The boy across let a faint sigh that could have only been heard if you were paying close enough attention to him only.
Chapter 14
Personally, my stay here in this recovery center, or Center, as some of the other patients called it, has not been a very joyful one. In my seven months here, I have avoided making deep or meaningful social contact with anyone here.
Staying here at this Center is a temporary stage in my life, and it will not define me. I am here because I need help, but I hope to get out as promptly as I can. I don’t see why I should make acquaintances with others, especially if I am not going to stay here very long. I am strong and independent, and I am fine just by myself. It is my choice not to build close friendships here.
I wouldn’t say that I am antisocial, because that would infer that I am trying to cause harm to others, but I just simply keep to myself.
I rarely have an incentive to talk to others, which is why I am sometimes set apart from some of the other adults here, because they often times choose to socialize, as opposed to me; I choose not to, no matter how much I am encouraged.
“Alright everyone,” Mr. Jenkins announced. “How are all of you folks doing today?” he asked as he took an open seat himself and repositioned his clipboard on his lap.
Collective murmurings of “good” arose from the mass. I remained silent, and so did the boy.
Since there are roughly thirty of us here at the Center, we are separated into three groups. After about a month, we are randomized and placed into new groups. Mr. Jenkins believes that a having the same group of people for a month is a good way to become familiar with each other and be comfortable to talk to each other, and eventually, offer each other a support system. For example, if one of us has a problem that we are trying to overcome, we see the same people so we can observe that person’s progress and give feedback. Also, having thirty of us in one large group is too hectic and not effective. This is why we have group therapies comprised of about ten people. As a result, we have three groups for every session—Group A meets first, Group B second, Group C is third. The first group that meets, also known as Group A, is my group.
“Okay, that’s great!” Mr. Jenkins responded, optimistically with a smile. “Shall we get started?” he asked.
A few “M’hmms” echoed from the circle, along with the repositioning of body postures and chairs.
“Great. Who would like to begin the session by sharing?” Mr. Jenkins proposed, and added, “Remember to state your name, age, type of disorder, favorite memory, and what you hope to gain from your treatments.”
From what I know, Mr. Jenkins has a Master’s of Arts Degree in Counseling Psychology with an emphasis on Abnormal Psychology. As far as his occupation goes, he works as a full time therapist at various locations. We here at the Center, only see him twice a week.
From what I understand here at the Center, the entire faculty has some sort of college degree that only allows qualification for their specific field. For example, Mr. Jenkins is only allowed to have group therapies. He likes using active listening, positive psychology, and other similar techniques. Mr. Jenkins, however, cannot diagnose or run exams on our disorders. Mr. Jenkins is also not allowed to give medication. We have different people working here for those areas.
As far as his approach to the therapy, we each take turns introducing ourselves and talking about our lives with our disorders. Our names, ages, and types of disorder are formal introduction so we have a general understanding of each other.
Mr. Jenkins, in particular, likes to ask us about our favorite memories, which I personally admire. He makes us talk about them to emphasize that we were normal people before we ended up at the center. That we were functioning people, people who had normal lives, just as anyone else—that we are humans, that we matter, and that there is still some part of our old lives that has not changed—that somewhere deep inside us, there is an individual who is not defined by a disorder.
Lastly, Mr. Jenkins wants us to talk about what we hope to gain from our time here at the center. It’s his reminder that we should all be aiming for something—something that we want to go back to or something that we want to achieve. He believes that we have to want an outcome to be able to achieve it. He is always encouraging us to live productive, functioning, and independent lives one day.
Some of the guidelines that Mr. Jenkins wanted us to abide by were to be supportive of each other and be respectful by taking turns to speak.
We all glanced at each other, and finally, one woman said with a scratchy voice, “If it’s okay,” raising her palm close to her chest in an awkward position, and added, “I can go first” and then bit her lips. She was slightly chubby, had rather pale skin, and had medium-short red hair.
