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Wrestling With Madness

I have been a psychologist for over 30 years, in various kinds of settings, but the most intense immersion I ever had in the world of real, dramatic mental illness did not come in my training or professional work.  It was in the peon’s job with which I worked my way through college, as an attendant on a psychiatric ward of my university’s hospital.  There I spent lots of time with unbuffered madness, and it was a real eye-opener.

One particularly onerous duty involved the small sub-ward reserved for the very violent.  This was composed of three small, truly padded, cubicles, a small bathroom, and a wide corridor outside them, all locked away from the main ward with its calmer milieu.  An attendant or two stayed in the corridor, with cushions to sit on ( no furniture that could be thrown around).  A big red button on the wall was for calling reinforcements.  State law required that the door locking a patient in had to be unlocked at least once each hour, and this was often a tricky exercise.  An eight-hour shift on this ward could wear you out.

I remember one all-nighter vividly.  A tall, sandy-haired man in his mid-30’s had come in kicking and screaming that afternoon.  He had not slept for three days.  His eyes were wide, his hair wild, and he bellowed like a bull.  The radio preachers had been talking to him personally for days, and each hour his fear and rage had grown.  He had reached that odd, somehow beautiful pitch of realization that comes in an acute paranoid state, in which all the evil in the world is distilled down to a concrete immediacy – the gas coming under the door, or the X-rays sending messages through the teeth, or the KGB whose agent I was.

It was a long night.  He was full of thorazine, but still alert as an electric arc, and quick as a cat.  He lunged for the door whenever I opened it, and twice we had long wrestling matches (I was a little bigger, but he was wilder) before I could stuff him back through the door and re-click the lock.  We argued through the door, each driven by compelling logic in opposing directions.

I had to do as I had been told, keep him contained, open the door hourly, and protect myself without hurting him.  I also had to try to talk him into calming down.  He, on his part, was in a Catch-22.  He was enraged at being locked up (Wouldn’t you be?).  I was telling him that he could only be let out when he was no longer angry.  He countered that you would have to be crazy to not be mad if you were locked up.  My not letting him out made him furious, but as long as he was furious I wouldn’t let him out.

“If you calm down, I’ll let you out.”

“I can’t be calm if I’m locked up.  Let me out and I can calm down.”

“But what do you want to do now?”

“Kill you!”

Etc.  We quarreled and wrestled through the night, and once he landed a good elbow on my face.  Finally, when the sky began to lighten and the birds to chatter, the fever of his fury broke and he was calm.  We chatted a bit, and then he wanted out to go to the bathroom.  I opened the door, only slightly wary, and he padded down the hall.  When he came back out, there was a little warmth in his tired eyes.  He held a roll of toilet paper in one hand, and pulled the paper out with the other, stretching it toward me.  He asked, “Tug of war?”