According to the Encyclopedia of Mental Disorders, involuntary hospitalization “is an extremely controversial course of action.” In her 2019 book The Collected Schizophrenias, Esmé Weijun Wang steps into this controversy. She presents arguments from both sides. And she offers a unique perspective on the issue, having been involuntarily hospitalized herself, three times.

On the pro side of the debate, sometimes people who suffer from mental illness are in danger of harming themselves or others. Wang tells stories about people who wish to help a family member with mental illness and prevent negative outcomes, but feel unable to cope with the situation on their own. She points out that being a loved one of someone with mental illness can be challenging and, in some situations, can result in feelings of terror. She also writes of her personal desire to retain the option to put herself in someone else’s care to avoid committing suicide, if it ever came to that.

On the con side of the debate are, as Wang explains, “crucial issues of autonomy and civil liberties.” She clearly considers these issues of vital importance, as she brings them up not just in the essay on the topic of involuntary hospitalization, “Toward a Pathology of the Possessed,” but in many of the other essays throughout the book. She writes about many aspects of the collected schizophrenias; the issues of autonomy and civil liberties arise again and again.

Wang’s personal experiences in being involuntarily hospitalized were far from positive. She explains the intense fear of being in a small, unfamiliar place and not knowing when she will be allowed to leave. She explains the feelings of despair that arise from not being able to make simple decisions like when and what to eat. Further, it is very difficult, she points out, to say or do anything in a mental hospital and be believed and taken seriously. Here are her words about the situation:

“I maintain, years later, that not one of my three involuntary hospitalizations helped me. I believe that being held in a psychiatric ward against my will remains among the most scarring of my traumas.”

And here is what she writes about Julian Plumadore, a speaker and advocate for mental health:

“He’s better now, he tells me, because he was finally told that he himself knows better than anyone else what he needs. For him, that included harm-reduction techniques instead of involuntary rehabilitation, as well as estranging himself from his family.”

This rings true to me. It can be hard to watch someone make their own decisions. You want to reach in and make the decisions yourself, to make sure they are the right ones. The trouble is, your definition of right might not be the same as theirs.

When I was in the worst throes of my bout with physical and mental issues, I did not always know on a conscious level what I needed. I relied on doctors, counselors, family members, and friends to advise me on steps forward. But the advice I received was contradictory and irregular. Much of it did not reliably move me toward recovery. It was only when I began to listen to and trust my gut feelings that I found that I could reliably make decisions that helped, rather than exacerbated, the problems.

I do not claim that I always made the right choices. And I continued to listen to others’ advice, take it seriously, and act on it (if I thought it might help). But if I had not retained the freedom to follow my instincts, I would surely never have found my path to recovery.

It’s admittedly hard to justify letting people make their own decisions when there is reason to believe that they might harm someone (self or others). But it’s also hard to justify taking away someone’s autonomy, without which personal improvement is virtually impossible.

Who makes your decisions?

When I was a kid, for some reason a popular discussion topic around the house was whether appearances, social connections, etc., mattered, or whether the main important things in life were personal grits and smarts and such. Ah, the perennial debate!

Nowadays, this doesn’t seem to me like such a debate. To my adult mind, both of these spheres matter. It matters how you develop yourself personally; and it matters how you present yourself to others. Unless you are a hermit, that is. But barring that, it seems to me that both should be given due heed.

Esmé Weijun Wang has something interesting to say about this non-debate. Her 2019 book The Collected Schizophrenias includes an essay called “High-Functioning.” In it, she describes giving talks about living with schizoaffective disorder, bipolar type. Wang has a desire to share her experiences with others, to foster an understanding of people diagnosed with a serious mental illness. However, as she is well aware, it is difficult to talk about having a serious mental illness without calling into question your validity as a speaker.

So she finds ways of establishing validity and winning her audience’s trust. She is careful to drop that she is a writer who was educated at Yale and Stanford. She wears her wedding ring and talks about her decade-and-a-half-long relationship. And she is careful to dress with impeccable style for all speaking engagements.

Wang admits that she has had a longtime passion for fashionable clothes—and for good reason. I love this passage about how she feels about fashion:

“The way 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 offensive: dress like everyone should be terrified of you.”

This makes a lot of sense to me. If who you are, as a person, is liable to provoke mistrust in others, why wouldn’t you do everything you could to appear powerful and in control? On the flip side, if who you are, as a person, is liable to provoke trust in others, why would you waste your time attending to every minute detail of your appearance?

“Dress for success” is a great mantra, in my opinion. Just don’t neglect to also put in the hard work of developing your personal strengths—as Wang has clearly done. Her book is fabulous. It’s well written, extensively researched, and thought provoking. I trusted her completely to give me all the facts: the good, the bad, and the ugly. And the chic.

