by Luke Carman
It’s humiliating, trying to explain a fetish for dying you have growing inside you, but it came out of my mouth as unresistingly as the tears had done, and Dr Lee, who cupped her chin in her hands and took on the appearance of someone keen and sincere, listened while I explained the scene where I intended to be found, under the prayer flags strung across the courtyard of the house, on the sun chair beside the succulents, a bucket on my head with a face painted on it and my pale wrists slashed wide open, bleeding a deep, wine red – a little river on which to sail into oblivion. I told her I had thought of nothing but this mock tableau for days and nights with growing certainty, and the wild colours and motions of that courtyard scene were more solid and real to me than the walls of the doctor’s office, with their bright charts of the human anatomy with veins dissected, and advertisements for vaccine injections on posters besides shelves with curved metallic contraptions whose utility I couldn’t begin to imagine.
I’ve heard it said that the first thing a lunatic loses is their sense of humour, and some psychs will tell you the best indicator that a patient is returning to sanity is a growing capacity to laugh at jokes of their own devising. When I first watched the Herzog film with the experiment in snow-blindness in the darkened house with my wife and child upstairs sleeping, there was something hilarious about those Arctic explorers’ blinkered bumbling, but there was nothing funny about it when I sat with the doctor. She seemed to be watching my face carefully and I became self-conscious that there might be an ugly tell in its expression that she was interested in understanding, but when the time came for her diagnosis she explained that she was not the doctor I needed, of course, since I was unwell in a particular sense, not merely ordinarily broken or damaged. She provided the contact details for another, subtler practitioner, and so began the weird saga of my time in the mental-health game.
Destitution afforded me one advantage – when Dr Lee sent me off with the names and numbers of people and places to help fix my head, I took with me a government voucher for a dozen free consultations. The first address she’d given me was for a clinic that charged next to nothing in a nearby suburb where pregnant women, newborns and lunatics all mingled in a wide waiting room under a series of staircases and lifts. Glass walls showed untended gardens between the offices and halls, and busy nurses and clinicians passed through the swinging doors with a maddening frequency. On my first visit there an older man in a flannel shirt and dirty sneakers sat beside me on the waiting-room couch and in a drawling voice said, ‘I know you, don’t I? From Port Hedland? That job out at the mines there. Haven’t seen you in a long time. Must be twenty years, yeah?’ He carried on with knowing winks and smiles, and each time I came to the clinic he’d be there, ready to resume our reminiscence. I nodded along while he found ways of keeping our conversations flowing without relying on any corroborating remarks. It was convincing, after a while – who am I to say I didn’t work in the mines – and in his voice was a gentle, rumbling enjoyment which made it difficult to dissent from the assertions he made about our former life together in the towns of the north-west.
The counsellors there shipped me along to a Redfern psychologist whom I took to be some kind of Freudian. On occasions she would suspect me of making one of those notorious slips of speech that are supposed to reveal something hidden about your unconscious, and her eyes would widen in astonishment. ‘Do you realise what you just said?’ she would ask me, and it seemed to me that she was satisfied we’d made some kind of progress. One afternoon I walked into the waiting room and took my seat while a man with a tool belt prepared to glue the name of the clinic to the wall across from the reception. The man made his way through the first word of the clinic’s title without much trouble, putting glue on the back of each letter and then making a careful estimation of how far along on the sky-blue wall it ought to be stuck. It was when he got to the word ‘psychological’ that his nerves began to show. He looked around for some point of reference, but the walls were blank. When he stuck the Y after the P, I made my move. Pretending to get up for a magazine from the table by the wall, I instead stooped beside the man in the belt to warn him in a whisper that he’d made an error in the order of letters. He said, ‘Shit’, then pulled the Y from the wall, taking a small eggshell collection of paint along with it, and for the rest of the day I felt euphoric for having done some good for my fellow man.
