I’m not where I’m supposed to be. That much is clear.
I work in a dark, unadorned, cement-block room, under fluorescent lights that flicker and buzz. Next to my desk is a black chair. I sit and talk with clients who sit there–men with AIDS and schizophrenia and major depression and hepatitis and developmental disabilities, and sometimes all of the above. The fax machine is a decade old and has cobwebs over the numbers. In the winter, the pipes groan and break, and we freeze. In the summer, the air conditioner dies, and we sweat. Insects fly around me. The windows are covered up with cardboard.
None of this bothers me. My clients and I just sit through it all, and they tell me their stories–odd, twisted, compelling, tragic, and deeply interesting stories that come flowing out of them within minutes of their taking a seat in the black chair. The stories are invariably improbable and bizarre: narratives about phantom battles in Vietnam or inside their heads; vignettes about rapes and lunacy and hallucinogens; stories about love and betrayal. If I tried, I couldn’t make up these stories.
So we sit there in the wreckage, the men and I, and we talk. They tell me about their lives, and I tell them about places (halfway houses, group homes, mental health programs, detox centers) where they might get some help. Sometimes they listen to my suggestions, and I send them to some marginally better place. Other times, they just leave, and I’m fated to become just a little blip in their ongoing odyssey of disorder. Either way, I feel I’ve done something. Whatever its outcome, I find my work exhilarating, and important.
I’m not sure where the sons of Andover and Harvard are supposed to be, but it’s surely not where I am, sitting next to black chairs in the rank offices of shelters and prisons. When I receive the shiny alumni magazines from my alma maters, I turn to the Class Notes in the back and read of former peers who now own entire companies and have homes scattered up and down the Eastern seaboard. I sigh and think of what might have been. But then another client comes into my office and takes a seat in the black chair. I become immersed in his story, and my classmates are left far behind.
There’s a specific reason why I chose to do this work. You see, when I was a freshman in college, I myself was waylaid. In the fall of my freshman year at Harvard (to which I’d arrived with top SAT scores, varsity letters, and the full arrogance of youth), a dam broke inside me. Compulsions and obsessions of all types flooded into my brain, and I was unable to push them back. I’d experienced brief previews of such thoughts in childhood and high school–thoughts that I had to talk out loud to Jesus in the middle of dinner, or that I had to wear a red shirt to school or terrible things would happen–but I had always put them aside and was able to function.
But that fall in college, terrible ideas simply took over. I remember stumbling, numbly, painfully, through a stark Harvard Yard, looking up at the silhouettes of the naked trees as they swayed eerily in the wind against the white sky. When I did go to class that winter, I couldn’t focus on the lecturer because I was counting the number of times I blinked, or breathed, or the times the professor said “obvious.” Or I was counting 1 to 10 over and over and over again. I lost the organicity with which one thinks, my mind freezing into a single word or series of numbers. Black was a word I repeated to myself–black black black black black black black black black black black black black black black. As my madness mounted, and my sheer, disbelieving outrage that I, of so much apparent promise and poise, could be mentally assaulted and overwhelmed by such nonsense, I started having thoughts of killing people. By the end of my freshman year, I couldn’t go out at night, for fear that I might grab some man, and drag him into the bushes, and stab him. I had the same fear about women. It got so crazy that I would have to look back at people after I walked past them to make sure I hadn’t harmed them. In the howling storm of thought, I couldn’t distinguish between what I’d imagined I’d done and what I’d actually done. I stumbled through the rest of freshman year, and dropped out over the summer.
One of the hallmarks of obsessive compulsive disorder, as I was to learn much later, is that those who experience it know that the ideas that bother them are crazy, yet they’re unable to absolutely, resolutely dismiss them. The ideas take root precisely because you try so hard not to think about them. In time, I also learned that what I was experiencing were classic signs of the disorder. Indeed, they were the first symptoms listed in a description of OCD I encountered, years later, in a psychology textbook. But I knew none of that back then: back then, in Harvard Yard, I just thought I was insane.
In time, I learned more about what ailed me. In a great deal more time, I accepted it. Later still, I sought treatment, in the forms of cognitive-behavioral therapy, then Prozac, then psychoanalysis–that, by and large, have been successful. While I still have disturbing thoughts on a daily basis, I estimate their power to be about 10 percent of what it used to be. What felt like a steak knife being inserted into my cheek has become a butter knife, or even a plastic implement.
I eventually returned to Harvard, and went to graduate school at Columbia. These days, I function well enough, pay taxes, floss regularly, have a wonderful family, and write books, in addition to talking to people in black chairs. I’m okay, or, actually, fine, almost all the time.
The enduring legacy of my own experience with mental illness is my willingness, my compulsion perhaps, to stay within the confines of black chairs and the people that occupy them, despite opportunities to go elsewhere, to move “up.” I like to think that I understand my clients in a way that my unscathed colleagues don’t. I know deeply how madness can take over; I understand how the most rational, best-intentioned treatment plan can be useless in the face of the unruliness of disorders; I understand that mental illness is a continuum, and a slippery one at that.
I know that we all have some tendency to depression, anxiety, obsession, compulsion, even psychosis–the divide is only in the degree to which those ugly things fill our brain. Not that much distinguishes “us” from “them.” And this understanding has proved invaluable. Even though I’ve never once divulged my personal history to my clients, it’s informed everything I’ve ever done with them, and made me better at my work. I’ve concluded that there are few consolations to having suffered in the way that I and my clients have. If one of them is to understand and support clients better, then I must surely take advantage of it.
There’s another aspect to mental suffering that I’ve learned in my travels through the dark wood. Some years ago, a straggly, wild-eyed man named Alan came to sit in the black chair beside me. He was intelligent, soft-spoken, and delusional. He looked like a mad scientist, and it turned out he was. He produced a transcript showing that he was a graduate student at Columbia (as I’d recently been), and it listed dozens of grades, none of which was less than an A-minus. Looking more closely, I saw that Alan had received his B.A. as a member of Phi Beta Kappa, and that his graduate studies had occurred every other year, with leaves of absence in between. Without having to ask, I knew that those were the years that he was too symptomatic to study, and had most likely been hospitalized.
I looked directly at Alan (who quickly looked away) and saw some small piece of myself. There wasn’t much that separated us. Six months ago, we’d been at the same school. Now his seat in the black chair was but a few feet from mine. I didn’t have to look at his transcript to know that it’s possible to be among “the best and the brightest” and a little crazy, each at the same time.
Charles Barber is the author of Comfortably Numb: How Psychiatry Is Medicating a Nation and Songs from the Black Chair: A Memoir of Mental Interiors. He’s a senior administrator at The Connection, a social services agency, and a lecturer in psychiatry at the Yale University School of Medicine.