Madness (16 page)

‘All I could think of at the time was spies – this group of people who successfully lead double lives. I read everything I could about techniques of espionage and counterintelligence, all the biographies, memoirs and straight non-fiction, mostly from the Cold War, and then I put what I learned into practice at home and school.'

‘What sort of things?'

‘It's embarrassing, Winsome.'

She waits.

‘Feeling one thing, physically and emotionally, and at the same time expressing the opposite. I practised sticking a sewing needle in my arm while chatting to friends on the phone or giggling, that kind of thing.'

‘Why?'

‘So when the people in my head shouted . . . stuff . . . no-one else would ever know.'

Winsome shakes her head. ‘These voices may be a part of you, but they are not all of you.' She pauses. ‘And they are telling you lies.' She pauses. ‘Let's think about how we're going to manage them.'

eeeeeeeee shhhhdie

I nod, lips tight shut, not-breathing. The smallest core of hope has lodged itself like a light, somewhere near my heart.

The first thing we do is to devise a way of surviving the supermarket: Sennheiser noise-cancelling headphones. With music up loud I can't hear the people in my head as clearly and by focussing on melody and lyrics, I'm somewhat disconnected from the mountains of competing colour on the shelves. We try other potential filters like breathing exercises and stillness meditation but they are less successful.

Because evenings are most difficult, Winsome suggests structuring the time with normal activities like gardening or cooking, and reducing stimuli – be it aural, visual, kinaesthetic or emotional. We explore ways to ‘wind down' that don't involve alcohol or other drugs.

The answer for me is cello. The violoncello is a member of the violin family, bigger than a viola, smaller than a double bass. There is something about the cello sound – its full, burnished tone, its richness, its ability to lament. Between the instrument and the musical score and the musician, everything is communicated without a need for words.

There is also a physicality to playing an instrument that I love – the sheen of the wood, the conifer-smell of rosin, the strings under my fingers, the bow on the strings. And the repetition of practice is meditative in a way traditional meditation is not, because my attention is drawn out of me and focused wholly on hand position and vibrato and sliding shifts and bow change and intonation.

Winsome and I have been working together for two years now, and for the next ten months we work particularly hard. I see her once a week. She stresses the importance of addressing both halves of my divided brain – the normal and the abnormal.

‘Our aim,' she says, ‘is balance and eventual wholeness.'

She is patient and consistent. It takes another two months before I can turn up to an appointment without an enormous bag of books and six layers of clothes. One evening we spend a whole session – close to ninety minutes – writing a ‘normal' grocery list.

‘What is normal to eat for breakfast, Kate?'

I frown. ‘Coffee.'

‘By itself, no.'

I glare. ‘Air.'

Winsome glares right back. ‘Do not play games with me. It is a waste of your time, and mine.'

The fast flush. The sudden rush of red.

‘We are working together,' she says gently. ‘I can see that that in itself is challenging for you – the process of trust.'

She's right.

‘I like oatmeal,' I say, my voice pathetic and low.

‘Could you have oatmeal and a piece of fruit?'

I think. ‘Okay. Yes.'

We talk about going to the supermarket to buy oatmeal and fruit.

We spent weeks discussing how to structure a normal day. If I'm up till 3 a.m. writing poetry, Winsome says, ‘Kate, this isn't normal. Did you concentrate properly at work?'

No.

If I leap out of bed and walk into the city because I suddenly have to buy some poetry, Winsome says, ‘Risky behaviour. Please don't wander around the city at night on your own. It isn't safe.'

She never lets anything go till we work it through.

‘It's normal to get a haircut at a hairdresser,' she says. ‘And it's fun. It's normal to find a bra that fits properly. It's normal to wear clothes of an appropriate size – clothes that are comfortable for the climate and season.'

And she never lets anything go.

Once I manage a reasonable daily routine, we shift focus in therapy to the idea of mind-body-spirit in equilibrium. I am afraid of the body. The concepts of ‘nourishment' and ‘pleasure' for the body are incomprehensible.

