Mental Illness Isn’t Who You Are

Sep 6

Experiencing any mental illness can be challenging, frustrating, and sometimes debilitating. It is something someone deals with, but it isn’t who someone is. Mental illness is a challenge, not an identity. Blue Black Jordan Shoes

You developed schizophrenia, and I know from talking to you that it’s scary and frustrating and it has brought a lot of changes to your life. Under Armour Rocket But it’s not who you are, Penelope. It is merely something you have to deal with. Your mind plays some pretty nasty tricks on you sometimes, but that doesn’t mean that you are unlovable. — Oliver to Penelope in Leave of Absence

Mental illness is a challenge, not an identity. Increasing understanding of mental illness helps this truth be known.That mental illness, any specific mental illness, isn’t an identity isn’t always easy to believe. Often, people associate their mental health challenges with who they are as a human being. There are multiple reasons for this.

  • Mental illnesses impact emotions, and often life feels out of control and hard to handle. It’s natural to believe that these intense, sometimes erratic feelings are a sign that we’re flawed somehow, unable to handle ourselves and the world around us.
  • Mental illnesses impacts thoughts. Parajumpers parka Mental illness can impact the way people think about themselves and the world. Nike Air Max Thea Femme Blanche Everyone has what are called faulty thoughts or automatic negative thoughts (like imposing “shoulds” upon yourself or catastrophizing/blowing something out of proportion and stressing out), but mental illnesses have a way of intensifying these thoughts.
  • Mental illnesses impact behaviors. Emotions, thoughts, and behaviors are intricately connected, and they affect each other. Faulty thoughts and intense emotions can affect actions people do or don’t take. Anxiety disorders, for example, can be very life-limiting when they prevent people from going out or doing certain things because of fear and worry.
  • Society doesn’t fully understand mental illness. Phoenix Suns A word commonly used for this misunderstanding is stigma. Canada Goose Chateau Parka There’s a lot of misperceptions about what mental illness really is, and this can negatively impact how someone living with mental illness is treated. Sometimes, outsiders see the mental illness before seeing the real person experiencing it.

Together, these can cause someone believe that mental illness is who they are. The truth is that mental illness (again, any particular mental illness) has affected the brain, not the essence of who we are. Memphis Tigers Jerseys The truth is that there are numerous treatments available to reduce the impact mental illnesses have on emotions, actions, and thoughts. The truth is that understanding can be taught. By listening to people’s shared stories, by reading memoirs and non-fiction books and articles about mental illness, by reading novels that show what these challenges are like for people, society as a whole is developing deeper understanding of what mental illness really is and what people living with mental health challenges experience. The truth is that mental illness isn’t who you are. AIR MORE UPTEMPO Therefore, you can rise above the illness to thrive. Journalism students from the University of Oregon interviewed me for a production for Allen Hall Studios. I share a bit about my own experience with mental illness — and transcending it. Sign up for my free monthly newsletter, Wellbeing & Words. Asics Gel Lyte 3 Femme Each issue is packed with useful tips for enhancing mental health and wellbeing, reading-related tidbits, and updates about my own mental health writing and activities.


Can Novels Really Humanize Mental Illness?

Aug 17


“How did Tanya J. Peterson know what is going on inside my head?  Can she read my thoughts? My Life in a Nutshell hit very close to home for me.” —Teressa M. with Window on the World

To receive such a comment is one of the most meaningful, and the most exciting, compliments I could possibly receive as a novelist. My characters face mental health challenges and live with mental illness, and it’s my hope that readers bond deeply with my characters and maybe even love them. Why? It will lead to increased understanding and empathy in the real world.

I write novels about mental illness and mental health challenges. My Life in a Nutshell: A Novel tells Brian Cunningham’s story. Brian lives with debilitating anxiety disorders, and he lives a severely limited life. He’s lonely, but he feels powerless to do a thing about it. A seven-year-old child named Abigail wriggles her way into Brian’s closed-off world, resulting in increased pain yet increased potential for life.

Oliver Graham and Penelope Baker (and her fiancé William) are the focus of Leave of Absence. Oliver, crippled by post-traumatic stress disorder (PTSD) and depression after the traumatic loss of his family, is hospitalized against his will. Penelope, wrestling with schizophrenia and the harm it has done to her life, wants to set her fiancée free. Will friendship and connection help them?

Novels humanize mental illness and increase empathy for people living with mental health challenges.I do indeed hope that readers fall in love with Brain and Abigail, Oliver, Penelope, and William. To love them is to connect with them. Human connection is one of the most powerful forces on the planet. Connection to characters leads to increased connection, empathy, and understanding of people in the real world outside the pages of a novel.

