On Mental Health

If I ever see a shrink again it'll have to be under a court order.

No, this has nothing to do with what happened with Frieda. Not, of course, that what happened with her wasn’t at the time disappointing. Fiftyish, on the boards of major psychiatric associations and married to a man who was also a prominent doctor, Frieda had been working with me for three years on my guilt and shame problem. Although I wasn't making much progress in that area—I remained as afflicted by self-deprecation and most of the maladjustments that attached to it as ever—I had, with her assistance, finally stopped trying to go down on myself. And for helping to rid me of this hazardous, independence seeking compulsion—it had already resulted in a couple of blown-out discs in my lower back and several hospitalizations—I’d come to have a large admiration for her skills, large enough to send a live-in girlfriend to her for counseling.

While I was partial to poor hygiene and self-destructiveness in a woman, I did have my limits. This girlfriend’s habit of picking her nose and then eating it, for example, had long caused my proudest erections to scramble into my bladder somewhere. What’s more, the drug overdoses had evolved into too regular a thing. Routinely called at work by neighbors who'd discovered her face down on the apartment house stairs, and rushing home to flashing lights and frenzied paramedics cutting through clusters of onlookers with a gurney, was increasingly vexing.

But after they’d had a half-dozen sessions together—the last couple of which were scheduled in the evening and were unusually lengthy—the phone rang in the middle of the night.

“Let me speak to Madeleine.”

“Freida? Freida, Jesus, it’s three AM, she’s fast asleep.”

“Oh. Is her little winkie pinkie nestled in her nostril?”

“What? Uh, yeah. In the big nostril—like always.”

“Marcus, damn you, you’re in my way. Get out of my way.”

“Frieda?"

“Your grandmother was right, Marcus, you should have been aborted. Now give me Madeline. I need Madeline!”

But Frieda, you see, was ultimately harmless. In fact, in hindsight, she left me better off than she found me. She left me, that is, more profoundly wedded to my considerable emotional issues than I'd been before.

Indeed, just a short time later I was in traction again.

No, I never had a true beef with Frieda. My quarrel is with the fool I saw after Frieda, with the bastard who cured me.

I knew Tim was special on our very first meeting. Somewhere in his forties, attired in a cashmere sweater and freshly pressed khakis, he was tanned and radiantly handsome, with a perfectly proportioned middleweight’s body (no slack anywhere), a fully relaxed countenance, a deeply sonorous voice and a quick and booming laugh that made me think of church bells. But if his appearance and bearing weren't enough, I was thoroughly enthralled when, as I seated myself in his office, in a spacious, sun-filled Upper West Side apartment that was furnished with exquisite taste and adorned with plants and abstract paintings, he took a long look at me, smiled, and said, "There's nothing wrong with you."

Altogether captivated by him, and although he had yet to learn anything about my troubles, I had no doubts about this guy's competence to help me. He was the real thing, a man who’d gotten into the psychology business to the purpose of sharing an earned wisdom—not, like many of his colleagues, in the hope of flushing out his personal demons and solving his own mysteries by delving into the disturbances of his patients.

And imagining, during our appointments, that the faint strains of tasteful semi-classical music always emanating from the other side of his office wall—music interspersed with peals of laughter—were from a party that his recently mended patients were having in the apartment next door (an ongoing party to which you were invited upon your achievement of mental health), helping me, or so I thought, is what he proceeded to do.

My situation, as I explained it, had commenced at the age of four (I was in my thirties now) and originated with my maternal grandmother. She was an exceptionally attractive woman—sixty at the time but freakishly capable of passing for forty—who'd come to live with us in the guest room of our apartment when my grandfather died. Vain, self-centered and foul-tempered, she immediately took a tyrannical command of the household and was critical of virtually everything my mother and father did. She reserved most of her ire for me, however. Relentlessly on my case, she berated and belittled me at every turn, with either snide comments or, when she was especially exercised, vitriolic outbursts.

(My parents, who were both employed, left me alone with my grandmother much of the time. But even when they were home they were too intimidated by her to counter her attitude towards me. In fact, I cannot recall a single instance in which they more than half-heartedly came to my defense.)