She looked over at Mr. Jenkins as he gave her a, “Yes, please; go ahead.”
“Thank you,” she said to him. She stood up in a very peculiar way, as if she had trouble with her joints, and looked like she had struggled a bit, and finally, stood very stiffly.
Her back was very straight, but she looked like she was very tense. She looked around for a half a second, and finally said, “Hello, everyone, my name is Ingrid.”
“Hello, Ingrid,” was politely murmured by the mass of people.
She faintly exhaled from her nose, and smiled. “I am thirty-one years old,” she said, but took a pause to bite her lip, and continued, “and I have catatonic schizophrenia. Which complicates movements.” She took a pause, almost as if she was holding her breath. Her left hand was very stiff, and she stretched out her fingers—jittering a little bit. And she closed her hand into a fist after five seconds, and her fingers stretched irregularly.
This situation would have been very awkward—to silently watch someone have such a rough control of their body. But the thing is, we had seen Ingrid before, we knew her situation, and we had also seen each other at our worst.
“Come on Ingrid, you can do it.” Mr. Jenkins said to her. Ingrid continued to stand stiffly.
“You can do it,” she murmured to herself, almost echoing Mr. Jenkins.
She paused, bit her lip, and started breathing again. “I am Ingrid,” she said once more, “And my favorite memory before I was,” she quickly cut off and clenched her fingers. “Was when I would practice health exercises. With a few of my friends.”
It was apparent that she was struggling to speak; her stiffness became more and more apparent. “A few years ago. My group of friends and I. Would go to take classes of stretching, like yoga. And it was a lot of fun. We did lots of exercises and from time. To time. We also. Also took dancing classes to learn how to dance and practice dancing.” Her speech was very clunky. “I was really happy when I went to those classes with them and we all would practice together. I had a lot of fun. Especially having control of my body.”
She took a small pause and looked around—and smiled. She had been so proud that she finished the sentence. We all smiled back. Ingrid finally locked eyes with Mr. Jenkins.
Mr. Jenkins saw that she might have needed a little more guidance.
“That’s great to hear, Ingrid!” He said to her, very optimistic and positive. “I am very glad you told us about one of your favorite memories. We appreciate it,” he said, with such a deep sincerity. Ingrid’s smile only grew bigger.
“Now, Ingrid, do you want to let us know about any goals from your treatments here at the Center?” Mr. Jenkins asked her.
“Yes.” She clasped her stretched fingers into a fist, her fingers tightly squeezing each other. “I hope to be able to go back home. To my friends, and two daughters, and husband. And I want to continue to take exercise classes again.” Her fingers unfolded quickly, stretching again—ferociously, and she smiled proudly.
She paused, and we knew she was done. We immediately started clapping, as was customary for the group therapy.
“Thank you for sharing Ingrid. We all support you and cheer you on as you get better,” Mr. Jenkins announced. He turned his attent
ion to the rest of the group and said, “How about we all thank Ingrid for sharing out?”
We collectively said, “Thank you, Ingrid.”
I found myself smiling as well.
Ingrid slowly reached for the chair behind her with one hand, and sat back down. Her slight shaking and stiff position persisted, similar to someone with a joint complication.
I noticed that heads were turning left and right again, glances beaming around the circle. That meant that someone else would soon present himself or herself again.
Mr. Jenkins broke the silence again, lifting and then setting down a piece of paper on his clipboard, with the pen still in his hand. “Thank you again, Ingrid,” he said and continued by asking, “Who would like to share next?”
Glances continued until they all focused in on one young gentleman raising his hand. He was sitting two seats to my right.
Chapter 15
“May I go?” he asked Mr. Jenkins.
“Sure, please do,” Mr. Jenkins responded.
This young man had a short, well-groomed beard and had a rather light brown skin tone. There was a slight amount of hair product in his hair that maintained his razor-cut hair upwards. He must have gone to the city for a haircut like that. As he stood up, his musky cologne emanated from him and reached my nose. The cologne smelled sweet, like something fabricated and modern, and reminded me of the city life. It was like the cologne of a stranger in a mall or plaza.