‘Nourishment might be cooking a simple, healthy meal or going for a walk.' Winsome says. ‘Pleasure might be buying and wearing silky lingerie.'

I swallow awkwardly.

She waits for my brain to catch up. ‘Or you could sink into a warm, perfumed bath.'

Now I've forgotten how to swallow.

‘You could have sex.'

‘Outré.'

‘C'est normale.'

She waits.

After a while I breathe out properly. We both half-smile. Eyes and minds stretching and meeting.

Some weekends I drive out of the city. Under a tree is the best place in the world to think, preferably where there are lots of trees – trees and silence and sky. I sit cross-legged under a manna gum just off a walking track in the middle of the Mornington Peninsula National Park and wonder about meaning and illness and the beauty of ordinary life. Can I have an ordinary life? What about the idea of a future?

The surrounding eucalypts, banksias and xanthorrhoea grasstrees remind me of Gondwana. Rhoea is Greek for flow. As well as having sap that flows down the trunk, the leaves of the grasstree look like a green waterfall, and the parts of the National Park where the grasstrees grow thick appear to be spouting and streaming, and within some, a black flower spike two metres tall, broader than my arm, is heading straight for the centre of the sky. Grasstrees have been around for 200 million years. Such resilience.

I wonder whether meaning is connected to pleasure. And then I wonder if addiction is pleasure without meaning. Addiction is certainly connected to illness. And illness is connected to future. The trees soak into my guts and still the shouting in my head. I make a decision: I will get off the benzos.

The brain is a delicate thing, not much given to sudden changes in its environment. If it adapts over time to a constant supply of benzodiazepine, then that supply becomes as necessary for daily functioning as glucose and water. I wake to the sound of music emanating from next door – Yo La Tengo. The bass runs through me. I will get off the benzos. Quietly, with the minimum of fuss, my own little experiment with the forces of addiction.

There is a website that counsels addicts on methods of dose reduction and withdrawal. I sign up as a new member and read that it can take a year or more to fully withdraw, a few milligrams of diazepam at a time. It is an incremental process because benzodiazepines directly or indirectly influence almost every aspect of brain function. They increase the activity of a neurotransmitter called GABA which is the brain's natural tranquiliser. Over time, an addict's brain like mine gets used to this tranquiliser effect, and begins to crave more and more of it just to feel normal.

I gather up the blister packs of lorazepam and alprazolam and the bottle of clonazepam and empty them into the toilet bowl where they disperse blue and yellow and white lines of powder that rise toward the surface of the water. I flush and walk away.

It is autumn. Next-door's crepe myrtle has caught fire. The air has a heavy warmth during the day and a sweet crispness at night. Streetlights come on earlier; people bend slightly into the wind. The first 24 hours without benzos passes. I go to work, I come home, I don't sleep. My jaw is so heavy I find it difficult to eat. Then I find it difficult to speak. Muscles in my neck and upper back spasm, my legs jerk suddenly in the night and now that it is morning, every hair on the pillow is sending an individual signal to the sensory cortex of my brain. I'm not quite sure how to get out of bed. The wind through the trees is a thousand ghosts, whispering, intent. I try opening and closing my eyes one at a time but my eyelashes get caught under my lower eyelid and all I can see is the long black of spiders' legs.

On the third day I sit cross-legged just beneath the ceiling in the corner of the room and watch my body below. I watch the body interact with other people, I watch it lie on the bed – frumpish, round-shouldered and fat. Speech becomes an exercise in chance, walking an exercise in the fragility of balance. The opening of the train carriage door, on my way to work, is as miraculous as the opening of Tutankhamun's tomb – letting in of the light. It takes half an hour longer than ever before to walk from the station because the ground is alternately rising up and sinking as though I am at sea. Within the rises and falls I negotiate putting one foot in front of the other. Sometimes I fail and find myself on outstretched hands and knees, the tips of my fingers curled into the ground to prevent myself from falling off the ends of the world.