Born frail and high strung, I'd been cursed as a kid with a plethora of allergies and disposed to continual minor illnesses, and my grandmother's favorite appellative for me, before it was determined that I needed glasses and she took to addressing me as "four eyes," was "weakling." (When those glasses were deliberately broken by a classmate three times my size and I didn't fight back, she called me a "wimp.") But that was only a piece of it. My performance in an elementary school musical wasn't exactly "reminiscent of Fred Astaire." Because some of my grades were less than excellent they "tarnished the reputation of the family." Moreover, I was an "inveterate slob." She was forever haranguing me about the stains on my shirts and the condition of my room. Much to her irritation, crumbs from whatever I was eating, and which seemed to follow me everywhere, obliged her to "constantly pursue me with a broom." On top of that, I kept my hair too long, at a length which, obscuring portions of my face, I felt comfortable with. But she twice embarrassed me by forcing me to return to the barber shop down the block to have it shortened.

The most egregious of my offenses occurred when I was six and barfed into her jewelry box, which happened to be open on the dresser in her room where I'd gone to chase an errant Spaulding. The event was entirely spontaneous. No feelings of nausea had predicted it. Frantic, I was about to try and clean the mess I'd made when my grandmother entered. Her wrath was awesome. Screaming loudly, slapping me in the face and calling me disgusting and despicable, I was never allowed in her room again. (It was on that day that she would utter the "abortion" remark and tell me I was ruining her life.)

I should note that though she never enunciated a word of praise for me or demonstrated any physical affection in all the time preceding her death when I was in my teens, my grandmother did exhibit odd moments of ostensible kindness. She baked a cake for my eighth birthday and gave me an occasional present—a toy truck, a baseball glove. But rather than interpreting such gestures as loving, I experienced them, under the circumstances, largely as acts of pity, and they managed only to harden my sense of worthlessness.

In the ensuing decades, and although I'd been reasonably active and held full-time (if unrewarding) jobs, the outcomes of my sense of worthlessness, besides a variety of peccadillos, one of which I've mentioned, had been a chronic middle-grade depression that was accompanied by a notable absence of aspirations, a marked diffidence in the presence of strangers and a series of unsatisfactory, when not downright abominable, relationships—I had little to give to anyone and elicited just as little in return.

Tim patiently listened to my story, then leaning forward and staring directly at me, he said, "Feelings of guilt and shame are neurotic, useless and stupid. They serve no purpose and help nothing." I’d heard as much from six or seven other shrinks without really digesting it. (Frieda who, incidentally, had divorced her husband, married Madeline and quit her practice, was among them.) But when Tim expressed this notion it took hold.

Absolutely, I thought, Of course.

On another occasion he said: "I can't comprehend how amazingly passive your parents were. Look. You were a victim, and so apparently were they on some level, of a deeply unhappy person with serious anger issues for which you bore no responsibility and you internalized everything negative that she threw at you. You didn't ruin your grandmother's life. It was already in ruins. She made you believe that your childhood physical ailments, most of which you eventually outgrew, and your youthful mistakes, goof-ups, fears and misbehaviors were signs that you were an inherently bad person, that you were deficient and inferior. This filled you with a consuming sense of guilt. You came to define yourself as deficient and inferior. But certainly whatever upset your grandmother didn't mean that you were a bad person. You were a kid, for God's sake. You were a sensitive kid who may sometimes have quite naturally behaved incorrectly or acquitted yourself in a less than stellar way. Fred Astaire? It's okay to feel remorse or regret when you do something wrong. You learn from that and go on. But it's not okay to feel a guilt that makes you think of yourself as intrinsically bad. That's the height of neuroticism. You feel, now, in your adult life, that there's nothing you can do about it because being bad is who and what you are. That it's your nature. Now your belief that you're bad contributes to and sustains a type of behavior that just makes you feel worse about yourself.

"Your grandmother was a screwed up bitch. A child in a woman's body. Get conscious, man!"

Along with such pronouncements, Tim, who was adamantly opposed to the use of drugs and relied strictly on therapy, instructed me to engage in extensive exercises between sessions. For the most part they involved making daily lists of my feelings of self-loathing which, he promised, would enable me to see how these feelings were merely the result of dysfunctional thinking.

