Modern Madness

by Terri Cheney

  ANNOYING EPIPHANIES

  For better or worse, talk therapy is a strip tease. If you’re like me, and uncomfortable with your nakedness, it can be unsettling. I want my therapist to like me—a perfectly human desire. But I also want him to see me, warts and scabs and bruises and all, because otherwise why are we wasting our time? It’s not perfect skin I came in to fix.

  Lately I’ve been trying to work on my emotional intensity in therapy. Again, it’s not something I feel comfortable talking about. I get comments about it all the time, and they invariably feel like criticism. “Can’t you just have a normal conversation?” people say. “Do you always have to go so deep?” It embarrasses me, as if I’d opened up a vein in public and didn’t realize I was bleeding all over the place. I don’t want to become an automaton, just tone things down a bit.

  It’s a challenge. For as far back as I can remember, I’ve always felt too much. Even as a little girl, I dramatized the most innocent pastimes. Hide-and-seek terrified me—I was certain that if I hid too well, I’d be lost from sight forever. Tag was even worse. I couldn’t stand the suspense of being chased, so I’d just refuse to run. This infuriated my playmates, who tortured me no end. I’d take refuge in the doghouse and cry my heart out until my mother found me in there one day. “Stop it,” she said. “You’re making the dog neurotic.”

  What she didn’t know, and I didn’t either, was that when you’re bipolar, life is always bigger than life. Emotions are never just feelings; they’re grand-scale productions. Joy isn’t joy; it’s sheer rapture. Sorrow isn’t sorrow; it’s utter anguish. Frankly, it’s exhausting—and I know it wears out the people around me. I can understand their comments about my intensity. I just thought I hid it better.

  It’s been hard to make progress on this issue in therapy. Emotions are like cranky children: they don’t like being told what to do. “But why can’t I be passionate?” I asked my therapist. “Isn’t that a good thing? Don’t most people want to feel more than they do?”

  “Passion is fine, but not when it interferes with your relationships,” he said.

  “It shouldn’t. That’s the other person’s problem, not mine.”

  “Then why are you talking about it with me?” he asked.

  That stumped me for a moment. “Because—because—you represent the outside world. You can tell me what other people experience. You can tell me what I’m doing wrong.”

  “There’s no right or wrong about it,” he said. “It’s simply a choice.”

  I wanted to strangle him (much as I care for him, I sometimes feel that way, although I never act on it). “But that’s the thing,” I said. “Being intense isn’t a choice. I’m just hardwired that way.”

  “Then why are you trying to change?” he asked.

  I suddenly felt very, very small and started to tear up. “Because it hurts,” I said. “People criticize me for being me, and it hurts.”

  Now and then my therapist belies his kooky Hawaiian shirts and comes out with something truly insightful. “Pain is inevitable,” he said to me. “Suffering is not.”

  I nodded, trying to look as if I understood, wanting him to feel good about his advice. In truth, I didn’t get it. Pain and suffering—weren’t they the same thing? That’s how we always referred to them in the law: “Plaintiff is entitled to monetary damages for his pain and suffering.” I couldn’t see the difference. But his words felt important to me somehow, and I kept thinking about them long after I left the office.

  Later that night as I was falling asleep, I got it: The essential distinction was time. Pain is abrupt and immediate—it strikes like a rattlesnake, sharp and sudden. But suffering evolves: It’s what we choose to do with that pain over time. Do we embrace it, make room for it in our hearts and bodies, allow it to come in and make itself at home? It seems strange that anyone would ever adopt a rattlesnake, but that’s what suffering really is: petting the pain that bites you.

  I had to ask myself: Despite being bipolar and prone to extreme feelings, did I sometimes overindulge in my emotions? And the answer was unavoidable: hell, yes. I have, after all, written three memoirs about my internal struggles. I attend weekly therapy, two writing groups, and a mental health support group. For years I’ve mined my misery for raw material—I’ve examined it from every angle and wooed its every nuance. I’ve become a bona fide connoisseur of angst.

