Schizophrenia is a complex disorder that few of us understand. Too often we reduce it to misconceptions and stereotypes—equating it, for instance, with split personality disorder; relating its primary symptom of psychosis, a mental break with reality, to “psychos” and violent psychopaths; assuming that anyone with the disorder leads a low-functioning life spent ranting on the streets.
In The Collected Schizophrenias: Essays, Esmé Weijun Wang clarifies these points and many others. She refers to schizophrenia as the schizophrenias, a term coined by the late-19th-century Swiss psychiatrist Eugen Bleuler. Schizophrenias, a label Wang takes as her own, looks at schizophrenia not as a single illness but as a spectrum of illnesses all of which exhibit psychosis.
Most of the essays tackle a mental health issue head-on. In “Yale Will Not Save You,” she discusses the Americans with Disabilities Act and the rights of students with mental illnesses at institutions of higher learning. In “The Choice of Children,” she looks the difficulties of (1) diagnosing and treating children with serious mental illnesses and (2) someone with psychosis wrestling with the idea of having children and the chances, if any, of passing on the disorder. In “Toward a Pathology of the Possessed,” she examines family rights as she recounts the story of Malcoum Tate, who suffered from severe paranoid schizophrenia and was shot and killed by his younger sister. In “On the Ward,” she unpacks the connotations of the word “asylum” and how it brings to mind stereotypes of psychiatric facilities made famous by One Flew Over the Cuckoo’s Nest and American Horror Story’s “Asylum” season. In the same essay, she speaks to the issue of involuntary hospitalization and the politics of inpatient treatment: who gets certain privileges, who is treated with respect, who is ignored or considered problematic.
She references key players in the history of mental health and in the mental health community. In doing so, she, perhaps, introduces the general reader to them for the first time: Nellie Bly, a stunt journalist who in the late 19th century posed as a patient to write about the conditions in the Blackwell’s Island Asylum; Kay Redfield Jameson, whose An Unquiet Mind is considered a seminal text on bipolar disorder; E. Fuller Torrey, a psychiatrist and advocate of involuntary hospitalization; and Albert Q. Maisel, a journalist who tried to expose the shameful conditions in psychiatric facilities in the 1950s; among others.
For some, Wang treads territory that will feel well worn. The stigma against mental illness: how people view cancer patients as healthy and stricken down by an illness but those with mental illnesses as somehow flawed. Person-first language: how one should refer to people with mental illnesses rather than “the mentally ill” or a person with schizophrenia rather than “a schizophrenic.” For others, especially those outside the mental-health community, it will be new.
But this collection, which won the prestigious Graywolf Nonfiction Prize, does more than educate the reader. It tells of Wang’s search for the right diagnosis and a way to live with the diagnosis she’s given: schizoaffective disorder, bipolar type. With a researcher’s sensibility, she recounts her experiences—as a student at Yale, as a lab manager in Stanford’s Mood and Anxiety Disorder Laboratory, as a fashion blogger, as a counselor at a camp for children with bipolar disorder, and twice as a patient in a psychiatric hospital.
When Wang makes herself vulnerable and relates her experiences, the essays are utterly engaging. In “Yale Will Not Save You,” she tells of her acceptance to and attendance at Yale, where she was first hospitalized and treated unfairly (to say the least) by the school. After she is discharged from the hospital, the dean and the head of psychiatry respond to her situation by telling her that she can remain enrolled at Yale as long as her mother stays with her off campus for the rest of the year.
Here, we get Wang’s gifts as a writer. Of the experience, she writes: “[My mother] made Taiwanese noodle dishes. She wrote elaborate medication charts on watercolor paper. She called my psychiatrist when I lay writhing on the floor, sobbing, caught in knotty torment.” Rarely has there been a more apt description of what people with serious mental illnesses experience than “knotty torment.”
The way Wang is treated by the school is heartbreaking. After agreeing to go on a yearlong voluntary medical leave ostensibly so she can return to finish her degree, she’s denied readmittance. Yet she wants to return, even though she was treated by the school as if she’d done something criminal—having her student ID confiscated and being told to leave campus without collecting her belongings (her father had to retrieve them).
Another example of Wang’s sharp sensibility as a writer occurs when she relates a scene in the hospital cafeteria during one of her stays in the psychiatric unit. She describes how she tries to imbue the situation with a sense of normalcy, as if she can simply make conversation and eat her breakfast as if it’s any ordinary morning: “I almost choked on the first bite before abandoning the rest. The home fries were warm and slicked my tongue with grease. I ate them all. I finished my plastic container of apple juice and looked around: the glass door and windows showed the bright blue sky we couldn’t reach….” The specificity of the warm, slick home fries juxtaposed with the blue sky impossible to reach is a signature of Wang’s writing. She gets at the contradictions of her situation by zeroing in on the details.
