[D66] The Collected Schizophrenias

[A.OUT]

(Welkom bij de club van hoogfunctionele schizo's... Al ben ik het
volkomen oneens met haar kritiekloze acceptatie van DSM-categoriën.)

In “The Collected Schizophrenias,” Esmé Weijun Wang Maps the Terrain of
Her Mental Illness
By
Anna Altman
newyorker.com
6 min
View Original

“To be alive and sick is a far more complex endeavor than we like to
admit,” Esmé Weijun Wang wrote in an essay for Catapult, in 2016. Wang
would know: as a teen in the Bay Area, in 2001, she was diagnosed with
bipolar disorder. Twelve years later—eight years after her first
auditory hallucination—she was diagnosed with schizoaffective disorder.
When she began to experience new symptoms—weakness and fatigue,
peripheral neuropathy, fainting, extreme weight loss—in 2013, doctors at
first suspected an autoimmune disease, or even cancer, and eventually
diagnosed her with late-stage Lyme disease. In the past two decades,
Wang has been committed to a mental hospital three times. Her symptoms
sometimes got worse with treatment instead of better. “I was so sick for
so many days that I could feel hopelessness nipping at my edges,” Wang
wrote in the Catapult essay, of one particularly rough period. “What I
feared was the in-between space: a purgatory for those too sick to truly
live.”

Wang’s recently published essay collection, “The Collected
Schizophrenias,” explores the peculiar questions of identity that the
ill, and especially the mentally ill, must contend with. Wang says that
it is far more common for people who suffer from mental illness to be
written about—by caregivers, by researchers—than to offer their own
accounts. Her book, in offering hers, joins a small but significant
canon, including Kay Redfield Jamison’s “An Unquiet Mind” and Elyn R.
Saks’s “The Center Cannot Hold,” two books that elucidate the
experiences of high-functioning women whose minds are both their
proudest assets and their biggest liabilities. The latest edition of the
Diagnostic and Statistical Manual, a clinical diagnostic tool created by
the American Psychiatric Association, emphasizes that schizoaffective
disorder portends “a lifetime of illness, and not an episode of
illness,” Wang writes. While some might dismiss this
characterization—indeed, some reject the notion that schizophrenia is a
sickness at all—Wang embraces it: “Under its auspices, I remain a rare
bird who . . . will likely be sick forever.”

Wang is certain of her fragility, but she cannot always parse where it
begins and ends. She begins “The Collected Schizophrenias” with a
meditation on the question of diagnosis. She speculates that her own
psychiatrist, having treated her for years for bipolar disorder, may
have shied away from assigning a different disease: “I believe she was
wary of officially shifting me from the more common terrain of mood and
anxiety disorders to the wilds of the schizophrenias, which would
subject me to self-censure and stigma from others.” Wang deftly
articulates how a diagnosis can shift a patient’s sense of self,
prompting simultaneous confusion and relief. “Some people dislike
diagnoses, disagreeably calling them boxes and labels, but I’ve always
found comfort in preexisting conditions; I like to know that I’m not
pioneering an inexplicable experience,” Wang writes, but she also
wonders about the stability of the identity that one takes on when one
is labelled schizophrenic. “It is easy to forget that psychiatric
diagnoses are human constructs. . . . To ‘have schizophrenia’ is to fit
an assemblage of symptoms, which are listed in a purple book made by
humans.”

Does someone with depression remain a depressive if her symptoms are
kept fully in check with medication and treatment? What about someone
diagnosed with the schizophrenias? (Wang refers to schizophrenia in the
plural to encompass schizophrenia, schizoaffective disorder, and
schizotypal personality disorder.) For Wang, the experience of
schizophrenia is defined as much by the spectre of her symptoms
returning as by periods of actual psychosis. She refutes a line in
Rebecca Solnit’s book “The Faraway Nearby,” about how illness “takes
away all the need to do and makes just being enough.” This “has not been
my experience,” Wang writes. “Prolonged and chronic illness stitches
itself into life in a different way than acute illness does. . . . The
absolution from doing more and dreaming big that I experience during
surgeries and hospitalization is absent during chronic illness.”

