Wednesday, February 03, 2010

Scarcely restraining tears

I'm thinking this morning of something St. Augustine said about the pervasive sadness of the plight of the mentally ill. He writes, "Crazy people say and do many incongruous things, things for the most part alien to their intentions and their characters, certainly contrary to their good intentions and characters; and when we think about their words and actions, or see them with our eyes, we can scarcely -- or possibly we cannot at all -- restrain our tears, if we consider their situation as it deserves to be considered."

I'm thinking of this for two reasons this morning. One is that a friend has invited and encouraged me to think a bit more intentionally about theology and mental illness. The other is the fact that a moment last night with Paul--funny in the moment--has left me feeling the sadness of his plight in a particular way today.

Paul is now going with me to monthly Harbor House meetings, and we had one last night. He does really well. He sits there patiently through about 90 minutes of what must be to him (and are sometimes to me!) very boring logistical details concerning the work needed to make Harbor House a reality.

Paul's major incentive for this, in addition to the long-term promise of being a part of the clubhouse and the always-lovely prospect of spending time with his favorite sister, is the more immediate promise that I'll take him out to dinner afterwards. This is all good. But on last night's adventure, we had one of those little moments that reminds me (in a funny little way) how deeply devastating his illness is.

So, last night we left the meeting and headed to a not-too-far-away Mexican restaurant. I basically knew where I was going, but had one of those minor navigational mix-ups where I pull up to a light at a certain intersection in the right hand lane. Once stopped at the light, I realized that this was in fact the LEFT turn I was looking for.

So, I cursed a little. Paul asked me what was wrong. I explained. In fact, I went into a bit of a monologue that lasted until after the light turned. "Lemme see. Maybe if I put on my blinker and get this guy's attention I can ... no, I can't really turn left here. Shoot! Going to have to go up there and turn around... don't worry, Paul, we're almost there. You hungry?" "Starving!" "Me, too!"

I thought he was paying attention. He offered some (brief) responses! And then I did the thing we've all done a thousand times. I took the first left I could take safely, which took me onto a residential street. I turned into the first driveway to turn around. And all of a sudden, Paul bursts out (I think he was both surprised and angry), "Hey! Why are we coming here? I thought we were going to that Mexican place!" I actually kind of forgot how distracted he gets sometimes and thought he was joking, so I said, "What? You wouldn't rather knock on these strangers' door and see what they'll feed us?" He was horrified at the suggestion (I mean, he had EARNED that Mexican food by sitting through that meeting). Backing out of the driveway I said, "Paul, I'm just turning around."

We were at the restaurant in less than 2 minutes and all was well. In fact, I was chuckling the whole way. What a funny thing that he somehow thought we were going to that house! But it stayed with me and began to eat away at me. This isn't just one of MY funny moments, one of those misunderstandings we all have, because we missed something important in the conversation. This is about his inability to stay with a conversation, to focus, to follow a thread. I think it's actually easier to get used the idea of hallucinations and delusions than just how hard it is for him to really stay focused, to pay attention to the aspects of the world that seem so obvious to the rest of us.

People distinguish between the positive symptoms of mental illness (things added, like hallucinations and delusions) and negative symptoms (the aspects of a healthy mind that are taken away). I'm told that there wasn't too much talk about these negative symptoms until the anti-psychotic medications got good enough to be truly effective (in most cases) in treating the positive symptoms.

I was thinking about how the positive symptoms can be scary and strange, but in a relatively isolated way. It's so easy in those moments to say "It's not him, it's the illness." But the negative symptoms--how do you separate those out? Their pervasiveness in shaping how he is in the world, how he sees it, who he is and can be--it just makes me so sad. And made me think, this morning and about this, that Augustine surely had it right.

No comments: