Mental

by Jaime Lowe

  Dave was always my therapist’s favorite. Dr. Schwartz would mention him first when I complained about boys and their badness and their badness toward me. He still talks about Dave because Dave was the only boy in my stable of self-obsessed flakes who actually stood me on a corner and said unequivocally, “I have a crush on you.”

  I remember that Upper West Side corner. It was September 1999; it was technically my first intentional date. It was one of the only seemingly formal dates I’ve been on, kind of a dork prom; we were both so green and ecstatic to see Tom Waits. I wore a skirt. Dave got the tickets for the show at the Beacon Theater. I imagine he thought very clearly about the best way to win me over, and he was right. We sat, tiny, young, and ready to marvel at the Waitsian duality—the somber lullaby swooner that morphed into the circus barker, punk rock shouter of the absurd.

  The theater was dark, darker than dark. It was a moonless sky in which the stars fell off. Silence reigned. Anticipation perspired through the walls. The electricity between Dave and me could have been mistaken as a “between” but I only felt it for Waits. A thick, persistent drumbeat began. Boom, boom. Boom, boom. Then a single spotlight shone at one of the two doors in the back of the auditorium. Boom, boom. Boom, boom. A mic’d gravelly voice—one that was very familiar—joined the drums. Boom, boom. “Arrrgh, arggh.” And a door in the back of the auditorium flung open as if possessed by spirits. Waits entered the spotlight, walking methodically, each step measured to the drums. With each beat, he threw out a handful of glitter that caught the spotlight’s glare and cascaded fancifully from hand to floor like a comet’s tail. Boom, boom. Argh, argh. Glitter bomb, glitter bomb. Until he made his way from the back of the theater to the stage, where he performed. I am a piece of shit when it comes to being an audience member—I criticize, I analyze, I am not satisfied. But this was stunning to me, a performance so perfect. It was even okay that I was sitting next to Dave, who I felt much less rapturous about. Tom Waits played the last song of his second encore—“Take It with Me.” He sang slow and sweetly, touching the piano. Lyrics of love, a long love, a deep love, a Russian doll of love, a lifetime of love: Waits finished the song with instructive lyrics, telling no one in particular, “It’s got to be more than flesh and bone / All that you’ve loved is all that you own.” And with that I freaked out. I did not have access to love. I did not have access to that kind of love. That kind of love had always been on a stage, in a box, far away from me. But it was what I wanted.

  And so when Dave and I stood on that corner, right on the curb and he kissed me and said he had a crush on me, I made some excuse and told him no. There were moments I thought Dave and I could date, I was convincing myself. Tom Waits described his wife, Kathleen Brennan, who co-writes many of his lyrics, as “a remarkable collaborator, and she’s a shiksa goddess and a trapeze artist, all of that. She can fix the truck. Expert on the African violet and all that. She’s outta this world. I don’t know what to say. I’m a lucky man. She has a remarkable imagination. And that’s the nation where I live. She’s bold, inventive and fearless. That’s who you wanna go in the woods with, right? Somebody who finishes your sentences for you.” Dave was not that to me. I told him something along the lines of, I don’t date people who are normal and that I actually like. And I think ultimately I was not convinced he really liked me. And so I fell back on aggression. As I told Dr. Schwartz later that week, I found Dave “weak and dorky.” I dug into the idea that I could only date the unobtainables. I wasn’t ready to date. And no one, certainly not Dave, was going to wrestle me away from bad decisions and greasy breakfasts with strangers. This phase seemed doomed to last for forever. It felt that way to me. And I think it did to Dr. Schwartz. In the same session, Dr. Schwartz asked in a parenthetical in his notes, “Is she a lesbian?”

  A week after the Tom Waits date with Dave, I talked with Dr. Schwartz about being molested. Up until then, it was more of a plot point in my therapy sessions, just something that happened to happen. In real life—beyond the Oriental rugs, dramatic photography, and turquoise sculptures of Dr. Schwartz’s office—it never came up. From Dr. Schwartz’s notes: “We tried to delve into the relationship between molestation and later difficulties with men. She went over what happened and seemed upset recalling how frightened she was . . . she wondered why she hadn’t realized why the knife wasn’t sharp . . . she agreed that her ‘aggressiveness’ now could be a consequence of wishing she had been more aggressive then . . . she also agreed that she repeats the experience in some ways with the strangers she has slept with and that she lacks the ability to feel relaxed.”

