Schizophrenia and Connection

What do you see when you think of someone living with schizophrenia? Probably a shadowy person hunched over themselves, hair unkempt, talking to invisible demons. How accurate is that stigmatized version of this peculiar illness? I would say, as someone living with schizophrenia and has lived closely with other folks living with schizophrenia, that this is not accurate at all. On the unit I lived on for nearly three years, folks wandered the halls, lied down in their hospital beds staring at the ceiling, and sometimes sat in the dining room, chatting to themselves, or sitting quietly as stone statue. I spent most of my time in bed, watching strange shapes and critters climbing my walls. Because I was on 1:1 supervision, I was always with someone. These people were MHWs (mental health workers), trained to take care of elderly psychiatric patients, many with physical ailments to boot. I was on the medical/psychiatric unit because I had a feeding tube for most of the time I was hospitalized. Most of the MHWs made conversation. Sometimes I liked it, and enjoyed the kind, sometimes interesting conversation. Other times I was too tired or too drugged or too psychotic to follow the arc of conversation, and I would just drift off. But overall, I appreciated them and their words more than I was able to articulate. But it wasn’t the words, it wasn’t the therapy. It was the relationship. It was the connection.

There is a very unfortunate notion about schizophrenia-spectrum illnesses that therapy is futile, a waste of time, even harmful. This could be because clinicians are looking at a very narrow definition of what constitutes as therapy. I agree to a certain extent. At my worst I didn’t really give a damn about Dialectical Behavioral Therapy with its Dear Mans and TIP skills. It just didn’t make sense, and I didn’t have the capacity to follow a train of thought from beginning to end, and I was convinced the DBT counselor at one of the hospitals I was at (for far too long) was trying to read my mind. not exactly a recipe for theraputic success.

Living with schizophrenia can feel like being stranded on an island, except that island is you. I think many people, clinicians included, are afraid to engage folks living with a schizophrenia diagnosis. We are not always polite, or reasonable, sometimes we hurt ourselves and others, sometimes we can’t even move we are so locked into ourselves and our illness. That doesn’t mean they should not try. I remember being hospitalized in a hospital in Anchorage, Alaska, where I had been receiving ECT treatments twice a week for months, as an outpatient. One day I went in for my usual procedure and was deemed a threat to myself. I was suicidal, hearing the voice of the devil himself. I was admitted to the inpatient psychiatric unit. I don’t remember much about the unit, except that I was in bed most of the time.

Happy Place

What even is a Happy Place? Is it a yoga retreat on a pearly white beach next to turquoise water? I’d like to think that some people would love that sort of spot, but it is only one version. Some peoples’ Happy Place might be the classroom, the office, the garden, their room. Mine? The mountains. Wherever you find yourself peaceful and present, might be your Happy Place. You might think this is absolutely ridiculous and think that Happy Places are a thing for people with too much time on their hands. I say, fair enough. But I’m going to try to explain something that occurred to me not too long ago. I didn’t have a Happy Place in terms of an ulterior physical location. I was my own Happy Place. I realized that no matter where I am geographically, I have my own, private space within myself that I can retreat to when I feel overwhelmed, or tired, or bored. This is not to be confused with dissociation related to PTSD or C-PTSD. It is more of a meditative space.

Many years ago I was on bedrest on an inpatient eating disorders unit. I spent my days staring at the walls and ceiling, watching hallucinations wander through the room, up the walls and across the ceiling. If I hadn’t lost it already, being confined to the hospital bed for days (months) on end certainly sealed the deal. One night I was having trouble falling asleep. I rolled onto my right side and looked up at the window into the night sky. I saw lights moving across the blank blackness. An airplane. I watched the sky, which must have been a flight path, until I fell asleep. Every night after that first plane gazing time, I watched the sky for the lights. They always came. The fun part was imagining where the planes were going, where they were coming from and who was on them. I could feel the movements of the planes, even though they were hundreds of miles away. Some sort of strange kinesthetic reach. Eventually I was moved away from that bed, that room, that hospital, I would never forget those lit nights. Those crawling diamonds and blinking sapphires. It was a way to be away from a place that did not feel good or safe.

I have found that I can conjure this same feeling of mild removal and safety whenever I need it. I will try to explain how I do it.

