Schizophrenia and Trust

Today I want to discuss the issue of trust, a specific kind of trust in my case, which is intimately tied to my sense of personal evil and a resultant paranoia that persists to this day. (Note: while I discuss this in the context of schizophrenia, the etiology of my schizophrenic symptoms remains Lyme disease.) Because I am evil, I must assume that people are out to get me, to kill me, to get rid of me by any and all means. This is a logical conclusion even as it leads me to a state of more or less constant fear and suspicion. I worry about where the next attack is going to emanate from. This puts me in a difficult position with most people, who do not like to contemplate the fact that I do not trust them. I must reassure each and every one that they are the exception to the rule, when by and large no one truly is, because I assume that everyone in their heart of hearts despises me! Deep down, deep down, no one really feels for me anything but the purest antipathy and revulsion, and perhaps unconscious to them even, wishes me ill (at a minimum) or like my twin, wants me dead.

That said, I am able to put this awareness aside and deal with people on the as if level, as if they were not my enemies, as if they did not wish me mortal ill, as if I were not somehow a source of scorn and disgust to them. I am aware of it nonetheless, and aware of the double entendres being exchanged, or being sent one way to me. But I do not allow any expression of comprehension to show on my face. That would be breaking the compact of civility. No, I pretend that I didnt “get it” and act insensible to everything but what is said on the surface. but I do get it, and I know what is really being said in the subtext…

Sessions with Dr O are an island of relief for me in all this. I don’t know why talk therapy is so frowned upon for people with schizophrenia. It has been nothing but a blessing for me, despite the many bad experiences I have had with certain incompetent shrinks over the years. Dr O has taught me so much about my symptoms, how to recognize them, what they are and how to handle them, both emotionally and intellectually, how to wrestle them and overcome them, that I cannot but be grateful…And I would never want to have gone the “meds only” route all this time. No, I think that is a terrible mishandling of schizophrenia, and deprives most people with the illness of what might have helped them recover to the best level possible.

But one thing about trust and Dr O is that I need to trust her to take care of herself vis a vis me. I need to know that she will not let me burden her or wear her down. For example, and this is really painful to report, two years ago when I was in the hospital with what turned out to be relapsing CNS Lyme disease, I must have seemed impossible to deal with. I was out of control, on one-to-one almost the entire 4 weeks I was there. I attempted suicide, refused half my medications an hour after agreeing to take all of them…BUT still I knew that when she said she would see me even during her August vacation that it was a poor decision, and I did not want her to do it. I just didn’t know how to tell her, nor if anyone would see me in her place. Well, she made some rotten decisions and got furious with me over things that she ordinarily would have handled better and differently…and finally, to my great relief, took her vacation and got another doc to see me in her stead. But I felt terrible, because she left abruptly and in anger, and it needn’t have happened in the first place if she had taken care of herself and gone on vacation the way any other doctor would have. So I spent the next week and a half in her absence thinking I would not continue to see her. I was too dangerous to her. Because I had not taken proper care to NOT be “too much” even for her…so it was time to leave.

Finally, I was discharged by my demand, no longer committed on the 14 day paper I’d been signed in on in the middle of my stay, not wanting to be still there when she got back. I’d see her in 6 days and for 6 days I deliberated whether or not I would return or find someone new. It wasn’t rancor on my part at all, it was purely fear that I could so misjudge a situation and my effect on things that I’d accidentally allowed myself to over-burden someone before walking away, before saying, Never mind, I’m okay, relieving them of any responsibility or worries. I hadn’t meant to. I hadn’t meant anything by refusing the meds except that I’d wanted to take only one pill of each category, not two or three of each category, and I figured that if I did so while she was away on a long weekend, and was fine when she returned, then I’d have proved it was okay to do so. My memory is SO bad that I simply did not remember that just an hour before that I had agreed to take ALL the meds, including 3 Haldol. This sort of crazy lapse happens to me all the time. The memory simply wasn’t there to hold onto.

In any event, much as I wish it didn’t, that incident haunts me even now. I want to talk about it with Dr O but am afraid to bring it up lest she get angry all over again or refuse to hear my side. And besides, it is not the incident itself that bothers me so much as the fact that I did not protect her from me! I did not protect her from me! And so she was harmed by me, worn out, wearied to the point of exhaustion. True also is that fact that I worry as well that I cannot trust her to protect herself from me! And if she can’t or won’t, and I must, then there’s no point in my seeing her. The only way I can protect anyone is by getting out of the way. Only if I know that someone will protect themselves, take care of themselves vis a vis me and not do things in any special way for me, can I trust them to help me. Otherwise, it always backfires to my detriment.

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