And it worked! Life transformed into a joy. I felt attractive and confident for the first time in memory. Enthusiastic about virtually everything I encountered, associating with people I would normally have considered to be above my station, I even stopped wearing glasses—I could see fine without them, better actually. And although it was winter, I could go out with only a light jacket and feel no chill.

And I stopped showering right after I masturbated—a pathetic soul-cleansing ritual that I’d practiced since adolescence and that had given my skin an unattractive prunish texture.

(Oh, I was right about the party. There was a constant gathering of the freshly healed in the adjacent apartment and I got to go to it. I celebrated my new mental health and I even got laid.)

But then in early spring, on one of those rare shining, cloudless days, with the temperature at a perfect 70 degrees, I was strolling though a crowded street festival replete with brightly colored merchandise stands, a rock band, a children's Ferris wheel and the aromas of all manner of ethnic cuisines, and realized that every last one of the people there would one day vanish. Me included! I suddenly saw, and much too distinctly, through the benign facade of nature into its sinister underside. And with this recognition, which wouldn't go away, I began to live in what became a continuous state of intense anxiety. Most of the time I cowered in my bed. I was afraid of accidents. Terrified of germs. Even the notion of achieving a kind of immortality through the prospect of reincarnation, which I'd sometimes entertained over the years, offered no consolation now. While oblivion would be awful enough, with reincarnation I could very well return as a gazelle only to be ripped apart by a leopard.

Tim had raised my consciousness too high.

And then it struck me. Born under a death sentence we are naturally prone to feel terror and guilty—guilty of whatever we did to deserve our harrowing fate. We can't withstand the guilt and the consequence of our ultimate expiration that we assume has resulted from an irredeemable transgression. We need to become absorbed in substitute, potentially rectifiable forms of guilt. Acquired or neurotic kinds of guilt. Neurotic guilt is ubiquitous and tenacious because it functions to divert us from and ameliorate the awareness of our fundamental guilt and the penalty that awaits us. We persuade ourselves that the acquired problem we're dealing with is the real and only one and that by focusing on it we can conceivably fix it and be happy. (Crucially, the discomfort and emotional pain it causes us imbues it with the authenticity that we need to serve our goal.) But the kicker is that since it palliates a deeper and more pressing issue, we are averse to fixing it. So, and necessarily in the interest of psychic self-preservation, we immerse ourselves in it. We "work" on it. We make an infinite project of it. (Essentially ineffective, interminable therapy, for instance.)

I could see now that my grandmother was suffering from a terror similar to mine, that her animosity towards me was rooted in the fact that by making her a grandmother I had brought her worse fears to the fore and that she had handled those fears in her own idiosyncratic way. (You could say that how we respond to the fear of death, the often convoluted manner in which we repress it, is central to what distinguishes us from one another.) Downtrodden as she may have made me, she had kept me afloat in the world. She'd presented me with a way to deal with the problem of being alive, given me a makeshift problem that, albeit oppressive, I could abide. By losing the effects of my grandmother's disdain for me I no longer had an acceptable reason for what was wrong. The guilt my grandmother laid on me had been a blessing. Removing it didn't liberate me but opened me to unmitigated horror. Mental health is the enemy, it yields a clarity that undermines and impedes anything resembling a satisfactory solution to our existential dilemma. To thoroughly clear oneself of neuroses is calamitous. We require a measure of mental illness in order to live with even a semblance of internal equilibrium.

I owed my grandmother big-time for providing me with the burden of low self-esteem and its attendant disorders and miseries.

But now I was defenseless—and genuinely fucked up! (I wondered how many of Tim's ex-patients from my period there were still at that party.)

So what did I do? I got my ass to a psychopharmacologist, that’s what I did. No therapy. Just pills. After months of experimenting with a multitude of anti-anxiety medications, most of which produced bizarre nightmares, we settled on Thorazene. No longer beset with trepidation (psychotropics are, at bottom, fear of death medicines, are they not?), but in a perpetual semi-stupor instead, I have literally no life to speak of anymore. Still, if I'm usually all but comatose, there are hours when I'm sufficiently sentient to feel cheated. Then what I fervently want is to appear unannounced at Tim's office door and, when he opens it, tear away, piece by piece, the beaming-with-mental-health mask on his face, the mask that concealed the skeleton behind it.