Diary Of A Psychiatric Survivor

Elyn Saks, University of Southern California Law Professor and prominent “schizophrenic”, recently gave an interview to the magazine Scientific America. Her interview was titled Diary of a High Functioning Person with Schizophrenia. I thought it would be interesting to respond to her perspective with my own.

I’ve heard people say everyone is unique, and I suppose there is some truth to saying so, Elyn Saks and I should certainly not be held in the same cage or pen together at the zoo. I would say that as far as perspective is concerned we are practically two completely distinct species.

Her view of schizophrenia, and particularly her own take on it, for one thing, seems very conventional standard psychiatry textbook stuff. She describes it as a “waking nightmare”–delusions, hallucinations, disorganized and confused thinking.

No doubt. Been there, done that.

She claims her symptoms were mostly “positive symptoms”–the obvious, delusions and disorientation, except for a couple of year’s at Oxford when she displayed “negative symptoms”–“apathy, withdrawal, inability to make or find friends.”

External reasons are not dealt with here. It’s all a matter of bio-chemistry and genetics. Did she crack under pressure? Did her bad mental and emotional state have something to do with a bad living situation? The assumption here is that such was not the case.

Professor Saks crack up took place in a social vacuum. We get a glimpse into her alone, and the constellations of people around her have been unfocused from the picture.

The rationality, in other words, behind irrationality is lacking in her perspective. It was not so in my case, I was in a very bad situation, socially, and the only way out was to escape into a fantasy of my own making. When you are caught in a room without doors, and you can’t build a door in reality, you are likely to build that door in your head. Eventually I saw through this metaphorical lack of a door (read options), and I found the factual door.

As my husband likes to say, psychosis is not like an on-off switch but like a dimmer. At one end of the spectrum, I will have transient crazy thoughts (e.g. I have killed people) which I immediately identify as symptoms of my illness and not real. A little further along the spectrum, I may have three or four days of being dominated by crazy thoughts that I can’t push away. And at the far end I am crouching in a corner shaking and moaning.

My psychotic break, or breaks, are history. If there is an on/off switch it has been switched off. I’d say I’ve managed to learn pretty effectively how to maneuver outside the mental health system. It’s not a matter of dimming crazy thoughts down here, or if it was, they’ve been dimmed out. I can say that after being labeled “schizophrenic”, I’ve completely recovered my wits, and disorientation isn’t such a problem anymore as perhaps it once was.

What’s more, I support a person’s right to think differently from a psychiatrist and his diagnoses, and to express those thoughts. I think there is life beyond the mental hospital, life beyond mental health treatment, and life beyond the psychiatric textbook. I like to call myself an advocate for the use of the doorknob.

Work kept Professor Saks going. I hope it was enjoyable work. I know that everybody makes sacrifices, and there is always a question of how great those sacrifices must be. I hope Professor Saks has also found time to rest and recreate. Work is her answer, and it gives her focus. Good, but I don’t imagine she is killing herself with overwork either, but then I speculate.

My bottom line? I like to say that I am very pro-psychiatry but very anti-force.

That’s her, me? I’m very anti-psychiatry and very pro-choice. When you force somebody, you take away their liberties, civil or otherwise, and this just doesn’t jive with the constitution of the United States. Professor Saks, being a law professor, should be very well versed in such matters.

There is a point when Professor Saks says she believes people sometimes lack capacity, and as lack of capacity is legal terminology, I’m not going to get into a linguistic skirmish over the subject. I’m just going to maintain my personal separation of the powers of church and state. I have no such ‘belief’. I’d prefer to take such matters on a individual case by case basis.

I disagree with her completely when it comes to what she calls the “one-free-shot” deal. She is certainly not against force when it comes to first time commitments. She wants to relax the criteria in these cases for civil commitment, outpatient commitment, and forced drugging. Because many people are grateful for the treatment they received later, she claims, such actions are justified. My feelings are that state hospitals are such dreadful institutions of total despondency and despair, that people are better off anywhere else, and that there is no excuse for locking people up against their wills on medical pretexts in what amount to prisons by another name.

I feel the recidivism rate in state hospitals in many ways has a lot to more to do with habitual ways authorities have of dealing with people than it does with the strength of any alleged illness.

She is a part of a study hoping to learn what makes an individual with ‘schizophrenia’ “high functioning”.

Well, I can answer that one pretty easily for myself, and I would never take part in any such study. It’s not listening to the psychiatrist that makes this individual “high functioning”. Much of today’s mental health treatment can be physically damaging to the person receiving such treatment. Long term drugging, for instance, can bring on those “negative symptoms” Professor Saks was talking about, and when it does, the indication is often that brain damage may lie behind those “negative symptoms”.

It’s interesting, though, that my life actually got much better once I stopped fighting the diagnosis and trying to prove—by managing successfully without medication—that I wasn’t ill. I always undertook such efforts with great gusto and always failed miserably. Once I accepted the illness and the need for therapy and medication, my life got much better. My illness actually came to define me less—it became accident, so to speak, and not essence.

Her experience hasn’t been my experience at all. We have terminology problems, in the first place, when we define personal crises in medical terms. There is a person in there, and there is no need to blot that personality out with the record of a diagnosis. It only took five fingers to scribble that diagnosis. Not only am I not a diagnosis, but any diagnosis I received is history. I have been desperate, surely, but the mental health profession never came close to relieving that despair. I got better by throwing off my label of mental illness, and by leaving the confines of mental health rehabilitation. This was not because I ‘graduated’, so to speak, no, it was because I recognized the absurdity of the system in which I had been entered, and I exited. I recognized that absurdity for what it was, and I chose sense instead. That was my ‘graduation’. I can’t say that everybody should do as I did, but what I can say is that it has worked for me.