The Agony of Being Mental

by Carl Nelson (October 2020)


The Flesh Eaters, Edward Boccia, 1996 (Courtesy of The Edward E. Boccia Trust)



I remember reading a reader’s response to an article in a local journal about single, divorced, or widowed women needing to get the normal home repairs accomplished that a husband generally would do. The response was from a male contractor who said that there was quite a pool of capable handymen available for small short-term jobs. Apparently, according to the contractor, there were a number of capable men who, because of their volatile personalities, were unable to keep jobs. They might do good work, but were unable to handle the constraints of the regular workforce without mucking it up. He added that you could often hire them for a good rate.

       Many years ago, I knew a social worker who had lived in Hawaii. She noted that the natives suspicious of oddly behaving people stayed clear of individuals they called ‘mental.’ How fine a line, I reflect often, we must all walk so that our lives accomplish our goals—or at least stay on the rails—so we’re not thought of as being ‘mental’.

       Every ordinary person knows many people whose presence they must acknowledge, others whose invitations they should avoid and still others for whom a prudent social distance is still to be determined. And mustn’t we all market ourselves a bit? Aren’t we all forced into the role of sometimes aggressive and at other times a truckling salesperson to some small extent throughout our day with wives, neighbors or relations? And then mustn’t one always remain calm and good humored no matter the provocation, and to choose one’s words carefully? Because no matter how justified your ire, generally the individual, who loses their ‘cool,’ loses the verdict. This is certainly true in most arguments with the wife and generally any argument with a woman—especially if the man is quite large and prone to waving his limbs when agitated. Then there is a way we must dress, posture ourselves, speak, respond, and so many details we must be aware of so as to remain at one with the bunch we mingle among, whoever they may be, in order to make our way and stay in the loop—and again, not be thought ‘mental.’

       Improper behaviors are proscribed by power and for some purpose.

       So long as persons of every degree behave according to fixed rules which everybody knows, their actions under all circumstances can be predicted by their associates, and confidence reigns in human relationships. Conversely, a nonconformist behavior upsets all calculations, makes every precaution necessary, stirs up acts of reprisal for its own wrongful acts of aggression, and, if the evil grows, unleashes in the end hatred, distrust, and violence. —On Power, Bertrand de Jouvenel, Pg. 214

       Don’t get me started on all of the bureaucratic genuflections that force themselves upon us nowadays where ‘hostile’ environments burble primordially. This is especially true in the corporate cubicles where, as in highway construction zones, fines are multiplied. It’s quite daunting.

       But let’s look at things from the vantage point of sales for a bit, as this is where I have some experience and is the account around which so much circles. Because one thing that is certain is that when you have fallen from the circle of conformity which forms a modern culturally integrated life, you have failed to sell yourself. Something’s “gone south.” Your personality “didn’t make the cut.” People “are not picking up what you’re putting down.” You “are not coming across properly.” You are describing a deal they can refuse, and your bottom line has suffered. Capisci?

       Since the rules of conduct can be subtle, complex, and because we may not understand the conventions the person we are speaking with adheres to, the easiest way out of this dilemma is to mimic the prospect’s behavior. One of the guiding techniques of sales is to ‘mirror’ the prospect. In this way, I am not a stranger. Rather I am someone of their crowd; someone they have just not met yet. And if I appear confident, intelligent and friendly, why, I might very well represent a prospect of one sort or another to them, especially if they are likewise ambitious. So let’s meet, and talk!

       However, a bipolar patient I once knew had been bundled off to us for serving tennis balls in a restaurant. (He had the sweater adornment of a bumble bee on a spring, so the diagnosis was an easy call.) The patrons who witnessed this would be hard for him to network afterwards. And a teenage schizophrenic who has taken off his clothes and walked up and down his neighborhood street yelling profanities may have difficulties returning his neighbor’s glances afterwards. Obviously these two were not ‘mirroring’ our society’s prerogatives well.

       Patients who have psychological disabilities often fail the test of ‘mirroring.’ For example, a rather romantic, dark, brooding young fellow on the lock-up ward where I once worked, spoke quite clearly but with a rather affectless intensity. He had been brought in for a stalking a woman he had been ordered away from by court order. He was not mirroring her behavior—at all, I would say. Another patient, Ted, who I will talk about a bit later, failed to arouse the love interest of a single mother living next door with his free flying feats of association accompanied by other difficult behaviors. With people who are ‘mental,’ just the normal routine of checking yourself in public—that is, adjusting how you look in the ‘mirror’ —can prove to be an insurmountable ordeal. Then, even after accomplishing the common courtesies, there is the even more sophisticated problem of selling oneself.