With her long auburn curls and her crossed fulsome thighs, the Redfern woman and her Freudian leanings made me think of the notion I’d gotten from the ubiquity of psychiatry in American movies and television, that falling in love with your analyst was an essential part of the therapeutic process. If there was anything happening at all in my sessions it wasn’t love, and if it was, there was no fidelity. She saw other patients, I saw other doctors. One of those was a woman who worked in the city, across from the State Library on Macquarie Street, whose office was located on the third floor, and sometimes we’d endure the indignity of riding up in the lift together in total silence. She was a serious psychiatrist, and seeing her wasn’t cheap. None of it was free anymore; I’d used up the vouchers in a matter of months and the help I was now getting from the series of doctors was eating up the small lump of savings I had.
One afternoon, waiting for my appointment and admiring the library across from the psychiatrist’s building, I saw a big man in a suit sitting under a café umbrella whose voice was loud and whose companions were also big men in suits who joined him in speaking at a conspicuous volume. There was something familiar about the man in the suit; his face was large and his chin was thick and his slitted eyes looked weary in the glare. I might never have figured out who he was if a car hadn’t stopped in the middle of the street, from which two men, also in suits, leaned out and began shouting, ‘Hey Twiggy! How are you mate?’ The slit-eyed man in the suit gave a short wave and smiled politely and the car drove on with the horns of the cars delayed behind them giving the interaction a carnivalesque effect. It was strange, seeing a man worth billions of dollars sitting at the café outside my psychiatrist’s building. It seemed to me that a man like that and whatever I was ought to reside in two different dimensions. ‘I’m going to mention this to the doc,’ I said under my breath, but sitting upstairs with a plastic cup of water and the serious doctor sitting across from me, I forgot to bring it up. That session she diagnosed me with Borderline Personality Disorder. ‘Most people who have your condition end up dead or in prison,’ she told me. ‘You’re doing well when you look at it that way.’
For a while I collected books on the subject of BPD, as we sufferers call it. For anyone considering reading up on the subject I’ll save you some time and provide you with this summary: you’re the worst prick there is and there’s nothing you can do about it. Reading up on BPD can give you the impression that the utility of this category of mental illness is the ability to assign it to people who present with the various characteristics of insufferable arseholes. If you feel empty, have a terror of abandonment, leave a trail of disastrous relationships in your wake, turn on the ones you love, are enslaved by your impulses to a self-destructive degree and lash out at the world with capricious behaviours, then you’re a prime candidate for the BPD party. There’s no cure, no medications, just endless cognitive therapy and a dishearteningly low chance of living anything resembling a remotely functional life. One slight silver lining for me was that I’d only borrowed the books from the library, and so was able to forget the dispiriting information they contained once they were returned.
At the Black Dog Institute they told me the problem was bipolar disorder. The receptionist there smiled in a way that encouraged me to think there was nothing wrong with me for turning up, which was more attention than most clinical practices can boast, and she brought me into a room with dim lights, where a touchscreen computer was set into the wall like an exhibit at a museum. The computer knew my name, and it asked a series of questions much like those I’d seen on the form with Dr Lee. When the quiz was over, the
screen flashed a big emoticon smile and told me to wait back in the foyer. The receptionist gave me an encouraging look when I told her I’d completed the test, and she informed me that an interview had been set up with one of their doctors. The good news, she said beaming, was that the doctor I was scheduled to see was a very important person, one of the top people working at the Institute – a professor, the director, or both. The wait wasn’t long, and I was ushered into a room upstairs to meet the important doctor, a tall man with a loose suit and a checked tie that hung down into his lap.
He introduced himself and asked me to sit, then turned his attention to a file one of the other psychs I was seeing had sent him. ‘Paranoid tendencies’, the important doctor scoffed.
‘Whatever that means!’ I wasn’t sure if he was talking to me or simply making a professional observation, and I didn’t want to be rude and watch him read, so I sat still and stared out the large window to my left, watching the cars passing on the busy roads outside, and the tall gums trembling in a sudden breeze, while he kept his chin thrust down into his neck and read over the report. He soon put this document aside with what seemed like disdain and read through another item on his desk, one I assumed the computer in the wall downstairs had produced. He read this without comment, making a few mysterious grunts and placing the back of his pen in his mouth till he was ready to begin conversing.
