A Thin Line: Two Tales of Mental Illness

Warning: This post contains graphic depictions of sexual assault and domestic violence.

This month, November 2017, was never going to be easy. Thirty years ago on November 5, my aunt Carol (after whom I am named) was murdered by her husband, Arthur W. Thomas. While the annual marking of her murder is always difficult, this year it is particularly hard because he is out of prison after serving thirty years on a sixty-year sentence. I spent that day as I have just about every November 5 for the last thirty years: in bed. Snuggled with my three attentive and intuitive pit bulls, I tried to sleep away the familiar depression that settles into my bones like a cold fog. Over the last twelve years of marriage, my husband has come to understand the peculiar habits of his wife who floats in and out of being present. Those moments when I can briefly forget that event and the innumerable crimes my uncle Art committed are tentative respites from the realities that I am forced to manage. Art’s crimes linger in generations of my family like an inherited disease that strikes down survivors ruthlessly.

Right now, my cousin Sarah (not her real name) is a constant reminder of what my life may have been or even should have been. On most days I find myself struggling to understand why she is a homeless, paranoid, psychotic who is unable to manage reality without her brain distorting it into fantastical fictions. In contrast, my brain daily combats a reality from which it cannot disencumber itself. Whereas Sarah managed her myriad abuses by fractionalizing and creating bizarre alternate realities, I carry my own around like an oppressive weight upon my back that I cannot put down. It is but a thin line that separates Sarah and me. We experienced similar events but our brains adopted different strategies for processing them and this seems to have made all the difference in our respective “survivals,” along with the fact that I have long had access to vital mental health services.

Sarah was born when I was seven. By the time she came into my life, our fates were already deeply intertwined. Her father had begun sexually abusing me years before she was born. He began abusing her almost immediately upon her birth. One day I watched him digitally penetrate her as he changed her diaper. For years, I labored under a dark and cruel guilt that I did nothing. I said nothing. Not a day passes when I don’t wonder whether it was possible to save her while there was still something to save. Had I said something to someone, would it have been possible to prevent this madness that inhabits her today? I feel culpable for her current state and wracked with survivor's guilt.

I stare at pictures of us as young children, our innocence plucked long before those photos were snapped. Our ashamed and helpless faces stare back at my adult self. We were on our own. No one stepped in to help us. Our family members chose to remain ignorant. School teachers, year after year, turned and looked the other way from our wounds, both visible and invisible. Guidance counselors managed our anger rather than investigate the reasons for our rage. Physicians treated our symptoms but never questioned their causes. No one reported us to Child Protective Services. No one asked us if we were safe. No one rescued us. We were and are the victims of multiple systemic failures that happened over and over again.

My abuse ended in 1982 when I was thirteen. My mother wanted to spend the Christmas holidays with her new boyfriend, father of my youngest brother without my brother and I while her soon-to-be-ex-husband languished in a mental health unit. I protested and offered to stay alone at our home. My mom would have none of it. She dropped me off at their trailer for the holidays and drove away in her red Pinto. I was seething but also sad beyond words. Art had commented upon my figure. He noticed my breasts. He and my mother actually joked that I was “built like a brick shithouse.” I was scared of what he would try next.

The first night, I slept next to Sarah in her twin bed and waited with the nighlight on. I knew he would come in as he always did. I pretended to be asleep but I had placed Sarah’s toy firetruck, which in those days were made of steel, by the bed. When he sat down on the bed and drew back the covers, I grabbed that truck and smashed him on the head. He screamed and stumbled out of the room. He would never have the opportunity to abuse me again.

However, he continued to abuse Sarah. I later learned Art sexually abused her brother, Jasper (not his real name) as well. Their torment would not end until that cold, dank November day in 1987 when Art killed their mother and went to prison. This price was impossibly high. And their anguish did not end then; rather it transmogrified because of the sadistic way in which Art snuffed out Carol’s life.

He killed her while they were at school. He didn’t kill her in a fit of rage. He plotted her death. He didn’t kill her quickly, perhaps with a bullet. Instead he beat her to death with a broomstick after dragging her to the dog pen outside their trailer. How many blows did it take? How many times did he consider stopping, short of extinguishing her short life?

