Voluntary Madness

by Norah Vincent

  But when Diggs led me into Jan’s tidy windowed office, the first in a row of similar offices that all opened off a slim main hallway, I knew that I’d let my apprehensions run entirely away with me. Jan was barely five feet tall in her shoes and comfortably built, padded but not plump. Her dyed blond hair was styled in a grown-out pageboy and her blue eyes hid no subtext. She was wearing sandals, three-quarter-length trousers, and a short-sleeved button-down blouse, which is what she wore virtually every day, the default warm-weather business casual for a low-maintenance woman in her midforties. She was kind and efficient, remarkably cheerful about what was a fairly laborious routine that she was often required to perform several times a week with each new bumbling client.

  Most of it was paper signing. I must have signed forty sheets—disclaimers and permissions for everything from the syphilis test, to a short-term lease agreement for the apartment complex, to a declaration of “patient’s legal and human rights.” But there was also the urine sampling, medication surrender, and bag inspection, as well as assorted sundry other smooth violations that constitute patient intake procedure in the bin. Jan, as anyone in such circumstances is required to do, took your dignity in one hand and your autonomy in the other, but unlike so many others, she did it like a den mother in the Cub Scouts, softening the blow of your demerit with a smile, even as she pinned the shaming badge on your sleeve. I half-expected to get a lollypop at the end.

  I’d arrived in the late morning, so by the time I’d finished with Jan, it was time for lunch. Diggs went to the local Boston Market and got me a meal. I ate it at the table in Mobius’s small kitchen, which was located just next door to Jan’s office.

  As I sat eating, Mobius staff and clients were breaking for lunch as well, so various people wandered in or lingered. That’s when I met Sam, one of Mobius’s three therapists and the instructor-in-chief.

  Superficially, Sam looked like Little Richard. He had the same pencil-thin mustache and wild kinky hair, and even a hint of the impish sparkle in the eye. But the likeness ended there. Sam was not a flashy entertainer. He was wearing what looked to be the traditional black-belted gi, and he sat very poised in his chair, like a person who was used to treating his body as an extension of his soul. He was calm and centered, as his profession would suggest, open but not loose, deliberate but unmannered. He was just there without agenda, like something in nature, alive and present but seeming to occupy no space.

  We sat at the kitchen table, he eating his habitual salad brought from home, and I eating my half chicken with sides. I asked him the usual background questions: Where are you from? How old are you? Are you married? Answers: New Jersey, fifty-three, and yes, two kids. None of this mattered much, though, when it came to knowing Sam. They were the wrong questions. There weren’t any questions, really—just a sense that you got in his presence, the immediate sense of who a person is, because he knows himself.

  Sam could teach me a lot, and would, not as my individual therapist—that job would go to another of the therapists on staff—but as a group therapist, and more so as our morning den chi bon instructor.

  This was Sam’s big gig. Every morning at Mobius the day’s activities began with an hour and fifteen minutes of den chi bon, which I can best describe as a cross between tai chi, tai bo, and a séance.

  At nine thirty we’d all gather in the activity room, which was at the far end of the long main hallway, at the opposite end from the kitchen. This was the room where all the group therapy and meetings took place throughout the day. It was the size of a small living room, piled with pillows and blankets, and people’s art catharses were posted all over the walls.

  Sam would start the class with yogic style stretches and deep breathing. We’d stand facing him with our feet positioned two to three feet apart. We’d spread our arms wide and swan-dive to touch our toes, and then we’d thrust our arms repeatedly from the prayer position at our heart centers, up and out to full extension above our heads, around to the sides, and back to center again. Soon these outward motions of the arms would grow more forceful and direct, like open-palmed punches, and the breathing would intensify accordingly, so that you looked as if you were parting a lead curtain over and over again, except that you were doing it gladly, as if mindless labor just made you happy and you gained energy and strength from the exertion. We’d do this for a long time, pulling and punching the air and stamping our feet, gesticulating more and more emphatically in ways that alternated between being voodooish and exaggeratedly masturbatory, and all the while breathing like we were about to give birth.

