Remember those women who walk the streets a bit too gracefully, a bit too lightly, like ballerinas? Those childlike female creatures whose playful steps subconsciously crave attention? And when you look them in the eyes, they communicate something very remote and intimate at the same time? Maybe you are not a great observer of people and fail to notice details. As an artist who appreciates individuality, I like to observe these moments of eccentricity in the streets. They flash by, important bits of the magical atmosphere of urban landscapes. I used to enjoy them until one day I read in a psychiatry book that “schizophrenic people are conspicuous in a caricaturistic way.” Their schizophrenia is said to be characterised by the so-called “oceanic feeling” described by William Blake. They suffer from disunity: no reconciliation of bodily and spiritual levels is attainable. As a great admirer of Blake, I felt uncomfortable upon reading this. Me, too: I am one of those people who wonder, from time to time, “Are my body and my spirit really the same thing?” Finally, what’s wrong with the desire to walk like a ballerina, if that’s the way you feel and you just happen to have bought new shoes? Should I pity those people who went mad and lost a sense of self-perception, or should I despise the so-called “normal” folks who don’t seem to wear a special sign of divinity in their faces?

Let’s forget about this romanticism and the over-emphatic approach and ask a commonsense question about psychiatry, antipsychiatry, and the perennial sad issue: “What happens to a person who gets a bit crazy and seeks help from the psychiatric system?” This is one of the questions we can’t help thinking about, although we might consciously avoid them unless the drama is happening in our own head or in the mind of someone we love. Now and then we encounter people who are obviously “different” and most of us have friends and relatives who have been in a psychiatric ward. For this reason, I want to tell an authentic story and convey a message. Since I have been in a hospital four times and have spent six years in psychiatric settings receiving treatment for my Bipolar Disorder, I feel like a poor little mouse who should address other fellow mice for the sake of telling the truth or, maybe one day, attaining justice through joint effort. These are really hard times and the mice should stick together. So I ask: Do the helpers, as a collective body of professionals, do their best or really cherish human values in trying to help us? Isn’t this a condition sine qua non of successful treatment?

During the pandemic, when the Serbian government decided to start a very long lockdown, the Clinic for Psychiatry where I used to be a patient offered no services. In other words, no telephone or Skype line was established for helping patients whose condition, as we all know, can get worse due to isolation. I once phoned the Clinic demanding a conversation with a doctor on duty, but the nurse who picked up the receiver told me that the doctor had no phone in his office. What prevented them from opening a telephone line, or were they just neglecting the gravity of the situation? Was it callousness? I still can’t tell. While the other two main clinics in the city provided SOS phone lines, the Clinic almost stopped providing any services and I did not feel like talking to anonymous professionals at the other two clinics, whom I had never met personally. I keep considering this absence of initiative a symptom of civil and professional irresponsibility, one of the reasons for my consequent decision to shun every further contact and abstain from seeking help. Step by step, the puzzle grew to be a full picture of a catastrophic situation: If you want to get genuine help in Serbia, you have to pay and go to see a private doctor.  During these private sessions, you are more likely to be approached in a dignified way.

Six years ago, when I was hospitalized at this clinic, I was obviously feeling very bad, developing the fanatical desire to keep praying— although three previous years of prayer in the synagogue had joined with terrible PTSD to produce the appearance of very serious psychosis. I was recommended to get disability. The last document I needed for this was the opinion of the doctor in charge of the ward. A part of me, deep down, naturally hoped for a miraculous solution, healing, and an optimistic prospect. I was alert and expecting a positive voice who would say something along these lines: “You will recover; you have a life to live!”

The pretty, well-dressed doctor that I had been appointed had an appearance and personal aura that wasn’t typical of a medical worker. As an expert in neuroscience, she did not insist on getting to know me well. Of course, I looked like hell, felt frustrated and angry,  and the testing she gave me led to the conclusion that I  had a radical impairment of working memory. The consensus was clear that no recovery was likely. The rather foxy-looking doctor kept insisting that my sex appeal was, in a way, the best quality I could rely on. One day, I was feeling such humiliation walking up and down the hallway with no windows and absorbing the murmur and movements of other patients in their rooms. There was a big television set in the middle of the hallway. On the brink of tears, I rehearsed in my mind all my positive thoughts, contemplated my successes and the bitter failures that had by that time outnumbered the achievements. The doctor approached me condescendingly and asked me “Bojana, why don’t you watch TV? A good-looking guy is starring in this movie.”