He chose the dog pen because months earlier they found him there sodomizing one of Carol’s dogs. After killing her, he arranged her body in the dog pen with her legs and arms arranged like a grotesque snow angel. She was naked, save her bra. Sarah and Jasper found her, with the dogs curled up next to her body. They ran into the pen and tried to wake her. Shortly after discovering Carol’s body, Arthur Wayne Thomas, called the trailer. Jasper answered and had to endure his father explaining that “she got what she deserved.”

Sarah and Jasper came to live with my mother and my step-father. This was not the only—much less optimal--option. Carol’s brother Ron and his wife Maria were the most logical caretakers for these profoundly injured children. They were financially well off while neither of the other two surviving siblings were. Their marriage was stable. Maria was a stay at home mother. They never ceased prating about their Christian commitments and the Christian schooling for their children, for which they had invested their ample resources. They opposed abortion because they believed that fetuses deserved the same rights as the mother, the flesh and blood human-being carrying the growing collection of cells within her body. Despite their resources and alleged commitments to the sanctity of life, they refused to take in Carol’s hapless children. I was and remain furious about their selfish decision. In the United States too many Christians are like them: they whine about the sacredness of '"life" while exhibiting callous disregard for the "living."

My mother, despite her numerous flaws and shortcomings, stepped up to raise my cousins. While she did her best, her best could never be enough. She was on her third marriage. Like the first two, this one was unstable, loveless and volatile. She unloaded trucks at a nation-wide department store. She had to be at work at 4 am to unload wares that would stock the shelves before opening. She could barely protect herself from her heinous husbands much less us. She had little time to attend to her own biological children and few resources with which to protect them from her husbands or other predators. She had neither the time nor the wherewithal to provide my cousins the inordinate support and help they desperately needed and deserved. Mom could never have beaten down recalcitrant bureaucracies to secure the resources they needed which she could not afford.

Once in our home, it became apparent how broken Sarah and Jasper were. We learned that they frequently fled to the forest surrounding their trailer when their father came home, drunk and violent. Their own mother it seems was increasingly unable to protect herself or them from Art’s savagery. My cousins were truculent and sometimes unmanageable. On one occasion, Jasper pushed my mother down the stairs in a fit of fury.

In 1990, my mother became diagnosed with advanced melanoma, a virtually un-treatable cancer at this stage. Her abilities to manage Sarah and Jasper and their myriad problems diminished exponentially: Jasper was 15 and Sarah was 16. Mom would be dead within three years, yet Ron and Maria continued enjoying their lake lives, skiing and boating across the various lakes that massive glaciers strewed around northern Indiana and Michigan. They broke from their lake-life leisure activities only once during the last three months of my mother’s life. They took a second break from their repose in September 1993 to attend mom's funeral.

Ultimately, Jasper was removed from our home and put into foster care. He would bounce around foster homes until settling into a loving and stable home in Pennsylvania with a doting physician and his attentive wife. By the time he landed in that loving home, it was too late despite their immeasurable efforts. The concatenating horrors of his short life were unbearable for Jasper. In September 1997 Jasper shot himself in front of his infant son and his evil wife who urged him to pull the trigger. He was barely twenty-two. After a long legal battle and after several years of neglect and abuse by Jasper’s widow, his son would also be raised by Jasper’s foster parents. Jasper’s son struggles with the long shadow of his trauma. I had hoped that Jasper’s son would never come back to Indiana and would live his life unaware of the story of his parents and grandparents. Alas, that was not to be.

In 1998, Sarah went on to marry and have two children of her own. That she was married was a relief to my brother and me. We deluded ourselves by believing that Sarah was in the best of possible worlds. But she was not. She was an intemperate and sometimes violent mother and wife. She insisted upon homeschooling though she was barely literate and not numerate at the time. While she had reasons to think the world was a dangerous place for her children, her efforts to protect them resulted in incalculable harm.

