Guy was a tall, thin man who moved with such grace. A Franco-Ontarian in his mid-fifties, he had intense, yet curious eyes. Guy loved music and art, but his greatest passion was the world of the spirit, the creative consciousness. He was so sad to die because he was convinced that he was to be one of the guides to take us into the new world of enlightenment and peace, which the Mayans had predicted would happen in 2012. Guy and I were born on the same day, and we shared the same interest in mysticism. Every time he chanced across a book he thought I’d like on that subject, he would send it to me.
He was very much a part of my inner circle, and a great gift to me. Guy taught me a lot about cooking, and we made elaborate travel plans together. Then all those dreams were stolen away.
Guy was diagnosed with colon cancer. When I’d got my sanity back, I always questioned whether I would be able to withstand another hard blow, such as the death of a cherished friend.
“Of course you will,” Guy assured me. And he, like Dr. Cameron, was right about that.
Guy was admitted to hospital, and I and several others formed a palliative care team that stayed with him around the clock, our shifts running four to six hours long. Sometimes I had to advocate strenuously for him when medical staff refused him morphine; they argued that he was in a position to make that request himself. But of course he wasn’t. All Guy wanted was peace and silence. He loathed and feared doctors and hospitals, and when he said to their questions “No!” he really meant this: leave me be with the friends I trust.
Guy’s death was a terrible loss for me. He said that he’d never leave me, that his spirit would continue to support me long after he died. I remember asking his aunt if she had any thoughts on what his totemic bird might be. A hawk, perhaps? A raven?
“Oh no,” she replied. “In our family, we drop pennies from heaven.”
And sure enough, I did find pennies after Guy died, and in the most improbable places.
Guy Rivet was a true friend, loyal and fierce in his love. He would constantly scold me for unnecessarily worrying about money. He always assured me that since my intentions were good, I would always have what I needed. I try to heed his advice and I am reminded often that the promise of pennies has been delivered: I have steady work and income and all that I need.
I miss Guy every day. He was the first of my friends I was ever there for, really there for, when that friend needed me most.
A few years ago, Justin and I were giving a speech before a huge crowd, the Board of Trade in Toronto. I laugh out loud, I hoot, to recall it. Justin was to introduce me in front of all these bigwigs.
“I want you to know something about my mother,” he began. “Few in this audience and few in this country know it. She was, and is, way, way, way smarter than my father.” I just about fell off my chair.
Perhaps what Justin meant was this: Pierre was trapped in his Jesuit prison. He was a far greater human being in terms of his substantive contribution than someone who’s got a quick wit. It’s not true what Justin said of me, but that is a measure of his adoration. Boys do love their mothers. Justin had every reason to understand that the kind of intelligence that I apply to life is different from the one deployed by Pierre, who had in him a little of the Jesuit scholar and a little of Star Trek’s Mr. Spock. Justin’s father was totally the man of reason and quiet dignity. And then there was Mom …
Justin and I have done a few of these Mom & Son presentations. Another time, we spoke to a large gathering of Jewish ladies in Montreal, and once again, Justin spoke in praise of his mother. It was very funny. Afterwards, some of the ladies came up to me. “What did you do? My son, he never calls …”
Over time, I have changed medicines and dosages and learned how to monitor myself and my moods, so I am vigilant for telltale signs of instability. I have accepted that there is a trade-off between feeling calm and able to handle the world and a tranquility that I sometimes find hard to adjust to.
I have learned to avoid too much alcohol and to try to keep away from marijuana. The scientific jury is still out on that drug. My current psychiatrist does not oppose the controlled use of marijuana because the drug can bring a patient into focus, and marijuana can also lift depression. Yet marijuana can also trigger mania—as it so often did with me. I may remember its highs with nostalgia and I can recall the excitement of mania, its all-enveloping sense of optimism and achievement, but I do not wish for the depression that inevitably followed, nor for the falsity of moods that are not grounded in reality. Marijuana is my addiction. I love it, and I occasionally take a puff with friends, but I cannot and must not use that psychotropic drug as I once did. How marijuana provokes mania is still a matter of scientific debate, but that it does is no longer being questioned.