  It was the kind of too earnest, misty-eyed exercise that I had trouble taking seriously, at least at first. Early on, I hovered at the back of the room, going through the motions, embarrassed, imagining all the people in my life watching me join the feel-good follow-along Dancercise of Mobius Inc. The therapeutic value of learning to make an ass of yourself.

  But then, after a while, I thought: “Jesus, you self-important snot, just let go and have some fun. Nobody’s watching.”

  And so I did. And then, before long, I started getting into it. Maybe a little too into it, actually.

  The beauty of all that heavy breathing was that it got you high, an interesting concept for an addiction recovery program. Learn how to get high on your own. Oxygen is potent stuff, and concentrated gasping will make you feel pretty buzzed after a while if you do it right.

  At the end of the air punching and limb flailing—the “air” and “fire” portions of the ritual—when we’d gotten around to holding hands in a circle and swinging our arms like skipping kids—the “water” portion of the ritual—I was usually smiling like an addict, my eyes closed, my head turned up and all loose and wobbly on my neck. At the close of the ritual, the “earth” portion, when we stood there swaying and humming along with the music, or declaring our sober guiding thoughts for the day, we were supposed to be coming back to ground, but I was usually floating somewhere around the ceiling.

  By the second or third day, I was hooked on den chi bon. We all were. Sam always had great music to go with it, the cheesier the better. The Phantom of the Opera was much loved, as was the starting music, which was always the same: a tolling bell and an Indian man with a profound liquid caramel voice talking about the dharmal door being open, transcending the path of sorrow and death, and refreshing springs of compassionate water causing all suffering to cease. Fabulous stuff.

  Sam was always so full of joy during the dance that sometimes he’d break into spontaneous laughter, and then several of the rest of us would, too, simply laughing at his laughter, and then laughing at our own laughter, and pretty soon we were crying with it, and the rest of the less game participants would look at us sideways wondering what demon had possessed us, and wondering whether they should break and run while they still could.

  Laughter, like heavy breathing, is another one of those natural highs that can drastically improve your mood, even if you’re laughing at nothing at all, because, as happened to us, pretty soon you’re laughing at the fact that you’re laughing at nothing, and how absurd that is, and yet how good it feels, and then you’re on the giggle train and rolling, and spasming in earnest, and having all kinds of bodily functions. Tears are rolling down your face, phlegm is coming up from your lungs, your bladder is ready to betray you, or maybe does a little, and you might even be drooling. It’s quite a heave, especially at the end of a vigorous dance when you’re already drenched in sweat. It’s like the happy version of vomiting, or the less profane version of coming, depending on your point of view. Your whole body gets into it and squirts, and it’s so pure and spiritual, it’s fun for the whole family.

  This was the kind of release that Sam could bring about in you with the simplest, most elemental tools: earth, air, fire, water. Yes, you’re smirking, those New Age medievalisms given a new spook. I know. Believe me, I know.

  But there is a perfect sense to it that becomes pretty blisteringly obvious if you give it a chance. What
are we made of, after all? Literally. Flesh, breath, heat, fluid. These are the most basic parts of us, and yet we have forgotten how to use them. Our mind drives us through the world, pushing us on, feverishly achieving, obsessing, looking for occupation and results. But it’s the body that gets us there. The body that mechanizes the mind, and the elements that mechanize the body. How strange, then, that we could be so removed from our own breathing, our own movements, from what we eat and drink, and excrete, so alienated from our own basic functions that someone has to reteach us how to perform them.