I’m a nationally certified counselor. I also have personal experience with mental illness. I’ve lived with anxiety disorders (generalized and social), biopolar 1 disorder, and the effects of brain injury. In my life experience, I’ve learned that mental illness is misunderstood.

The illnesses, be they depression, anxiety, PTSD, depression, or a whole host of others, are misunderstood, which means that people who live with them are misunderstood. Misunderstanding can lead to fear and prejudice, which makes those living with mental health challenges feel isolated, alone, and hopeless.

I write novels—Leave of Absence, My Life in a Nutshell, and Twenty-four Shadows (coming in spring, 2016) to deepen empathy and compassion, to humanize mental illness. When people love the characters in a novel, they empathize with them. That empathy is often transferred to real-life human beings. Additionally, and icing on the cake, people can be entertained in the process as they enjoy connecting and loving characters.

“Here’s the thing about Peterson’s work: her characters are key. Peterson isn’t afraid to show the true side of human nature, to open doors that society has slammed closed, and examine what truly makes us tick. I fell in love with her two main characters in My Life in a Nutshell.” — Ellen M. with The Canon

Humanizing Mental Illness; Increasing Empathy


Seek to Understand Someone with Mental Illness: Perspective

Sep 28

  in another's shoesThe novel Leave of Absence is set largely in a behavioral health center/hospital, a fictionalized version of one I stayed in. TEAM COURT One day, Penelope (struggling with schizophrenia) and Oliver (struggling with major depression and PTSD) were attending a group session. As part of an activity, Oliver was asked, “If you could invent one thing that could make the world a better place, what would it be?”


It’s an important question. So much so that Google once held a contest challenging the world to invent something that, in their minds, would make the world a better place. My own (unsubmitted) response to Google’s call was this: To make the world a better place, I’d create an in-someone’s-shoes machine. Here’s how it would work: in any interaction with another human being, especially, but not necessarily, one of conflict, each person would step into the machine. Maybe it would look like a giant shoe. Bo Jackson Maybe it would just be a box. But either way, the people would step inside and be given a perspective of the conflict from the other person’s point of view. Navy Midshipmen Jerseys They’d learn from an empathic perspective why the issue is important for each other. There could even be a larger machine for group conflicts. When we seek first to understand rather than to convince, argue, or judge, something wonderful happens. Air Jordan 11 Retro We begin to see the humanity in each other, and we begin to treat each other better.


Sometimes, when someone lives with mental illness, he or she is treated as someone “off,” someone who is defective. I myself have experienced this. Upon learning that I had been diagnosed with bipolar disorder and had spent time in a behavioral health hospital, I had friends turn away, an employer change his mind about my ability to work for him. Daniel Fells I’ve heard similar stories from countless people. It’s tragic, but in most cases, I don’t think it comes from anybody trying to be “bad.” Rather, it comes from a lack of understanding. I’m certainly not excusing those people who shunned me during my times in and out of the hospital and after they learned about my diagnosis. I think, though, that they were reacting to misinformation and preconceived notions about psychiatric care, mental illness, and traumatic brain injury. Xavier Musketeers


Hence, my in-someone’s-shoes machine. What does it feel like to be another person? I don’t have the technical know-how to actually invent such a machine. Air Jordan 4 Cement Yeah, like I could even do anything other than grab a shoebox and exclaim, hey, it’s a box and it held shoes! However, I am doing everything that is actually in my power to understand and to encourage understanding and empathy. Parajumpers Femme New Arches I live the principle in my own life, and I try to show what it’s like to live with various mental illnesses. I do this by writing novels whose characters live with mental illness or have someone in their lives with mental illness. Leave of Absence is a story of two people attempting to survive mental illness and life in a behavioral health hospital. My Life in a Nutshell: A Novel is the story of a man struggling with debilitating anxiety disorders, and Twenty-Four Shadows tells the tale of a man named Isaac, his alters, his wife and son, and his best friend as the all respond to Isaac’s new diagnosis of dissociative identity disorder. Losing Elizabeth, a middle grade book, shows adolescents, parents, and teachers the negative effects of toxic, emotionally abusive relationships. UGG Classic Short In a way, these novels are in-someone’s-shoes-machines.


