Memoirs of an Intermittent Madman

My name is Michael Kelly Jones, I shall pretend, as I did many years ago in a book called Brainstorm, and the writer whose by-line appears on this declaration is serving again, as he did then, as my ghost, my alter ego and guardian of my identity.

In Brainstorm, I described an astonishing experience I had gone through in the summer of 1940, when I was 27. Six and a half years earlier, I had married a slightly older woman because I had got her pregnant and was unwilling to let her have an abortion. It would have been her third or fourth. The entire marriage was beset by conflict of frequently violent intensity, but it lasted as long as it did because of my sense of responsibility for our daughter. I began drinking much more than I did customarily and treating my hangovers with bromides, spirits of ammonia, large quantities of black coffee and sniffs of Benzedrine inhalant. Meanwhile, I found myself undergoing a marvelous transformation. I became charged with mounting feelings of well-being, with greatly increased energy and with intimations that I was gifted with supernatural powers and insights into the secrets of the universe. My mind conceived ideas and received impressions with extraordinary ease and lucidity. My body became superbly light, agile, athletic, instantly responsive to my will. At first tentatively, then with mounting conviction, it came to me that I was soon to be revealed as a new embodiment of Jesus Christ, or else that I was a reincarnation of Joseph, who would father a new Christ child--or maybe a large brotherhood of them--under a new dispensation that would allow men and women to enjoy physical love with one another as freely as they chose, demonstrating that the doctrine of Immaculate Conception was simply a symbol for the miracle of all procreation. Out of the hell of my marriage, I was guided through stretches of purgatory, then into and out of enclaves of paradise, and finally to what I took to be an academy where my resurrected being would be given scientific study and final training for its divine mission.

It was, in fact, the psychiatric ward of a large county hospital. During the week I was held there for observation, I was given frequent doses of paraldehyde, a fierce-tasting, fiery liquid related to alcohol and ether that was then routinely given to alcoholics as a sedative and hypnotic and that had the effect on me of a triple shot of superbooze. At the same time, the skillful, humoring nurses, attendants, psychologists and psychiatrists sustained my fantasies of rebirth and divine inspiration. When, at the end of the week. I was brought before a judge, I fervently agreed to my commitment to a state hospital, certain that I was being moved up to a higher level in God's hierarchy.

On the night of my admission to the state asylum, I was smoking a cigarette in the toilet when another inmate set off a thunderous slamming of doors in the corridor and then retreated to his room. Four uniformed screws rushed into the toilet and accused me of making the racket. When I denied it, one smashed me across the mouth with the back of his hand. I protested and all four joined in--throttling me, slugging me with their fists, knees and feet, dragging me along the hall and lashing me to a bed under a canvas restraining sheet.

After that beating, perhaps partly as a result of it, my messianic delusions began to diminish steadily and within a week or so had disappeared. I spent the next six weeks in two wards containing a total of 60 or 70 miscellaneous inmates. Among them were two boys of no more than eight or nine--looies, in hospital slang for luetic patients, whose central nervous systems had been permanently blasted by congenital syphilis. A few senile dotards. Others of intermediate age who showed pronounced signs of derangement and alienation. But these were a fraction of the total number. The majority were dried-out drunks, failures at suicide and losers in marital or familial strife. We were the sort of community of the displaced one might find in an Army barracks, a prison or a concentration camp. We played cards and bitched about the miserable food and the regimented routine. We exchanged guesses about how long we might be in for, and one of us spoke for many when he said, "The first thing I'll do when I get out is get myself a quart of rye and a yard of snatch."

Over the next few weeks, in separate interviews with two staff psychiatrists, I was told that I had undergone a psychotic episode, of the "manic-depressive" type. The first of these interviewers told me that I should have been discharged from the first hospital and not committed to this one. He added that my domestic situation had undoubtedly precipitated my breakdown and that I should not think of returning to it. His superior, however, who had final say in my disposition, pontificated: "You've made your bed, now you must lie in it," and continued, "We will not consider you completely cured until you are ready to make the best of your marriage."

My "mental illness" might have continued "uncured," and my imprisonment indefinitely prolonged, if my situation had not allowed me an alternative: release in the custody of my mother.