For thirty years, I told myself that the doors of perception—that moment when the mind seems to go beyond the everyday and the commonplace—were all about pushing constantly at the edges. I have since discovered the far greater satisfaction in balance, in knowing my limits, in knowing when to exit, when to be alone, when to go to sleep. But I will never be anything but mercurial and I am instinctively wary of a world that is too flat, too unbuffeted by strong emotions or moments of profound feeling and even restlessness. In the past, I enjoyed brief moments of elation, often tinged with madness. I prefer what I have now: listening to other people, not letting them down, and the peace and calm of an ordered world.
One day not long ago, when I was talking to a large audience about bipolar illness, a psychiatrist put up her hand.
“But don’t you realize,” she said, “that there is no cure from being bipolar, no total recovery?”
“Yes,” I replied, “I do indeed know that. But what I have recovered from is fear—the constant fear of my bipolar condition.”
AFTERWORD
Time has helped to heal my broken heart, and my faith has been restored. With every new addition to our family, the circle of life, loss and redemption has been shown to me. My sons, Justin and Sacha, chose strong, loving women to be their life partners, and the love I feel for them is the same as I feel for my own children.
After Michel’s and Pierre’s deaths, I felt our family had been so depleted. In the last few years, Pierre’s and my boys have given to me the finest gift a mother could have—four healthy, beautiful grandchildren, Pierre, Xavier, Gala and Ella-Grace (in order of their appearance). My role as grandmother is the best one I have ever had.
Not long ago, Alicia turned twenty-one and there was a big party at Grandma’s house, as the grandchildren call my fifth-floor condominium. Let me paint the scene. The orders have come in: there’s osso bucco cooking on the stove, there are mashed potatoes and Sacha has asked for some special noodles that I bought at a German store in Ottawa. We have two cakes, a lemon-glazed cake that is Ally’s favourite and the banana cake with brown sugar icing that is Sacha and Sophie’s favourite. There are nineteen people—Ally’s boyfriend, the children, the grandchildren.
At one point, little Xavier—who is big for his age—has little Pierre pinned under him. “Gwamma, pweese help me!” the toddler calls out. There is so much fun, so much laughter. And there are so many cozy places in this condominium. Sacha and Justin will be in one corner having a heated discussion, and the girls always help me before and after with the cleaning and the cooking and the dishes—otherwise I couldn’t do it.
And, of course, there is the ritual of the “dwarf-tossing,” as we call it. Justin and Sacha literally toss their babies across the room, as the babies scream their delight and their mothers and aunts and uncles—not to mention their grandmother—scream theirs. The custom started years ago when one of us saw a painting of Queen Victoria on a beach in Jamaica watching as these huge men tossed their tiny counterparts. We are a nutty family, after all.
The boys have use of Pierre’s cottage deep in the woods at Morin-Heights in the Laurentians, and one time several years ago I went up there in midwinter with two girlfriends. The plan was to cross-country ski, snow
shoe and hike outside, and inside play double dominoes, drink wine and eat delicious food. I had brought with me my year-old black Lab.
The phone rang. A woman who identified herself as Caroline St. Ange told me in a very thick Québécois accent that she was in charge of wildlife and the environment for that area. She said she was calling cabins and cottages to alert people that a bear had come out of hibernation and was wreaking havoc. The creature had already broken into cabins close by and killed a dog.
“Oh gosh,” I told her, “what should I do?”
“Do you have curtains on the cabin windows?” Madame St. Ange asked me by way of reply.
“No,” I said.
“Oh,” came the replay. She sounded disappointed. “This is too bad.”
Then came her advice. If we spotted the bear, we were to retreat upstairs in the cabin. Told about the dog, the woman warned us to keep her inside and always on a leash when outside.
