The Loony-Bin Trip
Conclusion
by Kate Millett
I wrote The Loony-Bin Trip between 1982 and 1985. The last section was written first, in a hangover of penitence and self-renunciation, that complicity with social disapproval which is depression. Now, when I reread it, I find something in it rings false. True, it describes depression: the giving in, the giving up, an abnegation so complete it becomes a false consciousness. But typing it over I want to say, Wait a moment---why call this depression?---why not call it grief? You've permitted your grief, even your outrage, to be converted into a disease. You have allowed your overwhelming, seemingly inexplicable grief at what has been done to you---the trauma and shame of imprisonment---to be transformed into a mysterious psychosis. How could you?
I was trying to find my way back. Out of the unendurable loneliness of knowing. Acceptance. I could not bear to be the only one anymore. I could not pit my truth against so many, against the power of science, nor could I live without other people. I surrendered my understanding, lost myself trying to survive and accommodate. And I went on taking lithium. It seemed a condition of parole: if I stopped taking it and were found out I might be confined again. A sort of Pascal's bet: I was terrified that without the drug I could plummet again. What if they were right after all? My own mind was too dangerous.
For years the urge to break free of lithium tugged at me, but my fear of consequences was too great: another fall, another capture? Then I was invited to attend a conference of the National Association for Rights, Protection, and Advocacy, professionals recently authorized by the federal government to protect the rights of persons with "mental illness." There is a liberal faction within the Association that has consistently permitted the veteran organizers of the anti-psychiatric movement to attend and to speak out. I met them and was able to connect finally with others of my own persuasion, to discover their energy and support. I went to a few more conferences, still on lithium, deploring aloud the system and its drugs but in secret taking lithium, hedging my bets, maintaining my crutch, aware of bad faith, but frightened.
Finally my comrades Paul and Dayna asked me if I was on drugs. The movement attitude is tolerant: take them if you like; if you want to withdraw there is help and support. Dayna had withdrawn from lithium several years before. She told me to "drink lots of milk, don't get over tired, have faith, and tell no one." Paul and Dayna would be the only ones to know; they'd call me every Sunday night and I'd report.
In fact there was never anything to report. In 1988 on my birthday, September 14th, I took 600 mg of lithium instead of the usual 900, going below the therapeutic level for the first time. On January 1st, I reduced it to 300 mg, and on March 15, daring the Ides of March, I went to sleep for the first time in seven years having taken no lithium at all. Nothing happened. Nothing ever happened. None of the anger I had feared; indeed it seemed that lithium had created a stifled fury in me for years which abated and then fell away. To my surprise I had a new patience now, and serenity, was more tolerant and open, even able to fall in love again. And this time I kept my secret.
Over a year went by without incident. I still kept mum. Then one day when Sophie was visiting the farm--a flourishing place now, our trees full grown and our harvest at last able to support the art colony--it seemed the right moment; there was a great harmony between us. "I've been off lithium for over a year now, Sophie." The astonishment in her face, then relief. "What happened?" "Nothing, that's it, nothing." And then we laughed and the laughter freed us. She shook her head: had it all been for nothing?
The psychiatric diagnosis imposed upon me is that I am constitutionally psychotic, a manic-depressive bound to suffer recurrent attacks of "affective illness" unless I am maintained on prophylactic medication, specifically lithium. For a total of thirteen years I deadened my mind and obscured my consciousness with a drug whose prescription was based on a fallacy. Even discounting the possible harm of the drug's "side effects," it may seem little consolation to discover that one was sane all along. But to me it is everything. Perhaps even survival: for this diagnosis sets in motion a train of self-doubt and futility, a sentence of alienation whose predestined end is suicide. I have been close to that very death, remember its terror and logic and despair. One struggles to forgive the personal betrayals, just as one must come to analyze the forces that hemmed one in. But it is essential not to forget. In the remembering lies reason, even hope and a saving faith in the integrity of the mind.
It is the integrity of the mind I wish to affirm, its sanctity and inviolability. Of course there is no denying the misery and stress of life itself: the sufferings of the mind at the mercy of emotion, the circumstances which set us at war with one another, the divorces and antagonisms in human relationships, the swarms of fears, the blocks to confidence, the crises of decision and choice. These are the things we weather or fail to, seek council against, even risk the inevitable disequilibrium of power inherent in therapy to combat--they are the grit and matter of the human condition. But when such circumstances are converted into symptoms and diagnosed as illnesses, I believe we enter upon very uncertain ground.