On my release, I sank into profound gloom and despair such as I had never before experienced, and that lingered for many months. The doctors at the asylum had not prepared me for this reaction and I got no usable advice on dealing with it from the thoroughly misnamed "mental-hygiene clinic" to which I was obliged to report for periodic checks during the following year. What I was able to learn about my "illness" in that time came entirely from books on abnormal psychology I found in the public libraries. Furtively I read every reference to manic-depressive psychosis, fearful that others would see what I was reading and identify me as one who bore the stigmata of that disease. The descriptions of symptoms seemed close enough to mine to corroborate the diagnosis, though as I read accounts of other disordered states, elements of them also applied to what I had experienced. And I recalled that a psychologist at the county hospital had said of me to a nurse, in a marveling tone, "He's everything--catatonic, manic-depressive, paranoiac, schizophrenic." (Later, when I revisited the county hospital and got permission to see my case record, I read the notation, "Final diagnosis: schizophrenic-catatonic. Improved." At the time of my visit, a new director of the county hospital revised the record to read "cyclothymic with episodes.") Altogether, though, the texts convinced me that the extraordinary delusions that had arisen in my mind and the extraordinary behavior they had impelled were not the awesome and inexplicable phenomena I had at first taken them to be but typical manifestations of a distinct and quite ordinary "mental illness," less prevalent than schizophrenia, less severe in its effects and with a higher incidence of spontaneous recovery. I found no explanations of its causes, beyond a general agreement that they were to be found in early psychological conditioning and that a psychotic episode might be brought on by stressful, "precipitating" events. As to treatment, I learned that some authorities recommended psychoanalysis or "psychotherapy" of other kinds; others advocated shock treatments with insulin or Metrazol--later electricity--in both the elated and the depressed phases. The doctors at the county hospital had wanted to give me shock, but my wife and mother had withheld the necessary permission. From what I had seen of others' reactions to it, I judged that the beating I had been given might have produced a comparable effect.

By the time Brainstorm was published, at the end of 1944, I had been satisfactorily employed for three years, had remarried and had visited a young Adlerian psychiatrist every week or two for about a year, in search of clues to what had disordered me and advice on avoiding a recurrence.

During those three years, I found that my crack-up had heavily stigmatized me with some social and professional acquaintances but that others did not hold it as a blight on my character and ability. I continued my in-and-out career as editor and writer over the following six or seven years; my second wife bore us two children; I bought a house in the suburbs and I achieved the respectable preinflation salary of $12,000 a year.

During the second year of this marriage, I went through a second course of psychotherapy, with a renowned psychiatrist and author. It lasted approximately a year and seemed to have helped me "adjust" to sexual and emotional incompatibilities that had developed between my second wife and me. However, by the time our second child was born--a daughter, in 1950--and increasingly thereafter, my wife had extraordinary difficulties in her relations with our three-year-old son and virtually refused to have intercourse with me; or, when she grudgingly allowed it. wouldn't respond to my most gentle and prolonged lovemaking.

At last. I entered into a love affair with another woman. At the same time, my immediate boss was planning to launch a publishing venture of his own--enlisting my clandestine aid, while contriving for a younger protégé of his, a step below me on the masthead, to succeed to the editorship when he resigned. Once again, I assumed that I was to blame for the troubled nature of my relationships and began a third course of head candling, this time thrice-weekly sessions of modified psychoanalysis with a young lay practitioner of a revisionist Freudian school. Although he prefaced the course by saying he would make no "value judgments" of my confessions, he ultimately pronounced some memorable ones, among them: "Your prick belongs in your wife." That statement, along with torments of conscience resulting from puritanical influences in my childhood, led me to break off the affair. I tried to return to my wife and to behave as a responsible executive and family man. I failed, again, and resumed the affair.

In the final pages of Brainstorm, I had confidently declared that if the premonitory signs of another "manic" seizure ever arose in me, I would be able to recognize and subdue them. This confidence seemed validated on two occasions, when I was under stress and drinking more than I could tolerate. On the first of these occasions, in the year before my second marriage, I experienced hallucinations and delusive thought, and on the second, some nine years later, less pronounced alterations of consciousness that I nevertheless recognized as ominous. The first time, I was able to arrest my course by giving up drinking and getting away from the incentives to it for a week. The second time I did it by getting off the sauce and onto phenobarbital for the first few nights of drying out.

Then, a year later, during a walk in the country on a lovely fall afternoon, my two-year-old daughter riding on my shoulders, I experienced a sense of rapturous unity with the universe that made me believe I might be off on another "manic" flight. I disclosed my fear to my wife and, by telephone, to my analyst. My wife reacted with such panic that our family physician was unable to calm her except with sedatives. My analyst assured me that my feelings of well-being were evidence of a genuine "rebirth." Between the anxiety my wife's panic raised in me, the continuing conflicts that I was involved in and my analyst's encouragement of my illusions, I was impelled to pursue my escape course until it ended with my capture and imprisonment.