I called Justin and told him that some sort of forest ranger had just called to say there was a rampaging bear, an angry, hungry bear, on the loose.
“Oh Mommy,” my eldest said. “Look, find Dad’s gun—you know where it is.” Pierre had taught the boys to shoot a rifle, using targets. Well, I don’t shoot guns, but a little light went on. One of my friends at the cottage, who at that moment was heartily knocking back wine, is a sharpshooter. Now the plan, should the bear crash inside, was to have this riflewoman shoot down the stairs.
Four hours passed. We were all on bear watch, but the wine continued to be poured. The phone rang again. It was Madame St. Ange with more advice: when we went outside, we were to wear no bright colours but camouflage colours that would blend in with the forest. And where I could purchase these clothes, she further advised, was at Holt Renfrew with a personal shopper named Sophie Grégoire—then Justin’s girlfriend.
“Oh &%#*@!” I said. It was all an elaborate prank. I immediately called Justin and bawled him out. You went too far, I told him. “Do not give three old ladies who have been drinking wine access to a loaded shotgun!”
Welcome to the Trudeau clan.
A friend once told me that when her first grandchild was born, she became determined to do her part to make all humanity better. I share her desire to make as good a world as I can, in my own small way, for the sake of my darling grandchildren. While they may, like me, not be proud of some of the things I have done in the past, I hope that they will learn from me to reach out with courage when they falter, to ask for help when they cannot walk alone.
“Friends will come and go,” my father used to say, “but your family will always be there for you.” I have been blessed with a fine family. For that, and that alone, I will be eternally grateful.
On a final note, I consider my bipolar condition a gift to me. I have almost touched heaven in my mania, I have been plunged into the depths of despair in my depressions, but with the love and compassion that have been shown to me, I have weathered all the storms, and I believe I am equipped now to face any new challenges that life will inevitably put before me. My hope is that by sharing my journey with others, some readers—whether themselves afflicted with mental illness or close to one who is—will acquire a clearer idea of what it is to suffer from a brain chemistry disorder. May you find the courage to face your own realities and find the words to call for help.
LESSONS FROM CHANGING MY MIND
by Dr. Colin Cameron
In December 2000, I received an urgent call from a very concerned friend of Margaret’s. She agreed to an assessment but not at the Royal Ottawa Hospital, where I worked. Could I go to her Rockcliffe home? I had never seen her before, so this was an unusual request, but her family was desperate so off I went, uncertain about what to expect.
When I arrived, Sacha answered the door and introduced me to his mother. Margaret was in her nightgown, quite emaciated and with her hair unkempt. She seemed amused by my presence, and with a laugh invited me in. She did not seem to understand why her family had concerns.
We went to the living room, where I noted dried pine needles strewn across the floor leading to the fireplace. Sacha told me that she had had a fire going that morning when he got there from Montreal. Margaret spoke loudly and rapidly, alternating between tears and bursting into song. Elation, fear and sadness—her mood was all over the place. She made numerous phone calls between my questions, and went on about all the important things she had to do, including a trip to Africa. Margaret shared with me family photos and her grief at losing Michel and Pierre. She then became more irritated by my inquiries, and let me know I was intruding. Could I please keep my visit brief? When I expressed concern for her safety, she shifted to indignation and retreated promptly to take a bath, stumbling on her way up the stairs.
I conferred with Sacha, who very much wanted his mother to get help, but he feared that hospitalization might antagonize her and only make things worse. He offered to stay with her, but I convinced him that his love was no match for her illness. She already believed that her own son wanted to kill her, and there was no way Sacha could stand guard twenty-four hours a day to keep her safe.
With Sacha’s approval, I filled out a seventy-two-hour assessment order to force her into hospital, a form I intended to present to her when she finished her bath. Margaret’s intuition, however, had led her to catch wind of our intentions, and she quietly escaped into the dark of the late winter afternoon. After hours of searching, the police finally found Margaret and brought her to hospital. All this was decidedly against her will. She was enraged and very, very frightened. And so began our five years of work together.