       Not that I am adept at sales. Far from it! As soon I meet with people and utter more than a few lines, the relationship dwindles away. I must be, as the great logician, Kurt Gödel, was once described, “anti-charismatic.” While his Viennese intellectual mates argued solutions to the great logical paradoxes, Gödel’s anwers—whose contribution to the school of logic has been rated the greatest since Aristotle—were ignored. There was something about poor Kurt Gödel which made his presence a vacancy, a space to transverse. I would hypothesize, that being anti-charismatic is, in a passive manner, being ‘mental.’

       (Quite by the way, he eventually shared a home with a German stripper he married, while living in Princeton where he was a good friend of Einstein’s. Apparently he wasn’t a cipher to Einstein.)

       What I am thinking is that I can somewhat empathize with those who suffer this burden of being ‘mental,’ as it has something to do with one’s thoughts and actions not dating well. There seems to be some sort of ‘click’ which must take place upon meeting others that allows yourself to be shared. Not that anyone makes the sign of the cross, but they do drift off the more I reveal. (Are you drifting there? Here. Just hang on to the bottom corner of this page with thumb and forefinger. Steady . . . as we go.) It’s as if the more I try to make myself clear, the more incomprehensible I would seem to become. The ‘mental’ seem to suffer the same frustration. In a vague way, we click. I hypothesize that they seem to be trying to locate reality, while I am trying to figure what is going on—which is somewhat of the same thing.

       What I’m trying to do here, is to demonstrate that the other—the mental, amongst us—might be an awful lot harder to perceive than we might know; that we might miss what’s in the mirror—even though “objects might be larger than they appear.” How many of us are taken in by criminals, because we can’t imagine someone would do what they did? And yet, there they were, right there! We can’t believe it.

       This brings to mind a meeting myself and members of my family had with my cousin some years ago. He is from an extremely successful branch of the family—Ivy League, Presidential staff sort of thing (whose son was later to become a billionaire while still living at home.), who had flown into town on business. We lived in a big city, so there was a good chance he had come and gone from our locale many times before. But my cousin said he wanted to rekindle the relationships with his relations. So, I’m very chatty and involving myself in the conversation over lunch. But as I’m driving him back to the airport for a drop off he gets very vexed along the way and finally blurts, “What do you want from me?”

       I was rather at a loss. I didn’t want anything. In fact, it was he who contacted us. But I said nothing, sifting my thoughts as if sitting with my mouth open. “Look, I’ll get back to you,” he blurted as he hopped out at Departure.

       But let me return to this in a bit.


       For many years, I did telemarketing. I found telemarketing—though taxing and tedious—to be of interest, later of some use, and of great value to my wife who sells copiers. (Biggest plus.) Salespeople generally hate cold calling. Whereas I found it to be something like lifting weights, I could only lift so much, and do so many repetitions. But, as an unheralded writer, it felt good to be finally pressing back against gravity (that is, whatever was marshalling interest against me), and to be getting a bit stronger at it to boot! But I precede myself.

       When you do telemarketing they will give you a script. The script involves a sequential series of statements and questions to ask the prospective customer. Responses are given to the possible answers the customer might offer. My first thought was, ‘I am supposed to say this?’ The questions are quite bold, a bit intrusive and, more than anything, very stilted, very mechanical when recited outright. But the directions were to use the script just as is anyway, as it has been road tested. It has been proven effective. I was to think of it as a proven, killer script. I was to repeat the script so many times that it became second nature; so that it eventually felt natural. In short, I must perform it. And yet the script had me sounding and acting in a manner that my artistic friends—who do not like businesspersons and especially salespeople—said they hate.

       But I did what the script says, nevertheless—and it worked. It works. Prospects who would have drifted off before, listened. CFOs who wouldn’t stop to talk, volunteered information. What the hell?

       Well, I supposed . . . I could get new friends.

       After several years and thousands of phone calls, I can honestly say that I became very good at speaking with people for three, maybe five minutes tops. Any longer, and they would realize that I really didn’t have anything more in my quiver. But three to five minutes was usually all it took. The object was to get the appointment. As soon as a telemarketer nails the appointment, they say their goodbyes quickly as possible. Any further conversation could go sideways, and you’d have chatterers remorse.

