On Finding New Rhythms


This is a tentacle eyeball pumpkin that I painted. Happy Halloween!

I want to start by saying that I love Trudy Schoop. I think she was remarkably fearless and irrevocably passionate to choose to walk into an institution with the idea that she could share her knowledge that dance is therapeutic with such a difficult population. In a lot of ways, I strive to be just like her in my career. However, she said one thing in particular that caused me to have a negative reaction.

“An atmosphere of abstraction hung over the ward, and abstracted were all the individuals living out their dream-like lives within the utilitarian dormitories and dayrooms. Spellbound, I watched the portrayals, the personifications. It seemed to me that these men and women had all the attributes and techniques of the stage at their disposal. Here were the symbolic gestures, the magnified expressions, the intensity of projection, the masks, the make-believe, the fantasy.” (Schoop, pg. 24)

That didn’t sit right with me, not at first.

While I recognize the difference in time period is monumental, this “fantasy” business really rubbed me the wrong way and I couldn’t get it out of my head. I mean, I work with the same population that Trudy worked with—individuals with chronic and persisting mental health diagnoses. Most of the individuals I work with have psychotic disorders. I was bothered by the words “fantasy”, “dream-like”, and “make-believe” in relation to psychosis because by and large psychosis isn’t pleasant; it’s not an escape to fantasy land, and if it is, that’s not a good thing. My initial thought when I think “psychosis” is of hearing voices. Voices that convince you that you’re fat, ugly, bad, unlovable. Voices that say you have bugs under your skin, and insist you pick them out with your fingernails.  Voices that tell you to break things, to hurt yourself, to hurt others. Voices that say you’d be better off dead, so you’d better walk in the middle of the road and wait for a car to hit you. To me, this isn’t fantasy. It isn’t real, certainly, but when I think fantasy I think of Disney Land and cos-play and acting. I don’t think of hallucinations and delusions that cause an individual to become a person that they don’t recognize, to wholeheartedly believe that Bono or Jesus Christ is telling you that you’re worthless. No, that isn’t fantasy to me.

While this all rubbed me the wrong way, I knew that there was something I was missing, because Trudy Schoop really invested herself into helping these individuals unselfishly, and it wasn’t easy for her. We aren’t talking about a person who holds an ugly stigma against people with mental illnesses, not at all. She worked hard to reach the most difficult individuals, and I give her a lot of credit. I’d also like to note that Trudy worked with individuals diagnosed with psychotic disorders before the United States approved the use of the most effective antipsychotic medications, and before the United States realized that these immense institutions/asylums are not the appropriate way to care for its mentally ill. That’s all a very big deal. What was I missing?

My roommate is similarly a social worker. She is my former boss, and has several years more experience in the mental health field than I do. She’s been a mentor for me my whole time working in the field, and she challenges me constantly by forcing me to look at things from different perspectives. Sometimes she tells me to take the rose-colored glasses off and recognize reality, but sometimes she catches me without my positive, groovy glasses on and reminds me that life isn’t always shades of darkness. I asked her what she thought about the quote and whether or not I was hung up on the vernacular, or something else.

“Sometimes schizophrenia IS fantasy. Some clients make a decision to succumb to their illness, instead of fighting to hold onto the kind of reality you and I know, and maybe it’s not bad all the time. Not all hallucinations are scary. Think of Nancy*. Nancy totally lives in a fantasy land, and you know what? It works for her. Think of how serious Nancy’s illness is, but is she depressed? No. She is so confident and comfortable with herself, and she absolutely walks around living in her own make-believe, but it works for her. Who are we to judge? That’s how she’s learned to navigate her environment, and people like her for it.”

She’s right, of course. My pal Nancy is a fabulous human being. She’s in her mid-to-late fifties, and has had mental health concerns since she was in her twenties. However, Nancy is the most positive person I may have ever met. If Nancy feels like wearing a ball gown and parading around the apartment complex that day, don’t try to stop her! Should Nancy feel like painting a landscape, don’t you dare tell her the sky can’t be purple polka-dotted, because she’ll proudly tell you that SHE says it can be, thank-you-very-much. Nancy doesn’t shy away from social situations, and she blatantly ignores any prejudice that may come her way in the community. I have taken Nancy on many a trip into the community, from stores, to restaurants to potlucks to drum circles. Nancy is fearless, and not unaware of her own mental illness. She’s plenty aware. She simply behaves as if her illness makes very little difference in her day-to-day life, and she is quite pleased with herself, generally speaking.

It was hard for me to change up my frame of thinking in this way. I care very much about my residents at work, and I’m compelled to be an advocate for this population. I’m deeply offended by the way some people view individuals with mental illnesses so much that I think I become fiercely defensive of negative language. I was reactive to Trudy Schoop’s quote because I felt that she was seeing a room full of schizophrenic individuals as a room full of circus performers and minimizing their struggle.

I realized that in being too protective over my residents and people with mental illnesses in general I myself was generalizing their unique behavior as negative. There was the key that my mental lock was missing. Trudy never believed that this unique movement was anything but just that: unique. She saw the benefit to embracing this movement, and taught her patients to celebrate it. She allowed her patients to embrace their natural movements and apply them to something bigger: dance. In my work practice at least, it seemed that I had forgotten to celebrate individual differences. Instead of letting my individuals dance to their own rhythm, I was metaphorically trying to teach them the steps to a proper dance, kindly and patiently correcting them when they tried it a different way.

I’ve been thinking about this concept a lot at work now, along with Andrew Solomon. It’s challenging for me. I mean well in trying to teach my residents to “dance” in a formal way; I want them to be able to be functional members of their community and reach their goals. I was just forgetting that goals aren’t reached in only one strict way, that everyone has to find their own unique rhythm.

 * “Nancy” isn’t Nancy’s real name. I chose to call her Nancy because she sometimes asks if she can call me Nancy, says I look like one.

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