This time I underwent ten days' observation in a suburban county hospital and then was transferred to a private sanitarium. To preserve its tax-exempt status, the institution waived its customary fee of $250 a week for one or two favored patients at a time, and through the influence of my boss (by then my ex-boss), I was granted a full scholarship. The subterranean admission ward, lined with barred cells in which we newcomers were lodged, was a worse hellhole than the state asylum had been. But I was soon moved to one and another of the upstairs wards, where I found myself among groups of 20 or 30 displaced gentlemen of whom only three or four appeared more than mildly distraught, living as captives in a celibate country club. There were two types of therapy: hydro- and occupational. The first consisted of high-pressure hosings, very hot and very cold, administered by an avid water gunner who deployed his healing tool with the zeal of a riot-control trooper. The second involved such traditionally sovereign pyschiatric remedies as basket weaving and clay modeling. My doctor tapped his palms together as he talked, as though inviting one to a game of patty-cake. It would have been, I thought, as meaningful as our verbal exchanges.

My commitment by judicial order made it possible for my detention to be prolonged indefinitely. After two months--which I considered then and still do almost entirely unjustified by any psychiatric consideration--my custodians wanted to extend my scholarship for another month or more. At that point, I managed to speak with a state inspector who was making his annual tour. I was released at once. But I was a parolee for a year afterward and forced into a reconciliation with my wife. I felt--as I had 12 years before--that I suffered from an "illness" that originated in my own psychological flaws and must now "adjust" if I hoped to remain at large in the sane community.

So I tried. But this second breakdown had rendered me virtually unemployable. I went back to free-lancing, but even in my best years I could earn no more than half my previous income, which had, at its highest, never matched our expenses. There was more anxiety; disagreements with my wife over our steadily worsening financial situation, our children and our increasingly marked sexual and emotional differences. They combined to precipitate five more "psychotic episodes" over the ensuing years.

In 1956, episode three: ten days' observation in the same county hospital as before, followed by 90 days in a monstrous madhouse I shall call Hell Valley State Hospital.

In 1959, episode four: ten and 60 in the same places.

In 1963, episode five: 40 days in (I shall say) Mockrie State Hospital, in another state.

In 1967, episode six: ten days; and in 1968, episode seven: six months--same place.

Total time flushed down the institutional drains: some 18 months out of the past 32 years. I had experienced most of my detentions as profoundly debasing, occasionally brutal and needlessly prolonged punishment; and none had involved anything worthy of the name "treatment." Nevertheless, I assumed that society was justified in locking up its aberrant members until such time as they were again ready and able to conform to its standards and demands.

Then, during the past three or four years, I was introduced to five books in which I found strongly persuasive challenges to all of the assumptions that underlie the current practice of psychiatry and its social and legal applications. These books are The Myth of Mental Illness, Law, Liberty and Psychiatry and Psychiatric Justice, by Thomas S. Szasz, M. D., a psychiatrist and professor of psychiatry at the State University of New York at Syracuse; Asylums: Essays on the Social Situation of Mental Patients and Other Inmates, by Erving Goffman, professor of sociology at the University of Pennsylvania; and The Politics of Experience, by R. D. Laing, a British physician and psychiatrist.

These books hold the makings of an urgently needed Bill of Rights for the millions of us who have been, are now or may one day be subject to any of the many conditions of altered consciousness or behavior that our social establishment views as pathological and often insists on "treating"--usually without the consent of the treated--by methods that are of dubious efficacy at best and, at worst, cruelly dehumanizing and destructive. The radical criticisms these writers make are verified by many of my own experiences and observations.

In calling mental illness a myth, Szasz says that the term is "a metaphor which we have come to mistake for a fact" and is based on the false assumption that the conditions to which it refers are analogous to physical illnesses. Mental illness, Szasz writes in Law, Liberty and Psychiatry, exists only as a theoretical concept, which "derives its main support from such phenomena as syphilis of the brain or delirious conditions--intoxications, for instance--in which persons may manifest certain disorders of thinking and behavior. Correctly speaking, however, these are diseases of the brain, not of the mind." They are in the province of neurology, not psychiatry, which deals preponderantly with so-called functional disorders having no established basis in bodily malfunctions.

Szasz writes that "psychiatry--in contrast to the nonmedical branches of social science--has acquired much social prestige and power through an essentially misleading association with the practice of medicine." And its function as an agency of social control "is hidden under a façade of medical and psychiatric jargon."

Szasz doesn't offer "a new conception of 'psychiatric illness' or a new form of 'therapy.' My aim is more modest and yet also more ambitious. It is to suggest that the phenomena now called mental illnesses be looked at afresh and more simply, that they be removed from the category of illnesses, and that they be regarded as the expressions of man's struggle with the problem of how he should live."

