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Michael Hobbes | Longreads | March 2014 | 10 minutes (2,425 words)
Joe Guppy is a writer, actor and psychotherapist living in Seattle. Thirty-five years ago, he was 23 years old and a mental patient. He spent 10 weeks in a mental hospital and another 10 weeks in a halfway house after Atabrine, an old-school malaria medication, gave him visions that he was living in hell and that his family was trying to kill him.
Thirty years after he was released, Guppy decided to investigate his own case of mental illness. Through physicians’ notes, journals and interviews, he took stock of how he got sick, how he got better and what his story says about how therapy helps people heal. He is working on a memoir about the experience, and was kind enough to send me a draft and let me interview him about what he found.
OK, set the scene: You’re 23, you’ve just graduated college, you’re working at a language school and then you take some malaria pills in Mexico and go crazy. What happened?
It happened in January 1979, but it’s not like I was totally normal and then the pills made me nuts. It’s such a mix, it’s not just, this guy was dosed and then he went crazy. It’s that I was already on the edge and then this drug pushed me over.
I was in Mexico to seek work as an English teacher and that didn’t pan out. There was a girl down there and that didn’t pan out. I was still reeling from a breakup a year before. So I’m in my hotel room in Mexico City the night before my flight home and I’m having this gastrointestinal distress and I take these pills.
So the craziness slowly comes on. By the time I’m on the plane back to Seattle, I’m paranoid and delusional—I’m having hallucinations. I get this idea that if everyone on the plane has faith, if we all believe in the physics that the Wright brothers created with their minds, the plane won’t crash. I was terrified.
So you arrive back in Seattle…
I stayed that night at my parents’ house. I started thinking I was dead, like in hell or something, so I cut my hand with a razor to see if I would bleed. I did.
What’s funny about this now is that, yeah, it’s really obvious that I was going crazy. But when you are that person, you set up these rules with a sort of logic. They’re insane, but they’re rules. So if I can bleed, then I must still be alive. I remember pressing with the razor and getting blood and thinking “OK, phew, I’m still alive.”
Then I had this idea that I should go up to Volunteer Park, because I believed there were packs of wild dogs there that would tear me to pieces. This was my way of committing suicide. But I didn’t have the courage, so I fell asleep and the next thing I remember is my mom knocking on the door and walking in. It was like she burst in, and it was this hallucinogenic version of my mom, and she was hunched, with this claw hand, croaking at me.
So I guess that sort of thing is how you ended up in a mental institution.
I eventually told my parents what was going on and I got put in a low-security mental ward at the hospital. The first night I was there I jumped out a second floor bathroom window. I sprained my ankle and got captured by a security guard. Then I got put in the high-security ward for another week and a half.
What was it like there?
There’s not much to do in the low security ward, so you get plenty of time to ruminate. I was so heavily medicated that the side effects seemed to fit perfectly with the idea that I was being tortured in hell. I had this horrible neck cramp and blurred vision. But I could still participate in stuff like occupational therapy, where we made tile hot pot holders and baked snickerdoodles.[ad]
My psychiatrist and my mom were saying, “You’re not like these super-crazy people that are in here, you should go back to the lower security ward.” I went back for about a week. Then I was allowed to visit my parents, as a sort of test before they would discharge me.
I was (back) at my parents’ house, and I got this idea that demons who looked like my family members were planning to torture me with the tools in my father’s garage.
Again, in this logic, I thought I had to drive to Oregon to escape. It had to be Oregon. So I took the car and started driving. I cut the trip short when I dropped a rag in the gas tank trying to fill it up. So … back to the hospital.
And then you tried to escape again, right?
Yeah the ward had this elevator where they brought in laundry and other supplies. I had managed to get inside and was frantically pushing the “close door” button when two male nurses burst in and dragged me out. They literally hauled me back into reality.
It’s funny the multiple feelings you have. I have these clear memories from within the psychotic experience, and I still feel those feelings, the disappointment of “Damn, I almost got away,” even though I was planning to go kill myself.
Anyway, that landed me back in the high security ward where I stayed another month and a half before I was discharged to the halfway house.
And is that where you started to get better?
Back in the hospital, I ended up with a really great psychiatrist who listened to the worst of my paranoia and took my fears seriously. So I had already graduated to a more mild sense of unreality. But whenever I would come into reality, like real-reality, I would think: “I’m a mental patient, I’m insane, I’m going to be insane the rest of my life.” And then I’d get severely depressed. Every time the dawn would break and I’d look at reality, I’d want to escape right back into the craziness.
The big step forward was opening myself up to social relationships again. I started to care about my roommate, who was a schizophrenic paint sniffer. I also hit it off with some of the therapists at the mental health center across the street from the halfway house.
After you recovered, you have this normal life: You become an actor, and you’re sort of Seattle-famous for awhile.
Yeah so I come out of the halfway house into the alternative theatre scene in Seattle. Comedy, improv, then I get on Almost Live! [a legendary Seattle sketch comedy show].
Eventually I started teaching writing. A lot of the student writing was very personal and I thought, this is kind of like doing therapy, but I don’t have a license. So then I go get my degree and become a therapist. I’ve been doing that for 15 years now.