  We knew as children. But now not even breathing comes as easily as breathing, crying rarely comes at all, and laughter has literally galvanized to irony, a metal-hard mirth that tightens, never releases, whose only liquid is bile, passing through kidneys as stones. Who has ever pissed himself over irony? Pissed on, to be sure, with deliberation and scorn. Ever a critic. But the involuntary burst? No. We have medications for that, to correct it when it happens, keep the piss and the shit and the sweat and the tears under wraps, or expel them on our schedule, and all so we can forget that we have bodies. Is it any wonder, then, why we end up in rehab and therapy, dancing around with Little Richard and a crooning swami trying to put the pieces back together?

  That’s what they were trying to do at Mobius, to help you to put the pieces back together, however asunder they’d been torn by experience, neglect, bitterness, life. Mobius was all about process and change, learning to see and then go about your life differently.

  They called it process therapy, and as it happened, I’d arrived just in time to get my first exposure to it. By the time I’d finished eating my lunch with Sam, it was two o’clock. Carol, a Gertrude Steinish-looking woman with a close-cropped graying cap of hair, was the second of the three staff therapists, and the one with whom I’d be conducting my private sessions several times a week. She specialized in process therapy, and she was gearing up to lead that day’s group session on the topic. She asked me to join, and since there didn’t seem to be anything else to do until I could get a ride to the apartment complex later that afternoon, I said yes.

  Carol, like Sam, was a licensed mental health counselor, or LMHC, which is akin to being a licensed clinical social worker, meaning that she had completed a master’s degree as well as at least two years of graduate-level clinical work and had passed a certification exam. In action, this meant that she knew the literature, but she wasn’t bogged down by it, and tended to favor an experiential rather than an academic approach.

  She was a connector. She connected with people emotionally. Her technique was interpersonal above all, but methodic, too. She warmed to you and led you out by the hand, if you would be led. But she also liked to draw charts and diagrams, or numbered lists and tables that could help you to organize your thoughts. She looked for patterns and sticking points, the layers of negativity and doubt that laced her clients’ thinking and led them to despair or self-destruction.

  As I filed into the activity room that afternoon with the five other resident clients (none of whom I’d met yet), Carol was already standing up at the white dry-erase board holding a smelly uncapped cobalt blue marker. She was writing the phrase: “I do not see things as they are. I see them as I am.”

  Then she turned and waited for us to settle, either sitting in the low L-SHAPED sling-back chairs that we unfolded and positioned in a semicircle around her or lying on our backs, heads propped up against a mound of pillows.

  “True story,” she said. “I was sitting in my office talking to a client.” She paused here looking around the circle of six, scanning our faces for signs of attention, her eager eyes searching each deadpan slump for some shred of recognition. She went on.

  “All of a sudden, we hear this scratching sound coming from behind the wall. We both stop talking, and I say, ‘Do you hear that?’ And he says, ‘Yes. It’s a rat.’ ‘What?’ I said. ‘It’s a rat,’ he said. ‘You’ve got a rat in your wall.’ Well, you can imagine this freaks me out, right? I hate rats. I can’t bear the thought of them, and now I have to listen to one scratching behind the wall of my office all day while I’m trying to work.”

  She paused again.

  Bobby, a hard-partying graduate student and alcoholic Xanax-head who’d been at Mobius for nearly two months per court order (three DUIs in a month), was already asleep in her sling-back. She’d heard the rat story ten times by now.

  Carol looked at Bobby and frowned, but went on.

  “So then, next day, I’m in with another client, and sure enough there’s that scratching sound again. And I say, ‘Hear that? I’ve got a rat in my wall.’ He looked at me like I was nuts and said, ‘What? Carol, that’s a branch from a tree outside your window scratching against the wall in the wind.’ ”

  Again, the dramatic pause.

  “Now which explanation do you think I chose to believe?”

  She looked around for the answer. Finally someone obliged and mumbled,

  “The branch.”

  “Right. The branch. And why? Because I hate rats.”

  Bobby twitched awake.

  Katie, another early-twenties Xanax-head, snapped a picture of herself with her camera phone. There was a loud click.

  “Did you just take a picture of yourself?” Carol asked, whipping around.