My Writing Process: A Look at How and Why I Write Novels about Mental Illness

Sep 20

Recently, novelist Chris Longmuir invited me to participate in a blog tour in which writers discuss their writing processes. Kyle Arrington My initial impulse was to decline, as this is a mental health blog rather than a writing blog. I then realized that all of my writing, both fiction and non-fiction, is about mental health issues; therefore, I decided that this event does indeed have a place on my website. Below, I answer four questions posed to me about my writing process. It is my hope that this will provide some behind-the-scenes input into what I write and why I write it. Before I begin, I’d like to shout out a thanks to Chris Longmuir for inviting me to participate. She has written many novels, most of them crime novels. Check her out at   Why and how I write novels about mental illnessWHAT ARE YOU WORKING ON? While I wait for my fourth novel, Twenty-four Shadows, to be released by Apprentice House Press in the spring of 2016, I’m working away on my next. Like my others, it’s a character-driven novel that highlights a personal attempt to live life amidst mental health and environmental challenges. It’s a woman’s journey that spans a lifetime and two continents. My novels currently available are Losing Elizabeth Leave of Absence My Life in a Nutshell: A Novel   HOW DOES YOUR WORK DIFFER FROM OTHERS OF ITS GENRE? The genre of my writing is contemporary fiction, which is an extremely broad category, and the novels within are varied. It’s difficult to state why one novelist in such a huge genre is different from another. Portland Trail Blazers Perhaps my works are unique for their mission (more on that in the next question). I use fiction for non-fiction purposes. Air Jordan 5 (V) Actually, Leave of Absence was selected as a finalist in the National Indie Excellence Awards 2013 competition in a contemporary fiction sub-category they dubbed “Faction,” fiction based on fact. Air Max Flyknit Hombre Losing Elizabeth was awarded Storytellers Campfire’s top honor in 2014, the Marble Book Award for being a “book that makes a difference in the world.” Kirkus Reviews called My Life in a Nutshell: A Novel “A vital tool for sufferers and their families that broadens understanding of a debilitating illness” and named it to their top books of 2014.   WHY DO YOU WRITE WHAT YOU DO? My goal, through my novels, is to change the way the world thinks about mental illness and the people who experience it. I’m hoping to help increase both factual understanding and empathy. Fiction is a powerful vehicle for teaching fact. Nike Yeezy 2
People connect to characters in novels, and they empathize with them. Commonly, people transfer their empathy to real-life human beings. canada goose dawson parka So I use fiction as my medium for humanizing mental illness, for deepening empathy and compassion.   HOW DOES YOUR WRITING PROCESS WORK? I begin with what to me are the biggies: theme and character. I ponder what I’d like to focus on, what theme I want to illustrate, and then I envision the characters who will help me do this. While I do brainstorm as I create characters, I typically end up “feeling” them rather than “thinking” them. Moncler Homme For example, with Leave of Absence, I wanted to show life in behavioral health hospitals, and I wanted to portray schizophrenia and major depression. In My Life in a Nutshell, I wanted to show how very debilitating various forms of anxiety can be. With each story, I pondered, often with my eyes closed, almost in mediation, how that would play out. As I did this both times, characters came to mind, and with them, deeper issues than I already had in mind. Once I know the characters, I spend time with them in my mind, and it doesn’t take long before I’ve bonded with them and feel close to them. After all, if I don’t feel a closeness to and an empathy for my characters, how in the world will readers feel it? And isn’t my whole point to build empathy and understanding? Once my characters are firmly established in my heart, it’s time to delve into their specific difficulties. While I do have a Master’s degree in counseling and am credentialed as a Nationally Certified Counselor, and while I do live with bipolar 1 disorder and experience anxiety, I never, ever, think that I know it all. That would be absurd! I enter the research phase, a phase I never fully leave until a manuscript has been revised by me, edited by a professional, revised by me again, and re-edited by said professional. Research is an integral part of my writing process. Julian Edelman So are brainstorming and sketching and revising. UGG Classic Sparkles With each and every chapter, I begin by reviewing where I’ve been and where I want to go. Each chapter, as I write, is a step in how the characters are going to get where they need to be. Writing, while challenging, is great fun. Positive psychologists speak of flow, the period in which one is fully engaged in what he or she is doing. In flow, one is focused, and all other thoughts, worries, stresses, and other negative things fall away. asics lyte 3 rosso uomo Finding flow is important for mental health and well-being. I find my flow when I write. Hopefully, that helps me achieve what I’m writing for in the first place: understanding of mental illness and empathy for those who experience it.


Suicidal thoughts are serious, but they don’t have to be the end

Sep 10

Quietly, almost pleadingly, he asked, “What, exactly, do you suggest I do right now?  I can’t be here in Fairmont.  It hurts too much.  I am completely and totally devastated.  What you are telling me makes a little sense, but I just don’t know how to go on.”  (Oliver Graham in Leave of Absence)

Devastation.  Uncertainty.  The desire to die simply to end the pain (in Oliver’s case, of loss and depression).  The lack of understanding of how to continue to live.  This turmoil is common for someone considering ending his or her own life.

