The Caregiver’s Dilemma
By Ben KafkaSeptember 23, 2020
Many of us who have admired him from afar had no idea that all this work was taking place against a background of immense personal suffering. In the fall of 1991, his son Gabriel, then a freshman at NYU, experienced a psychotic break, which took the form of a sudden, overpowering need to become homeless. Over the months and years that followed, Gabe would retreat more and more into madness — diagnosed, for the most part, as schizophrenia. This struggle ended, in 2012, with Gabe’s suicide.
Or, rather, the struggle has continued, now differently, as the painful work of mourning. Mitchell’s new book, Mental Traveler: A Father, a Son, and a Journey through Schizophrenia, recounts the impact of Gabe’s illness on Mitchell and his family. The book is brief, matter-of-fact, and agonizing. I suspect that many who read it will identify with one or another of the people we meet there, all of whom are doing their very best under very difficult circumstances: the desperate parents, the distraught sister, the worried friends, the ineffectual mental health professionals, and of course Gabe himself, whose belief in his own greatness was so in tension with the reality of his situation.
One of the great virtues of Mitchell’s book is its honesty about the challenges of caring for someone who moves in and out of states of grandiosity. The British psychoanalyst Eric Brenman used to say that, in madness, you can be both Jesus or Napoleon and a very small child whose needs must be met by others. In these grandiose states, the needy part of the self is a despised part of the self, hence the impulse to experience it as if it were outside the self, something foreign and dangerous. In some delusions of persecution this takes the form of individuals or organizations that are trying to rob the self of its extraordinary powers, usually out of greed or envy. In other delusions, the enemy takes the form of invisible, or only dimly visible, social forces, though the motives and methods remain much the same. Gabe seems to have found confirmation for the latter delusion in the anti-psychiatric literature: R. D. Laing, Foucault, Deleuze and Guattari, and similar authors who encourage us to see schizophrenia as a political phenomenon rather than as a sickness. Tragically, it is both.
“I want to put my illness to work,” Gabe tells his father at one point. “My goal is to transform schizophrenia from a death sentence into a learning experience.” Tragically, here, too, it is both. Mitchell’s book carries that work on, making it possible for all of us learn from Gabe’s experience as well as his own. Mitchell and I spoke over Zoom about the Mental Traveler last month. A lightly edited transcript of our conversation follows.
BEN KAFKA: Thank you for agreeing to speak with me.
W. J. T. MITCHELL: As you may have noticed, I love talking about my son. I loved him dearly, and I thought he was an extraordinary person, so I’m always happy to talk about him. People always say, “It must be hard for you to talk about this.” I say, “Actually, no. It’s really good.”
Is that part of what moved you to write this book?
The basic motive maybe, I’ll never know. I felt I owed it to him, that I had a debt, that he had these wonderful ambitions that weren’t fulfilled, couldn’t be fulfilled, and that I thought could and should have been fulfilled if he had survived. So I wanted to give him some measure of what he wanted.
I also felt like I had to tell his story. As I say at the beginning of the book, there are some books you want to write, and there are other books you have to write and you never thought you would. I didn’t expect to do this, but I actually started writing it the day after Gabriel died. The first draft was completely different. It was terrible. It was defensive, an apology for writing this and for having to write it. I showed it to one of my closest friends, Bill Ayers, and he said, “Tom, this isn’t what you want to say. Don’t apologize, just tell his story.” Bill simply gave me permission to narrate.
Some of the things that are in the book now came in very late. The first things that I wanted to talk about were the things that made it clear, in memory and to a reader, why [Gabriel] was an extraordinarily lovable person. Parents love their children, but I wanted to specify it. What was lovable about him?
Many things come across powerfully in the book, but one thing that came across with particular force was the energy inside Gabe. There was clearly a kind of movement inside him all of the time.
He was a person with great ambitions as a filmmaker. I think this sometimes got the unfortunate label of “grandiosity.” I found myself warning him against grandiosity. “Be realistic.” I regret every time I said that, because it became an issue for him. “Oh, am I being grandiose now?” I don’t know what the right thing to say is when someone is going way overboard with their ambitions. Just as an example, he had a video camera, a Handycam, which we gave him, and he was constantly using it, constantly making movies. But he said, “The proportions of the image have to be for Cinemascope.” [Laughs.] I asked why, and he said. “Because when all of this is being seen on the big silver screen, it’ll need to be in Cinemascope. I don’t want to have to reshoot it all.” So yeah, he had a tremendous energy, but also tremendous blockages for it as well.