Perhaps the most vivid essay, “Perdition Days,” concerns a period of time during which Wang suffers from Cotard’s delusion, a condition where a person believes she’s dead. Wang makes palpable her confusion and desperate need to have what she’s feeling be true. Her experience of psychosis goes from one of curiosity, observing the living from afar and almost enjoying being in an “optimistic afterlife,” to the horror of waking in purgatory: “In this scenario, I was doomed to wander forever in a world that was not mine, in a body that was not mine; I was doomed to be surrounded by creatures and so-called people who mimicked the lovely world that I’d once known.” Though the essay includes a paragraph analyzing the TV show Hannibal, “Perdition Days” is one of the few pieces where Wang focuses on her own experience to the exclusion of any reporting or research. We get more of her, and it’s powerful.
“Perdition Days” shows how in the other essays Wang’s desire to educate the reader sometimes occurs at expense of her own story. For instance, a veritable litany of medical terminology appears on a single page of the essay “Chimayó”: MRI, EEG, myasthenia, gravis, Lamert-Eaton myasthenic syndrome, IGeneX test, LLMD, Borrelia burgdorferi bacteria, neuroborreliosis, schizoaffective disorder, calcium channel Ab P/Q type. The other essays are also dense with medical and pop culture references and the question is to what purpose? Wang often reverts to analysis and a clinical view of her situation, which is to be expected given that she was a researcher. But doing so often feels like a defense, a way for Wang not to delve too deeply into the realities of her experience of mental illness.
There’s also the issue of privilege. Wang doesn’t recognize how privileged she is. She ends up graduating from Stanford, which makes her slightly less sympathetic in her gripes about how Yale treated her. Yes, it was terrible, but, no, her life wasn’t ruined. She goes on to attend a fully-funded MFA program. She has a spouse who supports her. She even tries to get on disability, believing she should be able to “grow” a business online instead of working at a menial job, which is what many on disability are forced to do. In all her research, she seems to have overlooked the fact that of the millions who apply for disability each year, only 30 percent are approved. Ultimately, she presents her experience as somehow typical of someone with bipolar disorder and/or schizoaffective disorder. There is no typical experience. But simply on a human level, Wang has had opportunities most Americans with or without disabilities only dream about.
Perhaps this complaint of the collection is unfair. As Joan Didion writes in her memoir about the death of her daughter, Blue Nights (a text Wang quotes), “privilege” is a judgment, an opinion, an accusation. Didion refuses to “cop” to her family’s privilege because of the suffering her daughter endured. It’s not that this isn’t a valid argument; it’s just that it’s tone-deaf to those who struggle financially, socially, and emotionally.
It could be that Wang’s aim is not to spend too much time focusing on the low-functioning times in her life and instead present a different portrait of what someone who suffers from psychosis looks like: that of a woman who is often rational and appears “normal.” She chooses what to wear in the morning, just like anyone else. Hers just happens to be a “brown silk Marc Jacobs dress with long sleeves, carefully folded up at the elbows.” She puts on makeup, just like anyone else. Hers just happens to be “Chanel’s Vitalumiére Hydra foundation in 20 Beige (discontinued), and a nubby Tom Ford lipstick in Narcotic Rouge (also discontinued, replaced by the inferior Cherry Lush).” She explains much of this materialism away by the fact that she worked at a fashion magazine and worked as a fashion blogger and supposedly got all of her clothes for free.
None of this diminishes the power of Wang’s writing or The Collected Schizophrenias. As she struggles to make sense of her illness, Wang gives us yet another of her sharp insights. She calls out Rebecca Solnit (and by proxy Virginia Woolf) and the claim that there’s a tranquility in illness that allows a person to abandon responsibilities, escape from the world, and laze around in bed all day. Wang distinguishes between sudden, transient illness (the flu) and chronic mental illness (schizoaffective disorder, bipolar type): “With chronic illness, life persists astride illness unless the illness spikes to acuity; at that point, surviving from one second to the next is the greatest ambition I can attempt.” In her life, Wang has obviously done more than survive from one second to the next. She’s written an important collection of essays of which all of us will be more knowledgeable and sympathetic for having read.
There is going to be a documentary about Joan Didion. We repeat: a documentary about Joan Didion. This is not a drill. Watch the opening trailer and consider donating to the Kickstarter campaign here, and be sure to read our own Michael Borne’s review of Blue Nights and S.J. Culver’s Millions essay on “Getting Out: Escaping with Joan Didion.”