The following account of suicidal ideation is based on thoughts and feelings of someone with whom I’ve spoken, someone who wishes to remain anonymous but has given me permission to write this perspective based on our conversation.  We’re sharing this on World Suicide Prevention Day to help shed some light on a dark topic.

On the outside, everything looked normal.  Or at least I thought it did.  I thought I hid all of the chaos going on inside, but maybe I didn’t hide it.  I don’t really know, and I guess it really doesn’t matter.  I had been going to work, doing my job, coming home to family stuff, and starting over again every morning.  Over the course of several months, my job was becoming increasingly stressful.  There had been multiple layoffs which had everyone on edge.  My workload was increasing, I didn’t like many of my new tasks, and I was afraid to talk to my supervisor about it because I didn’t want to be the next one laid off.  My spouse and I have four kids, and we can’t do without my income.  I did think about switching jobs, but that was depressing.  It would just be the same thing in a different building.  I wanted to look for something completely different, a different type of career, but I’m not qualified for anything else and I can’t afford to go to school.  I mean, we’re saving for college for our kids.  Who am I to selfishly use those resources?  More and more I started to feel trapped and powerless.  I saw a therapist twice, but it didn’t do any good.  I knew it wouldn’t.  Who was I trying to fool?  I actually have been diagnosed with a mental illness (I’d really rather not say what one), but I don’t take the prescribed medication.  Sometimes I really think I don’t need it because I feel great and things are fun again, but other times I know that’s a joke.  It’s not therapy I need, it’s medication.  Maybe it’s both.  But I don’t feel like doing either.  I want to feel better again, but I just don’t have much hope that those will work.  I continued to feel worse and worse, and I felt like I had no options.  I wasn’t being a good parent or spouse or employee and I came to realize that none of this was worth it.  I couldn’t take it.  And what kind of an awful person thinks that?  I believed my family didn’t deserve me and would be much better off without me.  If I made my death look like an accident, they would get my life insurance money.  In a lot of ways, they’d all be way better off without me than with me.  The more I thought about it, the more I thought suicide would be the right thing for all of us.  Part of me still wasn’t sure, though, so I called an old friend.  This friend got mad at me, though, and we haven’t spoken since.  That hurts, and at the time it just further proved to me that I’m not good enough to be alive.  One evening, I told my family I needed to run to the store.  I left, and I wasn’t planning on returning ever again.  Then the image of my kids popped into my mind.  I saw all four of them sitting in a row on the couch, crying.  I realized that they wouldn’t understand.  They’d be hurt and confused and angry and would have to finish their childhood with only one parent.  I turned around and went home.  Later that night, although it was difficult, I finally talked to my spouse.  I’m getting help.  It’s still difficult and my thoughts of suicide sometimes return.  But I stay connected, I’m following through on the help I need, and I hold onto the thought of my kids.  It’s a slow process, but I’m glad I’m alive for it. 

Myth: Suicide can’t be prevented. If someone is set on taking their own life, there is nothing that can be done to stop them.

Fact: Suicide is preventable. The vast majority of people contemplating suicide don’t really want to die. They are seeking an end to intense mental and/or physical pain. Most have a mental illness. Interventions can save lives.

See this and other important information at The American Foundation for Suicide Prevention

For immediate help (24/7), call If you are in crisis, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255).

For a powerful video slideshow set to music that provides information and resources, watch this goose-bump-inducing video from MrBandKid2012.  It only takes four minutes of your life.

Suicidal thoughts are serious, but they don’t have to be the end.





Nothing Could Fix the Hole, and Nothing Could Fix Her: Penelope’s Experience with Schizophrenia

Sep 9

The novel Leave of Absence illustrates what certain mental illnesses are truly like and how they impact real people, real human beings. Because of a traumatic event and loss, Oliver Graham has PTSD, major depression, and complicated mourning (which is not in and of itself a mental illness, but it is a struggle that, in Oliver’s case, is intertwined with PTSD and depression).

Penelope Baker is another major character in Leave of Absence. She had a career she cherished, was engaged to a man she loved dearly, and was enjoying the pursuit of the life she always dreamed of. When she was twenty-eight years old, though, she began to experience odd symptoms. They worsened until she was hospitalized and subsequently diagnosed with schizophrenia, and her entire world was shaken. When the novel opens, Penelope is in the hospital (Airhaven behavioral health center) once again. She’s thirty years old; two years have passed since her diagnosis. She’s still engaged, but she doesn’t think she should be. The novel follows Penelope and shows just what this illness is like for her and those around her. In the spirit of increasing understanding mental illness and empathy for those who live with it, here’s a chapter from Leave of Absence, the chapter where we first meet Penelope. Penelope’s different patterns of thinking, feeling, and behaving are evident from her very first appearance in the story:

Penelope is like a mandala: intricate, complex, beautiful, and unique. But schizophrenia makes her feel incomplete.