Once at my desk I turn on the computer. The icons on my desktop are little dobs of fuzzy colour; emails are dark grey clouds on a white background. My handwriting is unrecognisable.

‘You are very quiet,' people from work say. I smile and try to nod without my head falling off. ‘Busy,' I say. ‘Reports.' Later, I say to my dear friend and colleague, Deborah, ‘I'm feeling a bit weird – I think I'll sit in the library for a while. Page me if anything comes up?' she nods. ‘Sorry,' I say.

‘It's okay,' she says.

I sit in the library with closed eyes – whenever I open them, the books are moving around on their shelves. I am subject to tics, odd sensations, confusion. I can't tell the time of day. Light enters my eye and lingers there, shivering slightly. The sky is too bright. If I rub my hands together I cannot quite feel where one begins and the other ends.

At night the sea enters me, my legs and arms ripple at random, the sides of the room merge with the roof and settle themselves there before sliding back to the floor. I listen to the radio and grasp at the voices – they have an animate form. The radio sound stretches and sways, it looms overhead and then narrows into the hush of a conch shell. Time is capricious. The people in my head flicker and bicker. They take up an enormous amount of space. Sometimes I hear them whispering just behind my right ear. I turn suddenly but they turn with me and remain out of reach.

Naava and I have tickets for a gig at the Corner Hotel in Richmond. I'm interested to see how my body will respond to music. Naava helps me out of the car and up the three steps like I'm ninety years old and in need of a walking frame. A string of clear light globes loops across the roof of the stage. In the dark as the lights flash on-off-on the filaments, frail metal, flower like gold. I merge into the people around me as waves into the sea; they rock and sway inside me. My head splits open to receive the music – its rawness is sandpaper approaching grey and white matter.

On the sixth day there is a soft sheen of fluid over my irises. The hairs on my arms and legs are erect; goose-pimpled. My heartbeat is insistent against my chest, the air palpable on my skin. On the eighth day I can swallow again and wrap my fingers around a glass of water and bring it smoothly to my lips. Water falls into my mouth like rain.

To manage phone calls at work, I listen politely and write down as much as I can in point form and I say, ‘Thank you, I'll look into this and call you back in ten minutes,' and I hang up and pinch myself hard to release some adrenaline and then I read the words in my stuttering hand over and over until they make some sense.

On the tenth day I peel myself off the roof and begin to walk in straight lines, but it is another week before I can own my limbs and my breathing. Life without benzos lends the world a sharpness, it is acute angles and white light and voices that sound out a white intensity. It is like getting glasses for the first time, like seeing the delicacy of leaves on the trees and street signs sharp in the dusk. Benzo-free consciousness means acute concentration, thought that is fierce, that expands and sways, and memory that has a life of its own.

After four weeks I am normal enough to go out in the company of other, normal, people – my presence at work is too ghost-like to count. I'm sitting in a cafe not far from the sea. It has dark wooden panelling, dark wooden chairs, little light, which suits me perfectly. I take out my pile of books, given that reading is again possible. The shopkeeper brings coffee – strong and bitter and black. Then she turns around.

‘Come on, you pigeons,' she says. ‘Out.'

The pigeons continue further into the cafe, under the counter, around the counter, into the back room, their necks bobbing, beaks to the ground and then as they reach my feet, they tip their heads to the side – one orange-rimmed eye each on my eyes . . . my feet . . . my eyes.

‘Hello you pigeons,' I say and I drop little pieces of cake under the table when the shopkeeper has her back turned – it is a rounded back, a soft curve from thoracic spine to neck. But the lines around her eyes and mouth are all old smiles. I drink the coffee, read, smile now and again to the shopkeeper and under the tablecloth the pigeons peck and swallow all of the cake.

‘Do you believe in the concept of soul?' Winsome asks the following morning.

I haven't yet found a way to tell her about the benzos, so I think about this, I look at the roof. ‘Yes.'

