Small Acts of Disappearance (13 page)

A different American poet, Wallace Stevens, puts it like this:

The mind has added nothing to human nature. It is a violence from within that protects us from a violence without. It is the imagination pressing back against the pressure of reality.

He adds that poetry is simply the expression of the mind, this violence within, which is why it ‘has something to do with self-preservation', why it ‘helps us to live our lives'. But even in this formulation, the imagination, as it presses back, sounds remarkably similar to delusion.

The psychiatrist in charge of the clinic where I was admitted for my third stint as a day patient, loves poetry, thinks metaphor might cure us all, would quote Walt Whitman at every opportunity. ‘You are large, you contain multitudes,' he'd say to a room full of bony women, many clutching cushions in front of their stomachs, some so underweight that the outlines of their teeth were visible through their cheeks. ‘You contain multitudes,' he'd say; and ‘there will never be any more perfection than there is now.'

I only realised later that Berryman's unfinished novel is actually only titled
Recovery. Delusions
is the title of his last collection of poems, and in the edition I have the two works are published together, as if in composite they might offer some kind of complete – and completely morbid – picture of
the poet's mind in his last days. I can't pretend that for me this isn't part of its appeal.

John Berryman began writing
Recovery
in 1970, a year in which he was hospitalised four times for alcoholism. His first hospitalisation occurred in 1958, and not one of the remaining twelve years of his life passed without at least one readmission. Nonetheless, he continued to write, and to teach, often giving lectures while on short passes from various hospitals and rehab programmes. His best-known work, the Pulitzer-Prize-winning
Dream Songs,
was written during this period; my favourite line from this work is ‘my psychiatrist can lick your psychiatrist'.

The main character in
Recovery
is Alan Severance, an illustrious and famous scientist, a man of high intelligence, creativity, and rigour, at times as severe as his Dickensian name suggests. He is, of course, a fictional stand-in for Berryman – it is impossible to read him otherwise, especially as the novel's epigraph states, ‘The materials of this book… especially where hallucinatory, are historical; all facts are real; ladies and gentlemen, it's true.'

There's something wonderfully appealing about the concept of an historical hallucination.

The novel opens with Severance's admission (his third, too) to Ward W of an unnamed psychiatric hospital, determined
this time to ‘submit' to the program, to dry out and straighten out and ‘find out what the
hell
[is] wrong and fix it'. And this means group therapy. As a ‘Repeater', to use the novel's terminology, Severance has to participate in both Group and mini-Group therapy sessions, all of which are run according to the precepts and structures (and with the strange jargon) of Alcoholics Anonymous, an organisation to which Berryman had, by 1971, held a membership for more than a decade.

There's no Anorectics Anonymous. This is perhaps fitting, because the disease is so often bound up with a desire for anonymity, even though, perversely enough, the body becomes increasingly conspicuous as it grows ever more extreme. It's so often, for so many, a whittling away of a self that feels intolerable, or somehow offensive: too big, too loud, too demanding, somehow too much. Part of recovering from the disease, then, is reclaiming an ego – reclaiming a sense of, and space for, the self and all its inconsistencies and imperfections.

Nonetheless, the addiction model pioneered by Alcoholics Anonymous is often touted as a method of treatment for eating disorders, especially in the US, and especially in private practice. Because hunger is – and certainly was for me – addictive; because it sharpens the senses and it numbs pain; because hunger, when it's chronic, feels so good. And like compulsive drinking, hunger happens in secret, and thrives on deception, and it cuts us off from the social world. There's even evidence that the changes it wreaks on the brain's structure are eerily similar to those caused by more obvious substance addictions.

According to the addiction model, the first step towards recovery is admitting powerlessness over the substance, over the disease: admitting that ‘our lives have become unmanageable'. Yet this powerlessness is one of the biggest ironies of anorexia, one of the hardest things to admit to. Anorexia is driven, at least in part, by a desire for control or predictability – a desire to assert some kind of silent and horrible power, even as the completeness with which it takes over, with which it shuts down possibilities and circumscribes day-to-day life, is incredible.

