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“The book, the book,” Joe said. “That’s all he wanted to talk about.” When Sam’s first child was born, Ray showed up with a revised draft of his memoir and seemed more interested in discussing his writing than in meeting his granddaughter.
Two different stories about his illness, the psychoanalytic and the neurobiological, had failed him. Now he was hopeful that he would be saved by a new story, the memoir he was writing.
Everyone began eating. “And my dad sat down next to me and told me the story of Chestnut Lodge again, as if I’d never heard it,” Joe said. “I froze. I just felt taken advantage of.” Even when his father was trying to repair their relationship, his effort at emotional connection was swallowed up by the story he felt compelled to keep sharing.
But he also sensed that any story that resolved his problems too completely was untrue, an evasion of the unknown. “At the end of life, after having lost everything,” he wrote, “I may be merely a crisp autumn leaf that blows away in a harsh October wind.”
A healthy person, according to this view, is “like every other John or Jean in the neighbourhood.” But Indian healing cultures were meant to raise the self to a higher ideal—detached, spontaneous, free of ego—rather than simply to restore the person to a baseline called normal.
In another paper, she called for a revival of the phenomenological tradition to which Roland Kuhn had belonged. “A ‘depressive’ does not just enact the symptoms,” she wrote. “She experiences the world differently. She uses language differently. She experiences emotions differently.” By ignoring these sorts of experiences—the “unclassified residuum,” as William James called it—doctors risk misunderstanding why mental illness can be so isolating, altering people’s lives in ways that cannot be captured only by symptoms.
For a Black patient to reveal her fears and fantasies to a therapist, trained in a field that has been dominated by middle-class white people, requires a level of trust that hasn’t typically been earned. “Many black folks worry that speaking of our traumas using the language of mental illness,” hooks writes, “will lead to biased interpretation and to the pathologizing of black experience in ways that might support and sustain our continued subordination.”
The philosopher Iris Marion Young describes pregnancy as the “most extreme suspension of bodily distinction between inner and outer.” Describing the growing fetus, she writes, “It feels somewhat like a gas bubble, but it is not: it is different, in another place, belonging to another, another that is nevertheless my body.”
At Chestnut Lodge, psychoanalytic insight was often achieved by upending a person’s story: the therapist uncovered the unconscious conflict or fantasy around which the patient’s life had always secretly revolved. A biochemical framework for suffering can operate as a similar jolt, prompting a person to let go of an interpretation of the world that has made him or her hopeless. But to have a new explanatory framework foisted onto one’s life is not always healing or generative. It can also feel diminishing, a blow to one’s identity and worldview. “Where is the sensitive side of psychiatry?”
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Maybe I was too young to process the way that people at the table were exchanging annoyed glances, but I never felt stuck in a particular story that others had created for me. I had the freedom to get bored of my behavior and to move on.
If I had been a little older, it’s possible that I would have had more social reinforcement and would have gone on to develop an anorexic “career.”
Deegan acknowledges that some phases of recovery require planning and work, but not every part of the process can be consciously orchestrated. “All of the polemic and technology of psychiatry, psychology, social work, and science cannot account for this phenomenon of hope,” she writes. “But those of us who have recovered know that this grace is real. We lived it. It is our shared secret.”
After his first period of depression, as a teenager, Tim, who is Catholic, had begun reciting a prayer at night: “Please help me use my sufferings to help others. Please don’t let my suffering be wasted.”
