Monday, May 21, 2012

Crossing the Line and Mary Richardson Kennedy

Like everyone else, I was moved by the sadness of Mary Richardson Kennedy's death. And, like everyone else, I wondered what could possibly have driven a woman with such a purposeful life to commit suicide.

As her family said, she was fighting her own demons, but there is something else she may have been struggling with, too, that I understand from my own experience, the sense of shame. That mental illness carries a stigma is clearly not breaking news, but the shame that often accompanies it is seldom discussed.

What appears to have been Mary Kennedy's inner turbulence reminds me of something that happened to me in my twenties, an experience that left me with both shame, and the feeling that I had brought disgrace upon my loved ones, and myself, feelings that are not uncommon for anyone who finds their lives taking a direction that is challenging. Those who venture outside the domain of normal behavior do so at a price for, as poet Hart Crane once said, "there is a line. You must not cross nor ever trust beyond it."

In the spring of 1974, I was living in San Francisco, and in the midst of writing a book of poetry. I was reading Arthur Rimbaud, and wanted to incorporate his "dereglement de tous les sens," disordering of all the senses into my own work. Being unable to achieve that state by natural means, like many of my generation, I began experimenting with drugs---principally cocaine which I used constantly over a period of weeks. As it made me hyper, and unable to sleep, or sit still even for a minuteI would drink to take the edge off, or take valium. In this, too, I was mirroring Rimbaud who is said to have used opiates frequently.

I was so caught up in what I was writing that I didn't eat much either, but mostly wrote poetry. One day, I noticed I was having paranoid ideation that got more intense---really crazy thoughts about airplanes being bombed, and phones being tapped. Being only 22, I hadn't a clue what was causing this as I'd never experienced anything like it before. In retrospect, the source of the paranoia was the cocaine. If there was Google back then, I would have looked up "cocaine" side effects,and would have seen clinical paranoia as among them, but I had no computer, and there was no Google, so I called my family doctor. He balked and said "Oh, you're a poet, you're not crazy." I insisted that I was so far gone that I was literally afraid to cross the street as I was too spaced out to even see traffic, and asked that he hospitalize me to get the cocaine, valium, and other drugs out of my system. "Then, if I continue to talk crazy, you can commit me."

Don't get me wrong, I'm not for a minute suggesting that taking cocaine once or twice will make one paranoid, and weeks on end of sleep deprivation combined with large quantities of cocaine, as well as alcohol will certainly help on the path to not merely "dereglement," but derangement. I wanted to break all the rules, and be the poete maudit, enfant terrible, and poet who dared to cross the line between normalcy and madness. Psychologists now identify the condition I describe as "cocaine psychosis," which often resembles paranoid schizophrenia, but the treatment I was to get strongly suggests that this was a condition of which clinicians at the time were unaware.

My family doctor at the time sensed that about me, and thought I might be exaggerating about my state, so he asked to speak with a neighbor who was standing beside me who told him I was "pacing around, unable to stand or sit still, agitated, and talking constantly," so I was instructed to go to the Emergency Room of a local private hospital where his colleague, who was a psychiatrist, would be waiting for me. My family doctor said, "I'm telling the psychiatrist you're a poet, and that you've been working too hard and need a rest." But, of course, everything changed when I got to the Emergency Room.

The psychiatrist friend of my doctor wasn't there. Instead I was seen by a resident who, by the way, was strikingly handsome. He took me into an examination room, and read off some questions waiting anxiously for my response. I seemed to fare well on all of them until he got to this one: "Are you hearing voices?" I hadn't a clue what the term meant, and asked: "What in the hell does that mean?" He didn't answer, but asked the question again. "Are you asking if I have internal monologues in which I debate ideas in my head?" I asked, or words to that effect. "Yes," he said, "exactly."

Yes, that's right. The admitting psychiatrist based his diagnosis of schizophrenia on my misunderstanding of the phrase "hearing voices," and put me on a regimen of anti-psychotic drugs that made me crazy. When I informed him of my then extensive drug use, especially how much cocaine I'd been using over the past few weeks, and urged him to let me get all of the drugs out of my system before giving me more medication, he ignored me. "There may be serious underlying issues," I insisted, "but how can you know what they are when I'm on so many drugs now? Give me a chance to clean out and, if I'm still paranoid, take it from there."

But, the resident didn't listen. Instead, he admitted me to the psychiatric ward, slapped me with a diagnosis that was based on a misunderstanding of the phrase "hearing voices," and doused me with high octane anti-psychotic drugs which, for the first time, helped me to understand what the phrase "hearing voices" really meant. Again, keep in mind this happened in 1974. Had it happened now, I would have been placed in detox.

