Even though Cognitive Therapy is not used very much anymore, there are times when I have to administer it to myself for the sake of being stable. The most common distortions I catch myself doing are personalization and mind reading. Old fashioned psychoanalysis is useless for schizophrenia yet we don’t get rid of it; we keep going back to it like a curse of history. I’m just tired of feeling miserable from this disease and wish for progress in the methods and techniques we use to treat it— short of a permanent cure. It’s weird the way humanity boomerangs back and forth between the Enlightenment and Romanticism. We can make great strides with science and then we’ll scratch it out with a return to religion or rank superstition. Why is this? It’s true historically as well as clinically: the Church always tried to shut down the progress of universities on the verge of a breakthrough discovery. Politically, we bounce between liberal and conservative, between progress and regression, when it would benefit us to simply move forward. Why can’t we do this? What are we afraid of? We keep returning to the primordial slime and worshiping gods with the heads of beasts. We feel comfortable this way, like the animal that won’t leave its cage when the door is thrown open. We cling to the bars and stay where we are.
It’s a fact that stress makes the experience of psychosis worse. This afternoon I resorted to taking a gabapentin for my anxiety and it worked very well. I didn’t get around to reading the next story of Paul Bowles. When I look at his writing, it pulls up memories of being a client in Serenity Lane, whose approach to recovery was not a rational one but rather psychological like the old school, drawing on Freud and Jung mostly, and throwing in mega doses of the Bible, justifying it all with the Pragmatism of William James. My attraction to Bowles’ stuff harmonized with the other ideas I was exposed to over fifteen years ago, but that irrationalism just felt kind of wrong for me. It was everywhere at the time in my hometown and across the nation as well, and Alcoholics Anonymous enjoyed huge popularity.
So anyway, about a week ago I was browsing the Library of America website and found this Paul Bowles book sale priced and I couldn’t resist the temptation. I had really forgotten what his writing was about. I guess I’m still figuring that out, along with all the ideas I learned up to twenty years ago. Funny but many people I knew back then are either dead or changed beyond recognition. I wonder if I might be one of them? A face among a lot of ghosts in an old photograph no one ever saw… which is dug up, restored, and presented to the daylight of the post millennial public?
Eight thirty five. It’s below freezing outside. I’ll go to the store after feeding the dog at nine o’clock. I’m a little confused on where I stand regarding the existence of magic. Generally I don’t believe in the supernatural, but I know a lot of people do. Why so, when there’s no evidence for their claims, I don’t know. I had a difficult time over the summer, debating with myself whether the apocalypse was a reality. I left the church up in the air for a while until La Niña kicked in. The seasons keep changing like normal, but we had a summer that suggested the end of days. Climate change is the truth. In fine, I didn’t want to believe in the Second Coming and the Last Judgment. Now the election is over and I still have to make a choice for or against metaphysics.
Nine thirty five. The day started out okay. I got a renewal of my food stamps, so that means I’ll save cash. Vicki acted a bit weird about it, as if disguising envy and resentment. Otherwise her mood was good. The leaves have really dumped at the end of my street, carpeting the pavement and lawns with gold. I saw Karen’s vehicle outside the salon, but the blinds were still pulled down. I didn’t feel like knocking on the door. All in all, people are not very sociable right now, but keep to themselves with their private thoughts. One thing I observed is that I’m a world class procrastinator. But I don’t think I’m marked for hellfire because of it. I’ve been through very rough experiences with treatment programs in the past twenty years. I’m still not a fan of those tactics, and I stay away from fundamentalist churches. I was educated in humanism; people are supposed to respect each other. Some of the immaturity I witnessed in group took my breath away. I also saw racism, but the counselor didn’t care. Nowadays, that particular facility is filthy rich and no longer takes Medicare. And people still pay out of pocket to be mentally abused. I guess we’re not very discerning as a whole bunch.
Today I’m going to swap bridges on my new bass. It needs a little boost in the low frequencies. Might be a fun experiment. I was just at the store. The rain missed me, gave me a window of opportunity. For a change I bought peanut butter and jelly and a loaf of white bread. Also dry food for Aesop and a two liter of cranberry ginger ale. It all was quite a load to carry home, but I live just around the corner. Now I feel a bit lonely, but things are quiet and serene at least. I’d be lost without Aesop’s company.
