Wei Tchou | Longreads | April 2019 | 11 minutes (2,983 words)

“I write this while experiencing a strain of psychosis known as Cotard’s delusion, in which the patient believes that they are dead,” the novelist Esmé Weijun Wang writes at the beginning of “Perdition Days,” an essay from her new book, The Collected Schizophrenias. (Read an excerpt on Longreads.) “What the writer’s confused state means is not beside the point, because it is the point,” she continues. “I am in here, somewhere: cogito ergo sum.” The passage moves swiftly, from first person agency (“I am writing”) to distanced third person (“the patient,” “the writer”) to the famous Descartes assertion, in Latin, “I think, therefore I am.” As a reader, it’s astonishing and a little unnerving to consider the immediacy of the prose, your intimacy with a speaker searching to find the correct vantage from which to narrate the strangely drawn, difficult-to-map districts of her mind.

That same authorial compulsion to navigate and survey pervades the book, which is notable for its subject matter alone: a first-person investigation of “the schizophrenias,” as Wang describes the four overlapping classifications of the mental disorder listed by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, often shortened to DSM-5. (Wang was diagnosed with schizoaffective disorder, bipolar type, in 2013.) Wang approaches the work of writing about her mental illness as if she were reporting from a foreign place, returning to it diligently, pursuing dark corners as if to case the joint. She publishes email correspondences between herself and her physician, written in a period of psychosis. She considers her desire for motherhood through the lens of her time as a counselor at Camp Wish, a bipolar youth camp. She recalls scenes from her three involuntary hospitalizations, describing the trauma of those stays, as well as the slippery interviews on which those hospitalizations were based.

Wang is courageous to do this work; it can sometimes be terrifying to read, let alone to live and write. In one essay, Wang watches Beware the Slenderman, a documentary about the 2014 stabbing of a 12-year-old girl by two friends inspired by a fictional supernatural figure who abducts and tortures children. The two girls are driven to the act after becoming fully absorbed by a world created in their imaginations. Later one of them is diagnosed with schizophrenia.

As Wang narrates the Slenderman story, she revisits her own memory of a fraught childhood imagination. Her young mind has been captivated by the world of The NeverEnding Story, a 1984 film depicting a fantasy world that eventually includes its reader in the narrative. Wang describes convincing her best friend Jessica that their life, too, was just another thread in the story, crafting a complicated universe of rules to dictate their time together. “We’re just playing, right?” Jessica finally asks, bemused and a little frightened; Wang’s childhood self disagrees, telling Jessica that the imaginary world was, in fact, real: “With my every denial, she became increasingly hysterical while I remained calm. I watched her leave in sobs; I remained grounded in the world of my imagination.”

Reading The Collected Schizophrenias, a reader finds herself often at this bewildering center of disordered thought, empathizing with a state of mind that has unlatched from its usual anchors of belief and self-awareness, to strange and often unsettling ends. It’s to Wang’s credit that her narrative ability and terrific scene-work situates a reader so fully in the experience of delusion. Given a different set of circumstances, one sees just how such a narratively-gifted mind readily absorbs into a work of fiction, initiates a game that has lost track of what’s real.

The vast and hazy, yet eminently familiar, territory between who a person is and who she presents herself to be.

It’s more common for writing about mental illness to focus beyond the present moment of an illness, to treat a disorder as the conflict of a narrative arc, rather than a plain, if at times disturbing, facet of human existence — Darkness Visible, by William Styron, for instance, or more recently Brain on Fire, by Susannah Cahalan, are narrated after the authors are presumably healed, back to their “normative” brains. It feels remarkable, then, to have access to the present mind of a person diagnosed with a chronic mental illness who isn’t so invested in representing the illness, itself, as the conflict, but rather, what it means for her identity to be anchored in the illness. Subtly, but powerfully, the question pivots from deeply rooted personal experience, What was it like?, to the universally relatable, Who am I?

Wang’s effort to answer that question involves excavating the complicated layers of how others perceive her. The stakes of her presentation are high; she describes the invisibility and dehumanization a person experiences when saddled with the classic stereotypes of schizophrenics: babbling, incoherence, helplessness. To give a wide berth to that invisibility and to achieve a baseline of credibility, she employs a strict routine of superficial markers of success and stability: a tube of red lipstick she applies every day, unless she is catatonic, an impeccable and enviable wardrobe, a company she established and maintains on her own, and a fixation on her tenure at Yale University. (She was hospitalized one semester and not invited to return.) She describes the particularly academic vocabulary she uses when giving speeches to health-care professionals, that it’s meant to curry respect from those who may have preconceived notions of her based on her diagnosis.

When Wang discusses her attention to these markers of achievement, she writes, “I care about recognition as much as I care about my own self-regard, in large part because I don’t trust my self-evaluation.” You might think that these admissions would serve to undermine Wang’s careful image, but in fact, they only underscore just how strange and empty society’s markers for success and normalcy can be, and in turn, Wang’s clarity in parsing the world around her.