       Once I achieved the appointment, it was on my wife’s plate. She would go hammer on them. And good luck to them, too!

       So—and here’s the pay-off—I realized several important things. First, that audience demands confidence. Second, people find it good manners if you pause every other sentence or so to invite their response. And finally, people expect you to ask for something! Otherwise, they sense you are either not being honest or are wasting their time. In other words, a salesperson must state what my cousin was complaining about! What did I want? People were not looking for a relationship, no matter what they said -no matter what my cousin had inferred. This all left me a bit blindsided.


       But when I took stock of myself, I realized that, number one, I don’t sound confident. But that’s because I’m always looking, and I’m never sure for what until I find it, and I often fail, but I find even that interesting. I would suffer a full-blown psychosis to project confidence under these conditions. And beyond that, I couldn’t say what exactly it is that I look for—except that, “Like a piece of ice on a hot stove the poem must ride on its own melting,” as Frost said. That would describe my perfect conversation. I suppose I wanted all my conversations to be poems. So, it appears, of the three necessities for a continuing conversation, the only thing I appeared to do well was to pause.

       I do pause well. I live in a rather lapsed state. In fact, most friends and acquaintances who call, ask upon my answering—no matter the time of day—if they had awakened me? No, I respond. But I exist in a rather twilight environment. Many poets do. So do druggies and the mental.


       This was all very interesting to learn how much desire for some achievement orients most normal conversation.  I hadn’t realized! That sort of achievement doesn’t orient my conversations at all. And I could never maintain this conversational attitude that regular life demands for much longer than the telemarketers three to five minutes. Nevertheless, those brief minutes could—and did—connect me with most of the normal human community. I felt good for that brief bit of time to be on script and at ease, and to participate with pragmatic corporate types in their activities—if only for a few minutes. I learned to hold my own. I could even muscle them around a bit. I became mentally tougher. I felt a sense of accomplishment, even a little more connected afterwards. And though they didn’t know me, I did learn a bit about them. And this was all worth money!

       Years ago, one lawyer began chewing me out one day for interrupting him at work. “Do you realize that I charge fifty dollars an hour for my time?”

       I paused to consider.

       “Well,” I responded. “My time pencils out to about sixty-five dollars an hour spent on the phones.” I paused. “So, you’re getting the better deal.”

       He said nothing.

       “You should be calling me,” I quipped.


       But, as I mentioned, I’ve found that the ‘mental’ and your garden variety person with ‘issues’ are big into pauses also. They tend to exist in rather lapsed, fugue-like states—preoccupied might be a word for it—even when chatting. Neither myself nor them tend to project great confidence, nor accomplishment. And while I’m trying all the while to figure out what is going on, they are trying to figure out what reality is. So, we were very nearly on the same page. In short, I mirror the ‘mental’ quite well. We were like tourists of a native Fugue State, who recognize one another’s commonality overseas and strike up conversation.

       Troubled people confide in me. I don’t know if I am selected more than others, or they are telling everyone and I’m just the one who responds. And sometimes I feel like the clairvoyant on TV who receives graphic images of their deaths from the victims of a serial killer.  A fellow teamster confided, off to the side during a warehouse smoke break, that while hopping the rails as a kid he had been raped by a bunch of hoboes. And what did I think of that, he wanted to know? Another warehouse worker shared the remorse he felt for having blinded a young kid in a desperate fight by pushing his eyes across a barbed wire fence. He watched for my response there, too. Another detailed how his Christmas spent in a motel on Aurora the past week with a hooker and her kid had fallen apart when he had tossed the Christmas tree out the back door during a fight. But he was just going for a rueful laugh.

       A fellow Metro driver said he’d walked in on his wife in flagrante. I raised my brows! My Metro bus had a stop outside of the King County Courthouse where released inmates would sometimes board. Some sprung aboard to declare with glee, “I just got out of jail!”

       “Happy for you, man.” I smiled.


       As I reminisce, I’m more optimistic that perhaps my life has not been The Cipher’s Progress, but rather a picture puzzle of community whose clues I have been snapping together as perhaps the Pieter Brueghel painting, “Netherlandish Proverbs” or “Wedding Dance in the Open Air”. In these sylvan psychological settings, I’ve listened and learned. But more often I’ve found myself way in over my head, as if I’ve wandered through the tangly wood right into quicksand and could use some help myself, getting out.

