Talking Through the Noise

Before I get rolling on this piece, I want to take a brief moment to say that this is being written largely in response to a Note put forth by the exceptionally well-read and well-intended Josh Slocum, of The Disaffected Substack and podcast. Mr. Slocum has a wealth of experience observing and contending with folks who suffer from various personality disorders, and his expertise on the subject of Cluster B personality disorders comes originally from having been raised by a mother who was, per his own disclosures, a Cluster B ‘Devouring Mother’ archetype individual. I am not personally aware of his education or training in the field of psychology or psychiatry, but I’m also not inclined to invoke the specter of credentialism against the man; he has eyes and ears, a functional brain between his ears, and exposure to the modern social environment in which we all reside, so I’ll trust to his capacity to observe, contemplate, and assess his takeaways from various sorts of folks’ behaviors over the course of his life.

In the Note in question, Josh observed that many folks, particularly women, who claim to be suffering from bipolar disorder are, in all likelihood, not actually dealing with that condition, but are instead living with borderline personality disorder, or BPD for shorthand. He observed that bipolar disorder seems to receive a great deal more sympathy from the general public than does BPD, and that this is quite possibly why more people will publicly claim this diagnosis, especially in online spaces, rather than the other. Given what I know of both conditions and the general public sentiment towards folks afflicted with either of them, I can attest that my own observations mirror Mr. Slocum’s on the matter.

In response to his Note, I commented, asking if he could, if so inclined, put out a similarly-themed Note regarding schizophrenia and its particular public misperceptions and commonplace misunderstandings. “Not every schizophrenic is a raving maniac or madman, they aren’t all universally dangerous, but there is a terrible capacity for many folks of this condition to BECOME a threat, so they also should have a keen eye kept on them.”

Mr. Slocum’s response was brief, polite, and perhaps expertly formulated to yield from me as a response the very piece that you are reading right now. “Perhaps you would better suited to write something up on this matter than me, as you seem to have a bit more understanding and/or experience regarding schizophrenia.”

Damn you, Mr. Slocum, that’s well-played. I say that because, well, here we are.

I have mentioned in passing a few times that I am myself someone who was diagnosed by both the Department of Defense and in the civilian sector as having a form of schizophrenia. The United States Air Force personnel who analyzed me didn’t give a specific sub-type to the diagnosis, but since that time way back in 2001, it has been pinpointed by the few professionals I’ve turned to for crisis-moment help as ‘Paranoid schizophrenia rising beyond the level of delusional disorder, but not to the level of non-function’. In common parlance? I have a relatively broken brain, but I have enough coping mechanisms, regular medication and native intellectual capacity to, for the most part, deal with the nonsense parade marching through my perceptions and thought process to hold it together and be a contributing member of society.

I have alluded on several occasions to having interacted with Quoth, the raven-like creature of Amelia City notoriety, in my day-to-day life. This is not fiction, ladies and gentlemen; that thing quite literally visits me on an unfortunately consistent basis, often snarling thinly-veiled threats and trying to convince me that if I simply find the 26^th door, I can press my way through it into Sanctuary, and be free of the oncoming nightmarish scenario wherein the bizarre creatures and spirits that owe fealty to him will break through into our prime material plane and proceed to ravage the world in a fit of madness and pain that will make the Bible’s Revelation look like a Sesame Street story. Again, this is not fiction, dear readers, this is something I contend with about once every two or three days.

Even when the bird isn’t saying these things or making me see oddly non-Euclidean bits of flotsam and temporially dislocated bits of furniture or biomass blinking and groaning at me for the sweet merciful release of death in a jar of mayonnaise, he hangs around on the outermost periphery of my vision for stretches of ten to twelve minutes a few times each day, just a constant reminder that he’s more than just some misfiring of neurons in my brain.

Right now, this moment, as I type this, I am aware that Quoth is most likely not actually, tangibly real in any way, shape or form. But even when I’m properly medicated, he is there, and I still hear these oddments; the medicine just helps me recognize that these things aren’t real. With the help of modern medicine and by keeping myself engaged with the duties and joys of being a Dad, husband and homeowner, as well as a storyteller of fantasy and horror, I’m able to keep these notions from gripping with the force of a strangler my skewed sense of reality for more than a few minutes.

My longest-running coping mechanism has always been my desire to tell stories in fantasy, sci-fi and horror. Part of my thought process and rationale runs like this: ‘If I tell this story to someone, and they are entertained by it, they’ll likely be able to point out that it’s all pure fiction. That’s useful, they’re entertained or enlightened by some bit of thoughtful contemplation I’ve worked into the story, and everybody walks away happy, so long as I’m skilled enough as a storyteller to make the experience enjoyable and/or thought-provoking’. Since the age of 14, when I had my first psychotic break hallucination, this practice of telling stories has been immensely helpful in taking control of these delusions and forcing them to bend to my active, coherent will.