What are you wearing today?

Schizophrenia runs in my family. To learn more about this mental illness is, for me, a way of trying to understand a piece of my family history. So when I saw a book called The Collected Schizophrenias featured at my local indie bookstore, cute cover and all, I had to buy and devour it.

The Collected Schizophrenias is a collection of essays by Esmé Weijun Wang. Each of the essays puts a different focus on her experiences as a woman living with schizoaffective disorder, bipolar type. The writing is fabulously direct, concise, and honest. This book, like A Mind Unraveled by Kurt Eichenwald (which I previewed earlier this year), does a great job of dispelling common myths about the illness at hand (Eichenwald writes about epilepsy), while offering insights into how to thrive in the face of the illness’s difficulties.

I admire Wang’s strength in writing and speaking about her experiences. Mental illness is still, despite great strides forward in this area, stigmatized. One of the first and most important steps in fighting stigma is to hear and to understand. What is it like to live with schizoaffective disorder, bipolar type? Wang endeavors, in this book, to explain.

It’s important to hear her. Wang points out that most information about the collected schizophrenias is presented from the perspective of an observer witnessing the words and behavior of someone else. For example, referring to a statement as a delusion implies that one does not believe the statement oneself. But the helpfulness of the outsider perspective goes only so far.

What does it feel like to be the person herself? Wang shares a few of her worst times in this passage:

“I’ve seen myself forget to feed my dog. I’ve seen myself remember, and then not care enough to do it. Sometimes I can’t even say more than two words or move. There are periods when I know that my husband has been replaced by an identical robot.”

To fully understand this passage, it’s important take into account the rest of the essay. For the essay is about some of Wang’s worst times . . . and best times. She tells a touching story about serving as a camp counselor for children with bipolar disorder. She was instrumental in helping a boy transform from hating the camp to loving it—from feeling all alone to feeling that he had friends. Here’s a passage about one of Wang’s best times. A camper was feeling sick:

“I told him to try and relax. I stroked his bangs with the palm of my hand. I hummed Chinese lullabies, and the longer I stood and stroked and hummed and whispered, the stiller he became, until he was asleep.”

It is important to remember, about oneself and others, that we all have our good and bad days. A diagnosis is not a life sentence. I don’t think it should be one, anyway. A diagnosis is, or should be, a tool to help people understand some of their personal roadblocks and look for ways to move forward.

I can personally identify with the worst-times and best-times passages. I know what it’s like to have terrifying thoughts along the identical robot theme. I also know what it’s like to sometimes want to reach out and help others, but other times feel removed from any reality except what’s in my head. It is unclear to me whether almost everyone has such thoughts and feelings, or whether it’s in my blood. That second possibility would not surprise me one bit!

On the other hand, reading this book drove home to me the seriousness of this illness. A recurrence of philosophical musings and doubts, even when they become obsessions, is a very different beast than a persistent feeling of utter certainty. Wang notes that on her bad days—which can last for months—she is incapable of doing things that others can easily do on their bad days. She also notes that powerful psychiatric drugs have given her a stability that she would otherwise lack.

But to return to the original hand . . . I suspect that we human beings are a lot more alike than we usually admit.

What are you like at your worst and best?

One thing Anna Burns, author of the prizewinning 2018 novel Milkman, does astonishingly well in the book is to portray the scary, unsettling realities of being young.

So many novels glamorize youth. One can find so many confident youngsters in books. They know how to make tough decisions, they know how to make and keep friends, and they know how to relax while alone. And they never, ever have an awkward conversation—unless of course it’s perfectly staged and thus not awkward at all.

One might argue that all of these well-adjusted kids should serve as good role models for all the less-adjusted kids of the real world. But this will only be true if those real-world kids don’t see through the farce. And this will only be true if the less-adjusted kids are not actually all that different from the well-adjusted ones. For the kid who’s mainly adjusted, but needs a few tweaks, sure. Such lucky kids might be able to see a better version of themselves in the heroic kids in books. But for the kid with big issues—and what kid has no big issues?!—even the most realistic novels can seem like farfetched fantasies.

I am probably biased in this matter, having grown up as one of those less-adjusted kids myself. Not to mention one of those less-adjusted adults. So for me, it is a relief to read a novel that keeps it real in the areas of social awareness, personal awareness, and level of mutual affinity to one’s world when one hasn’t been in it for all that long.

The protagonist of Milkman is an adult, but only barely so. I could very much identify with her social-emotional state at that age, as described in this passage:

“At eighteen I had no proper understanding of the ways that constituted encroachment. I had a feeling for them, an intuition, a sense of repugnance for some situations and some people, but I did not know intuition and repugnance counted, did not know I had a right not to like, not to have to put up with, anybody and everybody coming near.”

