The Center Cannot Hold: My Journey Through Madness (24 page)

It was May and I was home, just as a lot of other young people were at
the end of a year away at school. September to May—one full academic
year since I'd walked across the Yale campus sporting a
telephone-wire belt and babbling about my complicity in the
impending end of the world. And now here I was back home again,
completely off antipsychotic meds and somewhat functional, although
just barely on some days. Good days, bad days. More bad days. I went
to the beach with my brother and sister-in-law, and the light and heat
almost made me cower. In minutes, I was convinced that everyone
there had come to the beach to ambush me—they thought I was evil,
that I had killed many people. I was certain that if I moved suddenly,
they'd leap up and kill me. I sat stiff as a board on my towel down near
the water, silently begging not to be noticed. I wished I had brought a
gun with me to protect myself in case I was attacked.

Years of this illness had taken a toll. The constant effort to keep
reality on one side and delusions on the other was exhausting, and I
often felt beaten down, knowing that the schizophrenia diagnosis had
ended any hope I'd had of a miracle cure or a miracle fix. I'd
disappointed my family; I'd shamed them. I wondered aloud if I
would ever amount to anything. "Maybe it's too late," I said. "Maybe I
need to be realistic about my life."

"You have to stop thinking like this," said my father firmly. I knew
before he'd gotten to the next sentence that I was in for the familiar
"buck up—get tough" speech, variations of which I'd heard much of
my life. "This isn't terminal cancer, Elyn—and people have come back
strong even from that diagnosis, you know. What you've got, that's a
piece of cake by comparison. You can beat it with the right attitude.
Stop feeling so sorry for yourself!"

I wondered what I would have done in my father's place—if I
would have, or could have, given a child of mine that same speech
under the same circumstances. I had an illness, it was real, and it was
ruining my life—how could he make it all about (or
only
about) pulling
up my socks and getting tough? Didn't he get it?

But then I had to concede that yes, I probably would have given my
child a near-identical speech—because it reflected what I'd been
taught all my life: Intelligence, combined with discipline, could
overcome any challenge. And mostly, that belief had served me well.
The problem was, it assumed that the intelligence at hand was fully
functional, fully capable—but I'd been told by experts that my brain
had serious problems. Was my brain the same thing as my mind?

Could I hang onto the one while conceding that there was a big flaw in
the other? I resented my dad for setting up a standard that I might not
be able to meet, yet his opinion meant everything to me—and he
believed I could beat this.

I sought comfort in reality as I knew it: I was out of the hospital,
off medication. I was reading Aristotle again, and it was even making
sense. And I was going back to law school. My determination to go
back to school was not part of my delusional thinking; it was part of
my self. I believed myself to be the person who would go back to law
school and finish it. That's who I believed myself to be, and that
wasn't delusional.

In order for me to be readmitted, university policy required that I
meet with the head of the University Health Psychiatry Department.
And just as I'd done all my life, I studied hard before "the test": I
researched the director, and every single article he'd written. In a
wonderful coincidence, one of his published articles concerned the
questions university officials should ask people who've had psychotic
breaks and are applying to be readmitted to school. I couldn't believe
my luck—or was it fate? I didn't care what it was; I simply rehearsed
my answers to the questions in the article, and sure enough, they were
the ones he asked.

I was relieved to hear that my medical records weren't forwarded
from the hospital; no one from Yale, to my knowledge, had asked for
them, and I certainly didn't volunteer them. Did I have any
symptoms? he asked. Did I think I could take the stress of school? And
what might I do if I started feeling poorly? As nervous as I was (I
didn't sleep well the night before, and I had to fold my hands tight in
my lap to keep him from seeing me shake), I didn't actually have to tell
a single lie. Instead, I simply strategized, by staying as close to the
truth as I could without hurting myself. And in any case, I told him,
"With an analyst four days a week, I'm sure I'll be able to handle
everything very well." I was readmitted.

