- Dorothea Buck, Nazi survivor, helped me to rethink psychosis.
- To change, mental states must be understood.
- I learned to avoid the trap of “the madness of fearing madness.”
At age fifteen I heard a doctor tell my parents I was schizophrenic. And that I’d probably live institutionalized. Not long after hearing these words, I became reckless and suicidal. In other words, I acted like someone told her she has no future.
The doctor I needed then was not a doctor at all. The person I needed was Nazi survivor and psychiatric activist, Dorothea Buck. Her prescription for psychiatry: Don’t talk about “sickness.” Talk about meaning.
Mostly, she suggested, talk.
I was ultimately diagnosed with bipolar. The label’s less important to me than the experience--at times I live psychosis. It’s a different, non-consensus reality, consensus reality being the one everyone agrees on. In many cultures, this life is considered not blighted but potentially truthful in a different way, even shamanic.
I've mentioned Buck here before. Like me, she was diagnosed with schizophrenia. She was nineteen. For this diagnosis, she was sterilized under Nazi law for the prevention of hereditary diseases. One of her earliest hallucinations was a voice telling her, in 1936, that Hitler would start a war on a monstrous scale.
The adults in her life said that what Buck saw wasn’t possible.
Mad Experience and Living Whole
Like Buck I’ve heard voices, whispering under my windows. I’ve heard strange voices coming from within, a scary process I’ve learned to understand and tolerate. I’ve felt walls move. This has been my life: I had non-consensus experiences even as a child. At eleven and twelve I rifled through books to find an amulet to protect myself from witches and heard God speak through my tortoiseshell cat. At one point, I believed I was being poisoned.
I wrote my early visions in diaries I kept. Rereading, I don’t find a life painfully smashed by psychotic thoughts. The poison image was frightening but disappeared on its own. On the day I looked up witch’s amulets (oddly enough, in a World Book), I also wrote that the Chinese silver dollar I had was very pretty.
I had days of crushing misery I couldn’t explain. It was depression that got me into that first psychiatrist’s office, where I guess I shared too much of my inner life. I had days of what I called my “good stomachache” or “love knot.” Then I felt so overwhelmed by the beauty of the world I snuck off to cry.
These moments live in my pages with a crush on a red-haired boy named Kevin, my first lipstick. Ordering that weird 1970s fashion, the paper dress. I never doubted I had a future.
My life was a whole. My ability to think of it as a whole balanced me. I didn’t consider some thoughts “other.” Even disturbing ones lacked the intensity they had later, when I believed they were part of an illness process I couldn’t stop.
“The Madness of Fearing Madness”
Painful mental states, Buck believed, don’t just come from within. They come from what medicine and society tell experiencers about their minds. Moving from amulets to a word like “schizophrenia” is terrifying.
Psychiatric diagnosis can be its own mental crisis—what psychologist Richard Bentall calls “the madness of fearing madness.”
In her autobiography, On the Trail of the Morning Star, Buck recalls a nurse she’d been hospitalized with. The nurse’s medical training, Buck wrote, worked against her as a patient: “It was exactly her fear of an unalterable fate that made her experiences so torturous and frightening.” Buck wrote and spoke throughout her long life. To be changed, she said over and over, mental states must be understood.
Understanding Hopes and Dreams
The great psychiatric reformer Philippe Pinel wrote in the late 1700s that doctors must understand their patients’ “hopes and their dreams.” Pinel spent hours with his patients and kept detailed notes.
Now the average psychiatrist has hundreds of patients and conducts mostly twenty-minute med checks. Not much time for hopes and dreams. Buck was not anti-psychiatry, as we use the term. She didn’t think it had no place. She did argue that nothing happening in consciousness can be only disease-based and meaningless. My visions were intimately connected to my life. Buck's foreseen war did come.
Proving a biological basis for mental states has remained tricky. Writers like Anne Harrington in Psychiatry’s Troubled Search for the Biology of Mental Illness have unpacked this struggle. We live in an era of mental health crisis, particularly among the young. We also live in an era of constantly rising psychiatric medicating. Clearly, we’re missing something. Maybe, as Buck would say, what’s missing is a search for meaning.
It’s Healing to Trust the Mind
Research reinforces that metacognition—beliefs about the nature of one’s own thinking—affects how people respond to events like anxiety or voices. Inner worlds can be scary. Listening, not panicking, makes them easier. This madness of fearing madness comes at least partly from our medicine. The latter can help address it. In my experience, it doesn’t.
It is healing to simply try to trust your mind, trust that it’s somehow working on your behalf.
When I was twelve, I wrote that life was a sort of a play and humans were characters wearing “garments of such complexity and intricacy it dazzles the one who is slow enough to think about it.” The “slowness” to think about it, I indicated, was not normal. To be slow enough was to allow your brain to break the rules. I felt then that I could do this, and my difference let those “garments” dazzle. It’s saved my life more than once to believe this.