Four years ago, Sarah’s marriage unraveled after she beat her daughter severely and went to jail for it. With Sarah gone, her husband admitted their children to the public school system where they struggled to catch up with their peers. Her daughter Kathy, now twenty-two, remains incapable of basic math, cannot use email and struggles with tasks that young children complete with ease. Her son, James, was held back but will graduate from high school. Worse than managing the outcomes of their needlessly retarded intellectual development, both will grapple with many of the burdens of mental health that Sarah and Jasper unsuccessfully contended. My family is a sad testament to the cruel fact that the cycles of domestic violence and concomitant mental illness seem impossible to break.

Once Sarah was released from jail she became homeless, living in her truck. Sarah became comfortable in homelessness. She made a shiv from a rib bone. She hunted animals and fish in public forests and cooked them over a fire. She showered at truck stops when she needed to. She claims that truckers gave her food generously. It is hard to know what she really did to survive because her brain contrives fantasies that are discordant with reality. She talks of government conspiracies that prevent her from painting. She believes that Russia will come to help her and put a “hit out on her ex-husband.” She is convinced that her ex-husband heads a vast conspiracy that keeps her from working and which threatens her. She refuses to have a cell phone fearing that it will enable "the government" to find her and kill her.

While she was homeless, I mostly never heard from her or about her. But I never stopped thinking about her and how similar we were despite our different outcomes. I dreamed of her often as my sub-consciousness chided me for being unable to help her.

In September of this year, I heard from her at long last. She was arrested for a failure to pay child support. That any judge deemed her capable of working and thus able to pay this support struck me as judicial malfeasance. How could even the most ill-qualified or cruel judge have looked at her and listened to her deranged phantasms and still conclude that she is competent to hold down a job, much less pay child support? She didn’t even understand why she was in jail. She believes that she was incarcerated for illegally “painting the Indiana soldiers” with whom she is obsessed. Oddly, jail gave us some form of leverage over her. She does not want to return to jail.

Out of jail, she complained that her hand was injured. This motivated her to agree to medical care, including a psychiatric evaluation. I had hoped for her institutionalization. It was not to be. Her varied evaluators agreed: she was delusional. But since she posed no immediate harm to herself or others, she could not be admitted to in-patient care. Unless she was willing to be voluntarily committed, there was no means to have her committed against her will. However, as is frequent with mental illnesses of this type and severity, she was and is too ill to appreciate the extent of her debilitation. However, because she did not want to return to jail, she agreed to move into a transitional residential facility. Her fees are $175 per week which my husband I pay with some contributions from my brother and my uncle Rick and aunt Theresa. Unsurprisingly, the fetus-fetishizing hypocritical Christians, Ron and Maria Austin, do not. They live in their own fantasy-land where they can wash their hands and consciousness clear of their niece.

Sarah can stay in this home with its attentive staff and amazing social worker named Patti for a year. But then what? What is Sarah’s best possible outcome? In some ideal world, she would get healthcare, be declared disabled, receive some disability funds that would allow her to live in safe, subsidized housing, and eventually be able to manage her illness with medications and therapy to such an extent that she may be able to hold down some kind job. Maybe her own children, over time, could become less afraid of her and even understand and embrace her as the mom she could have been been. Right now, I can imagine no employer that would hire a person so enmeshed in bizarre alternative realities. Her concocted alternative reality is so disconcerting that the other residents in her transitional home are sometimes afraid of her. What employer could responsibly bring her onto their payroll without creating safety concerns for her other employees? Sarah has and will continue to be removed from this facility and returned to jail for failure to pay child support for her son and arrearage for her daughter which she simply cannot pay due to her disability.

While it is apparent to any sentient person who engages with her that Sarah is disabled, getting the state to declare her so is nigh impossible. Her paranoia prevents her from seeing a physician whose assessment is needed to have her declared legally disabled and thus entitled to benefits. The petition for involuntary commitment requires a physicians letter. But how can I get that letter when she will not see a mental health practitioner? My only hope is that during one those bouts of incarceration, someone will compel her to be evaluated. How fucked up is that? I cannot likely get her help through any other means but incarceration for a crime she cannot prevent herself from committing because she cannot work and cannot pay child support or the amount of child support previously unpaid?