And 30 years after you were discharged, you are re-investigating your own case.
It was a simmering dream of mine ever since I went through it. I had this box of archives, day by day mental hospital records, these taped interviews I did just a month after I regained my sanity with my psychiatrist, a nurse, fellow patients.
Were there any surprises for you as you went through the notes and journals?
There was this huge pile of psychiatric notes from the hospital and I came across this part where I had punched a nurse in the stomach, a male nurse. And I could not believe it. It was this eerie experience of having a memory actually fade in, and then I could see it in my head. But I had completely blocked that out.
Looking at the notes, listening to the tapes, it was extremely emotional, and I could only do it in short chunks. I kept this box of notes and tapes unopened for 30 years, and I just figured, this is my writing assignment. I had no idea how much I would have to relive the most traumatic experience of my life piece by piece.[ad]
Do you feel like it taught you anything?
One insight I figured out from doing this was that the experience had trained me to divide the world into people that knew that I had been mentally ill and people that didn’t know. The therapists told us, when you try to integrate back into society, don’t tell people about this. You’ve got to have a cover story. We were coached about how to minimize and not reveal where we’d been. In the course of writing the book I realized that I had carried that idea with me for my entire life.
Has re-investigating your own case given you a different understanding of what you went through? The model of mental illness most of us have—myself included—is that there is something broken, something that needs to be tinkered with and fixed. Is that how you see your own case?
The “repair” model is a bit too mechanical. Think of the way a wound heals. It’s a mysterious process. We give people medicine because we think that the science will heal them, but it’s not an exact thing, like billiard balls on a table just clicking into each other. The doctor gives you medicine and you take it and it works, but exactly why it works for some people and doesn’t work for others, we don’t fully understand.
Mental illness is even more mysterious than physical healing, because it has so much to do with social relationships. Therapy and counselling work because they incorporate this connection, person to person, face to face, which is difficult to quantify in minute scientific terms.
Does anyone actually know what it is about social contact that makes people bounce back from mental illness?
Emmanuel Levinas has this thing about “the face of the other,” what is it to look in someone’s eyes and know that you are being seen. That’s a complex interaction. When I used to look into my dog’s eyes, I didn’t get the same sense of being seen that I do when I look at another human being. It’s that loop—I see you seeing me, you see me seeing you.
One of the really fundamental therapy techniques is active listening. That idea of “so what I hear you saying is…” When you hear somebody reflect back the things that you’ve said, it’s more than just this robot repeating what you’ve said. You understand yourself more clearly when it’s reflected back. It’s an exponential loop.[ad]
So is that your narrative of how you got better? More social support, better social support?
That social connection was crucial. In my psychosis, I was extremely isolated, I was in my own head, trying to work out my problems with this feverish, rapid-fire thinking.
But there was also a big spiritual component in getting better. I was working through this really toxic Catholicism I was raised with. So the way I see my recovery was an opening up to others, and at the same time opening up to this spiritual connection.
That sounds like a contradiction. You’re saying more social support is important, but then you’ve also got this relationship with God that many non-religious people would characterize as something going on in your own head.
Yes. I say that I was delusional in believing that my psychiatrist was Satan, or that my family had been replaced with look-alike demons, yet part of what helped me get better was this profound spiritual experience I had in the hospital, and which I still consider authentic. I was strapped to the bed, loaded up on drugs, and the florescent light in the ceiling cast this glow that cascaded down, and I had a sense of the presence of God. That didn’t cure me, and I had lots more craziness to go through, but it stuck with me. That’s why I’m calling my memoir My Fluorescent God. I chose it because it sounds kind of nutty. I want the reader free to decide whether that was a delusion as well.
Like everyone else, I’ve had friends who have struggled with mental illnesses of various severities, and I always wonder what I should say to them, what “support” actually means. Was there anyone around you—family, girlfriend, buddies—who could have prevented what happened to you?
My case is so linked to the craziness of my past, how on the edge I was, and then the impact of this drug. It’s hard to imagine how that could have been headed off at the pass. That said, I was in my early 20s. The stuff I learned later in life about honest friendship and honest disclosure, that just wasn’t available to me.
But if you’re asking about how we ought to treat friends who are on the edge, I think it’s just being with and listening to and being supportive. Not being quick to give advice and try to fix them. Our own discomfort is a great barrier. Like, “my friend is going crazy, I’ve got to get away from him.” We need to relax and try to be with the person without being judgemental.
If you had your experience today, how do you think your care would be different?
The bummer about today’s mental health system is how underfunded it is. Washington State is 49th in psychiatric beds. Here we’ve got people shooting up the country with assault rifles, and yet if you wake up in the morning and think “I want to take my M16 and blow some people away,” where can you go to talk to somebody about that? I don’t know—get on the waiting list.
They’re doing this thing called “boarding,” where they take people who are in florid psychosis and strap them down to a gurney in the ER and just load ‘em up with meds. And that’s their only treatment, for days, even weeks at a time.
When I read these news stories, I imagine if that had been done to me when I was at my craziest, my mental state would have gotten worse and worse. It’s horrifying. But I got help from some very skilled and compassionate therapists. If I hadn’t, I don’t think I would have ever recovered.
Interview has been condensed for length and clarity.