At my sickest I worked mostly from home, to avoid eating lunch with my colleagues. I spent hours preparing salads and vegetable dishes before any picnic or party or family gathering so that there'd be something there that I felt comfortable eating, and my avoidance of the usual chips and dips and cheeses would be less obvious. I went out almost every evening so I'd be too busy to have dinner; my concentration was so fragile that I had difficulty driving. Even now, I'm nervous travelling out of range of my routines and support. Even now, I struggle to accept the advice of my doctors, because it feels as though handing over that control – the structure and regulation of my illness – means free-falling. I still don't know what it means to exist within the everyday chaos of the world, without disintegrating entirely.

And yet I know that my life had become unmanageable, that I was never in control of my hunger, that it grew stronger and more acute the more I denied that it existed.
I realise that it may well have been the unmanageability of my own young confusion, insecurity and sadness, alongside the unmanageability of my unusual and uncomfortable disease, that led me to hunger in the first place, whenever it was that the ground shifted. That violence from within pressing back against the violence of the world.

Recovery
is not a linear novel. (Recovery is not a linear process.) As well as having those strange gaps and the abrupt ending that is common in unfinished books that somehow find their way to publication, it is episodic, and it is interwoven with small sections of the journal that Severance keeps throughout his hospitalisation. This is where he most directly tries to understand his problem, his own personality, his progress – or otherwise – through the twelve steps of the program. This is largely where he struggles with Step Four: make a searching and fearless inventory of the self, and the related Step Ten: continue to take personal inventory and when wrong, admit it promptly. In his journal, Severance guesses and second-guesses at the causes of his drinking, the failings of his personality, what he needs to address to get better. The logical narratives he constructs continually morph and change: from recovery to delusion and back again.

These journal entries are remarkable because Severance always believes what he is writing: in one entry he states, triumphantly,
‘All
has pointed HERE'; in the next, ‘Humbled (I hope) and shook…ill, deluded' and
‘whether I've made any progress at all I don't know'. He writes long, interwoven explanations of his faith, his father's suicide, his overly-forgiving mother, his promiscuity, his childhood, his children, his work; each time working out a narrative whereby that particular issue lies at the heart of his addiction. Each of these narratives is logical, each chain of cause-and-effect makes perfect sense, until Severance's mind digs up something new and recasts what came before as mere delusion. It's a disorienting process to follow, and to follow in such a raw state. It's blackly humorous too (at one point, Severance becomes convinced his salvation lies in converting to Judaism), but most of all, it's terrifying for the unmoored, grasping despair it evokes in him. ‘For Christ's sake,' Severance writes, ‘tell me whether this belief of mine is real, and whether I can depend on at least
it.
I
am
a dependent man, I need something.'

‘The terror is real,' a long-recovered friend wrote to me last year, and I've held this close since. My illness terrifies me, and so does the prospect of getting better, because I don't know where I stand without it. But more intensely, and more frequently, I know that delusion terrifies me too. Delusion horrifies me, because I know how insidious and complete a process it can be. When I first sought treatment, it was simply for anxiety, because I genuinely believed that anxiety was the only problem that I had; I believed that the way I was eating, while by no means normal, was no more unusual than a coeliac not eating bread, a diabetic monitoring their sugar. Anxiety is, in fact, the brain's normal
and functional response to the threat of acute hunger, as well as the most common co-morbidity to disordered eating. I was so unwell that I only escaped forced hospitalisation because an administrator miscalculated my BMI, but I was also so deluded that I still thought, even at that point, that I was fine.

At one point in Group, Severance reads aloud from his journal, telling his fellow-patients, ‘I have lately given up the words “sincerely” and “honestly”, as mere con-words designed by my diseased brain to support its lying products.' He recognises and acknowledges how utterly convincing delusion can be, but ultimately qualifies even this, adding, ‘So I won't say this is a sincere attempt – though, friends,
it is.'

