A Troublesome and Troubling Reality
My eye hit upon a story from Canada the other day-- the publication in the Vancouver Sun of a report that an 85-year-old bipolar woman -- Moira "Betty" McFarland-- "disappeared herself" by getting on a bus in Vancouver, B.C. with a ticket to go to Edmonton, Alberta-- and thus has not been seen since the middle of this month (August, 2007.) The description in the paper is revealing -- Moira is subject to depression, agitation, anxiety, and lethargy; she must walk with the assistance of an aluminum cane. Released late in July from a mental hospital-- a place she has reportedly frequented a number of times, for duration-- she simply left a note for her husband of 62 years that she was "leaving." She is known to deny her own name on request. From what I can tell from the Internet, Mrs. McFarland has yet to "turn up" to this date.
This story parallels another item--this much closer to My Old Kentucky Home-- "Missing Man," as reported from Lex18 television dated June 23, 2007-- from here in Kentucky of recent date, where a bipolar man-- Travis Wilson, age 27 in the "mountains" of Bell County east of here went missing, apparently as a sequel to having a flat tire in that sylvan locale; he is said not to have been on mood-stabilizing medication for several weeks. Search and rescue efforts had been nearly abandoned at the time of the posting, and almost certainly are so now-- two months later with no positive result.
As a topic followed by Websites like "Treatment Advocacy Center," see entries for January 19, 2007 and March 15, 2006, one can get a clear sense that this "going-missing" is a "mishap that happens"-- with varying degrees of trauma to social-others depending on the "ties" of the mental patient-- chronically, and all over the United States and the world. Sometimes the missing subjects turn up dead, not necessarily of foul causes, as was the case of a bipolar man described in METROWEEKLY (of Washington, DC), January 18, 2007-- Donald Charles Ebe whose skeleton-body was found in a woods not too far from his Virginia home some time after simply walking away from a responsible job as receptionist in an "upper-crust" residential complex. The investigators who reported on the finding of the body said "it's not looking like anything but him just laying down [and dying.]"
Stories like this compel the mental health consumer to reach for explanation to a public which largely cannot fathom the "means, motive, and opportunity-structure" (which does obtain-- if in an illogical way-- even with mental patients in deep psychosis) behind such elopement. I think I can speak for myself as an example-- because I have BEEN THERE. I shall relate the circumstances of my hapless running-away-- perhaps in a way as to illustrate how betimes this behavior -- while abortive to the caring-ones left behind-- results from patient-impulses which need not be reprehensible. In my first psychosis some thirty years ago-- I left my wife completely "out-of-the-blue"/unannounced (to her) and "escaped" from home in the suburbs and professional job (as social worker) to head off to Indiana north-country. From misconstruction of something a man had told me, I wanted to go to the penitentiary in Michigan City, Indiana and serve out the sentence of a man whom I inferred was innocent of the charge for which he was "serving." I got as far in my Datsun as Purdue (the city known for the University by that name) when I had a flat tire, and to make a long story short, went to live in the "woods" in that suburbs (not very "wild woods," I'll have to say) until the police found me, and rather than lock-me-up, they permitted me to go to Our Lady of Peace (mental) Hospital here in Louisville. [It was the beginning of a long, bitter story of struggle with myself, my symptoms, and a community/society willing to have only-so-much-tolerance for my discomfiture: I am still-- though improving somewhat-- in that phase, after 21-- mostly involuntary-- hospitalizations for bipolar affective disorder.]
From my experience, I know that psychosis can mean the radical re-definition of the meaning of a (social, etc.) situation: the logic works for the assumptions it has, but the definition-machine has gone awry. Harry Stack Sullivan speaks quite adequately of this condition when he (mostly in reference to schizophrenia) invokes the notion of "parataxic distortions" in the psychotic-- meaning that the person in psychosis interprets incorrectly -- yet personally-- in serial logic ordering of events-- feels a connectedness that no one else makes with physical and social reality. This is not too far from the notion of "ideas of reference" [see this term in "Glossary: Terms in the Field of Psychiatry and Neurology"] so commonly witnessed in the psychotic process. Now in the end, the floridly psychotic manic and the same condition in the schizophrenic produce-- or can produce-- nearly identical symptomatology; and indeed much of the recent literature to this point suggests a blurring/overlap between the manic and schizophrenic conditions in the neurological substrate etiologically.
In this particular instance-- the case of "going missing"-- the elopements doubtless have a motivation. Logic needs to be evaluated -- the modern logicians would tell us-- modally-- that is according to the linguistic mood from whence it obtains. There is a moral logic and a deductive logic and an inductive logic-- and by virtue of the ideas-or-reference factor only the inductive logic feature may decompensate in people like me, "on the loose." This does NOT mean, of course, that the mentally-decompensated cannot "get themselves in a peck of trouble," and when that does happen, it is not an overweening possibility that any "insanity defense" will work to undo things in the social order. While with me, for instance, the desire to serve an innocent man's prison sentence might be considered the height of altruistic "martyrdom," I never was understood for that-- or forgiven, by my mental health professionals (I had one of top-flight Louisville psychiatrists upon arriving home), by the police (who only saw a wretch in an Indiana woods that day of "arrest"), nor was I ever again trusted or much-beloved by my spouse. It took ten more years of stuggling with this failure before she -- for this and every perceived/fancied psychopathology she saw in me-- ASKED FOR A DIVORCE. [OK: I didn't fight it: it was UNCONTESTED utterly out of respect for the trauma I had in all inflicted on her. From then on, I had to face-the-fray of life utterly alone, with only the cops to get me to the hospital when need-be.]
What one does in psychosis-- for whatever motive-- has consequences. The crimes one commits, which from the individual perspective of the patient may have a defensive or sympathetic rationale-- nevertheless "sting." Likewise, the business of "going missing" for whatever reason: of course, the elopement inevitably works out horribly for the one-who-runs; yet and still it will probably will deep-fry terror in ordinary "caretakers" and it is not impossible that secondary mental/emotional disturbance may occur in these loved-ones. A perceptive explication of the mental health contingencies associated with having a missing friend/relative is well-enounced in the Australian site, "Someone is Missing: Common Mental Health Issues," [undated]; here the one perhaps substantive weakness in the writing is its sole depiction is of psychic distress to the caretaker of the missing person, rather than of the sequelae of distress generated by a mentally-deranged eloper herself/himself: nothing is said about the specific contingency of a mental patient's missingness as causative in psychological trauma in others (like, for example, the generation of PTSD-- post-traumatic stress disorder), but it can hardly be doubted that due to the sheer misunderstanding-factor of such runaway-events, we may anticipate even greater stress/depression/anxiety-related disorder in these loved ones than may obtain in other disappearances, which in fact may sometimes be intuited as validly and realistically "getting away from a bad situation."
Accordingly, I think these stories and this material touches a deep nerve in social conscience-- both for the repentant mentally-ill eloper and perchance for thoughtful members of the "madding crowd." While elopements did occur from mental hospitals back in the bad-old-asylum-days, they must have been more rare, for these institutions were by and large fenced/walled-in edifices from which escape was not easy. Now in a bittersweet day of "life, liberty and the pursuit of happiness" for the mental health consumer, conversely escape is easy-- but the griefs caused by escapes-from-"reality" like these will never be easy. One may then consider this writing a "call for reflection, study, and (reasonable) action."
---Vernon Lynn Stephens, M.S.S.W.
D.S.M. IV-TR #296.44
Telephone: 1(502) 561-5419
E-Mail: freethink@bellsouth.net
posted by 2 Steps Forward, 1 Backward @ 8:47 PM
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