It was an unmitigated failure, the one time I ever visited a psychiatrist.
I'd told the doctor several times that I was contemplating carrying out serious harm to myself, and was not of the opinion that these thoughts were of the fanciful, speculative type.
I was prescribed escitalopram under the brand name of Cipralex, and these had the effect of ensuring that the edge was taken off the depressive feelings. I say feelings and not merely thoughts, because the prevailing characteristic I experienced was a sensation of dread rising upwards from my feet - in the way I assume a gas must propagate - with thoughts separate, but concurrent. The 'gas' has sufficient force to cause me to slump over my desk in the office, or to sink further into my bedclothes.
The Cipralex prevented the worst of these excesses, at the cost of being able to feel anything at all. The usual pleasures of an atmospheric football match, an absorbing book or article, an unexpected meeting with an ambling, purring cat gave no pleasure. For weeks, I was akin to a machine, completing processes in a detached manner. If any sentiment ever shattered this glass, it was inevitably something which confirmed the hopelessness and futility of existence, but not the opposite.
Nevertheless, I had undeniably been stabilised in some way: thoughts of self-harm were less frequent and less strong, and after a period of relative improvement, my GP made an appointment for me to speak with a psychiatrist.
I no longer recall every nuance of my conversation with her but do remember bemoaning the pointlessness of everything, and the certainty that my own life is worth nothing at all. I think I spoke briefly about childhood, and any ambitions I had left. The outcome of this was the conclusion that I must be suffering from stress, with the attendant instruction to attend counselling.
Stress counselling took the form of hour-long classes on six consecutive Thursdays: I was taught how to inflate a paper bag in the event of a panic attack, and given a mass of documentation about how I might cope with novel or difficult situations. From my statement to a GP that I wanted to die, I had thus washed up here, despite never having been close to a panic attack at any point I can recall.
So much for those dim and distant memories. Inspired by a Facebook post from a woman I don't even know, I want to ask what might be learned from it, and whether or not we can derive any general principles which could theoretically be applied.
It seems to me there is a straightforward correspondence which the mental health practitioner hopes to carry out: their first principle is that the past and the present do not commute, and thus the resolution to any psychological issues involves healing the discrepancy between memories and the present. It can be worded in whichever way - mending a break, removing a blockage. So from the perspective of the psychiatrist I had been allocated, there must have been some unpleasant experience in the past which had caused me to suffer from panic attacks. It can be dealt with either by working against the specific, particular incident or incidents, or by equipping me with general principles in order to deal with the past when it flares up in the here and now. We are aware, then, that there are two dimensions: the mind maps onto the world we experience.
There is another dimension which I don't believe psychiatrists have much interest in, and yet it is as valid as the other two mentioned above. There is a real past, and an imagined one - not the collective consciousness postulated by Jung, but a private, internalized fiction, signposted by hope, expectation and disappointment. It is accessible at will, and thus does not form part of any latent system as, say, Freud would hold.
If I ever visited Belgrade, I should be disappointed that there is no zoo on Humska Street and no plaque marking the territory of Veljko the deceased lion. That there is not, and that it nevertheless forms part of my psyche, is as worthy of discussion as the fact that the life of a woman I called Bluefish once overlapped into my own, or that I never felt I belonged in the east midlands.
What didn't happen, and what never could have happened, are fruitful terrain for debate and insight. Academics regularly purge the works of writers or painters for insights into their personalities. Such assessments are able to be made for us all, though, and I wonder if it is worth trying to establish a framework of some description so that it might be pursued further.
