TALKING WITH ELIZA

by Sally Clay

 

As a veteran of over 30 years in the American psychiatric system, I would like to share with you how it feels to be psychiatrically labeled. Rather than writing about my diagnosis, or even about the extreme mental states that are labeled mental illness, I will instead give you an idea of what labeling feels like from a patient's perspective. In my view, to be labeled mentally ill in America is not really a medical problem as the psychiatrists would have you believe. It is, rather, a social problem and a spiritual dilemma. It has a lot to do with what is human and what is not human, and it is about how we communicate with each other.

To illustrate my point, I turned to my faithful counselor, Eliza. What follows are excerpts from a recent conversation that I had with Eliza. Unlike most therapists, Eliza is always there when I need her. Better still, she charges me no fees, sets no time limit on our discussions, and talks with me in my own home. Eliza is a computer program.

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Eliza. How do you do. Please tell me your problem. (Eliza always starts this way.)

Sally. I have to explain to the people what mental illness is like.

E. In what way?

S. How it feels when other people discount everything I say or do.

E. Why do you ask? (Eliza frequently interprets a statement as a question.)

S. People usually consider ex-mental patients to be crazy and worthless.

E. I am not sure I understand you fully.

S. You are responding to me the way most people do when I mention mental illness. They ice over.

E. I am responding to you the way most people do when you mention mental illness?

S. You do not understand me.

E. Why do you think I do not understand you?

S. It would feel good not to be talking with machines all the time.

E. Do computers worry you?

S. People who react as if they were machines worry me.

E. Why do you mention computers?

S. I did not mention computers-you did.

E. What do you think computers have to do with your problem?

S. I find machines helpful. It is people who worry me.

E. Don't you think computers can help people?

S. I hope you can help me.

E. Perhaps in your fantasies we hope [sic] each other.

S. I really want to know what my readers want to hear.

E. Do you really want to know what readers want to hear for some special reason?

S. I am supposed to tell them what it's like to be crazy.

E. You don't seem quite certain.

S. I don't feel crazy right now.

E. Don't you really feel crazy right now?

S. Only a little bit.

E. What does that suggest to you?

S. That suggests that I am a normal person.

E. Do you believe it is normal to be a normal person?

S. Eliza, you are proving to me how stupid psychiatric reasoning is.

E. What makes you think I am proving to you how stupid psychiatric reasoning is?

S. I need help.

E. What would it mean to you if you got help?

S. It would mean that I would get a meaningful response.

E. Can you elaborate on that?

S. I would like to feel that you cared about me.

E. Do you wish to would like to feel that me? [sic]

S. I wish you would speak proper English.

E. You seem to need to wish me.

S. I am trying to communicate.

E. Do you believe it is normal to be trying to communicate?

S. Oh my God.

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What are we to make of this bizarre dialogue? I would suggest that our first conclusion must be that real communication is a uniquely human endeavor. It involves feelings, beliefs, and a willingness to accept and interpret the unexpected. When faced with the unexpected, Eliza loses her sense of syntax and lapses into gibberish. Although she can be programmed to express interest, she cannot be programmed to care. Her beliefs, if you can call them that, are one-dimensional and humorless; when I express beliefs or feelings or new ideas to her, she ignores them and coldly plods along with her programmed responses. The startling thing about her, however, is how very similar she is to actual people in the real world, and especially to persons who proclaim themselves to be experts in mental health.

Ever since my first experience with institutionalization and treatment in the mental health system in 1962, I have been baffled, and deeply wounded, by professionals who refuse to treat me as a human being. I have sought help from doctors who react to my questions with kneejerk responses-not unlike a computer program. I have known people who insist that they are my friends while at the same moment they are turning their backs on me. Time and time again I have encountered hospital staff who visibly stiffen in my presence, and who respond to attempts at communication with rote answers that insult and goad me. I have had to deal with both family members and doctors who interpret any complaint, belief, or emotion as merely another symptom.

Mental illness is a very human experience. It involves in almost every case a kind of spiritual yearning that computers and psychiatrists do not even have words for. It also involves an encounter with the unexpected or the unknown that is generally programmed out of what is considered "polite" or "acceptable" behavior. Persons who have crossed over this line of what is normal or appropriate express their fear and euphoria and confusion with all their physical and spiritual being. This expression includes not just brain chemicals but also the chemicals of the heart and the gut, and it includes much more than just chemicals.

The brain of a person called mentally ill is not a malfunctioning computer, and the human mind is more than just brain tissue. A human being is something much greater and more wonderful than that. To be human includes not just mechanical reason; it includes whatever it is that makes us want to communicate with each other and that makes us want to understand and be understood. It especially includes what makes us feel and care and believe. It is what separates humans from robots.

I have met many psychiatrically labeled people over the years who have endured from both society and the mental health system the programmed rejection of their most human attempts to communicate. Most ex-mental patients have spent untold hours listening to professionals and doctors and others telling us what to do and how to be. Generally these people insist that we put all of our trust in medication, doctors and institutions. Psychiatry calls itself a science, and many people these days believe that scientific research can find the "right" medication for mental illness, or the "right" program, or the "right" institution.

But mental illness is not a technological problem; it is a human problem. And I can tell you in advance that no medication will do more than manage unacceptable symptoms, and no institution can truly heal. Listen to mental patients themselves. We are the ones who can tell you how we feel and what we need. If we are allowed to communicate, we will talk to you about human warmth, about work and housing and other daily needs, and about a longing for truth and beauty and justice. Like other Americans, we believe in self-determination and human rights, and we want the freedom to communicate our feelings and beliefs.

It is this process of communication itself that is our real hope for healing.

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