We’ll Leave The Gaslight on For You
Listen to Editor in Chief Gabriel Nathan read this post aloud:
If anything is “contra-indicated” in a hospital setting, it’s hugely heavy doors slamming hourly through the night, especially on the psychiatric ward. Experience has taught me that my startle reflex is naturally heightened when I’m overloaded by information and my system is already too overwhelmed to process it all. When my senses shut down out of sheer self-preservation, it feels like every moment some person, place, or thing is sneaking up on me. But alas, innovation is not something that comes easily to the redheaded stepchild of Western Medicine that is psychiatric treatment.
I don’t expect anyone to silence the obnoxiously loud hospital doors any time soon. These days, when I find myself in this overwhelmed state, I no longer expect the system to accommodate me. Rather, THIS is the time I must be the most clever, the most innovative, apply what I’ve learned about what does work for me, and be my own advocate. Ironically, it’s in this time of greatest peril, of genuine vulnerability and cognitive dissonance; in these times which demand I put my trust in others; it becomes ever-so-much more important to trust my own inner, experiential wisdom.
Once the intensity of a mental health crisis has subsided, and one is away from the slamming locked doors, invasive check-ins, and external probing, there is time for reflection. Setting aside self-blame, guilt, and regret, there are periods of calm. I’ve found my evolution of perspective through mindfulness practice has allowed an expansion of these times and for greater insight. In retrospect, my mental illness journey began with the near-death events of my childhood, the trauma of separation, and the sense of abandonment. I merged onto the road to recovery and wellness when I realized there was no one left to blame, no one was going to rescue me, but most of all, every choice I made… I made for myself, they mattered, and the consequences, whether success or failure, were mine to own.
Once I return to the personal sanctuary of my home, I sit and rock in old reupholstered blue velvet and multitask while binging old broadcast crime dramas. In my fantasist’s mind, mysteries are solved in this forty-two-minute miracle space. I luxuriate in this fantasy as I indulge, for a moment, the belief that there is a power greater than myself with all the answers. It is why I buy lottery tickets and why I vote. Not that I expect to be the next lotto multi-millionaire or that the candidate with the most integrity will win, but I feel it gives me permission to indulge in that fantasy… if only for a moment.
One fantasy I inherited from my parents’ generation (and reinforced by each of the forty-two-minute procedurals I binge) is that I could trust professionals to not only know the right thing to do but to do the right thing. Early in my life, I was hospitalized multiple times with pneumonia. Because I had learned to trust the all-knowing professionals, I assumed a belief system of doubting myself and trusting others more. When I became a teenager, there was no one around able to teach me any different. I succumb to one of the most richly popular types of magical thinking: non-denominational, charismatic evangelicalism.
As an aimless teen, I took up with some young adults with these messianic beliefs. I wanted my shortcomings ‘healed’ and mistakes ‘erased.’ The offer of new life was appealing. I didn’t know what I would have to sacrifice to get it. I just knew that it seemed a shortcut to acceptance and to (what seemed to pass for) unconditional love. I followed the lead of so many in this young congregation by partnering with someone whose challenging past had also been seemingly erased. I was nineteen and he was twenty-four. The very best thing that came out of that relationship was hindsight.
My religious indoctrination of patriarchal authority was profound. It served my spouse well, as his childhood trauma at the hand of his own father left severe and deep scars. He developed an antipathy for authority while revealing his own as “house head” (the title bestowed upon the elder male, husband, or patriarch in a household). When he came into conflict with the self-appointed elders, his answer was to abandon the system that propped up his authority & autonomy and resulted in simple raging to get his way and self-medicating to appease his demons. He separated from the church group, but not from the value system that touted female subservience. More out of fear of my inability to support myself and my children independently than out of love or devotion, I separated from the group, too.
There is no magic in my escape from an abusive environment or the mindset that kept me there for twenty-one years and produced four babies in quick succession. Whether in my marital relationship or blind devotion to this church dogma that touted female inferiority and subservience, the insight that led to my realization of their deceit, fallibility, and exhaustive gaslighting meant to insure dominance was painstakingly gradual. My enlightenment evolved as my gullibility-based adherence devolved. It was fear that kept me cloistered there and that fear was reinforced by the falsehoods about mental health, obligation, parenting, heaven, hell, and a fear of acknowledging my true authentic self. But most damaging of all was that letting others interpret the world for me stymied my self-expression, self-discovery, and self-awareness.