So much of the book is about the movies.
Yes, it really is. He was destined to be a moviemaker. He was constantly shooting films and finishing a number of them. Not to mention all of the scripts that he wrote, and he studied film history.
What struck me, both in reading the book and in watching some of Gabe’s movies online, is his desire to get at some kind of truth, and his deep impulse to communicate it, to share it with others.
When it came to film and talking about it, that’s where he was very communicative. If you tried to talk to him about the voices he was hearing, about his illness, he became very defensive. A lot of people didn’t understand that he had a mental illness because he would present so well. But we knew because of the anger, the frustration, the unhappiness he would pour out to us. Even with us, though, he became more and more defensive, I think. The worse he felt, the more he felt he had to protect us from it, or that it would just be bad to talk about it. He never could open up to a therapist fully. I mean, he would talk, but as he’d describe it, “I filibustered for an hour, I blustered, bullshitted them. Because they can’t help me. They don’t know what they’re dealing with.”
I guess talking can be a way of getting at the truth but also of getting away from the truth. And Gabe was bright enough to do both well.
He was very good at evasive action. He was a complex and gifted person. There was an unexpected turn in the last few years, where I was starting to be his student. I was learning from him and trying to catch up with him. Partly because, as his interest in film grew and he became more ambitious about it, he wanted to pull me into it. I wanted to be pulled into it, and in fact I was pulled into his project for a nine-hour film that would show “madness from inside and outside.” It was an Histoire de la folie modeled on Godard’s Histoire(s) du cinéma. I became his research assistant, charged with assembling a global archive of images of madness, a “Bilderatlas” of insanity. The remains of that project will be my next book.
But probably my biggest decision was whether to retire from my academic job and go into the film business as his partner. But then, I’d think, no — that’s a bad idea. I was afraid that it could be really bad for him for me to be too involved. That’s why the decision about making films with him was so agonizing. I still have second thoughts about it. Perhaps this is why I’ve been watching lately lots of films about time machines, which all deal with the question of whether you could go back to a decision, take the other choice, and see if that worked out. What would an alternate history look like in which things did not go this way?
One feature of having someone in your family who’s suffering the way Gabe suffered is that you really just don’t know what to do. You don’t know what the right choices are. You feel like every choice is a wrong choice. And in some ways, every choice is a wrong choice.
That is the great dilemma of what they call the “caregiver.” It does seem like there are no good choices, except sort of being there, being sympathetic, and trying to hold it together. But to be proactive, to try to push in some direction or other, can be full of peril.
The major decision we had to make, very early on, was whether he should live with us. And we decided, and his therapists agreed, that it was bad for him to live with us. Of course, his perception of that, when he was angry was, “You’re throwing me out, aren’t you? You don’t want me around because look at the mess you made of me.” And we’d say, “No, no, we love you very much, but it’s not good for you to be here. You have to grow up; you have to be independent; you have to set your own course in life.” So you have these kind of impossible conversations. But, of course, the fact that you have been urging him to go into the mental health system, where he’s being labeled and diagnosed, most traumatically with schizophrenia, he says, “You’re throwing me out and you’re putting a label on me that makes me an outcast. And you’re collaborating in that exile of me from straight society.” His greatest fear was being cast out. That’s what schizophrenia is: you are cast out.
You’ve probably observed this in your own practice. Families don’t always agree about the right thing to do when someone goes crazy. And, as you said, sometimes there is no right thing. But you have to decide on something. And then when that becomes mixed up with family dynamics, it can become very toxic, dangerous for a family unit. People second-guessing each other.
In a way, it drives all of us mad, doesn’t it?
It’s contagious. You feel like, what are we supposed to do here? How are we supposed to understand this? What’s the reasonable and rational thing to do?