The entire construct of the "medical model" of "mental illness" -- what is it but an analogy? Between physical medicine and psychiatry: the mind is said to be subject to disease in the same manner as the body. But whereas in physical medicine there are verifiable physiological proofs--in damaged or affected tissue, bacteria, inflammation, cellular irregularity--in mental illness alleged socially unacceptable behavior is taken as a symptom, even as proof, of pathology. (There are exceptions to this: brain tumors, paresis [tertiary syphilis], Huntington's chorea, and Alzheimer's disease--in each of these there is indeed physical evidence of cellular damage. However, these conditions are not what we mean by mental illness. What we generally mean--schizophrenia, manic depression, paranoia, borderline personality disorders, and so forth--are all illnesses which are established upon behavioral and not physical grounds). Diagnosis is based upon impressionistic evidence: conduct, deportment, and social manner. Such evidence is frequently imputed. Furthermore, it may not even be experienced by the afflicted party, but instead be observed by others who declare such a one afflicted.
For in the case of "mental illness," the petitioner for treatment is very often not the one said to be afflicted, but someone else altogether. Commitment laws are so written that the afflicted shall be deprived of judgment on the application of next of kin in conjunction with psychiatry. Their purpose is to deny the allegedly ill person the legal entitlement of any and all rights, civil, constitutional, or human. This is unlike anything we know of in physical medicine, where the prevailing attitude is compassion and respect. In fact, the mental hygiene code, modeled originally upon the criminal code, binds the afflicted party under every method of legal restraint. The afflicted is in a sense one accused, hospitalization constituting a type of arrest, accompanied by police power and physical force both in seizure itself and in detention, where escape is prevented by locks and bars and prohibited by statute as well. Having committed no crime, one can--while drugged and unable even to comprehend the proceedings, without even counsel of one's own choosing--within a routine five-minute hearing lose one's liberty for an indeterminate period, even for life. Without the right to refuse "treatment," a human being is defenseless before such proceedings.
Indeed the involuntary character of psychiatric treatment is at odds with the spirit and ethics of medicine itself. The historic brutality of the methods of psychiatric treatment is well known--chains and manacles. It continues today in routine therapeutic treatments, such as "four-point restraint" (whereby a person is bound with leather wrist and ankle cuffs to a bed or table for days at a time) and the solitary confinement of "isolation" or "quiet" rooms. Such involuntary treatment takes on the character of control, even of punishment. Even worse are the stupefying effects of drugs and of fearsome devices like electroshock machinery. It is difficult to discount the hostility inherent in such course of "treatment," used on people who are, after all, incarcerated and helpless. Together with the shame and stigma felt on all sides, the general embarrassment and ridicule associated with the affliction of "madness," it makes the pretense that we are dealing merely with illness and healing quite untenable at last. Far more obvious is the fact of social control, the threat and consequence of a divestiture of human rights and the use of force.
Ethically, and eventually legally as well, there is finally the issue of the Hippocratic Oath: one shall do no harm. The "medical model" of mental disease has taken a terrible toll on the bodies of its victims as well as on their minds and emotions. Throughout the world millions of persons now suffer from tardive dyskinesia, an iatrogenic disorder of the central nervous system brought on by the ingestion of toxic substances, the neuroleptic and antipsychotic drugs prescribed as medication. Tardive dyskinesia is an irreversible condition, resulting in (among other injuries) involuntary spasms--physical disfigurements that stigmatize and often isolate the sufferers, minimizing social interactions and opportunity. Tardive dyskinesia is produced by the entire family of neuroleptic drugs: Thorazine, Stelazine, Haldol--substances derived ultimately from chlorine and coal tar. Lithium presents a threat to the kidneys and the heart. The Physician's Desk Reference, by merely reprinting the warnings of the pharmaceutical companies themselves, makes grim reading about any psychotropic drug. It is difficult to understand how anything this physically harmful could continue to be prescribed, even for an offending mind. Mens sana, in corpore sano.
Why should one of the thousands and hundreds of thousands who have known the pit and the betrayal--the fear of madness or madness itself--not tell of it? Break the taboo of respectability which has been broken so seldom. Challenge the system that keeps millions in line. Try to explore the region from whose bounds only silent and censured travelers return.
I wrote The Loony-Bin Trip in part to recover myself, my mind, even its claims to sanity. But in hope as well that I might relinquish that conundrum--sanity/insanity. Somehow avoid that trap while trying to find out the truth: what did happen that summer--the summer at the farm in 1980--and that autumn in Ireland? What light from there back to that other time, the first time, in 1973; that summer, that autumn? The winter following in each case the nadir of depression, the hope of suicide, the death in life. I wrote The Looney-Bin Trip to go back over the ground and discover whether I did go mad. Went mad or was driven crazy--that differentiation. But it is not so cut and dried, cannot be. And if I did go mad, even acknowledging latitude and overlap, then what was madness, the irrational, what was it like? Experientially, rolling back the secret and shame, remembering.