I guess today is the birthday of Alcoholics Anonymous. I’m not very impressed. AA members never did me any favors. Often they are terribly self righteous, crashing the meetings of alternative groups. After all, we are merely people. We all have red blood, and it is immaterial who has God on their side. Tomorrow I will have 33 months sober, totally without the involvement of AA. Maybe someday I’ll write my own recovery self help book, but I kind of doubt it. Every individual has to find a recovery that works for them. Some people, like me, are too smart and too defiant for a “simple program.” There are a few dozen reasons not to join AA. Nothing in life is ever that simple. You can stuff your brain into a little jar and force things to be simple, but eventually the jar bursts. Perhaps we’re all in the recovery game alone, but I can live with that.
I realize now that I have no libido as a side effect of the Vraylar. It makes my life experience different; a little frustrating, yet I’d rather be sane than psychotic. There’s hardly any bleed through of hallucinations or delusions now, and barely any other superstitions. I feel a bit like a space alien, someone from another galaxy. I have very little fear of anything. The scariest thing possible is human beings, but I know how people operate. Usually people are benign, or indifferent at the worst. If they are aggressive it’s because of drug addiction and sometimes mental health issues. I’ve been on the inside of that, so it doesn’t scare me. Tomorrow it’s off to Laurel Hill again to visit Todd and Heidi. I was really irritated this morning until after ten o’clock when I decided to go to the store. Very angry about something, but I’m okay now. It could’ve been a craving for caffeine, which means I’m getting addicted. But you know, the way my hypothalamus is being clamped on, my brain could be feeling very frustrated. This is not a natural state for me, nor for any average person. The desire is there but cannot be expressed except in my desperate words. It’s similar to D H Lawrence in the grip of tuberculosis writing like a maniac. Ditto for Katherine Mansfield. They wrote for dear life because they were doomed. I hope that’s not the case with me, but Vraylar hasn’t been on the market very long. No one knows what the long term is like for patients who take it. Again I identify with Charlie Gordon in Flowers for Algernon. Such a tantalizing experiment that ultimately fails. The difference is that my case is real. People can read about this live experiment as it transpires, and hopefully afterward. I don’t know what to expect in the coming year. What began as a success story could end in sudden death. In the meantime, hang onto your seats. It seems every silver lining has a cloud.
It pains me to recall the shape I was in three years ago, particularly the times I was taken to the hospital. But I remember it for contrast to now, when life is much better. Nor was my condition my fault; not a moral failing. I remember how mean the emergency room staff was towards drunk people— and not just me. I saw them humiliate another man once. Their eyes gleamed with sadistic pleasure, which I thought was sick and inhumane. I was never a fan of P—Health. I spent too long in their behavioral health program last year. They took pride in their care, but it was excessive. And they were judgmental about hygiene. I despised my occupational therapist for that reason. I gave her a hard time for it, too. It was an ordeal throughout, but Laurel Hill makes up for it. Way more experienced with the mentally ill, and more patient. I’d been the only schizophrenic person in P—Health. They really didn’t know how to treat me, and that was discouraging. But there are lots of us at Laurel Hill…
The sun has risen, lighting a clear blue sky. It didn’t quite freeze. My fortunes should be sunny too. I anticipate choir practice today. We may have three male voices, plus Pastor will want to play his guitar. Life is good.
I did so much studying of the Renaissance in school, probably the ultimate in finesse and snobbery… An old song by Stanley Clarke off of School Days plays in my head. The album title is pertinent. It is the way my subconscious mind works, sympathetic to the main argument… My hopes center on my house getting done. Until then I can imagine living in it: my own big space, subject to my rules and tastes. It’s all taking shape in reality, what was once a castle in the air. I’ve definitely paid a price for this gift. It’s the house of a Renaissance Man… Now it’s a song by Earthworks called “Shadow of a Doubt.” What is the doubt, I wonder? But The Sound of Surprise was a Cd I bought during my first recovery in May 2003. Treatment wasn’t so bad at first. The counselor was open to me as long as I didn’t drink. I was a good boy, honest about doing UA’s and such. Yet I was so different then from now. So much younger and fresher; it’s hard to believe I was the same person. Gradually I understood that alcoholism was something I was being blamed for morally, and that’s when I rebelled. I came to loathe the program for the shame it put me through. Alcoholism is a defect not of morals but of genetics, and forget the crap about “the sins of the fathers.” Years later I encountered practices that made schizophrenia a moral matter as well, and again it violated science and common sense. I guess I’m just a believer in modern science. The world will be a better place when old notions of moral blame and shame are replaced by understanding logically; when everyone puts on eyeglasses and looks at life through the microscope. The beauty of science is how it exonerates us from stigmas of habitual religion. Instead of holding a crows’ court and murdering our outcasts, we shall understand and love them even for the fact of their defects. Every ugly duckling is a swan in the eyes of science. And let there be no quack science either. The conspiracy of bullshit eventually must come crashing down. Thereupon we can rebuild society from scratch.