  Although I hated to admit it, I wasn’t gaining any further insight into life by being so intense all the time. Was my illness responsible, or had it just become an excuse for a bad habit—and did it even matter? It certainly wasn’t helping me, or the people around me. The truth was, I was petting my pain, and I wanted—I needed—to change.

  That’s the rotten and wonderful thing about therapy. It’s supposed to smooth your way through life, but sometimes it starts you on a whole new, and more grueling, journey. I knew I was in for a long, hard road of discovery, but I didn’t have the slightest idea how to start. So I did what I’ve always done when something really scary pursues me: I stopped dead in my tracks and refused to run. Then I reached into my bedside drawer and pulled out my journal.

  “For as far back as I can remember, I’ve always felt too much,” I wrote. And so the journey began. Again.

  THE RIGHT FIT

  In 1998 I checked myself into the UCLA Neuropsychiatric Institute. I was on perilous ground. I had just been arrested for the second of two back-to-back DUIs and was looking at mandatory jail time. My attorneys had immediately thrown me into rehab because they knew it was the best way to show the judge that my remorse for my conduct was sincere. And it was—legal tactics aside, I truly wanted to change. I had finally had enough of suicide attempts and shattered relationships and poisoned dreams and the broken promises at the bottom of a bottle of vodka. I didn’t want to be in a mental hospital, but I wasn’t ready for real life, either. I was willing to do whatever it took to reclaim my sanity, but I urgently needed help.

  And I didn’t get it. Not at first, anyway. Those first few “newbie” weeks in the mental hospital were nothing short of terrifying. Doors slammed locked behind me; the windows were barred; the rooms smelled like ammonia, stale coffee, and sour laundry. Patients wearing thick bandages around their wrists wandered the halls, carrying on intense conversations with things that weren’t there. People erupted into screams in the middle of therapy sessions, for no apparent reason. One day a man in the common room suddenly stood up and ripped off all his clothes, then poured himself a cup of coffee and sat down as if nothing were amiss. A young woman who must have weighed less than eighty pounds silently pulled out clumps of her hair, leaving angry bald patches behind.

  Was I the only one who noticed these things? Sometimes it felt like it, and I began to doubt my senses, and what little reason I could still lay claim to. I was scared, scared, scared every minute of every day—not just of the patients, but of the obvious burnout of many of the doctors and staff. They were dead in their eyes, if not in their hearts. The case worker I had been assigned to barely looked at me as she scribbled in my chart. “Gang history?” she asked me. “Varsity cheerleader,” I replied, and she didn’t even blink.

  A week or so after I got there, during an occupational therapy group (think moccasins and macramé), I was accosted by a middle-aged woman named Sal, who might have been pretty once but had obviously been beaten down by illness and hardship. Her long blond hair was tangled and dirty, her features ravaged by prolonged exposure. “I hear you’re a lawyer,” Sal said. I nodded, not wanting to interact but afraid to be rude. “You look like a Beverly Hills rich bitch to me.”

  “I’m here to get help,” I said, “just like you.” I glanced over at the counselor, who was staring out the window.

  “We don’t need no rich bitches in here,” Sal said. “Why don’t you call your sugar daddy to come take you home?”

  Some of the other patients took up the chant: “Rich bitch, rich bitch.”

  The counselor finally glanced over. “Qui
et,” was all she said. No one paid the slightest attention to her.

  Sal stood in front of me and pointed to the door. “Get out, rich bitch,” she said. “You obviously don’t belong here. What do you know about anything? You’ve still got all your teeth.”

  I couldn’t answer that. I knew what she meant: What possible claim could I lay to real suffering, with all the blessings I had enjoyed? I didn’t deserve help, I deserved to be censured for ruining such a life—a life of comfort and privilege that most of these people would never even catch a glimpse of. I got up and walked to the door. Sal threw a moccasin after me, hitting me in the back of the head.