Being totally out of balance, I couldn’t help hating her and all I wanted was MY LIFE BACK, my capacities restored. As a great reader of Shakespeare and Virginia Woolf, I kept dreaming about going to university again, because it seemed to me that without personal growth and a constant effort to attain excellence, you would get nowhere in life, neither socially nor spiritually. The big void was, of course, already gaping wide, threatening to swallow my soul.

After 30 days of chain-smoking and swallowing a handful of medication, I was summoned back to her office for the final talk. The doctor’s unmistakably expensive outfit was somehow incongruous with the context, but I could have never predicted that she would hurt me intentionally. Usually, I presume that people who emanate power and authority lack this desire, especially if the interlocutor is fighting for her life. She kindly asked me what I would do upon getting on disability and I naively opened up and said that I wanted to go to university again because this was a legal option in Serbia, assuming that I paid the fee. Shocked and bewildered, she replied that my right to study was as meaningless as her right to stand out in the street and yell— although, of course, there is nothing illegal about it. Was the scene I was taking part in just an instance of paternalism, of a benevolent attempt to stop me from getting frustrated in academic life, or just mental bullying?

After changing doctors, I talked to her a year later and the situation was finally brought to a satisfying level of clarity and intelligibility: For most psychiatrists, people belong in one of two categories: 1) those who can work and who can get a placement in the work market and who should, for this reason, have access to education and 2) the poor little psychiatric mice with invalidity, who should stay home. Actually, what was at stake here was an ideological question: the social-democratic idea that education is a public good accessible to all equally. Any purpose for education except placement in the work market was seemingly inconceivable, almost unreal in the mental space of my helpers. Inclusive education and facilitation of the learning process for people with mental illness are not topics that professionals in Serbia want to address.

For three years after I left the hospital and got on disability, I was completely lost and desperate. Not only that, I was dealing with symptoms, but I also asked myself: “What is the meaning of my life? Am I really so sick that people are justified in ridiculing my idea to take part in academic life, not very ambitiously but for the pleasure and gratification the academic community provides?” Ironically, bearing in mind the previous doctor’s insinuation that my good looks were my best asset, I started seeing a handsome young male doctor and began having histrionic tantrums of rage and love, believing I was Elizabeth Taylor’s little sister stuck in an asylum. None of this made me happy. I was going even more crazy and the young doctor only kept repeating the attitudes and opinions of his superiors.

And another humiliation was lurking in the background: He kept insisting that I should plan my day no matter how meaningless it was. In the beginning, I complied, but the plan was not something like going to Paris or doing anything really creative. Rather, it consisted of “doing small things,” those petty little things that are routinely done by the “normals” but which, poor nonfunctional little mouse that I was, I should take great pleasure in doing, emulating normality. It is as if I had a policeman or a guard in my apartment and the doctor’s voice permeated every muscular tissue in my body. Of course, this “help” was necessary because he had wisely noticed that my diagnosis also consisted of  “nonspecific insufficiency of the ego.”

At that point, I realized that both Foucault and Virginia Woolf were right: Psychiatry was a battlefield for two wills, and the submission of the patient’s will to the doctor’s is the only marker of its success. It was only later that I heard the same method of submission had been exercised over other, more vulnerable patients, those poor people who had no legal capacity. One girl’s pocket money had been taken from her and she was contrived to do housework in order to collect coins. Deprived of the liberty to own any money, no matter how insignificant the amount, the girl was actually a survivor of psychological and physical torture. When I talked to her, she obviously had no desire to rebel against this treatment. Uneducated and uninformed, oppressed by both her mother and the psychiatric system, she accepted a life of absolute anonymity.