‘Psychology is primarily a science, but there is also an element of art. Jung says it's a collision of nature and spirit.'

‘I like that.'

‘Thinking and feeling are equally important, as are perception and intuition and sensation and logic.'

I nod. ‘I'm scared, Winsome.'

‘What are you scared of?

‘It's mostly them, but I'm still scared you'll tell me quietly and professionally that I would be better off seeing someone else – like Aaron did.'

‘I have never – and shall never suggest that you see another therapist. Though I do question your medication, because, whilst it holds you, more or less, it doesn't stop the agonising stuff that goes on in your head, does it?'

Right here, I realise she has just saved my life.

The sunlight is bright-eyed through the window.

‘True,' I say.

‘Tell me what's been happening . . . in your head.'

So I tell her. ‘At night the hooded people come. They carry axes and long knives and I lie down on my stomach on the cold floor, naked, and they hack at my back, my skull – all that soft flesh. I know I'll die, but I do nothing. There is much blood, hot and red and black in the night. Sometimes the whole thing makes me smile. I really need my head drained, Winsome, I need a new brain. Iamasickfuck.'

Winsome listens, and then she says quietly, ‘Your recovery is going to be a very slow and gentle process of trust and taking small steps. It is not always going down a cognitive, action-oriented path: it is much more about the emergence of the real self – the mind and body and spirit together.'

She stands up. ‘I want you to keep telling those voices that they are shouting lies and that you won't put up with them anymore.'

When I walk outside there is a kaffir lime tree in a pot on the side of the road, shining. The rain, the smell of new rain, the way asphalt sings a little and the trees respond and right here, this kaffir lime tree on the side of the road is singing and shining and its double leaves, the newest ones, are midori green and there are drops of water on them reflecting my eye.

Benzodiazepines decrease time in REM sleep (dream sleep). Sleep without benzos is the people in my head and the dreams and me locked together in a cranial cavity fifty-seven centimetres in circumference. The frontal bone and the parietal bone, the temporal and occipital and sphenoid bones are articulated but not fused to allow moulding through the birth canal and later, growth of the brain, but they do not accommodate a way of escape from this violent phantasmagoria.

Is dreaming the closest a sane person can come to the experience of madness? Seventeenth-century physicians hypothesised that dreams and madness shared the same movement of vapours and animal spirits; the notion of waking was ‘all that distinguished a madman from a man asleep.'

I moan and whine to Naava and Zoë about the dreams, about being awake more than half the night – sweating, tachycardic and breathless, and about reeling through the workday with blurred vision and a high b'zzzz in my ears.

‘What about trying one of these?' Naava walks into my room holding a box of Pericyazine tablets. Pericyazine is an anti-psychotic, but some psychiatrists use a low dose for the symptoms of severe anxiety and insomnia because unlike benzodiazepines, it is not addictive and doesn't induce dependence. Tonight, I take a single 2.5 mg tablet and curl up in bed with fleece blankets and fat cats and the BBC World Service.

Two months on pericyazine, two tiny tablets at night, one at midday. The most extraordinary thing is happening – the people in my head are fainter, less insistent. There are whole hours when they disappear all together. And sleep. Oh blissful, beautiful sleep – for more than two hours in a row, for more than four hours in twenty-four. Mornings are new. I wake without the memory of the preceding night bitten into my brain, without the vague sense of horror. My pyjamas are dry and soft and they don't smell. Sun waves are reflecting from my neighbour's pool onto the bedroom wall and I've never seen anything so sleek or so tender.

Normal sleep is now thought to have an essential role in cognitive and emotional processing. Sleep deprivation decreases the metabolic activity of the brain, particularly in the prefrontal and parietal-associational areas. These are important for judgement, impulse control, attention and visual association. People with chronic sleep deprivation are usually unaware of the extent of their cognitive deficits.

‘Winsome,' I say. ‘I've started answering the telephone at home. And the television isn't leering at me at night when it's turned off. Who knows, next I might take the blankets off the mirrors, next I might even touch someone.'