Margaret’s initial resistance to accepting psychiatric help is an all too common story. Mental illness itself sometimes plays a role in such resistance by impairing insight into what’s actually going on. Stigma, however, is the key impediment for most patients, perhaps even more so for people in the public eye such as Margaret. Previous negative experiences with treatment also often contribute, as they did in her case.
Such negative experiences can include barriers to getting help when it’s asked for. (Canada ranks near the bottom of the pack in funding mental health services compared to other developed countries, according to a May 2008 article in The Canadian Journal of Psychiatry.) For many patients, help arrives only when danger is imminent to the person or to others and the issue gets forced. The courageous intervention of friends and family is often instrumental in making this happen. The import of such intervention is exemplified by Margaret’s case. Who knows what catastrophe loomed had her friends and family not taken action as they did?
Things were touch and go between Margaret and me for the first several weeks, and her trust in me was tenuous. Soon after hospitalization, she was found incapable of making treatment decisions, and Sacha provided substitute consent. That Margaret did not legally challenge either this or her involuntary status, as was her right, indicated that part of her was now accepting help.
Initially reluctant to take the pills prescribed (an antipsychotic and mood stabilizer), she did comply, knowing that she would be forced to take the medicine by injection if she did not. In time, however, she began to feel better and her insight improved. As is typical, within a short time (about two weeks), trust started to develop and she chose to stay voluntarily. With her insight improved, she took over her own treatment decisions. Forced treatment was over, and real collaboration began.
The meds were adjusted gradually, and the hard slog of therapy commenced. After ten weeks, Margaret was discharged, not yet quite sure of her new life. Like so many patients with mental illness, avoidance had become a deeply ingrained habit. Avoidance seems so appealing when the alternative is pain.
But pain is not the enemy; it’s avoidance of it that can kill (through addiction, recklessness, suicide or self-neglect). What gets lost is this hard truth: attempting to wall pain out tends simply to seal it in. It takes guts to make the shift towards dealing directly with our difficulties rather than simply wishing them a
way, and Margaret showed plenty of guts.
Cognitive behavioural therapy is focused on challenging the logic of our automatic thoughts and differentiating between what is and what is not in our control. This paradigm posits that it is our faulty thinking that disturbs our emotions, and that by having more balanced thoughts we can have more balanced emotions. Emotion focused therapy, on the other hand, contends that it is emotional suffering that leads to disturbed thoughts, and that by working directly with the emotions we can reframe them to allow for healthier cognition and the ability to find new meaning. Although these two therapies approach emotional upset from different directions, they actually complement each other well, and both were helpful in Margaret’s treatment.
“The Serenity Prayer,” associated with the theologian Reinhold Niebuhr, sums up the early task of therapy:
God, grant me serenity
To accept the things I cannot change;
Courage to change the things I can;
And wisdom to know the difference.
With knowing the difference comes a realistic action plan and opportunity for a new direction. Life may never be the same as it was before illness set in, but wisdom can grow in unforeseen ways. The late Viktor Frankl, an Austrian neurologist, psychiatrist and Holocaust survivor, put it well in his book Man’s Search for Meaning. “When we are no longer able to change a situation … we are challenged to change ourselves.” And change Margaret did. As a psychiatrist, I have the privilege almost daily of witnessing people change themselves in truly inspirational ways. Margaret’s example is an excellent illustration.
She set out to change her entire approach to life, including diet, exercise and giving up marijuana. To protect private time and space, she had to prioritize certain important relationships and let go of others. It was essential for Margaret to grasp and accept all aspects of herself, including making peace with her twin demons: bipolar illness and pain. To honour and respect these demons took courage and opened doors to her new sense of purpose. It is the skilled canoeist who paddles through rapids to find calmer water downstream and the novice who tries to avoid the whitewater and backpaddles en route to exhaustion and trouble. Scary as it was, Margaret paddled with determination.
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