The cologne of strange men who disappear as soon as they arrive—that was one signature scent that reminded me of the city.
“My name is Zoan,” he pronounced. His low-pitched voice broke me from my nostalgia from the city. He gave a quick wave to everyone in the group. “I am twenty-three years old, and I am currently diagnosed with residual schizophrenia.”
He was very tall and thin; he must have been almost six feet tall. He had this buzz cut around his head, but had a bit of hair on the top of his head. The fluorescent light continued to permeate into the room and reflected off his rectangular glasses. His left arm had this very simple and thin tribal tattoo that must have started from his shoulder, but ended at his elbow.
“Hello Zoan,” was murmured from the circle.
“Good to hear from you, Zoan,” Mr. Jenkins pronounced, optimistically once more. “Is there anything you would like to share with us?”
“Oh, yes,” Zoan responded. “I would like to share a favorite memory of mine.”
“Please, go ahead, Zoan,” Mr. Jenkins encouraged with a smile.
It wasn’t till I shifted my eyes from Mr. Jenkins’ delighted expression that I noticed Zoan’s solemn and emotionless face. Zoan had the same blank facial expression the entire time, but I didn’t take note of it till it contrasted with Mr. Jenkins’s smile. He stood there blandly—no excitement, or very much of any emotion to begin with. It must have been a negative symptom from the residual schizophrenia.
Zoan gave a small nod to Mr. Jenkins and proceeded to speak. “Well,” Zoan began, “one of my favorite experiences before I was diagnosed with schizophrenia was back when I lived up in Northern California as a writer and performer. I was studying at a community college up there at the time, and I was in the process of publishing my first poetry collection into a book. I would spend my weekends performing my original poems at poetry cafés in San Francisco.”
The young boy from before, who was sitting across from me, was completely mesmerized. This must have been his first time hearing Zoan sharing this about himself.
“I remember one night,” Zoan added, “I was performing one of my original poems called, ‘Empty Nights and Somber Busses.’ It was about a young man’s solitude in a crowded metropolitan city. It had to do with irony—that in a highly populated city, a young man still struggled to find comfort. The first time I performed that poem, the entire café went silent. When I had finished, the entire audience there was clapping and cheering for me, and it felt,” he paused for a second, trying to think of a way to describe it. “It felt incredible. In that enclosed small local café, I felt significant.”
The entire circle was silent, including Mr. Jenkins.
“Anyways, back to the point.” Zoan interrupted himself. “The best part of it all was that I was doing very well. I was finishing my Associates Degree and was looking into applying to a four-year school so I could complete a Bachelor’s Degree. I had been accepted to a private college down in southern California called Chapman University, over the spring and planned to transfer once I was done. But over the summer, my prodromal phase of my schizophrenia began.”
Suddenly, I felt a little sad.
I felt as if I was excited for him, he made me feel hopeful, but he mentioned his schizophrenia, and I suddenly felt as if he was about to lose. All of us suffered this misfortune, this abnormality. As soon as he mentioned his prodromal phase, I knew his story was declining; his heightened and functional life was going to deteriorate.
The prodromal phase is considered to be the early signs of schizophrenia. Typically, this phase does not necessarily have psychotic symptoms yet, but it does include behaviors of isolation, lack of interests, trouble expressing emotions, and even motor problems at times.
I looked at him and only felt a shared grief. It was the struggle that we all went through. No one’s early schizophrenia ever looks happy, or goes well. Functionality drops, behaviors change, and it’s just a terrifying time.
Zoan continued, and I felt dread. I knew that this was not going to go well. I wanted to stop him. I felt like if I stopped him from speaking, I could prevent this disorder. I felt like if I stopped him, it would never have existed in his life. If I could somehow restrain him from saying it, I could prevent his deterioration. I felt hopeless. It killed me.