The next hurdle would be my upcoming trip to England to see Mrs.
Jones. As difficult as travel was for me, and as many challenges as
getting well and staying well would present me with, there was no way
I could see the trip as anything but promising. Maybe our time
together would prove to be exactly the booster shot I needed.

It was a little odd, being back in Oxford again. Summer there was
green and leafy and still; it looked and felt as different from Miami as
anyplace could have. Janet was renting my old quarters to a lodger, so
I stayed in a little bed-and-breakfast near her house. It was a joy to
spend time with her, and visit with bright and beautiful young Livy.

For the next couple of months, I met with Mrs. Jones three times a
week. It was such a relief to be in that familiar office in her shabby
little house, to stretch out on the couch and have no care for what
came into my head or out of my mouth. I told her about the restraints,
and the drugs, and about my fear that with each episode, I was losing
more of myself. I reported my delusions, and the forces beyond my
control that were unbearably evil. I was malicious, I was bad, I was a
destroyer of worlds.

She was not afraid; she did not look at me with alarm in her eyes.
She did not judge, she only listened, and reflected back to me what she
heard, telling me what she thought it meant. And she did not embrace
the schizophrenia diagnosis, either (although she acknowledged the
existence of the symptoms and behaviors; after all, it was impossible
to deny them). "Don't focus on it," she said. "Don't define yourself in
terms of something which even many highly trained and gifted
professionals do not fully understand." To her, the best road to
understanding was psychoanalytic. There was little room for biology
and therefore little room for medication.

When at last it came time to leave Oxford again and return to New
Haven, my faith in myself was shored up. This time, I didn't feel the
overwhelming grief at leaving Mrs. Jones behind; she was there for
me, we would stay in touch, and I could come back to see her. For
now, it was time to get back to my intended life.

I had no way of knowing then that it would be the last time I'd see
Mrs. Jones in good health. The following year, she was in a terrible
automobile accident that required a tracheotomy and left her in a
coma for months. When she regained consciousness, her mind and
body were badly damaged; in fact, she was diagnosed with traumatic
Parkinson's. When her husband, Dr. Brandt, wrote me about what had
happened, I returned to Oxford as soon as I could, and what I saw
there frightened me. White as a sheet, frail and trembling, she reached
out her hand and said my name. "I love you," she said.

A year after that, I visited again, devastated at how fragile and
small she'd become. She wasn't ever going to be well again; she would
never be who she once was. Nervously, I began talking about my
successful second year at law school and my plans for the future. To
my great sorrow, she began to weep. "Oh, Mrs. Jones, what's wrong?"
I asked. "Did I say something to hurt you?"

"I'm sorry," she softly cried. "But I just don't remember you."

As I turned away, to leave our brief meeting, it occurred to me how
truly beautiful she was.

A few months later, she died. The grief at her loss burrowed deep
into my soul; this was, in every way that mattered, a death in the
family. For so long, through everything that had happened to me, I'd
taken courage in knowing that Mrs. Jones was there, in her house, in
that office. She knew me like no other.

chapter fourteen

I RETURNED TO
New Haven a few weeks before classes were to
start, in order to begin treatment with a doctor who would be new to
me—Dr. Joseph White, a senior member of the Yale faculty who'd
been recommended to me by one of the doctors at YPI. White had a
widespread reputation for his work in psychiatry, but his scholarship
also extended to the humanities. He had a great deal of experience
working with very sick patients, and he was also a well-known believer
in "talk therapy." In short, there was every reason to think I'd be in
good hands.

Psychoanalysis was by no means the obvious treatment for my
illness; indeed, most of the professionals at YPI cautioned against it.
Psychoanalysis, they explained, causes regression, and I was already

too regressed; supportive psychotherapy, combined with medication,
was the way to go. I needed, in their view, to shore up my
psychological defenses, not to delve behind or take them apart.