I love the paradox of this last sentence because it points towards a different kind of truth, a different kind of thinking – one that is at once sincere and diseased, as well as something in between. A kind of thinking that is the best the imagination can do, for now, to deal with the pressure of a reality that is equally as uncertain as it is inconstant.

Severance is, after all, a scientist – someone who, like a poet, is driven to find patterns in the world, to make ultimate sense of himself and his surroundings, to find meaning. Even if the systems and languages that scientists and poets use are vastly different, the impulse is the same. It is this
very striving for sense that lends itself so easily to delusion. Writing and science are perhaps each, in themselves, a peculiar form of madness.

In one group session, Severance is asked by a facilitator, ‘Alan, what sort of fellow do you see yourself as being?' and the only answer he can give is this: ‘Well, I do science. Write books, lectures and so on. Sometimes I give seminars…serve on boards, train younger men. Various things.'

The facilitator replies, ‘I didn't ask what you do, I don't give a damn what you do. I asked what you are.' And Severance is lost, for once, for words.

When I first read this exchange I was shocked, because it so closely mirrored one that I'd had in my first weeks of admission, when I'd responded to the psychiatrist's request to tell him about myself. I had begun, ‘Well, I'm a writer, mostly a poet…', and he let me speak for several minutes before stopping me and repeating, ‘Tell me about who you are, not what you do.' I too couldn't answer. At the time, I felt I had been silenced by frustration: because by saying that I am a writer I had been trying to tell him something important about how I am within the world, but I fear now that it points too to some kind of hollowness, some lack of essential self that my hunger fills – or at least masks – for me, the same way drinking does for Severance.

I lost track of how many times the doctors at this clinic, where my third admission took place, told me that my confusion and frustration are important, are generative, told me to stop trying to understand, to stop narrating. ‘Get out
of your head,' one therapist told me, ‘and into your body.' At the time, I countered that my head had never betrayed me as my body had, but now I'm not so sure.

Berryman's novel is most remarkable for its portrayal of the group sessions that Severance must attend; group sessions that are now an integral part of many forms of modern psychiatric treatment, especially those that involve hospitalisation. The clinic I attended for my third admission, my first in the private system, treats mood disorders, eating disorders, and drug and alcohol addiction in three separate wards, each with its own schedule of group sessions, universally referred to, here too, as Groups.

We'd go to Group. Say, ‘See you next Group.' We were asked by our psychologists, ‘So, how are things in Group?' These groups are fascinating little societies, partly because of the severe and strange conditions under which they form, and the intense experiences that members must share in order to qualify for membership, but also because they are constantly shifting and changing as patients come and go and shift and change themselves. And they're almost entirely invisible to the wider world, and even largely absent from literature – despite the incredibly high incidence of mental illness and addiction amongst writers. (The rates are higher still for poets.)

Severance's group includes a retired professional hockey player, a businessman who can't live up to the expectations of
his family, a pale girl with a manipulative, alcoholic father, a thin young woman who's convinced she's a compulsive eater (although this too is a delusion), a middle-aged janitor who phones his elderly parents several times each day, and a man simply described as a ‘benign lizard'. There are discharges, new admissions, one death. The group spends a lot of time, when not in Group, attending lectures on the physical and psychological effects of heavy drinking, reading the AA manuals (called
The Big Book
and
The 24-Hour Book
respectively), and eating Eskimo Pies and drinking coffee in the Snack Room.

All I want to say about my group is that we were not all women and that we ranged in age from eighteen to fiftynine. There were, at times, within it, two other literature students, an English teacher, an actor, a musician and a photographer, as well as an Army paramedic, a trainee doctor, a chiropractor, three mental health workers, a government clerk, a swimming teacher, three mothers, one father, and people whose illnesses have made it impossible for them to work for years. We arrived mid-morning, left mid-afternoon, had structured meal times, and sat at a single round table with happy aphorisms written on the napkin dispenser in coloured textas: ‘You are beautiful and you are strong', ‘It's just one meal', ‘Tomorrow you might wish that you started today'. We spent a lot of time, when not in Group, knitting or crocheting, doing crosswords, and looking up cat videos on YouTube.