  “Yeah,” Katie croaked. “Accident. Sorry.”

  Katie had been arrested seven times in the previous year. She, like Bobby, was at Mobius for DUIs. She’d done time in jail for them. She’d also had run-ins with the cops several times over domestic abuse. Giving, not receiving. She looked like the kind of blond buttercup whose primary task in life was working on her nails and her tan, so you can imagine my surprise when, sitting on the couch in our living room one night, she said of a recent assault:

  “Yeah, Jamie [her boyfriend] said something stupid, so I punched him in the face. He’s a pussy, so he called the cops on me.”

  With an audience peopled by the likes of Bobby and Katie, you could see why Carol must have developed a bit of a complex about her students. Were we there? Were we getting this at all?

  Outright snoring and cell phone diversions abounded among the sling-backs.

  Then there were the blank stares and the rude whispers, the skeptical blinks, the knowing sighs, and the more desperate harumphers who fooled Carol a bit as they leaned closer, not attentively, I’m sure, but hoping to catch a high off the fumes from her marker.

  But Carol kept right on, shoveling learned optimism in our direction, watching it fall over sloping shoulders and accumulate in a heap. Maybe she thought of it as confetti. Most of it would sprinkle down and be trampled underfoot, but one or two pieces would stick on a few stubborn heads and somnolent lids, maybe on a shrugging scapula, unseen, and so undisdainfully swiped away.

  Of course Carol probably miscalculated, because in order to “think positive,” as the T-shirt might say, you first have to be thinking at all, and there wasn’t a whole lot of thinking going on in that room. That was the whole point of the drugs. To shut out thought.

  People who pop Xanax—and I can say this from experience, it being a close relative of Klonopin—do it for the blank. Blank check. Blank out. Blank slate.

  So, actually, the confetti idea wasn’t even close. When it came to reaching most of us, Carol was clawing with quick-chewed fingernails on obsidian, smooth black volcanic glass, fired hard and unmarkable in the morass of mindless souls. She wasn’t making a scratch.

  But that’s not entirely fair. There were, after all, a few night-lighters like me who, though we had popped our share of benzos in our time, were actually trying to learn and change.

  I was even taking notes, and not just for the book.

  Despite all the apathy and distractions, Carol launched into the therapy anyway, full of gusto and design.

  She drew three columns on the board, the leftmost labeled Behavior, the middle one labeled Thought, and on the right Perception.

  “Okay,” she turned to face us, marke
r poised. “What’s the behavior?”

  The idea behind process therapy, a technique formulated by Dr. Franklin but akin to traditional cognitive behavioral therapy, was that most of us act before we think. The problem is the behavior, the undesirable behavior. That’s what sends people into rehab or the bin. In the addict’s case, it’s pill popping, drinking, snorting, what have you. In the depressive’s case it might be the same, drugging or drinking, or it might be self-abuse, cutting, burning, binging, or curling up in the bathtub and refusing to come out.

  The fundamental idea of process therapy is that so-called disorders of the mind are not just inert conditions that exist; instead, they are patterns. They have behaviors that go along with them, behaviors that are attached to thoughts and feelings, all of which can be changed and redirected. Traditionally, the approach has been similar with addicts, which is part of the reason why addicts and mental cases so often end up in the same facilities, blurring the line between substance abuse and mental distress.

  The treatment for both conditions generally operates according to a disease model. For example, the alcoholic, like the depressive, suffers from a disease, or so the common wisdom has it. It is not his fault. It is inherited, exacerbated by the chemistry he was born with, and accelerated by a fault in his system, some tic in his brain-body function, that doesn’t seem to know when enough is enough. Now, once again, this is good news for the drug companies, who have marketed drugs like Antabuse that interfere with the body’s ability to metabolize alcohol. Other drugs to come will target and block the cravings, and thereby thousands of drunks will be saved from oblivion by the newest miracle substance without ever having to do the hard work of changing their lives. The drug will do it for them.