He asked some questions after a while, crossed his arms and said in an officious voice, ‘Well, based on the information we have here, it looks to me like your diagnostics indicate something between Bipolar (1) and Bipolar (2).’ He explained that if we were to think of Bipolar (1) as being the category to which the extreme cases of the condition belonged – those who suffered delusional manias in which they believed themselves to be Christ reincarnated, for instance – and then considered Bipolar (2) to be that category of sufferers whose manias find them binging on eBay and engaging in Twitter feuds that cost them their jobs, then we’d have to consider the symptoms presented in the reports he’d just read to be somewhere in the middle. ‘So that leaves you more of a Bipolar (1.5),’ he said, and as he did so two pigeons collided with the large window to my left in an explosion of feathers and twisted wings. ‘Jesus Christ!’ The doctor laughed. ‘Suicidal birds!’ All these institutes and counsellors and Freudians were excellent people, but I didn’t give many of them a chance, in part because I’d been raised to regard those who worked in mental-health care as charlatans and kooks in need of the remedies they purported to peddle, and I considered those who sought the assistance of these frauds and fools to be losers and wackos with too much time on their hands and not enough common sense. I’d gone from that crude cynicism about the field to spending almost a year with shrinks of one variety or another on a weekly basis. Though the sessions often involved some sort of breakdown, breakthrough or revelatory release, the curative wonders didn’t quite seem to stick, and I’d wake up each morning, as always, back in the same wild miasma of confusion.
This therapeutic dialectic might have gone on with an irregular perpetuity if my wife had not intervened. She didn’t say it directly, but there was in her look the expression of a woman who had grown tired of cohabiting with the hobbled creature that called itself her husband, and she must have been sick of watching me lurch around the house in a kind of accelerating discombobulation. Also I was an unemployed mooch. She called on her friends and asked them to recommend a decent place to send me to. Many of her friends were veterans of the therapy scene and I was directed by one of them to the quiet, leafy street off the highway in St Leonards whose reputation was spoken off with the same empathic reverence you’d lend to a hip wine bar or a private swingers club.
It was a long drive, across the bridge, and a nuisance trying to find parking under the fat trees that loomed over the footpaths in the metered streets of St Leonards, but as I walked through the shade of the garden at the front of the clinic, a queer shiver of ease enveloped me like a cool, calm breeze, and in the low light of the waiting room, beside a water cooler and a stack of old Who magazines, I sat beneath a Whiteley-esque painting of a beach, with a curving coastline and frothy slashes of white where the sailboats and surfers broke the dark water’s surface.
I was the only patient there, and assumed the standard waiting-room trance until a door swung open at the end of a hall from which a tall thin man in a pinstripe suit stepped out and halted for a moment, expectant and prepared, like a porter coming through the gated entrance of a railway station. He looked at me from across the hall, gave a small waving gesture and said my name in a voice no louder than a whisper. We shook hands in the doorway, and he bid me to take a seat in a fat plush chair across from his own squeaking seat. The blinds were low, but I could see a shaded garden out the window, and behind the doctor were neat shelves of volumes on subjects with titles appropriate for a man of his position. He smoothed his lap and placed in it a clipboard loaded with sheets of lined paper. His brown hair was cropped short but it had a prickly look, like the frayed bristles on an old toothbrush. Most dramatic of all were the taut lines of the doctor’s face, the long trenches at the front of his cheeks, which might have had a severe effect were it not for his enormous eyes, set behind round glasses that his long-fingered hands would occasionally touch as we exchanged the usual things that pass between a nutcase and a doctor on a first date.
In what way our conversations differed from any other therapeutic session I’d experienced is not easy for a layman to pin down, but just as my encounter with Dr Lee had taken on a maternal dimension from the first instance, so my interactions with Dr Young contained a subtle trace of father and son. Like it had been with my dad when I was a boy, I paid Dr Young a visit once a fortnight, and he’d listen to all that had happened since we’d seen each other with an evident interest. My father always had the perspective necessary to interpret the immediacy of my childish impressions, and the words to affix them to some grand narrative of the bigger world. Dr Young supplied this same wisdom for me, and in his sessions it was possible to learn, not merely to talk – to confess and be consoled.