In Asylums, Goffman cites the work of other researchers: "Clinical experience supports the impression that many people define mental illness as 'that condition for which a person is treated in a mental hospital.' " Dr. Karl Menninger has said, "At least three presidents of the American Psychiatric Association have publicly deplored the use of 'neurosis' and 'psychosis' as misleading. 'Neurotic' means he's not as sensible as I am and 'psychotic' means he's even worse than my brother-in-law."

Despite the imprecision of these and related terms, and the lack of scientific proof that the conditions to which they refer are, in fact, "illnesses," they are commonly taken to define distinct diseases for which psychiatric treatment is required. The question of whether or not and how such "treatment" is to be administered to the individual is largely determined by his social status and what sociologists call "career contingencies"--chance factors in his environment and associations. Szasz recalls that when the wife of Governor Earl Long of Louisiana had him committed to a public asylum of his own state, he freed himself by dismissing its superintendent.

In considering the various reasons held to justify such detentions--and to prolong them in the case of those lacking Governor Long's veto power--Szasz points out that "the so-called psychotic state of an individual is neither a necessary nor a sufficient cause for his commitment. Impecunious elderly persons, addicts and offenders are committed; yet, they are not usually considered to be psychotic." A reason commonly given for commitment is that the individual is a danger to himself or to others. But "there is no evidence that mental patients are a greater source of danger to society than [others]," Szasz writes. Goffman states that for every offense that leads to hospitalization, "there are many psychiatrically similar ones that never do." He concludes that "in the degree that the 'mentally ill' outside hospitals numerically approach or surpass those inside hospitals, one could say that mental patients distinctly suffer not from mental illness but from contingencies."

Asylums is based on a year's field work in a public mental hospital of some 7000 beds and on wide reading of other studies of "total institutions." On this basis, Goffman rates mental hospitals as "storage dumps" and "places of coerced exile," whose inmates are reduced to "uniquely degraded living levels...it is difficult to find environments which introduce more profound insecurities; and what responsibilities are lifted are removed at a very considerable and very permanent price."

All commitment procedures are based on the proposition that confinement in a "mental hospital" represents "treatment" of the socially troublesome behavior involved. But, Goffman writes, "current official psychiatric treatment for functional disorders does not, in itself, provide a probability of success great enough easily to justify the practice of institutional psychiatry...especially since the probability that hospitalization will damage the life chances of the individual is...positive and high."

Szasz speaks of "the violence--indeed, the brutality--and also the completely unproved efficacy, of such 'treatments' as lobotomy, convulsions induced by insulin, Metrazol and electricity and, more recently, the chemical strait jackets." These are, of course, the tranquilizers, which--since their introduction in the mid-Fifties--virtually all mental-hospital inmates have been obliged to take. The most potent of these are generally, but by no means invariably, effective enough in relieving such conditions as excitement, confusion, agitation and anxiety. But none of them cures anything, and the forced taking of psychoactive drugs, since they make inmates more easily managed, is more of a service to the staff than to the inmate, as Goffman says in Asylums. Though the cruelly dehumanizing operation of lobotomy has mercifully been discontinued, the use of electroshock is still widespread--often, as Goffman writes and I have witnessed, "on the attendant's recommendation, as a means of threatening inmates into discipline and quieting those that won't be threatened."

On these grounds, Szasz ranks the "treatment" given asylum inmates, no less than their confinement, as punishment and coercion, not therapy. "Psychiatric hospitals are, of course, prisons," he states, and compulsory confinement in them constitutes "imprisonment without due process of law." Often, according to those who have undergone both, "mental hospitalization is worse punishment than imprisonment in the penitentiary"--a rating that a number of my bughouse buddies have ratified.

"The committed patient suffers a serious loss of civil rights," Szasz points out. "In many jurisdictions he is automatically considered legally incompetent: He cannot vote, make valid contracts, marry, divorce, and so forth.... [He] must suffer invasions of his person and body, cannot communicate freely with the outside world, usually loses his license to operate a motor vehicle, and suffers many other indignities as well." In most cases, an inmate held for longer than a limited period of observation suffers the further penalty of being put on parole (generally euphemized as "convalescent leave" or "trial visit") for a year after his release, with his civil and legal rights suspended and his status that of a ward of the state, subject to reimprisonment without necessarily being examined by a physician or psychiatrist.

In a similar summary in The Politics of Experience, Laing writes that "the 'committed' person labeled as patient...is degraded...to someone no longer in possession of his own definition of himself.... More completely, more radically than anywhere else in our society, he is invalidated as a human being."