It isn’t always easy, though.

But anywho, I’ve prattled on long enough about my own personal experience as a schizophrenic, and quite likely over-shared in the process. If any of this has made someone among my subscribers list feel uncomfortable or like they want to disengage henceforth with my work here on Substack, I understand entirely your decision, and won’t try to talk you out of pulling away. What I’d like to move on to now is addressing some common misconceptions regarding schizophrenia, delusional disorder, schizoaffective disorder, and the functionality of folks who contend with these conditions.

First and foremost, most individuals who are suspected of being genuinely schizophrenic are actually either schizoaffective or delusional. Folks who have delusional disorder hold to one or two particularly obscure and unprovable notions of the world and the way things work, often in the form of a delusion of grandeur, wherein they have constructed a sort of self-functioning mythology which renders them a Secret Savior of All Mankind. Or at least, of Their Kind. Or Their Nation, etc. You get it. The point being, they can usually function and be perceived as entirely reasonable, rational people, until some observation or incident in reality brushes up against a key detail or element of their delusional belief set, at which point, they tend to spiral into conspiratorial certainty that their delusion is ‘bleeding through’ into the world around them.

Folks who are schizoaffective suffer from intensely disorganized thought patterns, which tend to manifest in herky-jerky, seemingly ‘random’ behavior patterns and reactions. Their perceptions of events tend not to process in a straightforward, linear fashion ,and as a result, the schizoaffective may be listening very intently to you one moment, and then three days later, seemingly at random, will respond verbally to some question or comment you made during that prior conversation, as if it had been spoken just moments earlier. When they are responding without an a priori context, their minds insert a form of short-term hallucination, often referred to as an acute confabulation, in order to fill in the gap so that they will perceive their response as perfectly appropriate and timely. At times, prior experiences will replay in their mind’s eye so intensely that they will, for the moment, be lost in that prior experience momentarily.

And now, on to schizophrenics. Generally speaking, there are two types of schizophrenia, and each of these types, and again, I am speaking broadly, come in three degrees of intensity. Firstly, there is the paranoid schizophrenic, who has disorganized thought patterns predicated on an unfounded suspicion that some entity, be it supernatural or natural, is in opposition to them in the general flow of life events. This delusion can take several different forms, but the paranoid is convinced, utterly and even in the face of demonstrable evidence that their beliefs are falsehoods, that they must do whatever is necessary to oppose these antagonists, often engaging in rituals of some sort for their own protection or rebellion against the antagonist. Paranoid schizophrenia can be mild and manageable, middling and difficult to manage but functional with intense therapy, medication, and several layers of mitigation response, or overriding, wherein the sufferer is effectively lost in their delusions.

The second type of schizophrenic is the chaotic schizophrenic, who possesses no central or unified delusion, but rather, a hectic hodgepodge of mixed and matched beliefs and perceptions, many of which can overwhelm their moment-to-moment behaviors and responses, and all of which fail to project a single unifying element for more than a few months at a time. The chaotic schizophrenic, unlike the paranoid, can almost never function in most normal societies. They are either barely functional, or require copious amounts of hospitalization, medication, and monitoring.

To be clear, schizophrenics of both types experience variable quantities and intensities of auditory and visual hallucinations, and the degree to which they interfere with daily routines and function tends to be a variable dependent upon the efficacy of medications and/or other substances ingested throughout the day. There is a third variable, one that is often shunted aside by even professionals in the psychiatric field, because it is viewed as ‘rude’ or ‘distasteful’ to consider, but it has been demonstrated to play a huge factor in whether or not the schizophrenic individual can function in day-to-day life: intellectual and cognitive capacity.

I am myself a paranoid schizophrenic, and despite the usual associations one might make, I am not a persistent threat to myself or those around me.

I have a few factors going in my favor regarding all of this. Before I get into explaining those, a couple of important observations. Firstly, while most schizophrenics can lash out violently if their delusions or hallucinations and psychotic breaks are interfered with by an outside party, they actually tend to collapse in on themselves and curl up into a ball or hide in a corner, confusing real people for agents of whatever entity or organization they believe is ‘out to get them’. Most delusions of these sorts make the schizophrenic feel powerless, helpless, as if they have no hope. But one should always bear in mind that if the sufferer does lash out physically against them, they will be so amped up on adrenaline and the absolute certainty that they are in a life-or-death situation that they will fight as if they HAVE to kill the ‘enemy’ in order to survive. That’s why you need a response that is prepared to disable the individual having the ‘episode’ in swift and sometimes harsh fashion.