       For example, I encountered a woman on social media, who lived and worked alone from her small room by the sea. She was friendly, wrote a bit of current events and posted pictures compulsively of the same flat beach with the ocean disappearing away into the sky, plus her dogs sniffing and cavorting.

       I don’t know what prompted this next thing. I suppose she possibly had been afraid of having overreacted in some way and hoped to explain herself. But she suddenly messaged me of a long history involving both her mother and father and family incest spanning a decade. The only flag I’d noticed her flying seemed the sense of her being settled on some solitary edge like a lighthouse with its beam scanning the sea.

       But once the lid of her personal Pandora’s Box was opened, we both struggled with some difficulty to get the lid closed again. It took the both of us working with some sensitivity. It’s as if victims, such as this woman, have been marked with the sign of Cain and driven from the Promised Land, unfairly. I wonder if Pandora herself wasn’t cast outside the framework of a normal life, and left to observe and beat her head as if replicating the agony of an outlier fly on the window. Persons with issues, when they encounter someone who appears will hear, it seems they must speak.


       My experience with the troubled has been that once I’m through the exhaustive interrogation which accompanies getting a balanced story out of nearly anyone – their self-application of practical cures expertly reverse-engineers the remedy into another dollop of poison. My goodness, mental issues are truculent! Troubled people practice all the skills of alchemists—excepting that they turn the gold of life into mercury. You think they must follow what you’re saying in flagrante—but they don’t. They aren’t.

       But then, life has taught me that nearly everyone lives on a different planet.

Expulsion from the Garden

When someone blubbers you a problem,
realize that they are the expert.
And that they have birthed it,
they have lived it, created the floor plan,
built it from the ground up,
placed and weather sealed all of the doors and the windows.

They are experts on what you will see.
Believe me, they have scoured the view
and where it allows them to go.
They’ve been in and out, back and forth, repeatedly
day after hard day. Remember, they live here.
It’s the only home they’ve known.

And if you should remedy this,
they’ll be evicted.


       I first met Ted (name changed) as a medical student in Seattle, Washington, on Harborview 5th Floor North, which was the psychiatric lockup ward of the major downtown public hospital. My brief medical externship on the psychiatric ward was an eye-opener. The mental illness was expected, but the sadness and apparent wreckage of lives was something to consider.

       Ted was newly arrived to the ER, and fairly well along in a monologue, when we met, about the nurture and shaping of Bonzai trees. He was doing this in a verbal salad of observation—loose associations being one of the four ‘A’s in diagnosing a schizophrenic. He was a slight, elf-like fellow, around my age at the time, wearing wire glasses accentuating his intellectual appearance. I would get to know him fairly well during his stay.

       One of the reasons I got to know Ted fairly well during his stay was because he couldn’t leave. Or, more accurately, we couldn’t discharge him until he had a place to stay, that is, we got him “placed”. And this was problematical because his record was flagged with an incident of fire starting.

       In my new self-acquired role of advocate for Ted, I found that included in his intake records was the statement that he had been brought in after starting a fire in his apartment building. Being a ‘fire starter’ in the social services pantheon is the worst thing you can be. They would sooner house a serial rapist or murderer, I’d guess. No assisted housing would ever be available, period, while this was on his record. So our first avenue of hope was that he could return to live with his parents. But this hope was dashed just outside the door to the facility in the institutionally-painted green hall opposite the elevator bank. While making a request for shelter of his mother, the elevator doors would open and close discharging people. The indignities of life, eh?

       It is very common for psychiatric patients to relapse three or four times, often with worse and worse complicating incidents, before finally resigning and realigning themselves to a lifetime of taking psychoactive medication. I was told it’s difficult to face the fact that your thinking cannot be trusted. And also, few drugs are so selective that they only alleviate unwanted symptoms. At that time, drugs to control bipolar disorder would flatten a subject’s subjective highs and fill in the lows in such a way as seemed to take the air out of their lives. And during my time, the drug given for schizophrenia would induce a sort of mental slog as if the person thoughts were pushing through mush and also would induce unwanted psychomotor side effects. Medicated schizophrenics often had a tin man aspect to their walk.

       When I visited the Pike Street Market, which was a downtown area just up from the waterfront where fresh seafood was sold (among many other attractions plus arts and crafts) I would often see people exhibiting these drugged attributes moving about. The Market attracted an odd, eclectic local crowd. In fact, each visit there I would usually see one or two of our former patients standing mutely or slowly circulating. They wanted to be around people, I supposed, and yet hadn’t jobs. The Market was an environment where the odd and eccentric not only did not stick out unduly, but were tacitly celebrated as Seattle arcana by the city shoppers and tourists who passed through.

