How I cured psychosis

It’s about 10 years ago that I decided to go to a psychiatric hospital. I wanted to know what psychiatry was like. I decided to write a book on men’s depression, read quite a lot (often I found I knew more about depression than psychiatrists I spoke to – they mostly knew dosage), but I still missed one thing. I had never been in a psychiatric hospital. And as I had been reading Szasz or Scheff, my head was full of anti-psychiatry. So, it was time to see it for myself.

And so I did. I wrote to one of well-known Polish psychiatrists and asked him to take me on as an intern. After a few days he responded, we met and I was to meet the Head of Psychiatry at the Jagiellonian University. I did meet him, it was a formal meeting, when he approved my stay in the hospital and laid some ground rules for the stay. Remarkably it was nothing dramatic, I was, after all, meeting some regular people, who happen to have some difficulties. That threw me somewhat, after all, psychiatry was supposed to be bad, or maybe even evil.

He had one condition though. He wanted me to go see ‘proper psychiatry’ – psychosis. Yes, I said, not that I had any choice. But, I must admit, talking to people who live in their ‘science fiction’ (as one of the patients described it) was quite interesting. And so, I was about to enter the ward which had previously been headed by THE man of Polish psychiatry – Antoni Kępiński.

I was in touch with elite psychiatry.  And it was psychiatry that I didn’t expect to encounter. If ever I were in trouble, if ever I wanted psychiatric help, I would go there. What did they do? I have no idea. It was all pretty chaotic, to be honest, but somehow they managed to do things. Maybe it was empathy, maybe it was treating people as adults, or just with respect – no idea. What was the most interesting bit? Well, they all disliked nosology, thinking it was not particularly useful in dealing with their patients. However, a well-worn copy of the ICD-10 was on the table in the doctors’ room, as they had to fit patients’ experiences into diagnostic labels for the record.

But that’s them, what about me? Well, I met people with difficulties. I met a man who couldn’t go home because his family were ashamed of him. I met a woman who was delusional, until her husband admitted that he had been meeting their neighbour and not only for a coffee. And then I met a woman who was so scared, she pulled half her hair out. It was her grandfather; he started living in her, then the wolves came. And then her family took her for an exorcism (to get rid of the granddad). When she came back, she had half her hair…. It was actually sitting in an interview with that woman (with her permission) that made me cured of my anti-psychiatry sentiments. Call it what you will, but these people needed help and they were getting it.

But then the unthinkable happened. I cured Adam (at least let’s call him that – the name sounds roughly the same in Polish and English). Yes, that’s right, I cured a man, well, that’s what ‘everybody’ said. Did I really cure him? Who cares!? I have a story, though.

Adam came to the ward in crisis. He was convinced that there was a person controlling him – he did describe the mechanism of control in some detail. Anyway, whatever Adam did, the man made him do it. Adam was not prepared to give up his delusions, but when he was calmer, he was happy to talk to people, including me. So, I was asked whether I would like to talk to him. Needless to say, I said yes.

The conversation went very well, at least at the beginning. I genuinely wanted to know about his experiences. So, as he was telling me about a man controlling him, I was asking him to tell me more. First, Adam was happily telling me all I asked about, describing that the man even made him go to work (and other daily activities), until I said something like – I also come to work every day, so there must be more to this controlling. He looked at me and said: “You’re fucking trouble, ain’t you.” (well, something like that in Polish).  I denied, saying that I genuinely wanted to know more. And then almost immediately afterwards it all stopped. He said there was nothing more to say and ended the conversation. And that was it.

Except that the following day I heard that I had cured him. The doctors were buzzing – the linguist cured psychosis. Hey? Well, Adam decided nobody was controlling him. No matter how you asked him, he was telling everybody that he had been bloody bonkers. He was not controlled, he was obviously doing things of his own accord. A couple of days later, his girlfriend came to see him (the meeting was supervised, I was present at it with Adam and his girlfriend’s consent). He apologised to her, explained he had lost it. He was at a loss, trying to pick up the pieces of an extremely traumatic experience. She offered to help him along.

Obviously, I was extremely interested, so I asked for an explanation. Well, the shrinks decided that the reason was that ‘I had pissed him off’ and engaged in some psychological explanation that escapes me today. I did need to find my own explanation. I don’t know if I did, but it’s all about the film Pleasantville.

It’s a comedy in which the characters in a TV show slowly discover that there is a world outside their town. Their books, empty for the show, begin to fill up – as new realities begin to be available for the people. And this is how I see my conversation with Adam. He was telling me about his ‘Pleasantville’ (except it was not very pleasant). The story he was telling me, was limited to his ‘science fiction’. His book was as full as his delusions allowed it to be. As I was wanting to know more about his experiences, he found it harder and harder to come up with something. Unwittingly, I took him to the end of his story, except in his science fiction there were no special effects to fill up the book. Just like lying, inventing a new story is cognitively more difficult than simply telling a story you already know.

And so, he stood at the narrative crossroads. Adam, I think, had a choice – either to struggle to come up with the next chapter of his ‘book’ or give the book up and reach for one he had been writing all his life. He chose the latter, a more useful story. And he got better.

I wish I could say: linguistics prevailed. It didn’t. I simply wanted him to tell me more and at some point there was no more to tell. Also, it is only my interpretation, as I will never know what ‘really’ happened. As it turned out, I had not spoken to Adam again. He had not sought to speak to me, my stay in the the hospital was soon over, he was discharged soon afterwards.

And yet, I have an enduring story of how psychosis can be thought of (and, shall I say, cured?) in narrative terms.

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