It should be said that this is not a peer-reviewed, evidence-based methodology. There is no method to this. All you need is a little imagination and a little confidence in yourself. I also know that these two things can be hard to conjure when you are living with PTSD or C-PTSD. All I can say is do your best if you want to try this out, and if it doesn’t feel right, stop. It’s not very complicated. I will give you an example of a real-life time that I went to my inner space for peace and a reset. I was in my drawing class (one of my Happy Places in and of itself) and we had been doing critiques for quite awhile. I love seeing my classmate’s work, but offering suggestions and honest critique is not my favorite thing. I can do it if necessary, but I always feel a little strange about it. I’m sure it gets easier. It is part of sharing art, and part of learning from each other. For that I believe it is a good thing to know how to do. I was however, feeling a little drained by about halfway through the class. Fortunately we were given a ten minute break for bathrooms, beverages, and a break. I strode out of the classroom to the restroom, already starting to breathe deeply. By the time I was in the smaller of the two stalls I had already come down off the tension that I had built in my shoulders and back during the critique. I sat on the toilet and let my gaze soften and rest on the stall-door latch in front of me. I kept my breathing regular, and then closed my eyelids almost all the way, until they were slits. I inhaled for a count of 4 and exhaled for a count of 8. You can breathe or not, and you can certainly change the rhythm to what suits your body. I simply found a pattern that felt good in my body and relaxed my mind at the same time. You can keep your eyes open, or closed, whichever feels better for you. There comes a point when I drop into my body. Warmth spreads to my fingers and toes. I feel calm.

I do not lose track of time or place, I merely feel situated in the confines of my body. It does not feel like being stuck or crushed or locked in. Instead, it is a peaceful inhabitation. Usually there aren’t many words going through my head. Sometimes I think a mantra like “I am safe” or “I am strong” and sometimes I just let random words flow through my consciousness. The content of my mind does not really matter so much as the proximity to myself, my inner self, that quiet, unsullied space inside each of us. It’s not supposed to feel any certain way, so look no more for instructions. Basically, I follow my breath and still my body, and usually close my eyes. I don’t picture the airplanes, or that room or that bed, but the feeling of passive peace is the same.

It’s hard to describe something so simple that works for me without sounding prescriptive or bossy. I have been known to be a little bossy. Maybe I just know what I need and I’m not afraid to express myself like I was for years, both due to psychosis or poor self-esteem or both. Sometimes we must do things we are not good at, or are not comfortable with. I love my art class, and I am learning to enjoy critiques, because they are necessary for growth as someone who makes things (still don’t really feel comfortable calling myself an artist), and they are a way to help classmates on their journeys as well. I chose to use my ten minute break in my Happy Place because it is a way for me to reset. When I was younger and experiencing more severe symptoms, I went to this Happy Place much more often, as a way to escape my circumstances, which was usually lying in a hospital bed, tired and sick. Now that I have gained stability and have made some accomplishments, I rely on my inner place less and less, because I am finding that the feelings of safety and strength I find there can be found out here, too, eyes open, breathing regularly, ready for another critique.

There is No “Right” Way

I come home from school, and sling my backpack onto the floor by our dining room table. I have been busy today and I am finally home, alone. C is still at work. After changing into my “comfies” I retire to the kitchen. I am making baked salmon and roasted vegetables. I pull out a bag of russet potatoes from the cupboard and take out four large-ish specimens. They are going down and they don’t even know it. Now, people have been dicing up potatoes for quite some time. Like, a long time. My mother taught me to cut the potato in halves, take one half and slice them lengthwise, keeping the slices together so you can rotate the slit potatoes and chop them into little cubes the other way. There you have it. Now, a curmudgeonly potato farmer’s wife might shriek and throw a potato at me if there is–if she has–a better way to do it, and I have offended her deeply. So, I’m still here, still roasting potatoes, and the only consequence I experience is eating delicious cheesy potatoes with C for dinner while we swap stories of our days. No angry Potato Throwers. It’s all good. My way was enough.

My way is enough. As long as you are not hurting yourself or anyone else and you are speaking and living your truth, then your way is enough and right for you. I’ll just tell you that the gist of this blog post is that there is no “right” way. You might want to stop reading here and that’s okay, you won’t know what dad jokes you’ll be missing.