  CHAPTER 13

  HYSTERICAL METAMORPHOSIS

  LACKS THE ABILITY TO FEEL RELAXED. It was true. I defy anyone who has lost hold of themselves to feel relaxed, in a relationship and otherwise. And I defy any man to say that to a woman who has had any kind of sexual trauma. Part of my inability to date was because I couldn’t trust myself. How could I trust someone else? Lacks the ability to feel relaxed. It was true! In 2011, the CDC released an exhaustive survey that found that one in five women had been a victim of “rape or attempted rape” in the previous twelve months. Feel relaxed was code for calm down, a phrase I’d heard my entire life and I didn’t know how to calm down. Part of that might have been due to my sexual assault. Lisa James, director of health for Futures Without Violence, told the New York Times that she’d seen chronic health conditions associated with assault before. I was aggressive and angry and frustrated and I did have big feelings. I didn’t know why.

  It turns out there is a long history of women who had a hard time relaxing, and given historical sexism, and the variety of “treatments,” who could blame them? Just look at “The Yellow Wallpaper.” Charlotte Perkins Gilman explained in the introduction why she wrote the short story in the first place: “For many years I suffered from a severe and continuous breakdown tending to melancholia—and beyond. During about the third year of this trouble I went, in devout faith and some faint stir of hope, to a noted specialist in nervous diseases, the best known in the country. This wise man put me to bed and applied the rest cure. . . . [He] concluded there was nothing much the matter with me, and sent me home with solemn advice to ‘live as domestic a life as possible,’ to ‘have but two hours’ intellectual life a day,’ and ‘never to touch pen, brush, or pencil again’ as long as I lived. . . . I went home and obeyed those directions . . . and came so near the borderline of utter mental ruin.” The story she wrote in response is one of the most famous fictionalized recollections of how misguided “treatment” can be. It doesn’t surprise me that Weil, her famed doctor; her husband (also a physician); and her brother were all complicit in the treatment. Resting all the time doesn’t address a wild mind. A wild mind is much more complicated than that.

  There was a label for women like Gilman. There are words assigned to their condition: melancholia and hysteria. One of the first examples of hysteria was observed by Thomas Sydenham in 1681. According to the historian David Healy, Sydenham’s originally observed patient was a woman who “shrieks irregularly and inarticulately, and strikes her breast and has to be held down by the united efforts of the bystanders . . . fear, anger, jealousy, suspicion, and the worst passions of the mind arise without cause.” Healy goes on to say that what Sydenham was describing was an early version of mood disorders—specifically borderline personality disorder or bipolar disorder. Sydenham called it hysteria. Several leading psychiatrists at the same time were diagnosing psychiatric disorders by examining the unconscious or at least considering it. And attitudes toward the mentally ill were changing: French physician Philippe Pinel began reforming asylums by unchaining patients, pioneering humane treatment of psychiatric patients, and was one of the first physicians to demand evidence-based medicine. Pinel, according to a paper written by Healy, distinguished general insanity from mania in his paper titled “Medico-Philosophical Treatise on Mental Alienation” in 1809. It established the possibility for a d
istinct mood disorder, and by the 1830s Jean-Étienne Dominique Esquirol, a student of Pinel’s, wrote about deep sadness.

  In the nineteenth century, the French neurologists Jean-Martin Charcot and Pierre Janet introduced the idea of the unconscious mind. They went on to identify types of hysteria—modern concepts of mental and emotional disorders involving anxiety, phobias, and other abnormal behavior. Charcot’s student Sigmund Freud then radically and controversially changed the landscape of hysteria altogether with “talk therapy” or psychoanalysis. Erika Kinetz wrote, “Freud’s innovation was to explain why hysterics swooned and seized. He coined the term ‘conversion’ to describe the mechanism by which unresolved, unconscious conflict might be transformed into symbolic physical symptoms. His fundamental insight—that the body might be playing out the dramas of the mind.”