Penelope is like a mandala: intricate, complex, beautiful, and unique. But schizophrenia makes her feel incomplete.

Penelope Baker sat alone at a table in a quiet corner of the day area of Side B, coloring. Many different coloring pages were scattered about. They were various mandalas—pictures and geometric shapes, some simple, some elaborate—that she had gathered from the art therapy group that met each morning, each in a different state of completion, but none fully colored. The sheet currently in front of her was an elaborate flower with petals that grew progressively smaller as they spiraled inward toward the center. She bent forward over the picture, her face close to the paper, and her long hair spilled down over portions of the image. She moved a gray crayon swiftly back and forth over one of the larger petals and talked out loud to herself. “No…This…is…very…wrong. Shapes…and…colors are…important. No. …This is…very…very…wrong.” She didn’t look up when Dr. Daniels, her psychiatrist, approached.

“Well, good morning, Penelope. It looks like you’re hard at work today.”

Penelope continued to color the single petal without looking up.

Seemingly unfazed by Penelope’s lack of response, he pulled up a chair and continued. “Did you start all these this morning?”

Penelope stopped coloring and looked up. Eventually, she answered, pausing as she spoke, as though she were thinking about her responses. “Yes. I started them all this morning. …Yes. Did I start them all just now?…Yes, I did. I had…great ideas for them…but she took the ideas…out of…my…head. They just…disappeared…when I was working. …They went completely out of my head, and…my mind went blank. …That’s why I had to…start new ones. I started…all…of these…this morning…I wish she…wouldn’t…have taken…the ideas out of my…head when I was…coloring. She doesn’t…understand…the…meaning…of the…shapes…and…colors…like…I…do. The…Kerffies…only told…me…and…I…needed to…use…their meanings…but she…just…took…them…right out…of…my head and…she…won’t…give…them…back.”

“That must be frustrating. Who took the ideas out of your head?”

Again, Penelope took her time before answering. Finally, she said, impatiently, “Eleanor…Roosevelt. You should…know that…by now. …She…always…does that to…me.” Penelope’s voice became softer, kinder. “She just…zapped…them away…right while I was…working. So…I had to start…a new one…every time. And she…wanted me…to use a different color each…time too…She…doesn’t…understand…the…meanings of…the colors. …She took my ideas and…then told me her own ideas. …This time she told me…to use gray. Mrs.…Roosevelt told me…she would do…her magic and…turn it into a beautiful color.”

“Did you want to use gray?” “No,” she mumbled after a long pause. “Did I…want to use gray?…Of course I didn’t…want to use…gray.” Her eyes suddenly grew wide, and she glanced about, frightened. She dropped her voice to a whisper. “Please…don’t tell…her…that. I…didn’t mean…to say that. Please don’t…tell her.”

“You’re afraid of what would happen if I told her?” Penelope had resumed coloring the single petal. Frantically, she rubbed the crayon back and forth across the single petal. She made a small tear in the paper, but still she continued.

“Penelope? What do you think would happen?”

“I don’t…want to talk…about it…anymore.…You need to…go away now.”

“How about this: I’d like to stay, but we’ll change the subject.” He waited patiently while Penelope scribbled her crayon up and down, back and forth, with hard, swift strokes. The tear widened, and she colored on the surface of the table. Dr. Daniels gently placed his hand on the paper. “Penelope. Look at what you’re doing. You’re coloring on the table. Slide your crayon over.”

Penelope didn’t look up. At first, she didn’t even seem to have heard Dr. Daniels at all. Slowly, though, she moved her hand over, away from the gaping hole she had made. As she did this, the speed of her strokes slowed down and eventually stopped. She continued to stare at her paper. “It…isn’t changing to a pretty…color.…I’ve…angered her.”

“Is she telling you that she’s angry?”

She cocked her head as though she were listening. She concentrated for almost a full minute before responding. “No.…She isn’t…talking to me…right…now. I…think she is too…busy.” “Doing what?”

“I don’t…know.” Penelope stared at Dr. Daniels. Her face was nearly expressionless, but the corners of her mouth drooped into a slight frown. “She will…be back.”

“Has she been coming around as much since you started your medication again?”

Penelope fidgeted in her chair. She snatched up her crayon and resumed her activity.