“Style is to some extent everything to me,” Joan Didion recently said at the New York Public Library, discussing her melancholy new memoir, Blue Nights. Possessing a marked style has become almost a sin in contemporary literary culture: the fashionable line on Didion is that she is “trapped” by her familiar cadences, and the same is sometimes said of Alan Hollinghurst, whose novel The Stranger’s Child explores the biographical enigma of a minor English poet. Can a writer’s prose be too fine, too composed? In an age where language seems to be getting crummier by the minute, I’m inclined to doubt it. Didion and Hollinghurst are vastly different stylists: the one spare and Hemingwayesque, the other ornate and Jamesian. But each serves for me as a beacon or bulwark; I trust the grain of the voice, and am not let down. Their new books are haunted by a past that has taken on golden hues, but neither is an exercise in nostalgia, and what gives the reader hope, amid bleak scenes, is the persistence of style. Whether in Hollinghurst’s lingering glimpses of a destroyed English fin-de-siècle or in Didion’s flickering memories of a troubled child, the beauty of the writing is the thin, strong thread that holds together a tattered world.
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My grandfather died two weeks ago, in his bed, by the sea in Maine. Two days earlier, perhaps with a little help from his morphine, he looked out his bay window and said: “I am going to run across that water.”
I was reading Joan Didion’s Blue Nights at the time. On the aftermath of her daughter’s death, Didion writes: “‘Maintain momentum’ was the imperative that echoed … In fact I had no idea what would happen if I lost it.”
The passage struck me. I, too, felt the drive toward momentum. Not wanting to stop and think about my grandfather’s death, mostly not wanting to feel it, I was looking for things to do. From the Poetry Society of America events calendar, I read that a young artist, Jon Cotner, had set up an installation in the woods called Poem Forest. The name alone intrigued me.
Just days after Grandpa died — I should maintain momentum, I told myself.
It had only been three weeks since our last conversation. We’d talked by phone. I was walking my dog. Grandpa would have been sitting at that bay window, where he always sat, too arthritic to move, looking out on the ocean. “You’re looking good, Rosie!” he said. It was a joke — obviously, by phone he couldn’t see me. I laughed. This was our shtick. “You’re looking good, too, Grandpa. Nice haircut.” He was bald. My childhood nickname was Rainbow Rose. Most everything we said to each other was based off familiarity, old jokes.
“Where are you now?” he wanted to know. “I’m on Broadway, Gramps!” I said, trying to speak over the sounds of traffic. “Where, honey?” “I’m on Broadway!”
Just an ordinary exchange.
How could he be gone?
How could I answer this question? I continued reading about Poem Forest, a self-guided, twenty-minute, walk through the woods. It was unusual. Cotner placed 15 numbered signposts along Sweetgum Trail at The New York Botanical Garden. He also provided handouts at the beginning of the walk that included 15 numbered lines as excerpts from 15 different poems. At each signpost, a walker was to stop and read the line of poetry that coordinated with that post. What was most interesting to me was the idea that, by reading such lines in various parts of the woods, participants would be able to “see and sense more clearly, to inhabit the present more deeply, and to fill with enchantment.” So relayed the event description.
Soon, I was yo-yoing between doubt and hope. I didn’t really think Poem Forest would make me feel better, but I convinced myself it could. It was the word “enchantment” that really did it for me, a tug toward the spiritual, what I took to be the possibility of a panacea.
A past professor put me in touch with Jon, who, in his emails, was eager to discuss the work. He told me he had just published a different walking piece in The Believer; it had involved an eight-mile trek across Fire Island with his fiancée, Claire Hamilton. They created a slideshow of the journey — she took the pictures, and he wrote the captions. From the link he provided in one of his emails, I watched a slideshow that moved like a graphic short story, an art form I particularly fancied.
The duo had also collaborated on a slideshow for the BMW Guggenheim Lab. To get an idea of what this project is like, take the outline from The Believer piece and replace Fire Island with Bedford Avenue, Brooklyn.
Through our exchange, I also learned that Jon had co-authored a book with Andy Fitch called Ten Walks/Two Talks, consisting mainly of their conversations and resulting epiphanies as they engage with each other and New York City.
All of Jon’s projects advocated connecting to your surroundings. The more we emailed, the more excited I became. It seemed oddly providential that our paths be crossing now.
I told Jon I had walked El Camino de Santiago, The Way of Saint James, a pilgrimage through Spain, and I wanted to understand how his outlook on walking related to mine. I’d always moved to avoid unwanted emotions, as a distraction, I told him. When I walked El Camino I was frustrated and sad. I did not want to cope with my pain. I wanted to steamroll right through it.
This can’t work, of course. But, oh how tempting it is to try.
The next Saturday, I was standing at the bottom of Sweetgum Trail, waiting to meet Jon Cotner before beginning my walk. I was early, and a volunteer said Jon was finishing up some last minute trail maintenance. I didn’t mind waiting — above me, the sky cloudless. The air — perfect for November — neither warm enough to elicit anxiety in one’s inner environmentalist nor cold enough to cut the skin.