When I was sixteen I studied at a very well-respected liberal arts boarding schools in the North-Eastern US. I had been living in Taiwan (where I was raised) and this was the first time I had been to school in the states. I was accepted and flew across the world by myself. Scenes of Wellesley College (where I wanted to study after high school), and Harvard (where I wanted to get my doctorate), and the school I had just started at swirled in my teenage mind. There were other things going on in my mind, but these weren’t so positive. I became increasingly paranoid that the ballet majors were talking about me, sneering at each other as they imitated my serious and quiet demeanor. They weren’t, of course. They were actually very kind to me. Everyone there was kind, but I became convinced that eating was dirty (according to delusions starting to blossom) and was sure that the administration was conspiring against me to derail my progress and my trajectory to writing the next pulitzer and attending an ivy league college like Wellesley or Harvard. It was decided that I was not healthy enough to be a student there, so I was sent to eating disorder treatment. I won’t go into details but let’s just say I lost my shit.

The summer after my first round of inpatient eating disorder treatment (was difficult. The behavioral aspects of anorexia nervosa, which I was diagnosed with upon being admitted to a locked eating disorders unit, are under scrutiny these days as we find out more and more about the neurobiology of eating disorders. This is hopeful because I truly believe that eating disorders may start as behaviorally motivated, they very quickly become physiological. I’m not looking for an argument, and I have over a decade of lived experience. Your body and mind literally feel like they are conspiring to kill you. The schizophrenia didn’t help the situation. I tried time and time again to go back to school, eventually got my GED, and then did a semester of college. I was a biology major heading for the pre-med track. I was so excited, but so sick. I lasted a semester–with a 4.0 I might add–and then crashed for six months. If you are reading this let’s just pause here. Below are the stats on going back to work and/or school over the past ten years:

Spring 2012-tried to go back to boarding school, did not work

Summer 2012-got my GED

Fall 2012-One semester of college, then crashed

Not sure on the year, but lasted two weeks in retail

Spring 2016-registered for classes, which I did not take because of the illness and an emergency hospitalization

The next four years I was in and out of inpatient hospitals and finally three years in a state hospital in Massachusetts

In fall of 2019 I became engaged to the most wonderful human ever (in my opinion)

See? See all the failures and gaps. The stutter steps. I am in college now, thriving in the first class I have taken for about a decade. While the above probably sounds horribly cumbersome and exhausting and disheartening. You are right. It also made me who I am today. I am resilient. Now, we’ll look at the past eight months:

Summer 2022-started Clozaril for the fifth or sixth time, and it starts working and I get out of the hospital

October 2022-spent three days inpatient for a tune-up, setting my record for shortest hospital stay EVER

Spent the next six or so months, following a routine, taking a print making class, spending time with family

Spring 2023-complete a 20 hour introductory course to Trauma Centered Trauma Sensitive Yoga

Spring semester-took my first college class in an awfully long time, have loved it more than amy class I have ever taken, and I am finishing it up at the end of the semester, in early May

Spring semester-applied to and was accepted into the BA Psychology program, which I will take at the college in my hometown. This was a big deal

So what? you might wonder. I can only describe my circumstances and it’s up to you to empathize or not. I don’t need anyone’s attaboy. I know what I had to do to get where I am today. I might not have known it a the time. I felt like I had meandered off the path of success and would never find my way back. It took a very loving partner C and my amazing parents to hold my hope flag while I was not able to carry it for myself. I realized that I had not actually wandered off the path. I was on MY path. So I kept going. What choice did I have? I had tried to die many times, and each time I failed. I figured, not without humor, that I wasn’t sane enough to make a plan successful. I came pretty close, but was obviously thwarted. I thank the universe, God, whatever is out there with all my heart. There is no right way to live a life worth living. Some folks have linear paths and don’t think much of it. Others, like me and maybe you, are forced to take the “scenic” route. We didn’t ask for this. Nor can we do anything over again, the “right” way. There is no right way. You are on your way, and that is enough.

Your Symptoms Do Not Determine Your Worth

I used to have a tendency to determine my worth based on the symptoms I was having. If I was hearing a lot of voices, feeling demons stroking my arms with their horrible talons, I felt as though I was a the worst of the worse. A base creature. Below cockroaches and earth worms. No offense to them. One of my most common delusion was that I was in terrible trouble, that I was going to be accused of a terrible, unforgivable crime that I did not commit. In the hospital, I would meander around the unit, asking people repeatedly if I was in trouble. Some days I was so paranoid that leaving my room was not an option, except to get my meal tray. Sometimes not even that. The voices that rolled around my head all day sometimes made me feel so horrible that I obeyed their commands to injure myself. This happened a lot and at times was very serious. I always felt like I deserved the pain I inflicted on myself. I hated myself so much. I hated the voices. I hated the people I feared, which was at times, anyone who looked my way. It was a sorry state of affairs. Things are much different now. Sometimes I cannot believe my good fortune, the gifts that materialized in my life, the uncharacteristically good choices I made that moved me towards being part of the community sand not a forgotten patient on the back ward. The back wards were my stomping grounds. Not anymore.