  In 2012, four researchers wrote, “Hysteria is undoubtedly the first mental disorder attributable to women, accurately described in the second millennium BC, and until Freud, considered an exclusively female disease. Over 4000 years of history, this disease was considered from two perspectives: scientific and demonological. It was cured with herbs, sex or sexual abstinence, punished and purified with fire for its association with sorcery and finally, clinically studied as a disease and treated with innovative therapies.” Hysteria (as is the case with many female illnesses) has always been tethered to sex and sexual appetites or lack thereof. The paper describes two female doctors in the Middle Ages who both had a sense of hysteria and later melancholia, if not a grip on exactly what it means.

  But we cannot talk about women’s health in the Middle Ages without citing Trotula de Ruggiero from Salerno (11th century). While as a woman she could never become a magister, Trotula is considered the first female doctor in Christian Europe. . . . Trotula was an expert in women’s diseases and disorders. Recognizing women as being more vulnerable than men, she explained how the suffering related to gynecological diseases was “intimate”: women often, out of shame, do not reveal their troubles to the doctor. Her best known work, De passionibus mulierum ante, in et post partum, deals with female problems, including hysteria. . . . Trotula works at a time when women are still considered inferior to men because of their physiological and anatomical differences. Hildegard of Bingen (1098–1179), German abbess and mystic, was another female doctor. Her work is very important for the attempt to reconciliate science with faith, that happens at the expense of science. Hildegard resumes the “humoral theory” of Hippocrates and attributes the origin of black bile to the original sin. In her view, melancholy is a defect of the soul originated from Evil and the doctor must accept the incurability of this disease.

  • • •

  IN THE EARLY 1400S, medieval Europeans allowed the mentally ill freedom, assuming those people weren’t witches, in which case a common treatment was “casting out devils.” By the fifteenth century asylums started popping up outside London and in Valencia and Padua. By the seventeenth century, the male medical community “treated” hysteria by massaging a patient’s clitoris until orgasm. A medical publication on hysteria from 1653 cites the following medical notes that described a standard practice from the time:

  When these symptoms indicate, we think it is necessary to ask a midwife to assist, so that she can massage the genitalia with one finger inside, using oil of lilies, musk root, crocus, or [something] similar. And in this way the afflicted woman can be aroused to the paroxysm.

  This practice—of doctors and midwives massaging female clitorises—carried on for centuries. Physicians didn’t consider women capable of orgasm, which is why the treatment described was so clinical, without even a reference to sexuality. By the early twentieth century, doctors began complaining about their fingers hurting from the therapeutic practice which, combined with the invention of electricity, led to a new invention: the vibrator.

  Historically, mental illness has been categorized in three basic ways: supernatural, somatogenic, and psychogenic. Aspects of all three are relevant, and I find myself asking: Why am I bipolar? Psychiatry has included environmental histories and stressors in diagnosis for most of the twentieth century, though less so since the advent of psychopharmacology in the last twenty years. This feels especially true in cases like mine, where the genetic link is weak (my grandfather and his family are clearly a genetic link, but most psychiatrists look for a link within one generation, like my mom or my dad). I took the lithium, I relied on it, I took the diagnosis and rarely questioned either. But the words “lacks the ability to feel relaxed” echo in my head. A few years ago, the Mayo Clinic conducted a comprehensive study on the relationship between sexual abuse and whether a history of abuse can lead to psychiatric disorders. The researchers found that a history of sexual abuse is associated with an increased risk of a lifetime diagnosis of multiple psychiatric disorders and that medical literature has long reported an association between sexual abuse and psychiatric symptoms.

  A study published in 2016 by the British Journal of Psychiatry found that childhood traumas were linked with later diagnoses of bipolar disorder and that people who are bipolar are 2.63 times as likely to have experienced some type of abuse. What this means, in theory, is that the disease is not purely genetic; it is environmental as well. The ability to assign a beginning to the madness, to redistribute the weight of responsibility, felt like a relief. I thought of when I was attacked, the childhood molestation that occurred during the formative years of my brain. Post-traumatic stress disorder from sexual trauma and PTSD from war trauma are different, but they share common ground in that both are relatively unstudied. Dr. Farris Tuma, a National Institute of Mental Health psychiatrist, described PTSD to me as “someone’s stress response system or view of the world essentially hijacked, and it has to do with how memory works. PTSD is a disorder where people can’t forget, and it becomes a physiological response. There are intense feelings of horror and panic. When you bring back a memory, you are essentially experiencing it again.” There are times when my brain feels hijacked by panic and agitation, and I imagine for the women centuries and millennia before me who didn’t even have the benefit of diagnosis, it felt even worse.

