“If schizophrenia is the domain of the slovenly, I stand outside its borders.”
“If schizophrenia is the domain of the slovenly, I stand outside its borders.”
I enter the Chinatown Mental Health Clinic’s guarded front doors, and I’m wearing a careful expression as I step into the waiting room. I take in the Chinese couple sitting on a bench, the woman’s head in her hands, and consider how it takes a certain amount of energy to act as though everything is all right; few psychiatric facilities I’ve been in house people who are able to give such performances. I don’t want to stare, but it’s also too easy to look away from their pain, which is exactly what I do as I approach the glass partition and state my purpose. “I’m a member of the local speakers’ bureau, and I’m here to tell my story.”
I wear a brown silk Marc Jacobs dress with long sleeves, rolled carefully up to the elbows. Buttons to the dip between my collarbones, finished with a tied bow. No jewelry, save for a silver bangle and my wedding ring. Black wedge heels. Without socks or stockings, it’s possible to see the dark scars crisscrossing my ankles like dirt tracks. I wear an organic facial moisturizer that smells like bananas and almonds, Chanel’s Vitalumière Hydra foundation in 20 Beige, and a nubby Tom Ford lipstick in Narcotic Rouge (discontinued, replaced by the inferior Cherry Lush).
My makeup routine is minimal and consistent. I can dress and daub when psychotic and when not psychotic. I do it with zeal when manic. If I’m depressed, I skip everything but the lipstick. If I skip the lipstick, that means I haven’t even made it to the bathroom mirror.
My talk for the clinic is one that I adjust for a variety of audiences: students, patients, doctors. It begins with this line: “It was winter in my sophomore year at a prestigious university.” That phrase, prestigious university, is there to underscore my kempt hair, the silk dress, my makeup, the dignified shoes. It says, What I am about to disclose to you comes with a disclaimer. I don’t want them to forget that disclaimer when I begin to talk about believing, for months at a time, that everyone I love is a robot. Prestigious university acts as a signifier of worth.
Other signifiers: the wedding ring that I’m wearing, a referent to the relationship I’ve managed to keep for fourteen years; descriptions of my treatment plan, as if such a thing were infallible, stable, when in fact the treatment plan is constantly changing in response to my constantly changing brain chemistry; the mention of the small business, based on informational products and freelance work, that I started in late 2013. With these signifiers I am trying to say that I am a wife, I am a good patient, I am an entrepreneur. I am also schizoaffective, living with schizoaffective disorder, bipolar type, living with mental illness, living with mental health challenges, crazy, insane. But I am just like you.
Whom you is referring to depends on which talk I’m giving. At the clinic I’m told that I’ll first be speaking to a group described to me by Henry, the group leader, as “high-functioning schizophrenics.” Most of them, he tells me, have been meeting every week here for ten years. I can’t parse whether or not this is said with pride as he guides me into the small meeting room.
There are fewer than ten people inside, not including Patricia, the head of the speakers’ bureau. Almost all of them are, like me, Chinese, save for one older white woman whose eyes cast around the room like hyperactive ping pong balls. Before the talk begins, Henry passes around photographs from a field trip. No one passes the photographs to me; without seeing them, I can only guess at where a field trip for high-functioning schizophrenics would take place: somewhere educational, such as City Hall? Or maybe a nature-oriented jaunt to Muir Woods. The group admires the snapshots quietly. Some of them speak with the lilting disorganization that I associate with people who live relatively well with schizophrenia, given that they’re in this sort of medical facility—but who would be immediately labeled by others as crazy and to be avoided.
Before the presentation begins, Henry brings out—and this, I cannot help being charmed by—an enormous bag of potato chips. He searches the corners of the room for napkins and paper plates as a handsome twenty-something pries open the bag with his big hands. Nobody seems terribly interested in engaging with me, and I’m too busy reviewing my papers for this, my first talk in a clinical setting, to engage with them. Patricia introduces the presentation by speaking to our audience about different kinds of stigma. A few interrupt her with meandering commentary and need to be gently rerouted by Patricia or Henry. The quiet ones avoid eye contact and say nothing.