Goffman gives a description of this invalidating process that I find exactly applicable to my own experience. The asylum inmate, he writes, is often confronted by staff psychiatrists "arguing that his past has been a failure, that the cause of this has been within himself...and that if he wants to be a person he will have to change his way of dealing with people and his conceptions of himself." He writes further that mental-hospital staffs force the status of patient on a person by "extracting from his whole life course a list of those incidents that have or might have had 'symptomatic' significance...seemingly normal conduct is seen to be merely a mask or shield for the essential sickness behind it. An over-all title is given to the pathology...and this provides a new view of the patient's 'essential' character."

Goffman continues, "This dossier is apparently not regularly used, however, to record occasions when the patient showed capacity to cope honorably and effectively with difficult life situations." The record simply documents in summary terms the value system by which the inmate finds himself judged. Finally, his release will be contingent on his demonstration that he has achieved "insight" into the presumably pathological state that occasioned his confinement--in other words, that he accepts the institution's view of himself--and, usually, that he is ready to attempt again to "adjust" to the same environmental circumstances that he may have every private reason to believe--but must not now declare--drove him out of his gourd.

If we who are labeled mentally ill are not "sick," then, how are our behavioral deviations, our alterations of consciousness, to be considered?

In The Myth of Mental Illness, Szasz proposes that "so-called mental illnesses may be like languages," like "various types of communications" employing both verbal and nonverbal methods; and that understanding their meaning may be like the problem of understanding a person speaking a foreign tongue. Freud, he points out, "regarded the dream as a language and proceeded to elucidate its structure and meanings."

In The Politics of Experience, Laing parallels Szasz in holding that "to be mad is not necessarily to be ill." He regards the term schizophrenia (and, by implication, psychosis and its other subcategories) not as one that defines an illness, mental or physical, but as "a label that some people pin on other people under certain social circumstances." He describes the "double-bind" hypothesis, introduced by the anthropologist Gregory Bateson in 1956, which holds that a person might be diagnosed as schizophrenic as a result of being in "an insoluble 'can't win' situation."

Laing cites studies of the families of hundreds of "schizophrenics" by Bateson and other researchers in the United States and by himself and associates in England, all showing that the person so diagnosed "is part of a wider network of extremely disturbed and disturbing patterns of communication." He writes:

It seems to us that without exception the experience and behavior that gets labeled schizophrenic is a special strategy that a person invents in order to live in an unlivable situation. In his life situation...he cannot make a move, or make no move, without being beset by contradictory and paradoxical pressures and demands, pushes and pulls, both internally from himself and externally from those around him....

Nor is it a matter of laying the blame at anyone's door. The untenable position, the "can't win" double-bind...is by definition not obvious to the protagonists. Very seldom is it a question of contrived, deliberate, cynical lies or a ruthless intention to drive someone crazy.... A checkmate position cannot be described in a few words. The whole situation has to be grasped before it can be seen that no move is possible, and making no move is equally unlivable.

This description of the double-bind, can't-win position applies accurately to the situations in which I found (or placed) myself before each of my flip-outs. I encouraged my ghostwriter to ask in his preface to Brainstorm why, in the clash between myself and a complex situation, it had been I and not the situation that had succumbed. This latter formulation, it now appears to me, is nearly equivalent to asking why a soldier, and not the situation he is in, succumbs to combat breakdown. Of course, a soldier has much less freedom in getting into or out of his stressful situation than a civilian, and pressures from within himself can contribute little or nothing to its creation, but his reaction is no less individual a matter.

During World War Two--in which a substantial portion of all U. S. casualties were "mental"--individual soldiers reacted to the stress of combat by displaying one or several of the diverse behavioral phenomena that have been classified as "psychotic." Often, removal from the scene and relief from duty brought about recovery from combat breakdowns in as short a time as a day or two. It is evident that these breakdowns did not represent long-latent "mental illnesses" but temporary reactions that varied according to differences in temperament. It became an axiom that every man, no matter how "normal" or "healthy," had a breaking point; it was presumed that if he didn't crack up under one kind of stress, he would under another.

This presumption would seem to be equally tenable in regard to the reactions of individuals to social and emotional pressures in civilian life, and, indeed, is often stated as a tenet of common sense. But here the stresses involved are normally much less readily identified than those of combat. They are generally much more subtle, complex and, in Laing's phrase, "by definition not obvious to the protagonists." The situation that one person finds unendurably disturbing will usually not be experienced as such by others who have contributed to creating and maintaining it. They, in fact, may accept the view that any manifestations of disturbance are "symptoms" of "mental illness."

It seems highly likely to me, from my own experience and from observations of hundreds of fellow snake-pit inmates, that many seemingly irrational immediate reactions to stress might be as transitory as many instances of combat breakdown have proved to be, if they were treated as such. However, what happens all too often in civilian life is that such reactions, and even modes of behavior that family members disapprove of, are defined as manifestations of mental disease and are used to bring about the person's confinement.

