Problems We Address • 193reconnect with the personality which is the healthy self ... the Self that lives and learns
and loves with determination and vigor. I suppose we ought to be grateful that such
ruptures with reality are now rarely permanent, that the world within and without can
be regained, and that genuine living is possible for the majority of the time.
Nevertheless, it still seems unfair, and it is my fervent wish that some day, when we
understand much more than we do now of the biology and chemistry and electricity of
that delicate thing called the mind, we will be able to eradicate these scourges of man-
kind forever. Although this may sound callous, it seems to me that an illness affecting
the body is somehow less fearsome than one afflicting the mind, which distorts the
only thing we have to orient ourselves within our constantly shifting universe.
If the Self cannot be felt as a constant, through all the inevitable vicissitudes of
existence, that seems to me to be the worst possible deprivation. For with a stable,
ongoing sense of Self one can be centered, despite adversity and pain and loss. But to
be disoriented, to be cut off from who we are—even more than where and when and
how we are—must be an experience of such terror that ‘nightmare’ is a pallid way to
speak of it.
After that experience Karen reluctantly decided that medication compliance was worth
it, and she was able to forestall further psychotic breaks. But she was not able to maintain
enough consistency in her behavior to keep a job, and finally ended up living on disability
payments from Social Security, for which I helped her to apply. When I knew I was going to
retire from practice, because of the strength of her attachment to me (C), it was important to
be sure that Karen was connected to a mental health center where her medication and living
situation could be monitored regularly.
Both of us were disappointed that she was unable to accomplish so much that she had
seemed close to, such as working with children or getting married. She had a wonder-
ful spirit that I found quite inspiring, especially since her mother (who probably had an
untreated mood/personality disorder) was so rejecting of her.
Karen was eventually able, despite her very meager income, to move out of her mother’s
house, to furnish her own apartment, and to find pleasure in her creative pursuits. Painting and
making all sorts of things continued to be important to her, and when she would come into my
office it was almost always with something she had created (Fig u re 9.1)—a photograph of her
living space, her artwork (D), and sometimes even the cats who were her steady companions.
Because she functioned at a high level when taking her medication, Karen tried and
rejected outpatient art groups for those with chronic mental illness. Instead, she preferred
to go the Pittsburgh Center for the Arts, where she took classes in art forms she had never
explored before, thanks to their scholarship fund. One of the classes she loved was dance
with an instructor named Phoebe, from whom I took tap after retirement and who remem-
bered her well. Karen had always liked to dance, even though she had only a few years of
ballet lessons as a child. One of her favorite self-soothing activities was to put a record on
the phonograph and dance to it in her apartment. When the landlord complained, she had
to turn down the volume, but she didn’t stop.
Every year at Christmastime she would have a friend film her with a video camera doing
a series of dances, for which she designed the set and costumes. She was very serious about
this annual ritual, since it allowed her to give a copy of the video as a gift to each of the adults
who had supported her in her struggle to stand upright. In addition to me, there was her
grandmother and the only African American faculty member of the Child Development
Department at that time, who had become a good friend.