  “Where do you think you’re going?” the counselor said to me. “The bell doesn’t ring for another ten minutes.”

  I sat down as close to her as I could get. It was a very long ten minutes. I could feel Sal’s eyes, and the eyes of the other patients, burning into my skin. When the bell rang, I bolted to the ladies’ room and locked myself into a stall, tucking my legs up on the toilet so nobody could see me. I waited, but no one came in. The bell for the next session rang, and I stayed where I was. Fifteen, thirty minutes went by. If I could just stay there till dinner time, I thought, another half hour or so, I’d be safe. It was hardly a desirable hiding place—it was damp and smelled nasty—but I was long past caring about such things. It was as close to being invisible as I could get.

  I meant to be strong, I meant to be wily, but damn it, I was all alone with my thoughts—something I’d tried very hard to avoid since my second DUI arrest. Unbidden, tears started to flow down my face. What a sorry, sullied mess I’d made of my life. I tried to stanch the tears with strip after strip of the wafer-thin toilet paper, but they just kept on coming. The full impact of my reckless and culpable conduct finally hit me—denial is damn near impossible when you’re crouched on a toilet in a mental hospital, hiding out for your life. I gave up trying to cry silently and wailed like the lost and desperate beast I had become.

  There was a knock on the bathroom door. I froze.

  “Is somebody in there?” a male voice said. “Come on now, I heard you, you might as well come out.”

  At least it wasn’t Sal, I thought; and I had always fared better with men than with women. I clambered down stiffly and opened the door. To my immense relief, it was Roberto, the janitor who always grinned at me in the hallway and called me “Red.”

  “Hey Red, you know they been looking for you all over the place?” he said. “You got a lot of folks worried.”

  “It’s no use, Roberto,” I sobbed. “I’ll never make it in here.”

  “Well frankly, I never really thought you belonged here in the first place,” he said. “They got other places you could go, where it’s a little more your speed. You just come along with me now, I’m gonna take you to meet Mrs. T.” He held out his hand, and I took it.

  Mrs. T, it turned out, was high up in the hospital hierarchy; I hadn’t met her in the admissions process. She had a thick accent (I later learned her family was from war-torn Bosnia) and china blue eyes that seemed to glow with compassion. I’ve heard many a doctor fake a soothing voice upon demand, but I’ve never yet met anyone who could convincingly simulate kindness. She listened to me rave about my situation for what seemed like an hour before she smiled and said, “The answer is simple, my dear. You belong in IOP—our intensive outpatient program.”

  Outpatient sounded like Paris to me, like the kiss of a faraway breeze. “But they want to punish me for what I’ve done, and outpatient would give me more freedom,” I said. “Judge Rubinsky would never go for that.”

  “You just leave Aaron to me,” she said. I was extremely impressed that she knew his first name and felt comfortable enough to bandy it about. I was practically taught to genuflect before judges.

  But sure enough, not long after that the order came down—I was to be transferred to the five-days-a-week outpatient program, pending further direction from the court. My sentencing hearing was three months away. That meant I had three months to get so squeaky clean and sober that I could spark mercy in the soul of a bored and case-hardened autocrat.

  I can’t say it was easy, even with my move to outpatient status. Although Sal and her gang were locked up six floors above me, there were still plenty of tortured psyches in the day program. But they were recognizably tortured, like I was: not by unknowable demons, but by depression, anxiety, trauma, mania, OCD. Even the psychotic patients were more toned down—still frightening in their otherness, but only intermittently symptomatic. And so many of us, at least two-thirds by my estimate, had a dual diagnosis, meaning we were plagued by alcohol and drug addiction in addition to our mental illness. There was, in short, a lot of common ground.

  It was that common ground that began to heal me—not the lectures by the doctors, not the endless medication trials, not the six hours of assorted therapies a day, but the lingua franca of shared suffering. I made friends with people I never would have met on the outside because I would have thought them too strange and different from me, or our paths would simply never have crossed. But I saw myself now in their troubled eyes, and I cried for their pain as well as my own. I rejoiced in their victories, however subtle. Slowly, almost imperceptibly, I started to change. When I shared my story, it was no longer about what “they” were doing to me. It was about how I was hurting myself.