If someone has once been branded psychotic, and has been subjected to the degrading punishment of psychiatric imprisonment, he is under the lasting threat that those close to him may interpret any anxieties he reveals of his fears as indicative of a "recurrence" of his "illness." They may, in fact, so interpret almost anything he does or says, and when they do, they are likely to reveal their attitude and intentions toward him, and so to arouse or increase his fears either of losing his mind or of being incarcerated again. When confinement is brought about against his will, and carried out by the police, as is often the case, the act itself is likely to provoke resistance, if only vocal, that will be added to his list of "symptoms."

This snowballing process seems to me to have been at work in each of my episodes of "manic" excitement. In two or three instances beyond the one I have mentioned, my wife began to show apprehensions that I believe were unwarranted--or, to say the least, premature--and to express them with such suspicion and hostility that I feared that she would have me put away again.

Fear often leads to panic, which produces alterations of behavior, which arouse further apprehensions in others, etc. Fear also releases adrenaline, giving the threatened animal or person a surge of self-protective energy.

In Ten Feet Tall, one of his absorbing narratives of medical detection, Berton Roueché writes of the power of the hormone compounds cortisone (adrenal) and ACTH (pituitary) to alleviate a great number of diseases, and also of the potentiality of these drugs to produce highly unpleasant side effects. He relates the harrowing experience of a New York schoolteacher whose life was probably saved by cortisone therapy for a destructive inflammation of the arteries, but who experienced extreme (and classically faithful) "manic" euphoria, overactivity and excitement as a result of it.

I read the story when it first appeared in The New Yorker, in the mid-Fifties, and not long afterward found myself incarcerated in the shit wards of the monstrous city of the damned I have previously referred to as Hell Valley State Hospital. I was certain that I had been helped by the cumulative interaction of suspicion and dread I have referred to, and quite possibly by supernormal energy from a fear-induced overproduction of adrenaline. The doctor in charge of the several hundred men quartered in my ward was a Jewish refugee from Germany and quite a humane man, as institutional hacks go. But when I suggested this possibility to him, he reacted with an intense scorn.

"Hah! What is this? You have discovered perhaps a new theory of manic-depressive psychosis?"

Well, why not? I hadn't found an old theory that made better sense. Psychiatrists who hold that "psychoses" are caused by as yet undiscovered biological malfunctions generally believe that these will prove to be glandular or metabolic, and some point to surpluses or shortages of certain chemical substances in the body fluids of "psychotics" as evidence. Researchers have found that the urine of "schizophrenics," but not of normal people, often contains a chemical similar to both adrenaline and mescaline. It is conceivable that the one thing those tested had in common was their state of stress and that the production of the chemical might be a reaction such as normal people would show in a similar situation. At any rate, in the absence of proof that such findings indicate causes rather than effects, their most useful explanation would seem to be Laing's:

We know that the biochemistry of the person is highly sensitive to social circumstance. That a checkmate situation occasions a biochemical response which, in turn, facilitates or inhibits certain types of experience and behavior is plausible a priori.

Much of what Laing goes on to say suggests similarities between a psychotic "voyage of discovery" and the trips induced by psychedelic drugs. Following the synthesis of LSD, mescaline and psilocybin, researchers observed that these drugs produced alterations of consciousness like those experienced in the so-called psychoses, and it was supposed that further research with them might lead to the discovery of biochemical causes of mental disorders. Though this possibility has been increasingly discounted, it remains indisputable that many varieties of "psychotic" experience have been temporarily duplicated in the varieties of psychedelic experience on record.

Laing describes a "schizophrenic" episode as an entry into "the inner space and time of consciousness," as contrasted to the usual sense of living in "the outer world." It is a "journey [that] is experienced as going further 'in,' as going back through one's personal life, in and back and through and beyond into the experience of all mankind, of the primal man of Adam and perhaps even further into the beings of animals, vegetables and minerals." It may be "part of a potentially orderly, natural sequence" that, if allowed to, would result spontaneously in the voyager's return from inner to outer and an "existential rebirth." But, Laing writes, "This sequence is very seldom allowed to occur because we are so busy 'treating' the patient." Instead of the mental hospital, he proposes, we need "an initiation ceremonial, through which the person will be guided with full social encouragement and sanction into inner space and time, by people who have been there and back again. Psychiatrically, this would appear as ex-patients helping future patients to go mad."

Though this proposal will seem shocking to those who regard madness as a necessarily pathological process, it need not be to those who admit the validity of Laing's and Szasz's view of madness.