I try to be optimistic. But I know I will not likely to be able to effectuate this purported “best outcome” for Sarah. It is unbelievably difficult to get such a person declared disabled when she doesn't understand she is in fact disabled. Moreover, she’s in Indiana. and I am in Virginia. There are few facilities that will treat her even if we could wrangle health care insurance for her. How do I then move her to Virginia where I can oversee her care? It was extremely difficult to find a facility that would take her due to her history of violence. I’m a surmounter with a terrier's tenacity. But even I am overwhelmed and daunted when I let these realities settle about me.

I am enraged that as long as her murderous, child-molesting, incestuous father was in prison, the state provided for his every medical need. Now, the state protects his whereabouts by depriving his victims the right to know where he lives. (There is no homicidal lunatic registry and he was never arrested--much less convicted--for his sex crimes.) In contrast, the state accepted no responsibility to ensure the well-being of his victims. Had the state provided Sarah and Jasper the mental health resources they needed when they were young, their lives may have unfolded differently. Perhaps Jasper would have lived. He had already joined the Army National Guard before his death. Maybe he could’ve held down a job, paid his taxes, and cared for his family capably. Had Sarah been helped earlier, perhaps she could have been a competent wife and mother instead of a troubled woman who will impose costs upon the state in perpetuity. Had the state made these investments when it was possible to help them, the state would have received countless returns to those investments.

The United States is one of the wealthiest countries in the world. Yet it is no secret that our health care system is among the worst among developed countries. The problems of our system are evident to all who study it empirically or bother to think about it even briefly. It is also a well-known economic fact that mental and physical wellness are key human capital inputs that contribute to individual and collective economic productivity. Yet American politicians generally and Republicans in particular are wedded to fictions that our health care system is among the best in the world--despite the abundance of data that punctures this nonsense bubble. And even if it were, healthcare remains unaffordable to broad swathes of Americans who lack private insurance.

Going back to the thin line that separates Sarah and me: it is access to care. When I was seventeen, I swallowed pills. I did so not necessarily because I wanted to die but because I knew I needed help. My mother and her shitty husband were indifferent to my suffering even though my mother's employer provided us with adequate health insurance. As a consequence of this insurance and that hospital episode, I went to my first healthcare provider in the summer of 1986. While the methods of treatment were crude and reflected a rudimentary understanding of trauma, I began the process of my interacting with mental health professionals. I understood that I was injured and would need help likely for my entire life.

Throughout college, I sought help from a social worker who saw me on a sliding scale. She kept my suicidal impulses under control. I continue seeing mental health workers to date. I take medications, receive a new treatment for reworking the way in which my brain stores and processes the events of my abuse that relies upon eye movements, and regularly meet two kinds of mental health providers. It is a team effort to daily renew my commitment to staying alive, to working through past wounds even while sustaining new ones. I have learned that by being open about my abuse and ensuing mental illness, I have the support of friends, peers and colleagues many of whom have survived experiences similar to my own.

The financial cost has been enormous. Had I invested my out-of-pocket mental health expenditures into my retirement account instead, I would have accumulated nearly $100,000 by now (assuming a reasonable rate of return to those investments). This is literally the cost of my sanity. This is the cost I pay--along with my insurance companies--for being a productive citizen who pays more taxes than our current so-called President.

I have access to a network of resources and partners that Sarah cannot have because Sarah is incapable of seeing her illness. Even if she did understand her state of mind, the care that maintains my sanity is beyond her means. Infuriatingly, under the status quo, Sarah will eventually leave this facility no less able to take care of herself and unable to qualify for the disability she desperately needs. I will not likely be able to secure power of attorney over her and ensure that she is in a safe place for the rest of her or my life. Sarah will continue to float in and out of jail as the state seeks to extract from her that arrearage she will never be able to repay.

Sarah is not in this situation because she uses drugs or drinks. She does neither. But the chemicals her own brain produces are no less damaging. She is in this heinous place because she is the victim of enduring child-hood and adult trauma as well as countless systemic botches that failed to protect her and which continue to fail her repeatedly. And her own children, without massive mental health resources, are likely to travel down the same path she has worn thin.

This is America. We do not have the best medical care in the world. This is America where fetuses are sacrosanct but living, breathing human beings are as disposable as the fast-food wrappers we discard unthinkingly.

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