Many of Wang’s essays explore how navigating a chronic illness that
brings so much stigma can complicate even the most basic life choices.
What should she wear in order to continue to appear capable, confident,
and mentally sound, even if she’s locked in hallucinations and delusions
or hasn’t had the energy to bathe in days? What movies or TV shows are
safe to watch—that won’t trigger psychosis or dissolve the borders of
her sanity? Today, Wang manages her condition with medication, therapy,
journaling, and a spiritual practice of what she calls “the sacred
arts”: Tarot, divination, candle magic. She no longer holds a full-time
office job—as she described in an essay for BuzzFeed, leaving it felt
like “I surrendered my last benchmark of sanity”—and instead carefully
balances her writing and other freelance work with her physical and
mental needs. Wang is married—another signifier, she says, that she is
high-functioning—but she does not plan to have children.

“The Collected Schizophrenias” is not a memoir, nor does it tell a
linear story about the author. Wang prefers to use her own experience as
a point of departure for philosophical inquiry. In “Toward a Pathology
of the Possessed,” she digests a horrifying story of a violent,
schizophrenic man who was shot and killed by his sister while their
mother waited in the car. She considers the burden that schizophrenia
presents for family caregivers, and what remains of a person, and their
relationships, when their personality has been mutilated by illness.
Both the idea that mental illness destroys the person who existed before
and the question of whether a self exists apart from illness trouble
Wang. Elsewhere in the book, she considers involuntary commitment, the
treatment of mental illness on college campuses, the border between
psychiatric illness and supernatural abilities. Throughout her
wanderings, Wang points readers to a multitude of complicating and
enriching sources, from Nellie Bly’s 1887 exposé “Ten Days in a
Mad-House” to Susan Sontag’s “On Photography” and Marilynne Robinson’s
“Home.” I sometimes found myself wondering if this reliance on outside
perspectives was another way for Wang to reassure herself of her own
competence. She is not just a sick woman with stories of illness but a
woman with a vibrant mind who can do scientific research and formulate
complex cultural criticism, too. The very fact of her book, she seems to
assert, is proof that she can rise above her limitations.

Ambition and achievement are central to Wang’s sense of herself, and
throughout the collection she weighs the possibility that her illnesses
might lead to failure, or worse. In a lovely essay titled “L’Appel du
Vide,” Wang writes about her encounter with the work of Francesca
Woodman, a young photographer known for her self-portraits, whose
promising career was cut short when she committed suicide, at the age of
twenty-two. (Wang, too, is a photographer, and she confides that she
often photographs herself, as Woodman did, when she is at her most
psychically fragile.) Woodman’s demise haunts Wang. Is there something
ingrained in Woodman’s work that explains, or predicts, her doom? And,
by extension, is there a way to divine whether Wang will survive?
Woodman may have cut her losses by ending her life so young, whereas
Wang, who is thirty-five years old, can track the damage that her
illnesses have done over time. “The obliteration,” she writes, “can also
be gradual.”

While reading “The Collective Schizophrenias,” I often thought about the
toll that writing it must have taken on Wang, physically and mentally,
and the bravery it took for her to do it. In one of my favorite essays,
she writes from within the cloud of a particularly haunting delusion,
known as Cotard’s syndrome. For several months and the duration of the
essay, Wang believes that she is dead, trapped “in perdition” and
“doomed to wander forever in a world that was not mine.” Whatever coping
mechanisms Wang had developed up until that point—journaling,
scheduling, articulating goals and “core desired feelings”—suddenly fall
by the wayside. “Ritual, my therapist told me later, would help, but it
was not the solution; there was no solution.” There was no solution—this
is the level of uncertainty, even hopelessness, that Wang lives with.
And yet she perseveres, however imperfectly. It’s Wang’s ability to
reconcile these opposing realities, to allow them to persist in
contradiction, that feels most radical about her approach to being sick.