With this group, I deviate from the script. When I tell the story of my diagnosis and recovery, I exchange more complex language for simpler words. I remove the term avolition. I lean into descriptions of experiences that I think they’ll understand—including, in Mandarin, my mother’s explanation for why she lied to my first psychiatrist about our family history of mental illness. My mother had said plainly, We don’t talk about these things. In the final moments, I quote from an email she sent after I resigned from my full-time editing position, having realized that the work was triggering psychotic episodes: “Fly free. I love you.” The talk is designed to be inspiring. I am trying to light up the room with hope.
After I finish, two people are crying. One, the head of the speakers’ bureau, shows me her arm: goosebumps. “I thought I had it bad,” the woman closest to me, the other one who’s crying, says. I hear this, and my heart stammers in my chest, swelling and shrinking. I am her, but I don’t want to be her. I’m not her, I tell myself. I’m the one at the head of the table, visiting. She’s the one who has come here every week for the last decade. Not much is changing for her, but everything, I must believe, is possible for me.
“Yet you look very put together,” my psychiatrist told me. This was in response to my statement that, as a part of my treatment, I was working on improving my hygiene. Showering had become a challenge shortly after I began to hallucinate in college; my first experience with hearing voices occurred when a phantasm in the dorm showers intoned, “I hate you,” which may have unnerved me enough to become anxious about the act forever after. But because I care about my appearance—because I used to be a fashion blogger and writer—because I worked, for a time, as a fashion editor at a start-up—I pass for normal more easily than my comrades in the land of schizo. When I browse the virtual aisles of La Garçonne, I am considering a uniform for a battle with multiple fronts. If schizophrenia is the domain of the slovenly, I stand outside of its borders.
There is no telltale smearing beyond the borders of my mouth, and to some degree, the brilliant facade of a good face and a good outfit protects me. My sickness is rarely obvious. I don’t have to tell new people in my life about it unless I want to. Although I no longer fret about when to disclose my psychiatric condition, I’m still aware of the shift that occurs once it happens. At a writers’ residency in the Pacific Northwest, one woman responded to my disclosure with, “I’m surprised to hear that. You don’t seem to have those tics and things.” I reflexively smiled at this so-called compliment. I suspect that she found comfort in being able to place me in a different category than my brethren whose limbs and faces jerk from tardive dyskinesia, a side effect borne from the use of antipsychotics, and which does not go away when the medication is stopped. “It’s true,” I said. We didn’t speak of my diagnosis again.
There are shifts according to any bit I dole out. Some are slight. Some tilt the ground we stand on. I can talk about the fact that I went to Yale and Stanford, that my parents are Taiwanese immigrants, that I was born in the Midwest and raised in California, that I am a writer. If the conversation winds its way to my diagnosis, I emphasize my normalcy. See my ordinary, even superlative appearance. Witness the fact that I am articulate. Rewind our interaction and see if you can spot cracks in the facade. See if you can, in sifting through your memory, find hints of insanity to make sense of what I’ve said about who I am. After all, what kind of crazy person has a fashionable pixie cut, wears red lipstick, dresses in pencil skirts and tucked-in silk blouses? What sort of psychotic wears Loeffler Randall heels without tottering?
I went to the Alexander McQueen exhibit Savage Beauty at the Met in 2011 because I was a fashion writer then, and the McQueen exhibit was a significant occasion to anyone interested in art or fashion. The narrative of the McQueen exhibit: art as madness, darkness, beauty, death. His 2010 suicide hung over everything, throwing long shadows on the walls and the dresses. He’d ended his life not long after the death of his mother, and the death of his friend Isabella Blow.
The piece that most beguiled and frightened me was a blank-faced, pure white mannequin in a suit of inky feathers. In this ensemble, plumage forms massive shoulders that could be wings, and the body displays a nipped, severe waist. There is nothing charming about this aviary costume; encounter this creature, and surely Death has come to claim you.