So let’s talk a bit about your work of understanding. You said you began to write the book immediately after his death, so that was —
Eight years, almost a decade ago now. The book attests to your own long work of trying to make sense of Gabe, of his schizophrenia, of his death.
I’m not a psychiatrist. I don’t have any competence with these labels. But as a parent, I had to struggle with the labels. Gabe and I were also doing a reading program about schizophrenia from many different angles. E. Fuller Torrey’s Surviving Schizophrenia to the rescue! And Elyn Saks’s wonderful memoir of her life, The Center Cannot Hold, which Gabe and I actually read together.
What was that like, reading those books together?
I think the most exciting thing was when we started reading the anti-psychiatry movement together. We read R. D. Laing and Deleuze. And that’s when he began to turn it into a political issue, and to identify himself as part of a minority. He also started to treat madness, mental disorders, as a collective phenomenon. He would have thoroughly approved of an essay I wrote about the Trump election called “American Psychosis,” (published in the LARB, by the way), about how an entire country can go crazy. Whether that’s a clinical issue is another question, but there’s no doubt that something irrational, self-destructive, deeply deluded has overtaken American culture. He was very happy to make it a political issue. It made him feel better, in a way, to say, “I’m not actually cast out. I’m just a more sensitive seismograph of the craziness that is all around.”
There’s a tension in the book, and I think a tension in a lot of people’s experiences, between, on the one hand, this very private experience of madness — some of which can be shared, and some of which, for the schizophrenic, can never be — and on the other hand, madness as a sort of social, cultural, political phenomenon.
Yeah, we were really caught in it. Because on the one hand, I wanted him to be cured. I wanted the suffering to be alleviated. He was tormented. And of course the love story is central to that. When we read R. D. Laing’s The Politics of Experience and came to that passage where Laing says, essentially, forget about the modern labels, maybe schizophrenia is fundamentally a broken heart and a shattered self. We said, “That’s it!”
When Gabe was a freshman at NYU, he became obsessed with a young woman who was oblivious to the effect she was having on him. We met her a number of times. And they were never boyfriend and girlfriend, but she was the kind of young woman who could say, “Oh, I adore Gabe. He’s such a wonderful guy. I do love him.” And we would say, “Okay, you can tell us that, but don’t say that to him.” He didn’t know how to hear that without taking it in a way that she didn’t intend. “You are supposed to be his life partner, that’s what he feels. You are the key to his entire destiny.” A lot of his suffering was just unrequited love. He idealized this young woman and made her the center of his being. That went on until really very late. It never completely disappeared.
Then there his alternate narrative of his illness as PTSD. He believed that all of it had been the result of a single trauma, of being hit over the head with a tire iron, of being beaten up in a gang rumble downtown, a story we could never verify, but which he could elaborate with lurid details of betrayals by his friends.
And then the third narrative of his schizophrenia as a kind of social or political phenomenon. Your book argues that society has come up with a system for diagnosing or classifying people, who often end up feeling cast out …
Yes, and the casting out as being the most important thing. We went through the predictable cycle of labels, usually with a sense of relief that his condition had a name, and then disappointment when that name turned out not to include a cure. Even after his passing, I’ve had psychiatrists tell me with full confidence, “Everything you’re telling me suggests that he was bipolar, not schizophrenic.” When they say that, I get pretty pissed off. For one thing, you’re saying that on the basis of hearing my random remarks, you’ve never talked to him yourself. And besides, what difference would that make?
[Long pause.] Ben, have you been doing therapy on Zoom?
No. I only use the phone. I think, when we first had to start deciding how to continue working, there was this idea that video sessions would somehow be closer to in-person treatment, but if there’s one thing we media theorists know, it’s that this is an illusion. Also I just don’t like it.
Is it the face-to-face? Is that the problem?
The digital artifacts give it an uncanny feeling. The pixelation, the brief delays, the mismatch between sound and image. Not that the phone is great, especially the cell phone, but for me at least the phone marks a difference. Like, this is not a normal time, this is an unusual time, and we’re doing something different until we can go back to doing what we’ve been doing.
And then of course there’s the question of, “Could this be the new normal? Are we going to have to adapt?”
Most of my patients lie on the couch, so it’s not face-to-face anyway, though obviously the physical proximity, with all of its pleasures and anxieties, is an essential part of the experience.