I have been out of the hospital for six months. I have been on a medication called Clozaril for almost nine months. Every day my head is a little clearer. I feel like my thoughts–Kaiyuh’s thoughts–take up more space now than the voices. Now as I write this, I am not experiencing any voices. They are usually there right when I woke up, but lately, I have been having beautifully quiet mornings, too. Sometimes this doesn’t seem real to me. I feel good about myself, not because I am less symptomatic, but because I know how hard I worked to get here. And I am grateful for the support of medication and family that I hold dear. I don’t glorify the days of heavy, disturbing symptoms. I dream about them sometimes, and wake up shaken, checking my mind for deficits or things that should not be there. I won’t go too far into the extent of my institutionalization, but believe you me, it was deep, hard and still haunts me to this day. I would be lying to myself, and to you if I said I didn’t have work to do on my trauma. I just try not to take it out on anyone. I am much stronger now, stronger than I have ever been, but I am not perfect. Nor am I striving for that. I am going for steady. And so far so good.

I had a tough passage about a week ago. I began to slow down, catatonia creeping in. I alerted my family as soon as was humanly possible, and my parents came immediately to our yurt, where I was lying in bed, willing myself to feel better. My mother administered medication for both catatonia and psychosis. I bawled that I would NOT be going to the hospital. That was the absolute last case scenario. I refused. I kept saying it even as they assured me I wouldn’t be going to the hospital. C came home early. I was grateful, but I felt a little silly for upsetting everyone’s days. They were so loving and helpful. Let me tell you folks that my family members are my heroes. I want to be like them when I grow up. Or right now. Am I grown? Yes? Partially? We’ll find out. I am also aware of the immense privilege I have being a white woman with serious mental illness. I do not have any addictions or secondary medical diagnoses. I know this sounds strange, but I am glad I “only” have schizophrenia. Maybe that is why I am so hard of myself. Let me explain. I used to want to berate myself for any increase in symptoms. I couldn’t accept that because of my brain and the fact that I could not control it perfectly made me angry. I refused to cut myself any slack or show any compassion because other people had it so much worse. It has taken me a long time to realize that I am doing everything I can do to live a meaningful life, and comparing myself to others was a losing battle, and completely unfair. I believe fully that it is possible to recover from schizophrenia. To go into remission. It might take time–a lot of time–but it is possible. I am not there yet, but I am moving toward health and stability. It is a daily process, but it is one I am up for. I will never give up on my dream to become I clinical psychologist and a Trauma Centered Trauma Sensitive Yoga teacher. If you are out there living with schizophrenia or anything that creates obstacles as you strive for your goals, know that you are not alone. Reach out. Ask for help. Be the hero that you need. And never forget, you are worth the struggle.

Sometimes I wonder if I am just pandering. That I am just spewing platitudes. The truth is, sometimes I don’t have the words to describe my internal experience. Sometimes I don’t want to share my internal experience, because it is mine. I will say that breathing, meditation and yoga are not cure-alls. They are great, don’t get me wrong, but some mental illnesses need more than journaling, daily walks and talk therapy, though all of those things contribute to a life worth living. The truth is that most folks living with schizophrenia need pharmaceuticals to manage severe and unrelenting symptoms. I was in denial, my family was in denial as I cycled through antipsychotics that gave me tremors, pushed up my weight by twenty to thirty pounds. Though I wish I could say that this med or that med will help you, save you from the pits of psychosis, but the hard reality is that you are going to have to find what works for you. You might feel great on the first med they try, you might have to keep looking. Clozaril is a last ditch effort, I was a last ditch effort. But I am well, now. More well than I have been in a decade. I know I talk about this a lot, but if you are reading this, you know it is not to brag or glorify myself, but to show you that healing is possible, and that you are not alone. Don’t give up because you can and will surprise yourself. Again, this blog is non-prescriptive. I am not telling you to take meds or not to take meds. I am talking through my own lens of experience. Youve got to do you.

Thank you for reading this tome. Wasn’t sure where it was going, or even where it went, but such is life. Sometimes all we can do is meander until we find ourselves again.