When the psychiatrist who was supposed to be assigned to meet with me finally showed up, I was already medicated and, frankly, whatever small vestiges of sanity I had when admitted were gone. When it was evident that anti-psychotic drugs didn't work, I was put on drugs used to treat bipolar depression which only made matters worse.

When, after a few weeks, I called my father and implored him to take me out, he said, "You were half-rational when you went in there, and you're completely crazy now. What have they done to you?" He flew from New York to San Francisco, and signed me out AMA, against medical advice, after only six weeks, but it took fully two years before the psychotropic drugs wore off, and I was able to go back to being myself.

The way I see it, I had a little visit with the state of madness. I didn't become a permanent resident, but while passing through, I saw others who absorbed and incorporated the way others saw them into the way in which they saw themselves. It was a hard fight, but I made sure that didn't happen to me.

It took years for me to recover my dignity, and a sense of myself as a whole, sane human being. I was filled with rage at a system that I turned to in a time of turbulence, and that turned me inside out. More importantly, I was filled with pain and sadness that I had brought shame, anxiety, and despair to my family, that I had become a burden to my father and his wife with whom I had to live for several months, that I had nearly cost my father his marriage. I can't help but think, somehow, that Mary Kennedy would know what I'm talking about.

In a very real way, though this experience cost me two years of my life, it turned my life around as I pursued healthy living with the same vigor I once pursued altered mental states. What concerns me is those who, unlike myself, who are transformed not only by having to watch their own thoughts and emotions spiral out of control, but by those, with limited intellectual resources, who later stigmatize them.

For years, I did not tell this story to anyone as it was my sense that this temporary state of drug-induced psychosis that drove me to hospitalize myself would somehow diminish me in the eyes of others, but the news of Mary Kennedy's suicide compels me to step forward.

Of the few who did know me, and who knew about the incident I describe, an old college friend called years later and said she was "surprised" that I hadn't decided to kill myself after what happened. This woman, by the way, holds a graduate degree, and has a very big job at a major academic institution. Her ignorance evoked rage in me, and still does. For anyone to be that educated and that accomplished, yet have such limited intellectual resources is baffling.

Is this what one should do, take one's life to avoid disgracing oneself, one's family, and friends because one has had to work through a period of psychological turbulence? Does having a bout of pneumonia, or the flu provoke such shame, and disgrace? Why should mental illness?

The rage has passed, of course; I now rationalize by saying that many people simply aren't capable of understanding anything they don't experience firsthand. They lack the imagination to empathize with those who have suffered, and/or cannot imagine themselves ever crossing the line for the sake of some passion or other. Arguably, for many suffering involves the absence of pleasure, and creature comforts. They've never felt the kind of pain that can't be quickly resolved in a palliative manner.

Fortunately, I've never had another incident like this. I went through mild depression when beginning menopause that was resolved with hormone replacement, but despite the fear-mongering on the part of hospital psychiatrists trying to sign me up for a lifetime contract with psychotropic drugs, that was my one and only bout. Giving drugs to resolve problems caused by drugs seems, to me, effective in one thing only, making pharmaceutical companies richer than they already are. I was smart enough, back then, to demand to know each and every drug I was given, and the dose. Though I don't remember the doses, I do remember the drugs, and they were powerful ones as powerful, or more powerful than the chemicals I already had in my body. The fact that I was a "poet" was considered an irrelevancy, and was never mentioned by either psychiatrist or the staff. This was egregious to me then, and is egregious to me now.

For artists, life is often about taking risks. The great Irish novelist, James Joyce, described what he called his "nervous breakdown" in a letter to his patron, Harriet Weaver. Samuel Beckett suffered from such deep depression that he was in analysis for twenty years. Then, of course, there's Ezra Pound, Ernest Hemingway, Tennessee Williams, and Allen Ginsberg whose poem, "Howl," describes his own season in hell. One thinks, too, of Woody Guthrie, and Phil Ochs, as well as those who keep their despair locked up inside to avoid inflicting pain on their families.

And, of course, there are those who, unable to break free from the sense of personal shame they suffer take that most dreadful step, and decide to end their lives. What does it say about a society that still fails to understand those whose voyage takes them through rocky waters? We can travel to outer space, but we still have no clue about inner space.

Those who cross the line, whether by striving to achieve altered states to enhance their art or to find release from unimaginable pain, must never again be made to feel a shame from which the only escape is to end their life.