I wanted Zoan to become a successful writer and poet. I wanted him to be getting his Bachelor’s Degree at Chapman right now. I wanted him to live a happy life.
And I felt like if I could somehow manage to stop him, that his downfall would never have occurred. But I couldn’t stop any of it. I can’t save anyone. And I wish I could just warn people of this danger, but I will never in my life be able to stop it. And it kills me to see people develop this goddamn disorder.
Zoan opened his mouth, and I fell silent.
“I stopped going to the poetry cafés.” The entire room was quiet. Ingrid’s hand was still jittering.
And so it began. His downfall. Our downfall.
Zoan continued, “And I lost contact with my manager and I stopped writing poetry. I stopped performing. I stopped going out. I would refuse to see anyone. And I just. I don’t know. The busy world of San Francisco continued without me. And I watched it continue as I spent day after day in my apartment alone—refusing to go out.”
And there it was, our uncontrollable fortune, our illness. I felt like I had lost. I couldn’t stop him. And I lost.
“As you can imagine,” Zoan said, “I didn’t end up going to Chapman. My mother and my stepfather became aware of my condition, and they eventually sent me to my other dad here in southern California to get help.” He took a slight pause and looked at the circle of people for a bit. “And that’s how I ended up here.”
He gave a slight sigh, and finally finished with, “Boy. What I would do to go back to writing and performing.”
Even Mr. Jenkins was a little bit hesitant to say anything at first. However, Mr. Jenkins found a way to continue the therapy session by asking him, “Well, Zoan. What do you hope to gain from your treatment here?”
Zoan responded, “To write and perform my poetry again, finish my book, and go back to school if I am stable enough.”
“I am very happy to hear that, Zoan.” He gave a smile of relief after all the silence, and emotional dashes and turns. “Zoan?” Mr. Jenkins asked. “I was a bit curious. Did you say you have residual schizophrenia now?”
“Yes, I did,” Zoan responded. “Dr. Alvarez diagnosed me with it recently. I had undifferentiated schizophrenia initially, but the s
everity of my symptoms decreased over the year and a half. I had a lot of issues with organization and emotions, but Dr. Alvarez informed me that because my symptoms have become less aggressive over the past few months, I could most likely leave by the end of the month as long as I have a support system. The only thing she wanted me to do was to keep taking medication regardless if I stopped experiencing any positive symptoms.”
Undifferentiated schizophrenia is a subgenre of schizophrenia. This classification is only given when the symptoms of schizophrenia are not sufficiently present to categorize as another type of schizophrenia. Essentially, symptoms fluctuate erratically and to different severities, and can also overlap as other categories of schizophrenia. Often times these symptoms are harder to pinpoint and label, and also come and go at different rates, which is the reason why patients are labeled with undifferentiated schizophrenia.
As far as Dr. Alvarez’s current diagnosis of Zoan—residual schizophrenia is defined in two ways.
The first definition of residual schizophrenia is in regards to the three phases of any schizophrenia. Typically, most forms of schizophrenia follow three phases: the prodromal phase is the early tell-tell signs of schizophrenia. It does not necessarily include psychotic symptoms, like hallucinations, but is more commonly characterized by changes in behaviors. The active phase of schizophrenia pertains to the development of definite psychotic symptoms. On top of unusual behaviors, schizophrenics begin to experience hallucinations, delusions, disordered thinking, or motor dysfunction. Lastly, a schizophrenic may finally reach the residual phase. In the three phases of schizophrenia, the residual is the last phase. This phase is characterized as the decreasing of severity among symptoms. Both positive symptoms, such as hallucinations or delusions, decrease, but negative symptoms, such as the reduction of physical activity, motivation, or social interaction, may still persist. The residual phase may not have as severe symptoms as those in the active phase. Usually patients in this stage have very few, severe schizophrenic episodes throughout the rest of their lives. However, the only thing is that not everyone gets diagnosed with residual schizophrenia. Some of patients can remain in the active phase of their schizophrenia for the rest of their lives.
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