The second observation before relating my saving graces is this- a schizophrenic who is properly medicated and successfully deploying coping mechanisms and countermeasures can still suffer an abrupt psychotic outburst or hallucinatory fugue. These fugues are better known as ‘catatonic episodes’, or ‘space-outs’.

Now, I’m going to bring us towards my wrap-up by explaining my own blessings in regards to being someone who is himself a paranoid schizophrenic. For starters, I mentioned earlier, briefly, that subjects with slightly above average intelligence or greater tend to have better outcomes and life pathways when living with the condition. I’m not a genius, but thankfully, I’m just smart enough to grasp the situation I find myself in, and perform my own research into matters and pose questions about what I’m experiencing from moment to moment, comparing it to other moments as a form of self-check. ‘Does that Doberman-sized cybernetic scorpion, smoking a cigarette and blinking its pancake-sized eyeballs on its back while asking me for change for an Orange Dollars bill, smelling of foot sweat (olfactory hallucinations are a motherfucker, let me tell you) seem like the sort of thing other people would routinely have to deal with?’ I have the intellectual wherewithal to pose that question to myself, and ignore Charles about 90% of the time, even if I’m not level on my medications at the moment.

The second advantage I have is my primary coping mechanism- storytelling. Since I was about ten years old, I’ve been involved in the tabletop role-playing hobby, thanks to Dungeons and Dragons, West End Games, and similar systems. It wasn’t long before, being partial to reading a lot of sci-fi, fantasy, and horror already, I wanted to start telling my own stories, and my brothers and some of my friends were more than happy to let me sort of be the perpetual DM/GM. When the queer visions and noises started worming their way into my daily life, and especially after my first intense hallucination event, I decided that this ‘material’ was just the result of my own overactive imagination. I literally assumed I was just envisioning a new campaign structure for my regular players so intensely that I kind of lost sight of the real world around me momentarily.

I have leaned into that for nearly three decades now. It’s pretty useful.

The last and perhaps most important advantage that I personally enjoy over many other folks living with schizophrenia is one that, unfortunately, most of them don’t have; I have a family and friend support network that has my back, even in moments of acute dismay and confusion. I’ve only been involuntarily admitted for observation once in the last ten years, and despite my wife’s terror in the moment, she has clarified for me that, under no uncertain terms, she isn’t about to abandon me if I have another such incident. However, it has also made her a lot more persistent in double-checking that I’m level on my meds, and asking me, quote, “Where [my] head is at today”. My children, though only the oldest knows precisely what’s up with her father, have an understanding that Dad isn’t always like other kids’ Dads, that sometimes he might strike up a conversation with or respond to people and things that aren’t really there. ‘Involuntary pretend play’ is how we’ve tried to explain it to the boys, that sometimes Dad’s imagination just takes over, and that if they see that happening, they are to keep away from him until he asks them directly how they’re doing. But my oldest, the 12-year-old, also knows to immediately message my wife if she notices I’m slipping, and she knows where my ‘rescue’ medication is, as well as my regular daily stuff. The ‘rescue’ meds are only intended for just that, an acute episode wherein I’m about to completely fall off the connection with reality.

But I keep a solid supply of both on hand in my home. I have one dose of the rescue medication that I keep in my work backpack, which comes with me whenever I head to work or go to run errands. I take precautions against the worst circumstances that I might find myself contending with, and though I don’t disclose all of the details to everyone around me, I tend to give just enough of a head’s up to my employers and new acquaintances or colleagues so that they’ll have some inkling what they’re contending with if the worst should develop.

This long-winded diatribe was all birthed from a desire to see someone cover this condition cluster in a similar way to how Josh Slocum covers Cluster B personality disorders, and though initially I hadn’t wanted to do it myself (since this isn’t the sort of thing I tend to write about frequently), Mr. Slocum’s observation that I seemed more versed in the topic convinced me that yeah, it might be helpful to hear from someone with the condition (myself). Before I let you go, though, I want to bring up one more thing about schizophrenics that isn’t much talked about, to clarify for the general public:

I cannot speak for all such persons, but for my own liking, I will clarify that if you make a joke about this serious condition, I only ask that the joke actually be amusing. If it doesn’t land quite right, that’s fine, I don’t care. If you’re genuinely trying to just tell a joke, I don’t give a shit if it sucks, or is awkward, or needs some refinement, because I’d prefer that you include me as a member of society by allowing me to be the target of humour as opposed to treating me with fucking kid gloves, man! Not only that, but comedy is a form of Art, and I refuse to be the kind of hypocritical jagoff who will champion the Art of written narrative and tell the Art of comedy that it has to fend for itself! And hey, if your joke sucks? Just blame it on those raspy Whispers in my head, those fuckers are always causing trouble anyhow.

Cheers, folks.