I’m deeply in love with Freud, I don’t care what anybody says.
Who’s not in love with Freud?
Our young students, for one. They tend to dismiss Freud as hopelessly out of date, sexist and clueless about modern problems. That is why when I have taught, for instance, Freud’s case history of Dora, I don’t try to convince them that he understands Dora, or that he did the right thing, or anything like that. Of course it’s a failed analysis. But I divide the class in two, and ask half of them to mount a defense of Freud. Invariably, the defenders do the better job, because they have to work hard to overcome their contemporaries’ automatic prejudices.
You know, I think that there’s something about Dora, something about early Freud in general, that’s relevant to what we were talking about earlier, about family dynamics, group dynamics. So much of that treatment consists of Freud trying to get Dora to listen to reason, or what he thinks of as reason. It’s like he’s shaking her by the shoulders shouting, “Can’t you just be reasonable?” But of course she can’t be reasonable, her situation is crazy, it’s made her crazy, he’s making her even crazier, and soon she’s making him crazy as well. He keeps insisting and insisting until finally she says, “Fuck that,” and off she goes. It’s the only sane moment in the treatment. As we know, Freud then spends a number of years brooding over it and decides to publish this record of his failure and what he learned from it, which is the theory of transference, which implies that at some level we can never “just be reasonable” with one another.
I think that those of us who have spent time with madness in its many forms, in any of its forms, can relate to Freud’s attitude, as problematic as it is. On the one hand, I know that you’re going through something crazy, that you can’t just be reasonable. On the other hand, we still sometimes find ourselves insisting, Why can’t you just be reasonable?
That’s right. And Freud had the honesty to write it all down, and not to give himself the credit for any kind of cure, but to describe it for what it was: a failed analysis.
Did you have moments like that, of can’t you just be reasonable? with Gabe?
All the time. But then I’d think, “How reasonable can I be? What are my reasons here?” The line between mental illness and normality, the more we experienced it, the way we studied it together, it just seemed to slip into so many gray areas. Even the fairly clear line between neurosis and psychosis — the line that served as the boundary between where I am coming from psychologically and where he was — even that tends to fray sometimes.
It does seem that in a lot of the anti-psychiatric literature — and I can see Anti-Oedipus over your shoulder there in the background — there’s something that tends to kind of wish away the madness of madness, the terror that Gabe was experiencing, the terror that you, your wife, and your daughter were experiencing. There’s something about the romanticization, even celebration of schizophrenia in Anti-Oedipus that leaves all of that behind.
It was a real temptation for both of us. And this is probably, for me, a result of my early work. My doctoral dissertation was on William Blake, and though psychosis wouldn’t be the right name for his mental condition, he had visions, he heard voices. His poems were dictated to him, and he said he was “copying his imagination,” his visions of what would appear to him. But Blake’s madness was in a religious, artistic, and political context completely outside of any clinical framework. All he had was hostile reviewers who would say, “This guy is crazy … he would be confined as a madman except that he’s harmless.” Madness itself is, as we say, a historical construction — it’s treated in radically different ways with different language around it, and it’s constantly evolving. The DSM [Diagnostic and Statistical Manual of Mental Disorders] is itself evolving — and growing ever larger.
Gabe’s suffering with schizophrenia, most of all, was feeling isolated by it. And that terrible feeling of watching your friends grow up. The people you were kids with: they get married; they have a job; they have a profession. And he kept saying, “When’s my life going to start?” As if we could say, “Here, get started. Now you can do it.” That was some of the hardest stuff to deal with.
These are hard circumstances, but it’s been a pleasure speaking with you.
Well, it’s like I said, I don’t mind talking about this at all. It’s one of my favorite things really. If anybody wants to know anything about my son, I’m ready to talk about him because he was my hero. A hero of my own story and his.
Ben Kafka is a psychoanalyst, cultural historian, and critic. He teaches at NYU and sees patients in private practice. His first book, The Demon of Writing: Powers and Failures of Paperwork (Zone Books), has recently appeared in paperback. He is currently working on a book about gaslighting, folies-à-deux, double binds, Catch-22s, and other forms of induced insanity.
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