(Yes, she is referring to the man who appeared and drove up in one of his cars, as mentioned in my last blog post.)

Before closing today, I would like to mention that the author keeps it real in other ways, as well—most notably as regards politics. While the terms “Ireland” and “Catholic” are not used even once in the book, Burns is brilliant about making her setting clear. The protagonist, against her will, for she’d rather hide within her nineteenth-century novels, is embroiled in all the politics of her place and time. Burns does not sugarcoat the hard truths of this place and time. Additionally, she tells her story with great respect for humanity, in all its strangeness and variety.

How well adjusted were you as a kid? How well adjusted were you as an adult?

The inquisitive one traveled to London. It was going to be an exciting adventure!

While in a crowded street market, the inquisitive one saw some postcards. “I could send these to my nephew and niece!” thought the inquisitive one, as a bunch of people jostled into the back, shoulders, and butt. When the inquisitive one went to pay for the postcards, there was a terrible realization: the credit cards, cash, phone, and passport were all missing!

Instinctively, and in a panic, the inquisitive one ran to that timelessly universal haven for inquisitive types, the public library. Frantically, the inquisitive one Googled what to do when lose passport England USA help! and scanned through some websites. Next, the inquisitive one logged into the email account and composed a message.

Here it must be noted that, due to shock and anxiety, the inquisitive one had been stricken with a psychological disorder! The inquisitive one could no longer distinguish fact from fiction, information from misinformation! Furthermore, the inquisitive one could no longer recall a single rule of spelling, grammar, or word usage! Consequently, the email read as follows:

Not knowing whom to put on the To: line, the inquisitive one sent it to every contact in the address book. Then the inquisitive one waited for a reply.

But no one replied! The inquisitive one kept checking the email for hours, but then, night fell. The library closed. The inquisitive one was forced to scrounge through trash bags for food and sleep in an alley.

The next day, the inquisitive one fell in with a band of drug dealers. But the inquisitive one, having no talent for sales, was not able to make any money. As the days passed, the inquisitive one started to despair of ever again eating something that didn’t come from a garbage bag. But then a fellow drug dealer invited the inquisitive one to, along with him, ditch the drug dealers and join a band of political agitators: which the inquisitive one gladly did.

This was a better situation because the political agitators took tea and crumpet breaks 15 or 20 times daily, which filled the belly nicely. These political agitators were pro-Brexit, or anti-Brexit, or anyway they had a very specific stance regarding Brexit. However, due to their use of incomprehensible words such as queue, quid, lift, and mummy dear, the inquisitive one was not able to determine what precisely that stance was.

Anyway, a few days after that, Fortune smiled even more happily on the inquisitive one: someone replied to the email! The inquisitive one collected $10,000 using the bank information sent by a (wonderfully kindhearted!) acquaintance, whom the inquisitive one vaguely remembered having met a couple of decades previously. Oddly, though, at the U.S. Embassy, the inquisitive one learned that, contrary to what the Internet very clearly stated, such a large sum of money was not required.

While the U.S. Embassy was working on issuing a new passport, the inquisitive one (with wonderfully kindhearted generosity!) gave the remainder of the cash, as well as the bank information, to the good drug-dealer-turned-political-agitator friend.

This friend, the inquisitive one had been astonished to learn, was Hamlet, Prince of Denmark! Well, or maybe he was Charles, Prince of Wales. In all honesty, the accents in this city were so thick that the inquisitive one could hardly understand a word anyone said. Or was he a Nigerian prince? In any case, he was a prince, but he had fallen on hard times and lost his throne. He promised to return all the money, and significantly more, to the (wonderfully kindhearted!) decades-old acquaintance of the inquisitive one, and to give the (wonderfully kindhearted!) inquisitive one a sizable pile of precious stones and jewels, once his throne was properly restored. And it surely would be restored within the next few days, due to the temporary loan of the money in the account!

The inquisitive one, strangely and sadly, lost contact with the prince at that point. But the very next day, the U.S. Embassy issued the inquisitive one a new passport! While the inquisitive one was not able to recover the lost credit cards, cash, or phone, the issuance of the new passport was a truly wondrous occurrence: and the inquisitive one’s anxiety faded away. Knowledge of spelling, grammar, and word usage returned. Also recovered was psychological sanity, including the ability to understand what was real; what was possible but unlikely; and what was rabid delusion.

MORAL: Health is better than wealth; and it’s easier, as they say in the wisest countries, to pass a needle through a camel’s eye, Amen.