Three thirty. We’re having a rainstorm, and my dreams reflect the weather. I thought I was driving a car through the tempest. The trailer is a tin can in the cold and wet, but the heater works okay. The idea of lunacy shouldn’t scare anyone. I’ve been there and back, like a round trip to hell, more than once. It is a maelstrom of voices and images, a reservoir of our deepest fears and desires. But the only treatment for the madness is antipsychotic. The worse nightmare is the cost of the drug: over $1300 for a bottle of 30 capsules. If psychosis is hell, then the redeeming heaven is Medicare for the cost of medication. Smart people with schizophrenia are able to get themselves in the system and find relief for the symptoms. However, many patients aren’t so fortunate. If they don’t have the support of caring family, they may end up psychotic and homeless. My parents were great about getting me set up before they passed away. But I’ve had to be super wary of my older siblings with their incomprehension and outright envy. My brother is particularly poisonous, thinking only of what’s fair to himself… I’m thankful for my intelligence and for a good upbringing and education. My mother’s values were ten times worthier than the hollow ones I encounter in the remaining family. Everyone called her crazy, but I believe she will have the last laugh.
Seven thirty. The coat hanger in the trailer broke when I got home from the store. It was plastic and couldn’t hold up to three garments hung on it. But I’d known that I wouldn’t get the deposit back on the rental. Aesop is ready for a nap. It’s odd to recall how selfish the family thought I was. I was an intelligent only child, or raised like one. I was called a snob because I wore glasses and did a lot of reading. Now I think the schizophrenia was just a genetic fluke that could happen to anybody. There was no moral basis to it. To hell with therapists and their crap. Have mercy with your pseudoscience. Alcoholism is likewise hereditary and not a moral issue. I get so tired of defending myself against a moral majority that doesn’t understand human biology. I don’t know if there is overlap between biology and phenomenology, but I doubt that there is. A conscience is a sensitive thing, so don’t overtax it with false accusations. Shut the fuck up and I’ll take the goddamn medication and stay away from the booze. But I don’t do it for you or because you told me to. Fuck off!
Two thirty. I read the second book of The Prelude and then had my sandwich. The workers were done after twelve and now have gone. My back hurts from sitting in this seat, so I might lie down soon. Wordsworth says something critical of science that I like. To him it’s preferable to apprehend nature as a single whole with what he calls the heart, to dicing her up into different quantitative sciences. He assumes that Coleridge his friend would agree. And again W alludes to the plasticity and active quality of the mind, projecting as he says its own kind of light onto natural objects, thereby transforming them. Perception for W is a creative process, with the mind wrapping itself around things— like the “Anecdote of the Jar” by Wallace Stevens, but W had the idea a century earlier. So that: my experience with psychosis the day of my cemetery errand would be quite normal for Wordsworth, but nobody calls him psychotic for having those perceptions. What if “psychosis” really is just another way of sensing reality? Could we then abolish the DSM?
But I’ve seen some low functioning cases of schizophrenia that were very pathetic, peppered with religious delusions and odd speech. Some people have delusions of the FBI or CIA or other government agencies. One person with OCD I overheard obsessing about the future of the species. Another always wanted to use the fax machine to communicate something to the authorities. Still another believed that someone had sabotaged her TV and VCR with electromagnetic energy.
Thus there is a marked difference between delusions and Wordsworth’s active perception. It’s just difficult knowing where to draw the line. I think it would be terribly rash to eliminate the DSM on a whim, but again I am hung on the horns between two schools of thought…