Bateson writes that one comes back from a "psychotic" voyage "with insights different from those...who never embarked on such a voyage." This observation parallels the testimony of psychedelic trippers that their outlooks and insights have been lastingly changed by the experience. The terms Laing uses to describe the schizophrenic voyage, in the lines I have quoted and in further impressionistic and poetic passages of The Politics of Experience, are also similar to those that have been used to describe psychedelic states of consciousness. His recommendation of an "initiation ceremonial" virtually duplicates Timothy Leary's proposal to psychedelic voyagers. "You have to go out of your mind to use your head," as well as the insistence of Leary and others on the importance of the setting and auspices of the trip--and of having a knowing guide--in determining whether it will be heavenly or hellish.

In my "manic" highs, I experienced many of the alterations of consciousness that are produced by the psychedelic drugs. Though these self-generated trips may have represented voyages into inner space and past time, in the sense that they returned me to a childlike, atavistic state of unrepressed thought, emotion and action, they have been directed toward increased awareness of and participation in the outward world, toward a dissolution of the ego and a transcendental unity with the universe. My impulses have been outgoing, generous, expansive, responsive, seraphic and loving. Only when my ebullient acts and expressions have met with suspicion and opposition, with active threats of their suppression by capture and imprisonment, have I reacted with opposition, and then never to a menacing degree.

"So-called mental illnesses," Szasz states, "can be understood only if they are viewed as occurrences that do not merely happen to a person but are brought on by him (perhaps unconsciously), and hence may be of some value to him." He further proposes that "the behavior of persons said to be mentally ill is meaningful and goal-directed--provided one is able to understand the patient's behavior from his particular point of view." Similarly, Laing asserts that madness need not be all breakdown. "It may also be breakthrough. It is potentially liberation and renewal as well as enslavement and existential death."

Any individual, whatever his reaction to stress, follows particular patterns and trends of thought, behavior and emotion that are distinctly his own. In Law, Liberty and Psychiatry, Szasz makes a comment on some moral implications of this point that perfectly expresses my attitude toward my experiences of madness:

If psychology and sociology were taken seriously...we should have to conclude two things: first, that insofar as it is always possible to regard antecedent events as explanations of human behavior, men should never be blamed (or praised) for what they do; second, that insofar as men are human beings, not machines, they always have some choice in how they act--hence, they are always responsible for their conduct. There is method in madness, no less than in sanity.

This statement might seem to support the inclination of institutional psychiatrists, as Goffman has described it and I have experienced it, to argue that the "mental patient" has brought about his own "illness." It does so only if, in the second clause of the statement, the phrase "responsible for their conduct" is misread as "to blame for their conduct." To hold one responsible for his conduct is not necessarily to deny that his behavior may have been appropriate to his situation, that it may have been motivated by creditable impulses or that it may be directed toward healthy rather than pathological goals. To blame him for his conduct is, of course, to find nothing but fault in his personality. As this blaming process is applied in institutional psychiatry, it is an instrument of domination and subjection. Szasz's insistence that human beings are always responsible for their conduct, mad or sane, corresponds to the emphasis of existentialist philosophy on man's responsibility for creating his own nature and destiny by means of the choices he makes.

It's probable that some of the phenomena of altered consciousness that occur in "psychotic" episodes, like some of those occurring in psychedelic and mystical states, may be untranslatable into verbal terms, and so may be inaccessible to "rational" investigation and elucidation. They may thus be comparable to dreams, which often cannot be remembered on awakening, and at best are only partially conveyable in words. Apart from what meaning may or may not be found in them by Freudian methods of analysis, dreams are thought to discharge psychic energy and gratify unconscious needs in a psychologically beneficial way. It may be that many of the experiences of madness are and will always remain beyond the reach of objective investigation and explanation but may nevertheless serve purposes of maintaining balance or awarding satisfactions in the only partially penetrable domain of the id. Existentialist philosophy also holds that anguish and despair are unavoidable elements of the human condition and that reason alone is inadequate to the explanation of man's problems.

The goal toward which I now believe each of my excursions into madness has been directed has been the overthrow of repression, imposed from the outside by social demands and erotic and emotional denials, and from within by the standards and inhibitions that make up the conscience or superego. Oppressed by circumstances of my own and others' making, by failures and insufficiencies and frustrations, I have repeatedly hurled my being into a desperate total thrust outward and upward into joy and freedom--and overshot the mark.

Though at the time of each of my later imprisonments I have felt intense resentment toward everyone concerned with bringing it about, it has not persisted for long. I have come to acknowledge that--lacking the sort of guidance through such excursions that Laing has advocated, and having been unable to cut them short myself as I did in the two instances referred to earlier--some temporary restraint of my actions was probably advisable. Although there were considerable variations in the length of time between the onset of each of these excursions and my imprisonment, each of them came to an end within one or two weeks after the jailing took place. What I believe accounted for this outcome was my removal from the disturbing situations from which the flights took off. To allow an acutely troubled person such a reprieve from besetting pressures may, of course, be a considerable service to him. But what benefits it offers are greatly outweighed by the heavy risk of further detention to which he is subjected.