Although my four charming adult children may disagree that anything good came out of it at all, I was secure in the knowledge that there were so many good lessons gleaned, I’d never have to do that again. Twenty-one years is a long time to complete one course of study, but I did “graduate” (with diploma-esque divorce decree) and was able to move on, away from religiously-imposed doctrines of submission to assumptive authority, of invalidation, and institutionally justified abuse. However, with the implosion of that relationship and my Cinderella mindset came a hideously crippling depression and gravitating toward another sphere of influence I hoped would have the answers and the magic. It was a period, as in Dickens’ Tale of Two Cities, “…the best of times. … the worst of times,” as my divorce was liberating, but left me no one to blame or scapegoat for my problems. It was a painfully challenging period of accountability… but in that, a door of enlightenment opened.
An old tried and true saying goes, “If it sounds too good to be true… it probably is.” I think my experience with “marital bliss” and “church life” were good examples. However, from where I now stand, I know they were an integral part of my life’s journey and I regret neither of them. I learned that skepticism is an enviable quality and naivete a dangerous state that can and is often weaponized. I learned to listen to my conscience, honor my gut, not hesitate to question assumed authority, and as the late actor and screenwriter, Ruth Gordon said, “Never, under any conditions, face the facts.”
A white-coat aversion grew from my heinous childhood treatment by well-meaning health practitioners, but when my marriage ended and without a support system, my depression was so debilitating I had to seek help. I was offered hope in the form of pharmacological, “magic bullet” solutions. Side effects, interactions, and withdrawal symptoms emerged. I was led to believe they were manifestations of my diagnosis of bipolar illness, not significant information from a mind crying out for a less harmful solution.
My first psychiatric hospitalization was Super Bowl weekend 1997, three months after my separation and two months before my divorce. My primary care doctor had referred me to a psychiatrist for an assessment the previous September. He’d offered a prescriptive alternative and urged me to return to work as a “structured” environment, he suggested, was helpful. I lost count of my hospitalizations, sub-acute stays, and ER visits over the next few years that followed as I returned to college. Most of the next ten years are bound up in blurry reminiscence of numerous therapists draped in the standard “how does that make you feel” verbiage who’d come and go, and the prescriptive bottles of empty promises offered by psychiatrists and nurse practitioners.
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Time and again, when I’d tell a healthcare partner about an issue I was having, whether hypo/hypersomnia, knee pain, migraine, impulse control, restless leg, or inordinate libido, it was attributed to bipolar disorder, being heavy, aging, and in some instances being peri-menopausal. When those excuses didn’t jive, the condition was simply labeled “idiopathic.” I hate cop-outs, and “idiopathic” is the Western Med version of that. Never did any one of a litany of providers suggest I could be suffering a side effect or interaction from anything on the laundry list of medications I dutifully swallowed daily. And so it went for a dozen years; in and out of hospitals, and in and out of functionality. The answer was inevitably, “I have a drug for that.”
After a time, I lost my faith in the magic of Big Pharma, just as I had with quasi-organized religion and my abusive spouse. There seemed no magic little pill, jagged or otherwise, that was going to bring me peace. Nevertheless, just as the churchy folk and my former spouse tried to convince me to believe and have patience with the process, I got to the point where I had to question my need to be spoon-fed answers by others. One after another, these well-meaning, all-too-human Lucys would pull the wellness pigskin out and my Charlie Brown gullibility would land me flat on my back. And like Charlie Brown, I continued to hope against hope, faulting myself, questioning my own better judgment, insanely repeating the same behavior, and expecting a different outcome.
When my own children cast their most-kind aspersions about the cowardice of not leaving their father earlier, I am now well aware of the reason and do not take their criticism too seriously. Just as I lacked faith in my own self, it was exacerbated by fear… mostly fear of being deemed a failure and, therefore, unacceptable, unwanted, and disposable. It reminds me of the time when I couldn’t have been more than four, a nurse to whom I’d been disagreeable pointed outside the hospital window at some smokestacks and told me THAT was where children go who don’t get well. Fear is a dynamic motivator. But, I would suggest, not the best one for small children and the mentally ill.
