Sunday, January 27, 2013

Living with Schizophrenia

Elyn Saks was told in her early adult years that her life held no prospect and that to hold down a cashier’s job would be an accomplishment. But she defied the criticisms. Today she is a chaired professor at the University of Southern California Gould School of Law, has an adjunct appointment in the psychiatry department of psychiatry at University of California’s San Diego medical school. She’s also on the faculty of the New Center for Psychoanalysis. 

In 2007 she wrote about her battle with schizophrenia, "The Centre Cannot Hold: My Journey Through Madness". The MacArthur Foundation gave her a genius grant for it. I read the sample ten odd pages of her memoire. It’s beautifully written, and her story - and what she's achieved despite mammoth obstacles - has inspired me, but something about it gave me chills up and down my spine. In her introduction she writes of her family as a normal, upper middle class Jewish family.

The word ‘normal’ is mine, not hers, but the intimation is hers, as far as I can gather. She paints a picture of parents in love with each other who made time for enjoying each other’s company – Saturdays were for them, Sundays for the kids. She mentions in passing that actually they probably preferred each other’s company more than that of their children. But her comment about it is a throwaway one.

Her family life sounds pretty sane. There was enough money, there was enough love. Normal. She writes of a little bit of sibling rivalry – she was the oldest and very driven – which she mentions as a plus because it helped her survive the damning diagnosis and the reality of her schizophrenia – but nothing massively destructive. 

So why were my alarm bells ringing? Three or four pages in she writes of the early warnings that she had schizophrenia – hallucinations of intruders. Night terrors. And suddenly the ‘normal, loving parents’ image kind of melts away. They criticized and even mocked her. Her mother’s response was “Oh don’t be silly darling”. Her father was more cruel and dismissive.

Later, she put on weight and pinned all her low self esteem onto it, refusing to eat properly. She got thin, looked ill and had no energy. Her parents’ response? Anger. I have to get the book to read more, so I’m not sure if Elyn Saks made any observations about the absence of empathy in her parents and what it did to her, how it may have contributed to her later diagnosis of rank schizophrenia.

The world still largely believes that a faulty brain structure is the cause of schizophrenia and its symptoms. But the whole diagnosis is predicated on two things: an assumption of what’s normal, and an absence of sensitivity to how potently childhood experiences influence and damage us – and what that might do to the structure and functionality of the brain.

Mostly as adults we don’t see the potent emotions that run beneath the surface of our ‘normal’ exterior. We behave as if the surface is all there is. But there’s nothing anybody on earth can do to stop those underlying emotions from impacting incredibly powerfully on children. As adults we just don’t notice it. Children are force-fed the idea that what they’re experiencing is ‘normal’.

Many adults can’t get beyond that force-fed idea. Even when they can’t get their lives together and have blistered self esteem and entitlement, they cling to “I had a happy childhood”. So many parents can’t let themselves acknowledge that their children suffer from the consequences of whatever they, the parents, bury beneath the surface. 

This idea we have of what’s ‘normal’ is more about keep things nice on the surface, but destroying each other in reality. And when a person can’t their life together in the way they feel sure they should be able to, if you go back to their childhood you’ll find the key – violent emotions in the parental environment being spewed out in every neurotic direction but cloaked by “I’m not angry, I’m normal”.

This isn’t about the blame game. Everybody does their best; denial is an unconscious thing, that’s what makes it so lethal. But we need a greater understanding of how sensitive children are to those underlying emotions that parents have learned to suppress and how much it damages them. 

And what impact does that unrecognized emotional deprivation have on brain development and subsequent schizophrenia? Is the brain structure that is cited as being the cause of this terrible affliction actually itself the symptom of a cause that is much more subtle and difficult to diagnose? Unrecognized wounds don't heal.

Elyn Saks has shown immense resourcefulness and courage and, at a time of huge vulnerability, pushed through the damning barriers to entry of a fulfilled life as schizophrenic.  She hasn’t stopped at medication, she’s stayed in therapy and reached out for the emotional support she needs. She’s searched for ideas that would help her hold her course. What a courageous woman. But I wonder if we’ll ever see the book “What My Childhood Really Did To Me”.