What happened in the last two instances of my confinement is vividly illustrative of this process and its attendant risks. In August of 1967, not long after I had told my second wife of my determination to separate from her and start divorce proceedings, I was carried away, very much against my will, to Mockrie State Hospital, where I had been committed twice before--once involuntarily, in 1963, for 40 days, and the second time of my own volition, in 1964, for one week. (On that occasion, I felt in urgent need of a respite from a tough laboring job and a succession of long, late evenings with friends down for vacations of sunning and drinking.) I'd found the admission building of M. S. H.--in a state to which we had moved in 1960--a fine place of its kind, and learned that the institution had been rated fifth or sixth in excellence among all the nation's public asylums, by whatever body makes such determinations. I had no dread of the place itself that August, but the means of my reinduction into it were atrociously assaultive and needlessly forcible. I felt largely vindicated and vastly relieved when the young psychiatrist in charge of my case authorized my discharge after ten days' observation, against my wife's strenuous protests. Legally, a lawyer friend told me, this meant that I had been found not in need of psychiatric care.

The following April, I'd been separated from my wife for seven or eight months and had asked my lawyer to begin divorce proceedings. The hearing hadn't been scheduled, however, when it appeared that I was losing my mind again. My wife blew the whistle on me once more. This time the doctor told me that I was "less disturbed" than I had been the previous August. The estimate was debatable, but I was not about to debate it. From all he could learn from a telephone conversation with my wife, and from my edited account of the events she described, the worst he could charge was that I had shown "poor judgment." It was enough, along with my status of repeater and some other entirely nonpsychiatric factors, to serve as justification for my being given a "prolonged judicial commitment"--an indeterminate sentence such as has doomed many thousands of people to living out their lives in the miserable shitholes which the back wards of even such a highly rated asylum as this one continued to be.

After two months in the admission building, I was transferred to the oldest--100-odd years--most dismal, dirty and neglected of the institution's eight or nine buildings, above the main entrance of which is still visible in faded lettering its original name, Mockrie Insane Asylum. There I spent four of the most agonizing and heavily degrading months of my life, in the company of 400 or 500 of the state's most wasted and unwanted men and women. I might be among them still if I hadn't been lucky enough to meet what at first seemed an impossible condition of my release: that I find a job in the city two miles from the madhouse and work at it for two or three months while continuing to live in the institution. No one on the staff had any leads to offer, there was nothing I could qualify for in the want ads and I had no money for taxi fares to and from the city.

But I was lucky enough to find a job, with a painting contractor willing to take a chance on a certified loony, to hold it for over two months, and then to surmount a further obstacle the doctor put in the way of my release. I made it out and continued working at the least congenial labor I have ever done and living in the most charm-forsaken city I have ever been stuck in in a long lifetime. By the terms of my parole, which ended October 10, 1969, I was free to move elsewhere in the state but not out of it, nor to drive a car, vote, proceed with my divorce or to appear likely to violate any "laws, ordinances, conventions or morals of the community" (to quote a statute that Szasz cites as justifying commitment in this and other states).

I accept the tough existential truth that my choices in the past have brought me, step by stagger and lunge by lurch, along the route I have traveled. One's field of choices tends to become narrowed over the years in the best of circumstances, and after a lifetime of making choices that have been judged wrong by supposedly expert examiners and custodians, one's confidence in his ability to make the right ones diminishes.

Nevertheless, in reflecting on the critical decisions of my life, and on the seeming impasse to which the whole sequence of them has brought me, there isn't one I can think of--given the sum of what I was at the time of making them and the alternatives that confronted me--that I could have made differently. I find it pointless to judge any of them right or wrong, good or bad, in terms of what it led to; each was, in the full context of its making, necessary. I honor the responsibility that, as I see it, went into each of them and accept the responsibility for the results of each.

Indeed, it was responsibility that dictated my choice of continued exile and isolation and that will guide whatever steps I take out of it. If some unfathomable and irrepressible force should lead me to choose to lose my mind again--or to launch another expedition into madness in quest of it--I want no one I love or have loved to be burdened with the obligation of putting me back into bedlam, where, with less luck next time, I might live out my days with the legions of once-human beings turned into zombis by shock, chemicals and indifference. If the choice must be made, I want it to be unequivocally clear that it has been mine, so that it may be said of me, and I may say of myself, there, now, is a responsible, self-made madman.