a good and
kind friend. He deserved happiness, and I truly wished for him to have
it. But for the most part, the wedding, and the reception afterward,
went by in a blur. It simply felt like an endless passage of time in
which I could not engage and could play no part.

I go to my session. I threaten Mrs. Jones with a knife. I am very
psychotic and out of control. Mrs. Jones is kind and gentle. She asks
me for the knife and I give it to her. I start screaming. I throw myself
against the wall. Mrs. Jones and her husband restrain me. The
ambulance arrives and takes me to the hospital. I become out of
control again and am subdued. I am crying and sobbing that I will
be leaving Mrs. Jones.

With psychosis, the wall that separates fantasy from reality
dissolves; inside my head, the fantasies were real, and everything was
actually happening. The images I saw, the actions I took, were all real,
and it made me frantic. Mrs. Jones had been the glue that held me
together. With that glue soon to be gone, would I not shatter into a
thousand pieces? The anxiety was overwhelming, and our sessions
became more intense and hallucinatory:

Me: "You can't leave. I won't let you. Plupenitenary issues must be
addressed. That's a dress. Come home with me, please?"

Her: "I think, you see, that you make yourself confused because
you want to avoid the pain of separation. It's upsetting to think I have
a life of my own, apart from you. You are trying to live inside me."

Me: "I
am
inside you! Your organs are slimy, just like you are. You
think you own me, but I own you. My every command is your wish.
You don't exist."

Her: "You would rather kill me off than think I am separate from
you."

Me: "I see truth. You see lies. In my mind I'm going to Carolina."

Her: "You are so upset about leaving because it disrupts your
fantasy that you own me. You have had the fantasy that I was totally
under your control. Your possessiveness then spoils me. But I must
remain under your control at all costs."

Me: "You
are
under my control! You go where I go. There will be
no separation. I've killed people before and I will kill them again. I
give life and I take it away. You have no choice. I am God. Nothing
comes from nothing. Nothing. God. Taken away."

Her: "Your fantasies help you avoid the pain of separation."

Me, raising my voice: "They are not fantasies! It's real. I am God. I
am the One. One. Two. It's a mess."

It was indeed. I left each session completely drained, and
wandered around for hours trying to summon enough calm (or
enough energy to fake it) to go back to Janet's house, where I would
have tea, sit on the floor, and read a fairy tale to Livy.

After a lot of thought and research, I finally decided to apply to law
school, rather than to graduate school in psychology. My list of schools
was ambitious—Yale, Harvard, Stanford—and in preparation for the
upcoming LSAT exam, I was reading more intensely than ever, plus
attending the lectures in law, psychology, and one that combined
psychiatry and the law. But I was getting only a few hours of sleep
each night, and it was making it difficult to concentrate the next day. I
needed to calm down, to rest, and to somehow focus my mind. For the
first time in my life, I actually
wanted
to take drugs. I went to my
doctor and explained what was going on, and he gave me Halcion to
help me sleep. This time around, no one needed to convince me to take
meds; in fact, each night, when the drug kicked in and I felt myself
falling into unconsciousness, I was, for just a moment, deeply grateful.

The exhaustion may well have been a factor in what happened
next: another moped accident. Two days before I was to go to London
to take the LSAT exam, a cyclist came around from behind me, then
turned abruptly in front of me. I hit his bike and fell again to the
ground, this time breaking my collarbone. If there was a worse pain
than this to be had, I could not imagine what it might be. The doctors
said I would be in a sling for six weeks. It meant postponing the
LSATs, and doing my best to keep my restless body as still as possible
while the bone knit itself back together.

Things with Mrs. Jones were going from bad to worse. During
session, I paced restlessly back and forth, or sat curled up in a corner,
moaning in pain and grief. At times, I lay on the floor and clutched her
legs, muttering that I could not live without her. When would I see
these rooms again, how would I cope? I even took to locking myself in
the bathroom. That problem was quickly remedied when Mrs. Jones's
analyst-husband, a transplanted American named Dr. Brandt, simply
removed the lock from the door.

Often, I couldn't leave the office at all when our sessions were
over. Mrs. Jones would say a very calm good-bye, then Dr. Brandt
would walk me out the office and out of the house. More than once, I
stood out front, rocking back and forth, keening and moaning quietly.
Inevitably, Dr. Brandt came out and asked me, gently and firmly, to
please go home.

Finally, the time came to go to London for the LSATs. The night
before, I stayed in a bed-and-breakfast, where a couple on the floor
below me managed to argue with each other, loudly, throughout the
entire night, the ebb and flow of their fight rising through my
floorboards like some kind of toxic air. At the most, I got two hours of
shredded sleep, and felt stupid and clumsy all during the exam the
next day. I was convinced I'd done poorly. Yet when the news came, I
learned I'd done as well as I needed to. All my schools accepted me. I
chose Yale.

I felt enormous, if momentary, relief. My plans were set for the
following year. I needed the structure and the challenge, I knew that
much about myself, and now, once again, I had set the bar high for
myself.
This is the right thing to do,
I thought.
I'll be fine. I have to be
fine.

My final session with Mrs. Jones arrived. In stunned disbelief, I
remained silent for most of that last hour, and when the end of the
session came, I ran out into the waiting room and sat down, sobbing.
Mrs. Jones came through the door right behind me.

"Elyn, you must go now," she said. "Another patient is coming
soon, and our time together has come to an end." She and her
husband must have been prepared for this, as he was suddenly there
as well—he was a chain-smoker, and the scent that came from his
body and clothes filled the room. I felt as though I were fighting for

"It's time to leave us now," said Dr. Brandt. "Come now, Elyn, this
won't do. We'll just say good-bye here, shall we then?"

"No," I said, hunching my shoulders as though I expected them to
hit me. How could they be so cruel to me? "I'm not leaving here. I
can't."

"Yes. Yes, you can." The two of them, in chorus now.

I shook my head. I looked up at them, pleading with my body and
my eyes. "I can't, don't you understand? I cannot leave her. I will not
leave her."

"Other patients are coming, Elyn," said Mrs. Jones, gently but
firmly. "You'll upset them. Just imagine if you arrived for your
appointment, and came upon a scene such as this between me and
another patient. That would not be fair, would it? You can do better
than this. Come now, it's time."

Dr. Brandt stepped toward me, gently but deliberately, and just as
he was about to take hold of my arm to walk me out of the room, as he
had done many times before, I lunged for the pipes lining the wall and
grabbed onto them as tightly as I could. Luckily it was summer, since
they were heating pipes, and I would have been badly burned. Cool to
the touch now, they provided a kind of ballast that made me equal to
the strength of both Mrs. Jones and Dr. Brandt. How could Mrs. Jones
do this, after all we had been to each other? Surely there was
something I could do or say that would sway her, and draw her back to
me?

"I'm not going!" I cried, and tightened my grip.