‘The consensus,’ he explained during one of our chats, ‘is that to categorise a person as “having” borderline, or any other personality disorder, is a less useful way of thinking about diagnostics.’ Apparently the data collated by the top clinicians indicated that it was more useful, and truer, to think of people as exhibiting behaviours that can be correlated with a spectrum of personality disorder traits. In short, the best minds in the field had concluded that we are not our disorders, and they don’t constitute us. This was encouraging news, and on some level it seemed like common sense.
Whether it was part of Dr Young’s role as an encouraging father-figure or not, he appeared to beam with pride when I went back to work, or wrote some piddling essay, or even expressed an idea in an unusual way. I asked the doctor to help me return to the PhD I’d left years before. When I quit, they’d warned me there was no coming back, but I hoped a letter from Dr Young stating I’d done so under internal duress rather than mere foolishness would have some kind of incantatory power over the university administration. He said he was happy to help, but wanted to know a bit more about the subject.
In polite company, it is common knowledge that asking a PhD student to explain their research is a regrettable faux pas. In all but the most exceptional cases – none of them coming from the humanities – the student will instantly deflate with insecurity, not sure they can speak to their subject without reviewing their notes, or crippled by the suspicion that no one in the world could possibly be interested in the abstruse subject they’d foolishly married themselves to. Against this overwhelming reflex to self-sabotage, I managed to mention two literary critics, Bob Hodge and Vijay Mishra, who had written a book in the 1990s in which they describe Australian literary culture as an attempt to deal with the guilt and illegitimacy of a settler-colonial legacy by constructing a mythical Australian authenticity. All I wanted to contribute to their diagnosis
was to argue for augmenting their concept of guilt with an idea of shame – since shame, unlike guilt, is not bound up in a need for forgiveness: it cannot be expunged. Shame, as the affect theorists have it, teaches us what we value, whether we know it or not, and displays it for the world to see in the capillaries of our cheeks and in the bowed posture of our heads. If we deny shame’s bitter bite, or attempt to evade its withering touch, we risk pathologising ourselves and those around us.
There was nothing extraordinary or revolutionary in my description of the project, but something about this idea of shame piqued the doctor’s attention. At any rate he said, ‘interesting ideas,’ as though he meant it, and I didn’t disagree since none of them were mine anyway. We got back into the swing of our therapeutic relationship, but there seemed to me some lingering preoccupation with shame in the air, and the doctor pressed his pen to his chin while we talked.
Not long after this conversation all our appointments were shifted from Tuesdays to Wednesdays, and when I asked why during our next session I was shocked by his response. ‘I’m no longer doing my other job,’ he said. I had the sense he wanted to leave the subject alone but the idea of my doctor having a second job was too much of a curiosity to be left unexplained. It turned out Dr Young happened to be the shrink overseeing the mental health of every asylum seeker detained by Australia, on- and off-shore, and he was leaving the job to blow the whistle on the toxicity of the entire detention system. My preoccupation at the time, rather than the moral and ethical dimensions of what the doctor had just said, was merely to marvel at the thought of Dr Young flying out to those island camps with barbed-wire fences and armed guards, seeing patients with their mouths sewn shut, or those who were refusing food in protest.
It occurs to me that I can offer a second piece of advice for the reader: when Dr Young returns your sanity to you, don’t assume your troubles are over. With his guidance I got my mind back and along with it came work, family, friends and other benefits. I didn’t mean to stop going out to the leafy-gardened clinic in St Leonards, and I never intended to stop seeing Dr Young, but things were so well that it just sort of happened. In our last session before I gave up on therapy, we chatted as usual, and he was happy to hear the university had let me back in on the strength of his letter. ‘All’s looking well then,’ he said. ‘That’s really great news.’ There seemed to me something just under the surface of his taut expression, and he was holding a long finger up to his lips as though some secret was close to being spoken. We shook hands at the end of the hour, and just at the last moment, with both of us standing in the doorway where we’d first met, he said: ‘I have something that might be of interest to you. The journalists at the Guardian – they’re good people. When you go home, keep an eye out for an interview I did with David Marr. You’ll find it interesting I think.’