Breakthroughs and the Nature of Imperfection

I am a recovering perfectionist. And honestly, it has been harder to let go of the vice grip of perfection than it has been to manage my schizophrenia. That might sound hard to believe, so I will go into it a bit, into the why of it and how perfectionistic tendencies make chronic mental illness even worse, to the point of being acutely dangerous. Also, it is worth noting that folks who are not neurodivergent or carrying a label can and do exhibit perfectionism. It is very common in the society we live in today.

In my art class yesterday I was working on a life drawing with a model. I felt myself shutting down as I added ink, feeling like I was ruining it. My teacher saw something different. She told me I had loosened up, that I had a “breakthrough.” I was shocked and amazed. Suddenly, I could see what she was seeing. It was not perfect, but it was organic. My gestures were loose. I could see that it was beautiful because it was not perfect. I learned from this.

When I first began to unravel in high school, I began severely controlling what I ate. There were a couple of reasons for this that all synergized and tanked me. The thoughts and quiet but loudening voices made eating very difficult. I felt it was “impure.” I ended up in treatment with the guise of an eating disorder (anorexia nervosa). I was a seventeen year old girl who was severely underweight and didn’t speak much. I fit that label. But there was so much more going on that had nothing to do with anorexia nervosa, but rather the early years of schizophrenia. I left high school, got my GED, and continued to struggle, going in and out of treatment and hospitals for the next ten years. Food became a fixation because the older I got, the more explicit the voices were. I stopped eating solid food and was sent to a state hospital, where I was tube fed for over two years. I think I felt so out of control with my wayward mind that following the voices’ admonitions and my own desperate need for some agency was all that I could do. And I almost died doing it.

When I was home, in between hospitalizations, I would take on a lot. I would read and write, I even found myself work in a couple of non-profits. It would be an understatement to say that I wanted to do well in my jobs. I worked long hours, perfecting posts, redoing things until they were satisfactory to my now-apparently ludicrous expectations. Whenever I would come home from the hospital, I had it in my head that this was going to be “the last time.” That I was never going back to the hospital. Unfortunately, I set myself up for failure over, and over and over again. If there was any conflict at all amongst my family members, I would crumple. If I was symptomatic, I would spiral into psychosis, fearing that my family was actually trying to kill me. More than once I hurt myself significantly. I think that there was an underlying current of “if it’s not perfect, it’s nothing,” or “if everyone is not perfectly happy, it’s the end of the world I can’t be alive anymore.” I was projecting my inner perfectionism onto everyone around me, but I was also barely functioning due to my schizophrenia symptoms. One issue magnified the other. One had to go, and it wasn’t going to be the schizophrenia.

We mitigated the schizophrenia with medication, namely Clozaril, an antipsychotic used to treat treatment resistant schizophrenia. I broke the cycle of my perfectionistic behavior with the mantra/affirmation “Relentlessly Positive” or “Relentless Positivity.” When I was inhabiting this state of mind, I didn’t need to be perfect. In fact, I could look back on the years of compensation with sadness. I didn’t ask for schizophrenia, but I made everything worse with my inability to accept myself and my circumstances, and so I repeatedly failed to trust in my self and in my own growth. I also felt forgiveness. Hence the frequent return to the hospital for stabilization and essentially a very loud and obvious statement that “I am NOT PERFECT.” In fact, “I AM REALLY SICK.” Well, that didn’t work out too well. With the help of my family and my outpatient team, I was able to slowly but thoroughly create routines for myself at home. My fiance and love of my life, C has also dealt with perfectionism and we are now able to hold each other accountable for any lingering perfectionism that might hurt us both. It’s exciting to live without perfection. I laugh more. I cry less. I have no anxiety. I have mild symptoms from the schizophrenia, but nothing compared to what they used to be. I am grateful for that. The more I trust myself and do the basic things I need to do to remain healthy, the more I realize that I am enough. I don’t need perfection to be happy, which makes me very happy just to think about. You try it! Imagine what it would feel like if you gave yourself permission to try and to fail. You can make a “mistake” and know that mistakes are really just learning opportunities. I know that sounds a little hokey, but trust me, it helps soften the self-talk that we all experience.

I am a work in progress. I am far, far, far from perfect. This is a relief. Why? Because I can be myself, Kaiyuh, and perfection has nothing to do with that. I am free to try and fail and then try again. And if I don’t get this the first time, well, on we go for a second.