“You’ve become agitated,” Dr. Daniels observed. “What is your body saying right now?”



“Your…glasses…are…circles.…Circles…mean…caring…but…they are…silver and…I…haven’t…learned…the meaning…of…that…so…you…need to…go…now. I have to…color. Just…go now.”

Dr. Daniels jotted notes down on his notepad. He clicked his pen closed, tucked it into its holder, and closed his leather padfolio. “These medications take time to work, and you’ve only been on them again for six days. They will help, though. Tonight we’ll be increasing your dosages, and that may help you feel a difference. We’ll talk more about it later.” He watched Penelope.

Her fingers squeezed the crayon tightly, and her entire forearm moved furiously. Again, her head was bent forward and her hair hid her face from view. She uttered not a sound. Clearly, she was done talking. When he said goodbye, she gave no acknowledgement that she heard him.

She colored and colored in an attempt to placate Mrs. Roosevelt. Sometimes Mrs. Roosevelt talked about things that didn’t make any sense. When she did that, it sounded like a loudspeaker in Penelope’s head, like she was a spectator at a bizarre event she didn’t fully understand. Other times, Mrs. Roosevelt told Penelope things she should do. This morning, it was coloring. But Mrs. Roosevelt was being mean and critical. That looks dumb. Why would you do it that way? Your idea of art is pathetic, so I’m not letting you think about art at all. And then she just deleted Penelope’s thoughts.

Mrs. Roosevelt didn’t understand that Penelope’s work wasn’t based on human ideas of art. Penelope followed the Kerffie language, a complex system of shapes and colors even she didn’t fully understand. Mrs. Roosevelt didn’t comprehend this, so she had emptied Penelope’s mind. Penelope’s mind just went blank, and she didn’t know what to do next. Then Mrs. Roosevelt had shouted at her, What the hell are you just sitting there for? Don’t be so goddamn lazy! Pick up the crayon and color. No, not that crayon. Use gray. You’re not creative enough to choose your own color. I’ll work my special magic and turn it into a beautiful color when you’re done. You don’t have the right to choose a beautiful color. Don’t just sit there. Work! No. Not that picture. A different one. And remember—if you don’t do what I want, I will hurt you.

Penelope didn’t want to be hurt; therefore, she did what she was told. Plus, she wanted to please Mrs. Roosevelt. Eleanor Roosevelt had been Penelope’s heroine for years and years, and it hurt her feelings when her beloved idol disapproved of her, especially since she had always thought that Mrs. Roosevelt was a kind, compassionate woman. What was so bad about Penelope that she brought out this wonderful woman’s wrath?

Thankfully, though, it seemed that Mrs. Roosevelt had gone away for a while. She did that from time to time. Penelope didn’t know where Mrs. Roosevelt went, but, despite the fact that she admired the great woman, she was always glad when she was gone. Actually, “glad” was perhaps the wrong word. She was never glad anymore. When Mrs. Roosevelt was around, Penelope was anxious and tense and afraid. When she was gone, there was room for different feelings. When Mrs. Roosevelt took her occasional breaks, Penelope was desolate and hollow and depressed. Always, always­­—whether the woman was hanging around harassing her or off doing who knows what—Penelope felt “off.”

Simply put, Penelope knew she wasn’t normal. And this knowledge wasn’t just from the conversation with Dr. Daniels when she was first diagnosed. “Penelope has schizophrenia,” he’d said so matter-of-factly, as though he were telling them she had a cold. Without waiting for a response from either her or her fiancé William, he had continued his delivery of her diagnosis. “It’s a very individual disorder; it looks a bit different in each person who has it. Penelope, in your case it’s called undifferentiated schizophrenia. It’s different from the paranoid version we so often see stereotyped by Hollywood.”

Disgusted, Penelope pushed the memory of the rest of that conversation out of her mind.

No, it was not just from that conversation that she knew she wasn’t normal. It was more than knowing the label. She was aware that she was different. She wasn’t like everyone else, and she hated that. She hated knowing it too, because knowing it made it all even worse. Dr. Daniels didn’t hate it. He thought it was wonderful that she was so aware of herself. When they first talked about her feelings about being different, he had been thrilled. He had called her awareness “insight.” About half of all people with schizophrenia lacked insight into their condition, he had explained. Of course, that meant the other half were aware that the hallucinations, delusions, and everything else associated with the illness were not things most people experienced. According to Dr. Daniels, having this insight meant the person had a better chance of managing schizophrenia.