Soon, Jon was running down the trail.
We introduced ourselves, shook hands. He was exactly as I expected, poised. He was tall and stood with perfect posture, and was focused and concerned that each signpost on the path was properly angled, positioned just right. He was also polite and warm, excited about Poem Forest. How it allowed walkers to participate with the art, by moving through it.
“I look at this piece,” he said referring to Poem Forest, “as a perception primer.”
What, I wondered, would I perceive?
I began, aware that though I was in one of the most beautiful parks in New York City, I was still, in fact, in New York City. Teenagers bounced off each other as they passed me. I passed a leaf-rubbing table for toddlers. The numbered signposts were laminated, and the flashes of plastic seemed out of place against the old wooden guardrails covered in moss and lichen. I encountered a woman painting a watercolor alone; the designer dog sitting beneath her bench was wearing a zebra-print coat. I sucked in my breath, tried to corner my scattered thoughts. I already wanted to be elsewhere — in Maine, with my family, where soon I would be.
This walk is meditative; it works, I struggled to convince myself, if I remember to focus on my breath. The interruptions shouldn’t matter as much as my focus. I tried to see clearly.
Fire-orange and red leaves were hanging from gray flaking branches, and the dark brown leaves on the ground crushed beneath my boots.
Signpost number three: The nature of yesterday / Is not nature. / What has been, is nothing.
What should have been a dreamy line of poetry felt insensitive, even mean. Thinking of Grandpa, I took it personally.
The air tasted clean. A crisp autumn breeze. I walked, hoping, not really believing, that something amazing would happen, something enchanting. Wouldn’t it be wonderful if it did?
The walk would have been lovely. There was nothing not beautiful about it. But that afternoon in the forest, I relearned an old lesson. There is no antidote to grief. There are only ways to cope.
My grief aside, I was still intrigued by what Poem Forest had to offer.
I walked the trail again later that afternoon. This time with Jon. Part of the art, he said, is in the dialogue and in the thinking aloud.
I asked him something that was bothering me. Jon had called Poem Forest a perception primer. But what if there were things in this world you did not want to recognize?
Jon said he believed being here in the forest was greatly political. John Lennon and Yoko Ono’s Bed-In came to mind, the idea of advocating your beliefs by enacting them. Jon brought up Occupy Wall Street, his eyes refracting the colors of the leaves and the light that entered in glints: “Part of the trouble of our troubled times is a lack of perception.” Which could have been an academic response, a cop-out, except he immediately applied this philosophy to reality: “Did you notice, by the way, the [line of poetry] one stone is not like the other?” He motioned to the signpost by the river. “Did you notice the rocks around the riverbank?”
I hadn’t, but Jon pointed out the failed attempts to build a wall along the water’s edge. The rocks didn’t fit together, and the wall was eroding.
Then he said, “Isn’t it great to hear the rushing water? That it’s always making this sound?”
But my mind was still on the wall — and the probability that it would take me decades to work up to a perceptiveness as keen as Jon’s.
We continued talking and walking. Jon, with a mind like a library, quoted thinkers from Heraclitus to Frank O’Hara.
Regarding Poem Forest itself, the philosophy was quite simple. Jon said, “To some extent, this is an exercise in de-familiarization.”
Clearly, I was out of shape.
After finishing our walk, we continued talking until it was time for me to catch the train back home (the dog would need walking). As Jon and I moved toward the elevated platform, we agreed that a lucid perception of your surroundings slows time. As opposed to how some people experience life, as Jon put it, “in a trance.”
I thought about Grandpa and — how quickly time goes. And then, I thought: I don’t want to live in a trance. I want to appreciate everything.
On the elevated platform, I tried to see it all: the train rattling closer, silver cars luminous in the sun. The air was getting cold. Inside the train: florescent light scattering rectangles along the glossy backs of plastic seats. There were people — everywhere. I felt crowded. My mind began to wander, already. Already? My head against the clammy seat, I was tempted: If I just close my eyes, maybe I will sleep. And if I sleep, I won’t have to think. And when I wake up, I will get off this train, and it will be as though no time has passed.
Except it will have.
So my eyes were open, and there I was, on a train that hadn’t even started moving.
Images: Claire Hamilton
Jacket Copy visits Joan Didion at her apartment in Manhattan to discuss Blue Nights, which moves back and forth between the death of Didion’s 39-year-old daughter, Quintana, six years ago and the author’s reflections on aging. The book is a much anticipated follow-up to 2005’s The Year of Magical Thinking, in which Didion wrote about the death of her husband, John Gregory Dunne.