Returning to the section I quoted above, written under Cotard’s Delusion, one recognizes the same appeal to observers for self-definition (and self-preservation) when Wang’s first-person report of her disordered state skids into the clinical third-person observation of “the patient,” relinquishing agency over her material self to psychiatric authority. The passage resolves with a reliance on the philosophical authority of Descartes; the speaker reasons out her psychic existence, and by extension, validates her intellectual and cultural worth, her connection to the thinking world.

By this paragraph, it becomes apparent that you are also participating in this bid for recognition, page by page. The precise sentence-craft, the meticulous research and reportage, the book, itself, is yet another arrangement of the self into a recognizable format, dictated by whomever is watching: a psychiatrist, a friend, in this case, a reader.

How unreliable those observers can be! And how destabilizing it must be to feel that in moments of crisis, your identity is resistant to self-reflection and relies, instead, on the authority of others. It’s a complicated position for a memoirist, to say the least. In the end, I suppose The Collected Schizophrenias, is very much a book about place, but not, as I said earlier, a foreign one — instead, Wang’s searching prose lights out into the vast and hazy, yet eminently familiar, territory between who a person is and who she presents herself to be.

*

I admit that I’ve had authority on the mind, lately. Of course, it’s a common preoccupation, given the apparent human tendency to certitude and infallible systems of justice, to classification and definition. We delight in all manner of category: checking items off a list, diligently filling in bullet journals, the rigorous optimization of being. As such, we delight in imposing category on others and on the outside world. (I mean, who isn’t at least little scared of getting unceremoniously “canceled” these days?) More pernicious are the subtle ways we turn that judgement on ourselves.

That is all aggravated, of course, by social media, which simultaneously mimics and condenses these interactions at lightning speed, a few taps here and there throughout your day. Your photographs, your thoughts, your skincare regime, all offered up to be liked or passed over by friends, colleagues, or strangers, trained by their own experiences and by whatever mode of justice is trending at the moment. Our world has become a closed loop of authority, our identities increasingly regulated by wincing external anticipation of others than by some consistent internal whirring of the self.

There was either not at lot wrong or something irreparably wrong with me.

At least, that’s how I find myself often feeling, expansive but rudderless, my gut instincts and intuition a few steps behind input from the outside world, as represented on street ads, on television, by people performing versions of themselves online. I felt this most acutely last year, in the throes of an undiagnosable condition that left me bedridden for two weeks at a time each month during my menstrual cycle, dumbly staring into space as a rectangle of white light refracted onto the wall from my bedroom window. It would slowly arc its way across the ceiling in the morning, honey in the late afternoon light, then finally evaporate into the darkness of the evening. That was all I had the energy to do, really, aside from weep near-constantly, fearful and furious at my newly stupid brain, at how impossible doing any amount of work seemed, how my friendships and my relationship felt as though they were retreating from my grasp.

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I saw five different physicians or psychiatrists for second opinions during this time, each of whom believed there was either not at lot wrong or something irreparably wrong with me. I was told, at different points over the year, that I should cut caffeine, increase caffeine, cut alcohol, cut sodium, take various vitamin supplements, exercise more, exercise less, take on a low dosage of SSRIs during my cycle, take a low dosage of SSRIs indefinitely. I turned to forums on Reddit, whose community members recommended more supplements, exotic tinctures, marijuana, dietary shifts, aromatherapy, acupuncture. There was simply no straightforward diagnosis, given that my symptoms lived in the diffuse realm of fatigue, depression, insomnia, and brain fog, and most maddeningly, lifted completely when my period arrived. My mind would immediately distance itself from its past depressive spells by compartmentalizing it into simply a bad memory. When I felt clear, I would often even question whether or not there really was a problem. Perhaps I’d just has a run of bad days, maybe it was just a particularly bad few months of PMS.

So I had little to show for myself when I arrived desperate and exhausted or lucid and forgetful at the OB. I could barely find a way to describe what my problem was that didn’t just sound like I was just more or less depressed sometimes, as always. All the while, the world spun on without me. I followed along on Instagram and Twitter as others rose with the day, went to work, walked their dogs, observed birthdays, weekends, sunsets. When I was bedridden, it was impossible not to scroll through an infinite timeline of others’ lives and think: that’s what my days should be like, that’s what I should be doing. All these images of achievement and action, that is what life would look like to me, if I were well.

By the time a new doctor had discovered the issue was likely my birth control, I had not only become dependent on authority, I was desperate for it. For someone to offer the right mix of vitamins, the right foods to cut. To tell me I should set my alarm for eight hours a night, force myself to wake up and hop on a treadmill each morning. I wanted someone to say that publishing a little more would make me feel better, that putting on a thin sheen of makeup would open up an entryway back into the world as I remembered it. Left to my own devices, I feared my body and mind would disintegrate into just two watchful eyes, studying traces of light on my bedroom wall, and nothing else. How could I fork over authority to that self who had, for seemingly no reason, abandoned me entirely?