But to me, psychoanalysis was the
only
treatment that made sense.
I had been cripplingly ill in England. Psychoanalytic treatment kept
me out of the hospital while I actually completed my Oxford degree. In
the States, in exactly the same situation, I was hospitalized, tied up,
and forced to drink foul antipsychotic meds—a year of my life wasted,
at a cost to my parents of thousands of out-of-pocket dollars, since the
thirty days' worth of inpatient care that my insurance covered hadn't
even scratched the surface. I may have been crazy, but I wasn't
stupid—I was going with what had worked before.

I met with White at his office at a community mental health center
(for those who couldn't afford private care, although I'd be seeing him
as a private patient) affiliated with Yale Medical School. White was
head of one of the divisions, supervising residents in their placements
at the center.

A two-story, nondescript gray building, the center was not
particularly inviting, and neither was the doctor's office, which was
equally gray and nondescript. Nevertheless, I took to the occupant
immediately. White was distinguished-looking, with an almost
patrician reserve. Then, as now, he struck me as the quintessential
Yale professor. For the time being, we would meet four times a week.

White was more classically Freudian than Mrs. Jones. Kleinians go
deep and fast, wasting no time to get to the heart of the matter,
whereas White's style was to be more attentive to my defenses, those
psychological tools we all use to protect ourselves from painful
thoughts and feelings. Mrs. Jones quickly focused on my thoughts and
feelings; White examined instead the ways I kept certain parts of my
mind at bay. Where Mrs. Jones might discuss my envy, White
discussed how my being overly admiring of someone allowed me to
avoid
my envy of them. He'd wait, listen, say a word or two, then wait
and listen some more. Despite his relative silence, nothing escaped his
attention. And he set limits.

"Elyn, I need you to stop pacing," he said one afternoon.

"Why?" I asked. Part of me was genuinely curious; another part
felt my hackles rise in defiance. "We can talk just as well if I'm
pacing."

He shook his head. "No," he said. "I need you to talk about what
you are feeling, I need you to not act." His voice wasn't harsh; his
manner wasn't angry. He was calm and knowing, and spoke as a
teacher might to a student who was restless in class and therefore
likely to miss the lesson. White recognized early on that my own
powers of wall, which had often served me well, were just as likely to
serve me badly when they pushed me to behavior that was destructive.

Once I was set up with White, my next order of business was
school, and how to deal with the awkward "story" of my abrupt
departure the year before. I'd learned an unpleasant lesson that
long-ago day when I'd tried to volunteer at the Warneford. Any
attempt at telling the truth would condemn me, both socially and
professionally. So I made up a story about how I'd taken a leave of
absence to decide if law school was really for me. The story worked
well enough, but whenever a classmate said how impressed she was
that I'd actually taken time away to consider this decision, I felt like a
fraud. Piling a lie on top of a secret didn't feel particularly good, but
mental illness comes with a price tag—and I was willing to pay it.

And then classes began. I walked into my first class of the new year
and sat down with a quiet, almost fragile joy and a near-audible sigh
of relief: I was back.

I especially liked the professor of my "small group," the
semi-narlike class of about fifteen required of all first-years. His name
was Bob Cover. At the age of forty, he'd won the Ames Prize (given by
Harvard Law School for a book deemed of profound legal scholarship)
for
Justice Accused: Antislavery and the Judicial Process.
In addition
to being a wise and compelling teacher, he was also a scholar of
philosophy, literature, and Jewish history, as well as a civil rights
activist—a leading supporter of the unionization efforts of Yale's
clerical and technical workers, and active in the movement to get Yale
to divest itself of South African investments before the end of
apartheid. Engaged, passionate, and genuinely humane—everything I
hoped someday to be. Later that year, I'd be fortunate enough to be
Cover's research assistant on an article for the
Harvard Law Review
entitled "Nomos and Narrative"
(nomos
is the Greek word for "law"); I
was thrilled to see that he'd thanked me for my efforts in the article's
first footnote. (Sadly, at the end of my third year of law school, in
1986, Cover died of a massive heart attack at forty-two. His loss
profoundly touched the legal community at Yale and far beyond.)