In 2015, I realized I had to do something. My mood had been stable for some time, but on the rare occasion what I perceived as symptoms occurred, it usually happened after I had inadvertently missed a dose of medication for some reason (nausea, oversleeping, forgetfulness or just a busy day). It dawned on me that what I experienced might not be symptoms of my diagnosed illness but rather sudden withdrawal symptoms (which proved to be the case). I conferred with both my primary care doctor and my psychiatrist. I knew it would be a challenge to find alternative methods of addressing my various symptoms, but my intention was to do that, to apply awareness and active accountability. It seemed to me that it happened overnight (tapering off all the medications I was on), but it is true that objects (and memories) are larger than they appear in the rearview. It actually took three years to rid myself of pharmacological interventions and for my body to adjust to life without chemical mood stabilizers, proton pump inhibitors, antidepressants, statins, anti-coagulants, synthetic thyroid hormone, antipsychotic and soporific drugs. No more magic in a bottle, I thought. No more smoke and mirrors.
The process was tedious, life-altering, but liberating. Not unlike my divorce from my abusive spouse, it opened a whole new world, yet again, of awareness and accountability. The need to acknowledge early symptomatology, discover and implement strategies to intervene, and maintain my Family of Choice (those who support my wellness efforts and whose judgment I’ve grown to trust).
I was mistaken. In 2018 I took a job that provided an opportunity in which I excelled. My mind was clear and I felt both assured and assertive. When my supervisor changed, we were at loggerheads about my work style and I reacted to her assumptive authority. In retrospect, the constraint I felt by having my judgment called into question was reminiscent of the gas-lighting I’d experienced in the past. After a few months, I relapsed with cognitive impairments, impaired executive functioning, debilitating fatigue, and tardive dyskinesia (involuntary muscle movement, a recurring side effect of psychotropics that manifests as part of this cluster of symptoms) and was hospitalized, where I was offered more magic bullets.
Providers were incredulous when I told them I had been functioning well for nearly two years without medications. I dutifully complied, albeit reluctantly. Though somewhat resentful and reluctant at first, this time, however, I was the one making the decisions, informed decisions. Being off the psychotropics for nearly two years had given me a much clearer head and the ability to delineate between symptoms and side effects. My perception of my healthcare team members (outside of the hospital) was one of supportive partners, not overseers with an agenda prescribed by Big Pharma sales reps. And my perception of self had evolved, too. I was hell-bent on researching medications that were prescribed/recommended, diligent in maintaining awareness and documenting changes, however subtle or insignificant they seemed.
During the week I was there, there were three occasions when I collapsed and was unable to move. In this catatonic state, I could hear everything going on around me, but I could not move my limbs, open my eyes or speak. On one occasion, a nurse found me sitting on the bathroom floor, my back propped up in a corner. She yelled at me, but I could not respond. She called an emergency response team who shot me with Narcan, assuming I had somehow gotten opioids on the psychiatric ward. They pounded on my sternum and pinched my calves to the point of bruising, but could get no reaction. I’ve never been so vulnerable, so terrified, and felt so victimized. “This,” I thought to myself, “must be what it feels like to be buried alive.”
After three hours of tests, including a CAT scan, I was delivered to the cardiac ward. A night nurse covered me with a warm blanket and offered reassurance. Within fifteen minutes, I was fully functional again. The cardiologist was incredulous until I told her all that I had heard/experienced while I was presumed to be unconscious. It would be over a year before I would learn that these seemingly idiopathic events (which re-occurred with increased frequency) were caused not by a PTSD dissociation brought on by stress or a neurological anomaly, but were in all actuality an adverse reaction to a simple, everyday beta-blocker. Had I not forgotten to take that medication one day, and not experienced a seizure (which was happening multiple times a day by then), I would never have known. No one seemed willing to fault the pharmaceutical, despite my having a history of rare and severe adverse effects from commonly prescribed medications.
Since that discovery, there have been others that border on malpractice. I have to remain vigilant. I have to trust my experience, my gut, and my intuition. Equally, I have to stay educated and maintain a support network (my “Family of Choice”). Our bond requires that we trust each other and honestly call each other on our shit. I’ve tried this with healthcare providers, but there is such a fear of litigation if responses are vaguely noncommittal. It seems the only way to dim the gas-lighting is to first realize that, like the startlingly heavy clasp of the hospital door breaking the stillness, it will annoyingly abide. Nevertheless, faith in my own enlightened self-awareness and willingness to own my own shit; having comrades who know me inside and out of functionality and dysfunction… I now see clearly through the gas-light into the brilliance of hope.