  CHAPTER 14

  TAPER MEDS, THANKSGIVING IN MAINE, KYRGYZSTANI MAN

  WHEN I MOVED to New York, I was not manic, I was not depressed, but I was in a frenzy. Maybe it was the kind of frenzy that people go through, that transformation from coddled college life to real-not-real adult life. My form of psychological frenzy did not match well with my day job, but when my job switched to the photo department, I had allies: a boss, Dana, who acted as a mentor and champion; a colleague, Amy, who was a hippie goddess with dramatic bangles and colorful swing skirts, closer to me than any of the Condé ladies. I knew Amy’s husband, Donnell, from the LA Weekly, and I had been to a barbecue at Amy’s house in LA when I was a summer intern, which felt like the best kind of small-town coincidence ever.

  Magazines were still in their glorious excessive heyday. Jay McInerney was our wine columnist, and we had a contributing editor whose main job was to smuggle unpasteurized cheeses in from France. When we moved to 4 Times Square, Dominique hired a Feng Shui expert clad in marigolds and caftans to bless the halls. I worked in the electronic sign shaped like a can, filing chromes (large-format negatives) from photo shoots that cost thousands of dollars to produce. Occasionally I’d step out on location to assist in the luxury pet shoots, or I’d scout an interior. I scoffed at the money spent and hauled home whatever I could carry from the free pile. To Dominique’s credit, I pitched relentlessly within House & Garden and wrote a few small things that kick-started my national magazine career—a piece on animal print rugs, one on artist installations, and I produced a shoot of Matthew Ritchie installing a wall drawing. I was building clips (realizing one half of my aforementioned goal: becoming a working writer).

  I even wrote for Dave after he went from being an assistant at Details to an assistant at Maxim. By August 1999, Dr. Schwar
tz and I began talking again about tapering off lithium with the idea of eventually not taking it at all. “Today she arrived late talking about bipolar disorder as being a form of spirituality or inspiration or something that didn’t make sense.” It didn’t make sense to him, but when I think of being bipolar, I always think of it as something that elevates me, that has taken me to spheres of the universe otherwise unknown (for better and worse). I got so religious in high school, my experience felt more godly than anything I’d known. I didn’t do drugs, I didn’t need ayahuasca, I didn’t trip on LSD because I had done all that without ingesting anything. When I did cocaine for the first time, I thought, This is it? Coke was closer to Bud Light Lime than mania. (Dr. DeAntonio was slightly off in his initial analogy: mania is more like unbridled dizzying love or the first sparkling spring day when daffodils are bursting and everything is coated in warm rays and looking like a rainbow paradise, prisms of iridescence beaming.) Being bipolar meant I had access to the other side. But there were still functional kinks to work out—living with daily tasks was sometimes a challenge. I was anxious, short, and impatient, and unable to draw straight lines. “She seemed to want to be talking about getting off the lithium . . . she strongly disagreed with me, saying that wasn’t the issue—she’s still irked by my having called her ‘damn assertive,’” Dr. Schwartz wrote.

  My solution to everything was wild and disorganized and forceful. I continued my practice of crushing out on unavailable dudes and supplemented that absence with one-night stands. But if I needed to sleep with some strangers to get to the other side of a painful experience, I’m not sure that was the worst thing in the world. Dr. Schwartz and I talked about relationships and dating, but that was far from possible. I just wasn’t ready, it wasn’t in my vocabulary. (And according to Dr. Schwartz, I was too aggressive anyway.) Maybe a relationship would have validated me, made me feel normal and unscarred? But I doubt it. I wasn’t alone entirely. We—my friends, my roommates, my colleagues—were incubating. We had parties at the loft almost every month, my roommates were now a bunch of attractive dudes who had attractive dude friends, and my friends were single and we lived in bars until closing time and sometimes walked home as the summer sun cracked the horizon line, glowing against the city’s geometry.