High-Functioning

Psychosis is believing my worst thoughts, my own interior monologue taking on a life of its own, physical sensations that don’t line up with reality, fears bigger than the moon, and logic that is completely inexplicable to anyone else.

“Are you having delusions?” my psychiatrist asked me on Monday.

“I don’t know,” I told him.

“How am I supposed to treat you if you can’t tell me what’s going on?” he asked.

“How am I supposed to know what’s a delusion and what’s not?” I snapped. “Everyone tells me, ‘You should know it’s not real,’ but I don’t believe them.”

“What about the snake?” he asked. “Is the snake back?”

He was referring to Henry, the yellow ball python who came to live with me when I was nineteen and never left. I’ve been told countless times, “You know it’s impossible for a snake to live inside your body, right?” But my body is not the same as others’. It is home to snakes, rats, worms, and bugs.

My psychiatrist said he doesn’t feel as though he can adequately treat me because my case is “too complex.” He suggested intensive outpatient treatment (IOP). I’ve been to treatment six times, not counting hospital stays. I highly doubt there is much more for me to learn about cognitive behavioral therapy, mindful eating, or meditation.


I am an individual who is considered “high-functioning.” This means that I can go to school, work, and other commitments, and that I appear “normal.” I know better than to bang my head into walls in public places, than to walk down the street naked (despite Henry telling me this is a good idea), than to tell acquaintances about Henry, than to ask people if they’re real, or to talk to the voices out loud in a public place.

It takes immense effort to appear this way, and I can’t always keep up the facade. Sometimes, I go to some strange, dark place in the recesses of my mind. I feel like the man being buried in the catacombs in “The Cask of Amontillado.” Except I am both victim and victimizer. I did not choose to have this illness, but there are times I can choose to let my guard down, to indulge in the madness. Like some kind of perverse pleasure, it almost feels good, satisfying to know that I’m never alone, never without Henry or any of the other voices. Though they taunt me, tell me to do horrible things, or blame me for things that others tell me I could’t have possibly caused, it is better than silence.


On Tuesday, I went to see a trauma therapist who specializes in EMDR, in the hopes that this particular kind of therapy would help me to stop living in the past and move on with my life. As soon as the therapist called me “dear,” I had a bad feeling about her.

She explained the basic therapy stuff that all therapists have to explain (confidentiality, when she can break confidentiality, etc.) and then handed me two vibrating balls. She asked me a little bit about the memories I wanted to work on, and then asked where I felt them in my body.

I happened to have a cold, so I said I felt them in my chest because that was pretty much the only physical sensation I could feel. I try to avoid feeling mentally connected to my body, so that was the best I could do.

The thing about EMDR is that it’s very theoretical. You have to use your imagination, and just kind of roll with it. The therapist asked me what color the feeling was, and I said it was black because part of the reason my chest feels so heavy is because I briefly reverted back to smoking cigarettes for a few days last week.

The therapist turned on the vibrating balls and told me to simply focus on the blackness in my chest. At this point, it was like my brain exploded. I thought of Sherman, my family’s black Labrador from when I was a child. I thought of how I painted my boyfriend’s nails black a few weeks ago, and he got sent home from work because of it. I thought of my dad’s hair, how it used to be dark and thick, and how he’s going grey, and that it scares me to see my parents getting older. I heard the voice of the little girl inside me crying, saying, “They were supposed to take care of me.” I heard Henry saying, “Shut the fuck up, you stupid little bitch. Get over it. It’s all your fault.”

I started to cry, and the therapist said, “It’s okay. You can weep. You have much to weep about.”

I put the balls down. “I can’t do this,” I said. I was ready to bolt out of there, not finish the session, and never see this woman again.

We spoke for a few more minutes. I told her I wasn’t ready, that it was too overwhelming. She basically helped me calm down a marginal amount so I’d be safe to drive home, and I left.


My parents and I are trying to get things moving with finding a treatment center that will provide IOP services for me. I had an evaluation with a center called La Amistad over the phone today. The woman on the phone was pleasant enough, but I’ve come to hate these sorts of evaluations. I feel as though the person on the other end of the phone is weaseling around in my brain, trying to see if I’m dangerous to myself or other people. She asked me if I had a history of property damage or starting fires, and if I had access to any weapons at home. (Sadly, I do not have any weapons at home because my dad wouldn’t buy me a bat’leth at the last Star Trek convention we went to.)

At the end of the call, I asked her what she thought their recommendation would be for me. She kind of gave me the runaround, saying that I have “a lot going on,” and that she didn’t think IOP would be appropriate for me. She followed that up with, “On the other hand, you’re functioning very well, so I don’t really know.”

I tried to make it quite clear to her that I am not willing to go back into residential treatment. I do not want to disappear again, leaving people wondering where I’ve gone. Moreover, I do not want to spend yet another holiday season in a psychiatric facility. The woman on the phone assured me that the average stay at this particular facility is two to three weeks, which was cold comfort. If I actually did need residential treatment, what could possibly be accomplished in such a short time frame?

I feel as though my psychiatrist has basically thrown his hands up and said, “I don’t know how to deal with you,” and passed the buck to someone else. It feels like a repeat of Magnolia Creek, the second treatment center I went to. While I was there, I began showing signs of schizoaffective disorder. Because the Creek was an eating disorder facility, they basically said, “We’ve done all we can for your food issues, and we can’t treat your psychosis, so here’s the door. Good luck.”

I am thankful for the people in my life who refuse to give up on me. My mom and I were talking about what might happen next in the treatment process, and she made it abundantly clear that she wasn’t going to force me into anything I don’t want to do. She told me that she just wants me to feel better–whatever it takes.

I also have a best friend and boyfriend rolled into one. He goes out of his way to make sure I am doing as well as I can. We’re planning on seeing some punk concerts later this year and next because we had so much fun seeing Bad Religion together. I am especially grateful that he loves to cook because while I do too, I’ve been so depressed lately that it’s easier to just drive through Dunkin Donuts or microwave some soup. Most importantly, we make each other laugh.


Perhaps I sound like a harbinger of doom and gloom. While I am not thrilled at the prospect of going back to treatment, things are not all bad. Yesterday at work, I got to help a Spanish-speaking customer, and on top of that, the customer service staff let me watch the front end for a good chunk of my shift. I am currently a cashier at work, but if I were to move up, I’d go into the customer service office, and one of my responsibilities would be acting as front-end coordinator (FEC). The FEC basically fills in the gaps on the front end and makes sure everything is running smoothly. I felt a little weird telling my coworkers to go collect carts from the parking lot and whatnot, but two customer service staff members and my manager (who never gives much praise) said I did an excellent job. I don’t have the proper hours of availability to actually get promoted right now, but it made me happy that my coworkers trusted me to make sure things were handled properly.

I also ran into my high school Spanish teacher and told her that I still remember a lot of my Spanish and that I use it at work all the time. She was thrilled!

My boyfriend tells me all the time that I am “loved by many,” that people smile when they talk about me, and I always tell him, “Yeah, but they don’t know me that well.” But there is something to be said for letting some light in. Perhaps I do not need to let everyone know the sadness and insanity that lies within me. Perhaps it is enough to simply treat others with kindness and hope that that same kindness will find its way back to me. In some ways, it already has.

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