Penelope didn’t feel that her insight helped her one bit. She wondered if she would actually be able to feel happiness if she didn’t know how different she was. Sure, Mrs. Roosevelt would continue to lurk and beleaguer her, and the Kerffies would keep teaching her about their language and ideas. They would keep taking Penelope’s thoughts away and leave her mind frighteningly empty, and then invade her by forcing their own thoughts and ideas into her mind. She would probably continue to physically feel the source of the Kerffies, too, as they tickled her or poked her to make sure she knew they were right there beside her.

But what if she didn’t know this was abnormal? Would ignorance be bliss? Would she just be able to live life thinking that she was okay? Certainly that would be better than the way she experienced it now. How was she supposed to feel happiness, or even slight contentment, when she knew she was mentally ill? She was only thirty years old, and the life she had known and loved for twenty-eight of those years was over.

Penelope looked down at her coloring pages. They were all incomplete, just like she was. She stared at the hole she had made in one of the papers. How fitting. The picture was broken, just like Penelope. Nothing could fix that hole, and nothing could fix her.

You think you’re broken? Mrs. Roosevelt was back. I’m here with you. I’m not good enough for you? You ungrateful bitch! You want to be “fixed?” I’ll fix you. Eat the crayons. All of them. Chew them up and swallow them.

Penelope stared, wide-eyed, at the pile of crayons on the table. Mrs. Roosevelt must have sensed her apprehension, because she lowered her voice to a whisper and crooned, It’s okay. Please trust me. You know I’m magic. Eat the crayons, and they’ll plug up the hole that’s inside you, and I’ll make them glow brightly in all their dazzling colors. You’ll be dazzling then, Penelope. The whole world will be in awe of your alluring radiance. They’ll admire you again. They’ll admire you as much as they admire me. You’ll see. Try it. Eat the crayons, now.

Penelope wanted to be better, to be complete, to be attractive again, and, if eating the crayons would transform her, then eat them she would. One by one, she cracked them into pieces. Snap! Snap! Snap! She split the wax, slashed through the wrappers, slid her fingers into the stack, and shoveled smidgens of color into her mouth.

A tech chose that moment to check up on her. “Penelope! Stop!” She grabbed one of the coloring sheets from her table and held it under Penelope’s face. “Spit it out.”

Penelope grabbed for more crayon pieces and continued to chew vigorously. The tech quickly pushed the pile across the table, sending broken bits rolling and scattering onto the floor. Penelope cried out and tried to swallow. The crayons wouldn’t go down, and she gagged. Involuntarily, she spit them out onto the paper that was still held under her face.

“No! Claire, why did you do that? I have to have those!” Penelope shouted and grabbed at the paper. Claire crumpled it up and shoved it into the pocket of her smock, so Penelope dove onto the floor to snatch up more pieces. Claire intervened. She knelt down by Penelope and gently covered her hands with her own. “Stop, Penelope,” Claire said gently. “Eating crayons is bad for you. I need you to stop.”

Just forget about it, you worthless loser, Mrs. Roosevelt sneered. I was going to “fix” you. You only had to do one little thing, but you screwed it up, just like you screw up everything. You ruin everything. William knows what I mean, doesn’t he, Penelope? You don’t deserve to eat those crayons anymore. I won’t help you.

Angry and hurt, Penelope jerked her hands away from Claire’s. She sprang to her feet. “Mrs. Roosevelt was going to fix me, but you ruined it!”

“Let’s talk about it. Would you like to sit here, or should we walk and talk? We can do laps around the day area.”

Mrs. Roosevelt shouted at Penelope. She summoned others, people Penelope didn’t even know. And from nowhere and everywhere, the Kerffies joined in too. There were so many of them, and they all spoke at once. Penelope couldn’t understand what they were saying. This wouldn’t happen to her anymore if she had only been able to eat the crayons. Mrs. Roosevelt had been right; she screwed up everything. Maybe she could have eaten them, though, if Claire hadn’t come along.

“Where do you want to talk, Penelope?”

Between the shouting and Claire’s chatter, Penelope couldn’t think. She grabbed her head. “I…” What did she want to say? If everyone would go away, she could think again. She had to make herself heard above all the noise. “Leave…me alone!” She yelled at Claire. Even her heart was upset. It pounded angrily in her chest as though it were trying to bruise her on the inside. Her head felt her hands tremble, and it felt their sweatiness too.

“What would help you right now?” Claire remained calm. Even though Penelope wanted her to leave, she appreciated Claire’s soothing voice. “I…need…a…cigarette.” It took a long time to form the words because of all of the roaring voices.

Claire glanced at the clock at the wall. “Well, you’re in luck, my dear, because the morning break is going on right now. The others went down already, but I’ll take you down so you can join them outside. Gratefully, Penelope followed Claire to her locker for a cigarette and then to the elevator. 