After I had my birth control device taken out, my symptoms intensified for a spell. On a particularly bad day, I quit social media entirely, fed up entirely with how unhappy looking at it made me, despite my mind’s protests. (How will you know what’s happening outside your apartment? How will you stay in touch with friends? How will you make a career as a freelance writer? How will you know what to achieve?) In the absence of online chatter, and the authority of whatever the fuck it means to be normal, I started to feel better, less bothered by the opinions of others, more like myself, even if that self could only manage to take a short walk down the block every day before slipping back home and under the covers. Simultaneously, my body’s reaction to its own hormonal cycle began to evening out, and fairly soon, I was more or less back to my unsick life again, albeit richer with the lessons I gained from what I continue to hope was a temporary illness.

It’s a powerful resolution, though not the kind we’re generally used to.

It wasn’t until I read The Collected Schizophrenias that I connected the temporary alienation I experienced due to my illness, extreme and brief as it was, to the daily act of portioning out my agency to social media, and by extension, to the outside world. But whereas Wang, in her book, describes having little choice but to rely on outside systems of thought and routine and tradition to help her define herself and to keep her grounded in moments of delusion or psychosis, I’d all but enthusiastically shoved my means of self-assessment into the hands of external influences without considering the purpose or effect of doing so — the why of it — anywhere near as carefully as Wang had done. In doing so, I loosened the entire mechanism of what it meant to be myself.

Wang’s book is a revelatory work of memoir that articulates the experience of a member of an often disrespected and marginalized group who must find a way to live with her disability and to reckon with its effects. But I also felt that it was an insightful rendering of a universal human condition. At its heart, The Collected Schizophrenias is an affecting account of the lifelong tension involved in resolving the distance between the individual and the collective, in the equal necessity and cost of forgoing the self for some greater attainment in society.

*

In the end, what I needed most during those months of severe hormonal imbalance was the opposite of what helped Wang, at first, to cope with her delusions: to learn to listen to myself, as unfamiliar as that self seemed at the time. I needed the rest, needed to locate a pocket of peace and spaciousness, even if it meant doing nothing for a while. Attempting to force my body and my mind into structures I’d gleaned from previous experiences or other people only exhausted me more and possibly even extended what was already a trying period.

However, Wang also describes an afternoon in which she is able to see a deck of cards she is shuffling with eyes closed — a brief clairvoyance. She is not psychotic, at the time.

“I decided to further test this ability by holding colored pens, randomly chosen from a pouch, before my shut eyes. The pen test indicated that I could also “see” the colors behind my lids — imperfectly, yes, but well enough to gasp whether I was looking at a light color of a dark one, and I called out the hot-pink one immediately.” It’s frankly shocking to hear a speaker so concerned with reliability, so swiftly move into the realm of magic, of things the rational world, or at least a psychiatrist, would most likely dismiss outright.

From there, she goes on to describe her deepening interest in mystic advisers, students of the “sacred arts” who research the occult and suggest that her periods of psychosis and delusion hold insights for her, encourage her to think of her illness as an ability rather than as a setback. Schizophrenics, according to these mentors, may just be “thin-skinned” or more susceptible to peering out beyond the human realm. Wang, characteristically, reminds readers of her supreme rationality while narrating this section: “Even as I considered that I might be thin-skinned, and therefore privy to otherworldly experience, at no point was I inclined to quit talk therapy or my regiment of psychopharmacological drugs,” she writes. Yet at the time of the writing, Wang reveals that following her interest in the mystical, four years have passed without any major delusions.

We can’t know the answers to the questions raised by the section, but one can’t help feeling that that inaccessibility is in part the point. In a life defined by relying on external authority, how stabilizing for Wang to at last receive something, fleeting as it is, that only she can know the contours of, know to be true. Later, Wang learns to tie a ribbon around her ankle when she feels she is slipping into delusion, into other realms, to help keep her grounded in our human realm.

What that talisman of a thin cord represents, is perhaps, the constellation of new mystical beliefs Wang has cultivated away from what is generally considered “rational” or “mainstream.” What Wang hopes to stay grounded to in her life, only she can know for herself. It’s a stark departure from where the book begins, rooted in the arguably similarly slippery DSM, with its clinical language, attempting to define a singular condition for a general audience. It’s a powerful resolution, though not the kind we’re generally used to — the self retreating assuredly, at last discrete and whirring once again. No need for us anymore to provide rejection or approval.

* * *

Wei Tchou is a writer in Brooklyn whose essays about culture, identity, and food have appeared in The New Yorker, The Nation, The Paris Review, and GQ, among other publications. She is at work on a memoir about ferns.

Editor: Dana Snitzky