Paternalism, negation of human dignity, lack of informed consent.  Antagonistic strife, the domination of the stronger and healthier will over the weaker, supposedly “sick” will. The imposition of a liberal capitalist sense of meaninglessness and isolation and the intrusion into the domain of basic human rights… these were just the first impressions painfully carved into my nervous tissue when I heard her story and summed up my own experiences. This led to my getting interested in psychiatry and antipsychiatry because, apparently, I am one of those “masochistic” people who, after being raped, want to look at the rapist’s face again. Or maybe it is that I have a desperate hope that one day, things will change for the better.

I started doing research on my own because I realized that nobody would be able to help me if I didn’t help myself. Simply because society wants a technical solution, a cheap solution that will leave me in a state of dependency and frustration for the rest of my life. Every patient has an idiosyncratic story to tell. Often we meet in hallways and happily find relief in confessions and identifications. We stick to diagnoses and labels, although we can sense that the theory that founds the classifications and dictates the treatment is way too complex for our understanding. Making things simple, submitting and complying, are sometimes the only ways to avoid a personal existential crisis. Still, this mutual recognition is a mimicry, a veil shrouding our personal dynamics. The psychiatrists know how complex medical science is and refrain from giving too much info. It is preferable to talk about small things each patient can do to ameliorate the quality of her life.

Fortunately, I have always been a very non-compliant patient, resolutely fighting for substantial change, a ray of light, hoping I ultimately wasn’t sick for life, praying for a real solution, real healing. Of course, the use of psychotherapy for psychosis is not predominant or frequent in this era in which medication flourishes. Still, I have always had an inner voice, which related to me that the prospects could not be so gloomy as presented by the so-called “professionals.” The first spark of intellectual curiosity and the impetus to know more and get well induced in me a desire to keep reading and experimenting with myself. The first question I wanted to answer concerned audiovisual hallucinations. What was it that I heard? Intrusive thoughts or voices?

After reading a text on criteria relevant for the differentiation of these two symptoms and the philosophical controversy in the domain of philosophy of mind, I decided to go and talk to a doctor to help me decide what was it that I had. Despite all my negative experience, a part of me was seeking communication with people who claim to be experts. The fact I could not taper off made it necessary for me to keep consulting the professionals. When I entered the doctor’s office I had two questions in mind, one concerning the general cause of my symptoms, the other one on the exact nature of the symptoms.

“Is it possible that three years of fanatical prayer contributed to a dopamine imbalance in my brain?”

The doctor was visibly irritated by the first question and gave a short reply: “You are not supposed to be interested in dopamine.”

Sensing that I was stepping into hostile territory, I nonetheless had the courage to ask the second question: “What is the difference between intrusive thoughts and voices?”

Although that was the first time we had met and she had no idea as to the contents of my thoughts, she spoke a sentence that sounded almost like an order: “I can see that you are hearing voices.”

Upon being asked whence came this magical intuitive or supernatural knowledge, which gave her the authority to deal with my case in less than a minute, she calmly replied, “I am good at diagnostics.” Of course, just as I presumed, reading the relevant literature finally led me to discover that what I suffered from were neither just voices nor intrusive thoughts. Instead, I had the symptoms of a phenomenological variance of the syndrome of mental automatism (probably triggered by an excessive, three-year-long period of fanatical prayer.) This consists of pseudohallucinations and their intensification, the peak of which is best described as a sense of hostility. This is something I had been experiencing for years, hearing thoughts like “You are disgusting, I will kill you, jump out the window,” etc.

It was a great comfort for me to find out that philosophers like Lacan wrote about the syndrome and that it was discovered by a Russian psychiatrist who had himself survived an episode. Luckily, the “diagnostic” intuition of the doctor was not relevant anymore and my work had paid off, since the outlines of my condition have finally been set. It was really rewarding to discover the truth after six years of confusion. The fear disappeared and I started to recover and gain intellectual self-respect.

This moment marked the beginning of a new phase in my life. I no longer had any fears concerning what psychiatrists might say. I don’t need helpers anymore. Nobody will ever again define me without knowledgeable insight. Except for a few extraordinary people who wholeheartedly invest their time and energy in both research and healing, endowed with a moral capacity that prevents them from doing harm, the self-proclaimed “professionals” are almost always a failure. An average user of psychiatric services could guess that they care more about getting published than about treating people with dignity. Due to carelessness, their so-called “professionalism” easily transforms into its opposite.

 

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.





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