From When the Sun Bursts, by Christopher Bollas, out this month from Yale University Press. Bollas has been a practicing psychoanalyst for more than forty years.
People who work with schizophrenics often describe something that might be called schizophrenic presence, or the experience of being with someone who has seemingly crossed from the human world to the nonhuman. It can be an eerie and uncomfortable feeling. Those who knew the schizophrenic before his or her breakdown may feel that they are encountering the person’s bizarre double. Action is accomplished painfully. Ordinary, everyday gestures become mechanical. The schizophrenic reaches for a cup of coffee in tensile slow motion, his torso moving first, as if corseted by some hidden metal fabric, his shoulders and arms operating in curious opposition to each other, as if he were simultaneously reaching both toward and away from the object. He approaches the cup as if it were dangerous. He might take five minutes on the first sip and seem to derive no pleasure from drinking. He might blink rapidly, or abruptly push the cup away as if afraid it will attack him. We see a robotic self, one that appears to have no subjectivity, no interior.
Strangely, though the person seems mechanical, the object does not; it is approached as if it were alive and might spring into some unforeseen action. This conviction, rarely voiced, is uttered through the tacit language of the body.
Sometimes, the clinician finds himself in freakish agreement, seized by the thought that the mug might indeed go flying across the room. He, too, starts to feel afraid of ordinary objects. Is this simply concern that the patient may throw the thing, or drop it? The clinician is not sure.
Perhaps for this reason, staff members in residential settings are unnaturally calm. They move in slow motion, they speak simply and deliberately, they smile a lot and look at their patients with a doe-eyed gaze.
When this calm breaks down it can be startling. I once watched a therapist who had been sitting silently for some twenty minutes next to a mute schizophrenic. Suddenly, by apparent accident, the schizophrenic nudged a magazine off the arm of the sofa. In response, the therapist jumped up with such force that she banged into a coffee table and fell on her face. As she excused herself, upset and disoriented, I saw the patient smile.
What was he smiling about? I don’t know. But it seems reasonable to assume that, for a moment, he was pleased to have brought about in his companion the kind of terror that was usually his alone.
The therapist jumped up, of course, not because the magazine was dangerous but because its movement embodied the potential movement of the patient. The patient was the magazine; as it fell, so might he. But instead, as the magazine fell, so did the therapist. In this way she experienced firsthand the frightening world on the other side, the world of the belief that objects are just barely asleep and can awake at any moment to do something sudden, bewildering, and dangerous.
The schizophrenic reveals the hallucinogenic potential of the object world. He has seen the object change its character. It cannot be trusted. His self-transformation is consequently protective: objects may come alive to destroy him, but if the self is not there to begin with it cannot be damaged.
Clinicians who react to the patient with unreal calm are unconsciously, and astutely, meeting the patient halfway. They are attempting to operate in an intermediate zone between the psychotic and nonpsychotic worlds, a neutral territory where there is no strong affect. Here, observations are of a very simple kind. Speech is slowed down, language laundered of color. With the aim of being completely unthreatening, the clinician transforms herself into an impossibly benign form of being, an exoskeleton of the human.
If clinicians were to behave like this in any other circumstance, they would seem very disturbed indeed.