  Humility, like healing, doesn’t happen all at once. It comes by degrees—a flash of insight here, a brief recognition there. By watching the other patients struggle, I began to realize the extraordinary value of traits I’d always sidelined before: empathy, patience, honesty—not necessarily weapons you’d find in an ambitious litigator’s arsenal. Most important of all for my recovery, I learned that mental illness exists on a continuum. It comes in all different shapes and sizes, and treatment has to mirror that. The secret to success is to search for the right fit, then stick with it. I must have gone to thirty different AA meetings before I found one that I could stand, then begin to like, then treasure. It’s the same with meds, or therapy. If you just keep looking, you’ll feel it when you find it: a safe harbor, a place where you can drop your guard and let body and mind and spirit renew.

  To my astonishment, I found that right fit in the outpatient program, as witnessed by the fact that I stayed there three years, which is surely some kind of record. Do I regret that ellipsis from “real” life? No. I went in splintered; I came out as whole as was possible for me. Mental illness still scares me sometimes—but only untreated illness, especially when it’s exacerbated by substance abuse. But I’m no longer terrified of being alone with myself.

  TRIED AND TRUE

  I underwent twelve rounds of ECT (electroconvulsive therapy, commonly known as electroshock) in 1994—or at least that’s what my records say. I remember only fits and spurts of that year, and what I do remember is pretty damn scary. But then, it was a scary time. I was at the height of my professional career and the nadir of my personal life, so profoundly depressed I didn’t care what they did to my brain so long as they made it work again. Of course, I’d read One Flew over the Cuckoo’s Nest and seen what horrors ECT had wreaked on Jack Nicholson in the movie. But surely, that was just dramatic license—my doctors wouldn’t let me do anything that was truly dangerous, right?

  I wonder now how any doctor gets informed consent for a radical treatment from a suicidally depressed patient. It didn’t matter to me back then whether I lived or died, I just wanted the never-ending pain to stop. I was willing to believe in anything that offered relief, and oh, the promise of ECT! It was the last resort for severe “treatment-resistant” depression, and it almost always worked, my psychiatrist had told me. Naturally, there were bound to be side effects from having seizures electrically induced in my brain—significant memory loss the most common among many. But what in my miserable life did I want to remember, I thought at the time. Forgetting this harsh and brutal existence would be a mercy, not a deficit.

  Three separate docto
rs (as required by my insurance company, which ended up paying for very little because my depression was deemed a pre-existing condition) examined me inside and out and pronounced me a good candidate for ECT. I did my best to convince them of this. Desperate as I was for help, I was a terrified proponent of the procedure, which may sound oxymoronic—although perhaps not for a lawyer who got her start doing criminal appeals, defending rapists’ and murderers’ rights to a fair trial. I am capable of great cognitive dissonance.

  And the ECT worked, to a certain extent. It lifted the depression that had been weighing me down for so long. But in the process I was untethered, hurled into a manic episode that went higher and lasted longer than any I’d known before. I went textbook crazy—spending every last penny I’d ever saved, engaging in reckless, carefree sex with strangers, taking extraordinary risks with my own life and others’. When I finally came down to earth, reality had disappeared and in its place was a new world where I couldn’t remember what my middle initial stood for. I had to ask my mother.

  ECT has since been improved, or so I’ve come to believe. Different techniques are now being used that supposedly lessen the risk of memory loss: unilateral vs. bilateral placement of the electrodes, for example, and briefer pulses of electricity. In the support group I facilitated at UCLA up until a few years ago, I witnessed patient after patient undergo the procedure with great success. The ones with the best outcomes were treated more frequently and had regular, ongoing “maintenance” sessions. I’d watch them emerge from hopeless, practically catatonic states to become productive and functioning people again. Sometimes it seemed near-miraculous.