What gets called mental disorder or illness, mild or severe, shows itself as a misplaced fear of others. Personal relationships break down, followed by an inability to form and maintain new ones. The sufferer becomes progressively more emotionally and cognitively isolated. Madness results from our failure to constantly update and modify our mental map of the world. If we do not ‘test’ our predictions, beliefs, dreams, thoughts, internal dialogue, fantasies, hypotheses, plans, ideas about how the world is, and what the people within it think and feel, our map becomes rapidly out of date. If we act with an out of date model of the world - we will look mad to others, and they will treat us as mad. If others don’t share a large part of our model of reality we are emotionally and cognitively isolated. We need an accurate map; by sharing we come to have a more complete understanding than we could ever achieve alone. The ability to doubt and live with uncertainty, and hence know that we must constantly test our vision of the world - is sanity. To control and fix our view is the first step on the road to disaster and the way an unchanging outlook is maintained is by isolating oneself from any evidence that might contradict it. An unmodified and out of date model of the world is one where our thoughts and feelings are anchored in the past, hence our predictions of the future may be hopelessly wrong.



Sunday 28 December 2014

The man with no name (updated 2014)

(This piece first appeared in a local newsletter in 2008. At that time I slightly censored my original text but restored the cuts and updated the content when it was first posted here in January 2010. Now I’ve briefly added more text in italics at the end which brings it up to date again! When it first appeared some readers wondered if the other person referred to was real, I can assure you he is).

I first met him on a psychiatric ward, I knew his name then but have forgotten it since. We lived in almost the same street for many years but rarely spoke, though we saw each other all the time. The last time I saw him, a few weeks ago, he passed briefly through the café before jumping the train. We have known each other now for nearly sixteen years, and it seems that there is a bond of shared experience that will never go away. Let me try to explain.

At times he seems like my mirror image. He’s certainly a benchmark by which to measure myself. On one occasion when we met (passed on the street) I was in a neighbouring town, and waiting for the bus home. I was sitting on the wall, staring in the direction the bus would come, looking south-west; the setting sun illuminating me, my body relaxed and my eyes rested naturally on the horizon. I saw him coming from the same direction, the perfect opportunity to ‘read’ him and therefore myself - the simplest of encounters with the minimum of ‘noise’. I knew his gaze had to past across the uprights of the bus shelter and that would clean his memory at the right moment. I remained motionless and allowed the gaze of my eyes to remain fixed. At the right moment I glanced away for a split second in recognition, then back to look directly and uncompromisingly into his eyes - demanding a response. It was then that something remarkable happened. For the first time in all those years he looked undeniably normal, and his expression, in response to mine, was one of sorrow and sympathy. With my seemingly fixed stare I looked distressed to him - he had misread me, in a way only an ordinary person, who cares but doesn’t understand, can do. He had lost, for a while, his capacity to be mad.

He’s a walker, night and day, and so am I. But he needs to be outside more often - he covers more miles. Those who are disturbed don’t wander, they walk with purpose, rhythm and speed. To the onlooker they may appear to be staring blankly ahead whilst taking an erratic course - they look crazy. But this is only because urban landscapes are artificially regular and regimented. The real walker, who moves swiftly but smoothly, is actually following the most efficient path through the real contoured landscape beneath his feet. The path of least effort up a slope is always curved. The apparently fixed staring eyes have in fact come to rest naturally on the horizon - seeing through the fixed artificial urban skyline. But they do blink from time to time, like a camera shutter recording fixed points for navigation. The so called ‘psychotic’ hopes to achieve a kind of walking meditation; whereby the hallucinations, which may be of sound, smell, taste, touch or vision, and the unwanted delusional thoughts that emerge to explain them, may be relieved. If he can stay ‘in the moment’, in the here and now, create nothing but constant change around him, know that all thoughts and feelings can only be about the past or future and let them go - then survival is possible. Finally he may be able to allow his unconscious mind to make all the decisions and find a few hours of peace whilst in constant movement.

By the time he comes to rest, his ‘balance’ (physical coordination) and ability to ‘navigate’ (be orientated in three dimensions of space and one of time) will be restored and his mental awareness as acute as his hunter-gatherer ancestors. Alas, opportunities to be alone and abroad at night are ever more restricted by modern society. When forced into the crowd then disaster may strike unless you are particularly confident and relaxed. You may even be able to ‘part the waves’ by walking briskly in a dead straight line through a crowded pedestrian precinct staring relentlessly ahead, not deviating nor giving way even for a moment. The first time, I did it by accident; I was pre-occupied with my own thoughts and didn’t realise until I was in it and saw its effect. It’s both frightening and amazing if you have the confidence to keep going. The crowd parts in front of you, you are like an arrow travelling through air, it gives a wonderful sensation of power. But you mustn’t take your eyes of the real horizon and make eye contact otherwise you will become rapidly disorientated and liable to fall. I must have gone a hundred yards without touching anyone. Afterwards you need to be able to switch realities; and must make eye contact to be balanced, and able to navigate in the landscape of others!

When we met on the hospital ward it was a crazy place, the staff occupied one mental universe, whilst we the patients had our own individual realities - well almost! There is a realm where two, at most three, psychotics can understand each other and therefore act together. We each define a situation differently and ascribe different meanings to it, reflected in the mutually incomprehensible content of our words - but how much real communication depends on language? He’s a bit of an artist and one day I helped him cover the walls of the music room with graffiti. The unit was attached to a general hospital, any part of which could be explored - if you had the confidence to act as though you had a right to be there. At night the grounds could be a playground too.

The fastest way out of a prison is usually the reverse of the way you came in - through the front door! You are never more than three keys away from freedom in the psychiatric system; one out of seclusion, another out of a secure ward on to an acute ward which is open at some point in the day, and the third which unlocks the transport taking you to and from units or the outside world. Physical methods are extremely slow, the psychological much faster - you have to get those who want you in, to want you out. Using what have become the 'black arts' of psychiatry and psychology, against those from whom you learnt them, can be fun; non-verbal behaviour, hypnotherapy and NLP - plus a little old-fashioned distraction and sleight of hand. Two of you can cause chaos, three of you can get one of you - out of anywhere. And it is a game. If you can understand the source of your distress in the system of care; see its rules, routines and the habits of the workers who reproduce it - then there is much to amuse. But it is addictive and I still can’t walk away from it all.

(Oops! I may have just self-diagnosed myself with an ‘anti-social personality disorder’).

(Now it is 20 years since we first met, and I haven’t seen him for a couple of years – which doesn’t necessarily mean he is not around, just that our awareness’s have changed. I know mine have and I suspect his have too. First there was the time I saw him working in an out-patient art therapy room, absorbed in a very elaborate large drawing. Then months later he had a dog in tow, he was still walking but obviously the pace and priority had changed. Then came the van, the woman and the child. One day the van was parked outside the café – the first time we had been stationary in the same space for more than fifteen minutes, ever! Finally the last time, all three were dressed as if part of a wedding party, on their way to a local music festival.)

Bus shelters are often effective barriers for forcing a 'pattern break' from one kind of a 'trance' like state to another involving more 'reality testing'.