Filed Under: Wellbeing & Words

The Nature of Grief: What is Normal? When Does it Become Complicated?

Sep 4

“Each substance of a grief has twenty shadows.” — William Shakespeare

The pain and sorrow that accompany loss are deep and cast many shadows.  There is “normal” mourning and complicated mourning.  There are STUG reactions, or sudden and temporary upsurges of grief, that can occur throughout one’s life. There are thought to be stages of grief.

Feeling impacted by a death or other loss is a part of the human condition.  We can feel, we can love, and we can connect.  When someone with whom we’ve connected dies, it’s logical and expected for us to mourn that loss.  (This makes sense, as one emotion can’t exist without the context of its opposite.  We only know happiness because we know sadness, and vice versa.)

What does this normal grief feel like?  It involves varying degrees of sadness, loneliness, guilt (Why didn’t I do more when she was alive? Why him and not me?), trouble sleeping, anxiety or numbness (often both), fatigue, and even physical pain.  Those are some of the most common feelings, but there are others, too, and each person experiences grief in a unique way.  Each person mourns differently, too.  Two people dealing with loss might feel many of the same emotions (known as grieving), but one might express them (or mourn) through frequent crying, while the other withdraws.  And yet another might become irritable.  As long as no one is harmed, there isn’t a “wrong” way to grieve and mourn.

It’s widely accepted, although admittedly disputed by some, that the above feelings of grief are experienced in five stages.  Researched, categorized, and described by Dr. Elisabeth Kubler-Ross, they include denial, anger, bargaining, depression, and acceptance.  It’s important to know that this is not a linear progression, nor do they all have to be experienced for equal length and with equal intensity.  It’s very common for someone in mourning to “bounce” back and forth, to move from one phase to another and then back again before moving on.  This is part of Shakespeare’s twenty shadows.  The shadows hide things.  Someone may be feeling anger (at the world, at himself, even at the person who died), but lurking in its shadow is both denial and bargaining.  Denial might come back to light and keep the others in its shadow.

A brief note regarding depression:  Grief isn’t a mental illness.  The symptoms discussed above are considered normal, and a person experiencing them after a loss would not be diagnosed with major depressive disorder.  Even the “depression” in the Kubler-Ross model doesn’t mean clinical depression.  It refers to the expected sadness, emptiness, and lack of energy that accompanies loss.  Major depressive disorder is only diagnosed when the required criteria are met.

Can grief ever escalate beyond what is considered healthy?  Yes, it can.  It can become what is called complicated mourning or complicated grief, and it can happen for a number of reasons.  A death that is unexpected or traumatic can lead to complicated mourning as can the death of someone with whom one has had a complicated relationship.  If there is an event, such as a car accident, in which someone survives but others die, survivor guilt can escalate into complicated mourning.

I wanted to show what this is like, so I incorporated it into the novel Leave of Absence.  In the story, Oliver Graham has experienced the traumatic loss of his wife and young son.  He’s admitted to a behavioral health center after an unsuccessful suicide attempt, and at one point in the story he laments to his doctor, “I don’t want to live my life! I have nothing to live for.  Why can’t everyone just accept that and let me go?”  This sentiment is a very common part of complicated mourning.  A person so rooted in grief often wants nothing other than to die.  This feeling can be part of “normal” grieving, too, but it’s fleeting and doesn’t turn into an obsession or a mission like it does with complicated mourning.

Complicated mourning can make it feel impossible to move forward.

Complicated mourning can make it feel impossible to move forward.

With complicated mourning, the symptoms simply don’t fade, and often they intensify over time.  The person becomes completely stuck in his grief, unable to move on.  The longing for the deceased loved one is so intense that the deceased becomes the sole focus of the grieving person’s thoughts.  The person loses all ability to enjoy life (hence Oliver’s lament that he has nothing to live for), and as a result he or she becomes not only numb and detached but completely withdrawn.  In Leave of Absence, Oliver barely uttered a word for several months (this of course occurred before the opening of the story or it would make for a pretty boring novel).  Clinical depression often sets in, making it extremely difficult to carry out daily tasks.  Oliver had such difficulty concentrating on what he needed to do that he quit his job and walked away from his life.

Frustrated, at one point Oliver expresses his feelings this way:  “She’s gone and I’m here and it’s my fault and I don’t deserve help and I miss them so much and I don’t want to betray them by getting better.”

With complicated mourning, it is absolutely essential to get help.  And even with less intense mourning, mourning of the expected variety, help can be useful.  Treating grief is possible and important.


Filed Under: Wellbeing & Words