McQueen said about his clothing, “I want to empower women. I want people to be afraid of the women I dress,” which is another truth about fashioning normalcy: the manner in which I clothe myself is not merely camouflage. It is an intimidation tactic, as with the porcupine who shows its quills, or the owl that puffs its body in a defensive offense.
And yet there are some things that good costuming can’t hide. For one season, I saw shadowy demons darting at me from all angles, and I couldn’t control my response, which was to jump to the side or duck or startle at things that no one else could see. If I was with someone, I’d pretend afterward that nothing had happened, and usually my companion or companions, who knew of my diagnosis, would generously pretend that I hadn’t just ducked, rather dramatically, for no reason. But I was mortified. It didn’t matter how pulled-together I seemed when, for example, I was crossing campus, ducking and dodging specters that no one else could see. I knew that I looked crazy, and that no amount of snappy dressing could conceal the dodging. Because such movements were a necessary concession to my craziness, I responded by trying even harder to seem normal when I wasn’t being assailed by hallucinations. I went dancing. I ate potato skins in Irish bars and pizza joints. I did all the ordinary things I could think of.
At the clinic, I am led downstairs into another room. This one is brighter, cleaner, and clearly the clinicians’ domain. There is a water cooler in one corner. The tables have been moved to flank the walls, allowing space for an assembly of folding chairs in the middle. The clinicians begin to wander in—men and women in business-casual dress who don’t talk to one another but instead find seats and stare blankly into the middle distance. There is one man in particular who is seated in the back and actively scowling; I can practically hear him thinking, I can’t believe I have to come to this goddamn thing. He makes me nervous, but it’s also true that all of them, even the friendly-seeming ones, make me nervous.
Being faced with this many clinicians causes me to flash back to my first psychiatric hospitalization, when a battalion of psychiatrists, social workers, and psychologists made their daily rounds throughout the unit and interrogated us patients about how we were doing. The flock of officious questioners stopped by when I was sitting at the threadbare sofa near the television, or listlessly pushing around puzzle pieces at a table. Rarely have I experienced such a radical and visceral imbalance of power as the one I experienced as a psychiatric inpatient amidst clinicians who know me only as illness in human form. During that first hospitalization, I learned that clinicians controlled when inpatients were granted privileges, such as being able to go downstairs for meals or outside to smoke for ten minutes twice a day; most importantly, it was my team of clinicians who decided when I could go home. I became accustomed to play-acting for the benefit of doctors: Look! I’m fine! To the question, “Are you thinking about hurting yourself or others?” there was only one proper answer, and it was always followed by suspicious, persistent questioning. Knowing that it’s time for me to talk about being crazy for a group of such people, even as a free woman, ratchets up the dial on my already rabbiting heart.
When it’s my turn to speak, I am aware of the need to sound eloquent. I slide avolition back into my talk. I emphasize, again, my education. I play up the entrepreneurship. I even add an extra bit of information about my time as a lab manager in the Psychology department at Stanford University, where I was the head of a multisite study about bipolar disorder, and made weekly visits to the Psychiatry department’s respected Bipolar Clinic as a researcher and not a patient. The Bipolar Clinic is one of the best of its kind in the country, and I briefly wonder if these clinicians could even find work there, which is a defensive and sour thought.
All of this posturing reads as paranoia, and even unkindness, toward the professionals who come to this clinic, who are not making as much money as, say, a psychiatrist at Stanford’s Bipolar Clinic, and who do this good work because they’ve been called. I finish my talk. No one is crying. The scowling man is still scowling, but less aggressively so.
As I sink back into my folding chair, Patricia asks if there are any comments or questions. A bespectacled woman raises her hand. She says that she is grateful for this reminder that her patients are human, too. She starts out with such hope, she says, every time a new patient comes—and then they relapse and return, relapse and return. The clients, or patients, exhibit their illness in ways that prevent them from seeming like people who can dream, or like people who can have others dream for them. When she says this, I am fingering the fabric of the expensive skirt to my expensive dress. I’ve fooled her, or convinced her. Either way, I know, is a victory.