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Many years ago I worked with a man in his early 30s, who was sent to me by a psychiatrist because he suffered from "delusions of persecution." Short and slight, "Roger" believed rays were being beamed into the bus he was on.
Schizophrenics are supposedly people who are crazy and "out of touch with reality."
At the end of our first session, Roger leaned forward and asked if I would treat him using only intensive psychotherapy, without forcing him to take drugs and become a "zombie."
"Let's try it and be honest about how it goes," I said.
During a session several months into treatment, Roger began to get angry with me, but immediately squelched it. I asked him why he cut off his feelings.
"My feelings are like nuclear waste, they could contaminate the world," he said.
I learned that when Roger was 18, he tried to separate from his dad, an overbearing man who was devoted to socialist politics and "high" culture. Roger's efforts to carve out his own life put him increasingly at odds with his father. But his dad's approval still meant the world to him. While Roger longed for the appreciation of his remote father, he felt compelled to have his own voice. "I hate you, I hope you die," Roger said to his dad.
His father shook and began crying. Roger felt horrible.
When our parents are devastated by our feelings, we develop distorted ideas about ourselves. We may think we are despicable or burdensome. Or poisonous.
After his father's crushing reaction to his expression of hostility, Roger developed the deadly idea that he was "toxic," and other people were excessively fragile. He repressed his natural aggression and he began to see the world as if it was like his father -- incapable of handling his genuine feelings. So he began moving through the world in a highly controlled and excessively timid way, terrified of damaging other people through his words.
The safety of our relationship eventually provided an anchor for Roger and me to explore his horrendous past -- especially the invalidating experiences and massive absence of attunement to his feelings and needs, which drove him crazy and undermined his belief in his own personal reality. This caused paralyzing self-doubt and was annihilating. Delusions developed, which were a desperate attempt at self-healing and symbolically expressed how he had been endangered. His delusions were emotional snapshots of traumas he had endured but which no one had ever acknowledged or understood. Feeling that aliens were stealing the encyclopedia he was reading and that rays were being beamed into the bus he was riding masterfully evoked the twin feelings of being robbed of vital knowledge and of being taken over by an outside "alien" force that was oblivious to his own wishes and needs. When he alerted his mother that the roof was leaking and needed to be fixed, for example, she ignored him and read Finnegans Wake as water dripped on the rug nearby.
One of the gravest dangers afflicting our culture in general and the field of mental health in particular is the assault on human subjectivity; the decreasing interest in honoring and valuing people's experience.
Over the course of our work together, Roger made profound strides. Understanding the roots and current impact of his delusions helped him gradually develop a fragile faith in the validity of his own experience. As his self-trust deepened, the voices that assaulted him lessened. He began feeling more real and alive. He moved into his own apartment, bought a car that he used to get to work and to our tri-weekly sessions, learned several computer languages, got a job working in a college admissions office, and slowly developed several relationships of value and substance.
Roger taught me many things over our 10 years of working together. Chief among them was the inestimable importance of valuing human experience and searching for the emotional logic underlying even apparently bizarre and crazy behavior. My patients -- even the most obviously troubled ones -- have repeatedly shown me that their words and actions make sense; that there is a secret meaning they are striving for that I must struggle to understand. So when I hear something that seems self-destructive such as 'delusions' or suicidal ideation or self-mutilation, I try to find the underlying meaning, which makes it possible to reach people who feel lost and alone and locked in a private world of torment.
One of the gravest dangers afflicting our culture in general and the field of mental health in particular is the assault on human subjectivity; the decreasing interest in honoring and valuing people's experience. In the craze to map the brain and prescribe pills for psychological disorders, the field of mental health is not only getting hijacked, it is losing its soul.
In Dante's Divine Comedy the Roman poet Virgil accompanies Dante to the underworld. No one wants to be Virgil anymore -- to "go into hell with Dante." But the willingness to explore with patience and empathy the actual experience of what people undergo, no matter how horrific, is indispensable in healing the emotional afflictions that haunt human beings. And we shouldn't be surprised that recipients of such understanding will be capable of both remarkable resilience and extraordinary healing.
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