Writing these last words in Paris, sitting before the perfect window, number 60, rue de Seine, looking out over the tile roofs of the city, my eyes delight in the spire of the Sainte Chapelle, chapel of the medieval kings of France, an amazing ornate sculpture, a great work of imagination. Focusing upon it I bring together my own experience and that of the multitude who like me have known the cruelty and irrationality of this system, that I may plead for a new respect for the human mind itself, its reason, intelligence, perception, acumen, and logic. Let there be no more forced hospitalization, drugging, electroshock, no more definitions of insanity as a crime to be treated with savage methods. No more state intervention into grief or ecstasy. Let sanity be understood to be a spectrum that runs the full course between balancing one's checkbook on the one hand and fantasy on the other. Possibly higher mathematics as well. At one end the humdrum but exacting work of the mind, at the other, surrealism, imagination, speculation. In the center there is occasionally a balance between logic and the creative forces, which generally tend to fall upon the wilder side; metaphor, simile, parallelism, abstraction, all along a median range. To one side reasoning, equations, expository prose. To the other, theater, painting, déjà vu, recollection. A spectrum. A rainbow. All human. All good or at least morally indifferent. Places within the great, still-unexplored country of the mind. None to be forbidden. None to be punished. None to be feared. If we go mad--so what? We would come back again if not chased away, exiled, isolated, confined.
It is well we say "go" mad, for it is a place--inasmuch as it exists, what little "madness" there is, what has not simply been manufactured out of other things; social controls, family disagreements, lovers' quarrels, professional interests and advantages, the state's ambition to control private life. What little madness one can still extract from simple eccentricity, the "inappropriate" offenses of deportment--like hippies at high mass or punk costume at state functions--since what passes for crazy in one situation is only "crazy" in another. Say then, that there is still "another country" in consciousness. Visited in drugs. Willingly and for fun. Or unwillingly and for nightmares; for we are in technique only at the beginning of negative pharmacology, and its nefarious uses still only in the "seminal" stage and not yet the plague they can surely become among us in an age when torture is revived and institutionalized--unless they are stopped. Forced hallucination, forced delusion. Enforced "insanity," insanitas itself, because a deliberate sickening of consciousness and perception.
But madness? That small remnant of altered consciousness, pure or in response to circumstances. Circumstances of life, even those of the body itself and its chemistry. How cruel and stupid to punish this as we do with ostracism and fear, to have forged a network of fear, strong as the locks and bars of a back ward. This is the jail we could all end up in. And we know it. And watch our step. For a lifetime. We behave. A fantastic and entire system of social control, by the threat of example as effective over the general population as detention centers in dictatorships, the image of the madhouse floats through every mind for the course of its lifetime. More mysterious that the thief in the night, the hit-and-run driver. It is death, but death in life, entombment, burial while alive. Only the fortresses of the ancien régime rivaled the entirety of this capture. Or certain places nowadays, private houses on certain streets in certain countries we know not of. But the madhouse lives for us all.
It waited for Jonathan Swift's great mind to "break," to "crack," to be lost. I have escaped his imprisonment, but I have no more lost my mind than he did. Only my freedom. How tragic that he never recovered his, the great mind in chains for years, a dog collar around his neck. We do not lose our minds, even "mad" we are neither insane nor sick. Reason gives way to fantasy--both are mental activities, both productive. The mind goes on working, speaking a different language, making its own perceptions, designs, symmetrical or asymmetrical; it works. We have only to lose our fear of its workings. I do not speak of Alzheimer's disease or any other condition where the mind's function itself appears to be hampered. I mean plain old "insanity." And I say it doesn't exist.
Madness? Perhaps. A certain speed of thought, certain wonderful flights of ideas. Certain states of altered perception. Why not hear voices? So what? If you break a window, you pay for it; break a law and you see a cop, a lawyer, and a judge, pay a find or go to jail. But surely it is the law of Thought Crime to forbid, punish, or incarcerate different thoughts. Mental activity at the margin. Or over the line. We do not know the mind. Yet. We have forbidden much if not most of human activity, from sexuality to science and learning or thinking aloud, through the greater part of our history. Now we have, through technology, the capacity to forbid and enforce still more.
Unless we stop. And jump--actually jump--right past our superstitions. Craziness. Insanity. Still worse, psychosis, episodes, disorders, and so forth. Let the mind be free. Thought. Talk, expression, exploration. That at least, where so little else is free in this short and so often miserable life. Bring down the madhouse, build theaters with its bricks, or playgrounds. Let us leave each other "alone." No longer meddled with, we can muddle through without interfering relatives or state psychiatry. The human condition is helped best by being respected.
Let us stop being afraid. Of our own thoughts, our own minds. Of madness, our own or others'. Stop being afraid of the mind itself, its astonishing functions and fandangos, its complications and simplifications, the wonderful operation of its machinery--more wonderful because it is not machinery at all or predicable. As ingenious and surprising and uncertain of result as the first stroke of a painting, as various in possibility. As full of ornament and invention as the spire of the Sainte Chapell outside my window. a really crazy steeple full of frills, and balls, and cuckoos.