       Ted’s mother was a small, slight person like Ted. They discussed matters softly. She seemed a kindly woman to whom the situation was a torture. I remember Ted quietly explaining his situation; that he hated to impose but that he really had nowhere else to go and asking if he could return to live with them for a bit, if only to get himself out of where he was now. Hearing his mother having to tell him “No” was one of the saddest situations I’ve ever witnessed. “In know this is hard . . . but we just can’t,” she insisted, softly. Ted didn’t argue, but accepted it silently.

       One of the odd things that will happen when you get to know a mental patient of one variety or another is that with time you may begin to communicate with them fairly naturally. For example, after presenting one of my patients to the weekly rounds—after he had left the room, the attending and others agreed that the fellow obviously exhibited the loose associations and loss of affect common to a schizophrenic. I had to object, “He seems to communicate fairly normally to me. At least, I had no trouble understanding what he had to say,” I replied.

       They all laughed and nodded their heads.

       But the object of this essay is to point out what difficulties the psychiatrically disturbed and/or emotionally troubled person has with day to day living, and what a straight and narrow path most of us need to walk to survive both socially and practically, that is, the balance that is required. Psychiatric problems destroy lives as if they were a buzz saw sending chips of a flourishing existence hither and yon.

       For example, Ted was a physics major on scholarship to the University of Washington during his first psychiatric admission. At the time I met him, he had been making do managing a brownstone of cheap apartments in the Cascade area of downtown Seattle—an area which had transitioned to small industry and businesses. Since Ted maintained he had not tried to start any fires, I decided I would drive there to find out more. It got me out of the hospital, and it made me feel as if I might accomplish something. Plus, I’m inveterately curious and a snoop.

       The Cascade area was a low rent, crumbling district ripening for the bulldozer of Paul Allen’s Vulcan Development and to soon flower as the South Lake Union Tech Corridor. I ended up speaking to Ted’s neighboring tenant. She was an attractive, if frazzled, single mother with a small child, who was obviously struggling to keep their situation afloat. This much was plain from the cramped accommodations. Careful but sympathetic, she said that Ted was very considerate of her but that she had told him that she didn’t want a relationship. And though he was very sweet in wanting to help her, what with all of his psychiatric problems and her own . . . she gestured with dismay, turning slightly, “I have my hands full enough as it is.” Apparently Ted would suffer a breakdown and be difficult to talk to. Or he would leave his food cooking on the stove. The resolution, however, was that I discovered that Ted—as apartment manager—had not been trying to start a fire, but had been trying to fix an electrical problem in the building’s utility box. He had ‘fixed’ the problem with a screwdriver during one of his psychotic episodes—and had fried a circuit instead, resulting in flames. I’m guessing he was lucky in not having fried himself.

       But it had been a profitable trip.

       With this information, I was able to get the firebug flag removed from Ted’s record, and then to get Ted moved out of lock-up and situated in the Wintonia. At the time, the Wintonia was a huge, old building in a small triangular block of Capital Hill used for halfway services for the handicapped of all sorts. My thought, when I first stepped inside of the place was, “What have I done?” It seemed the worst of everything: drooling inhabitants, dreary, compassion-fatigued social workers and old fixtures repainted in bureaucratic color wheels of thick, chipped paints. But Ted was exuberant to have acquired the situation and thanked me warmly as I dropped him off and we parted ways. Years later, I saw him on the street pushing his three-speed bike with the chrome towers of mirrors on both handle bars. So I’m guessing he found a way to soldier on through his life.


       But, to sum up.

       Oh my goodness, how much bad advice have I ladled out in my time to the poor and deserving? If my essay seems a bit confused, it may be because life is confused, and any explanation likely carries a seed of this. And possibly my capabilities are a bit to blame . . .


There are more things in heaven and Earth, Horatio
Than are dreamt of in your philosophy.

       Shakespeare might also have said something about any essays which Horatio might have scribbled. Because the biggest take away from this life might be humility. People and life are very difficult to grasp. And what we understand is probably just a fingernail of the thing. It is common to err, especially when the physician is fallible, and the cure is far more difficult to administer than the disease is to nurture.  

       Nowadays, when I sense a revelation coming on in a conversation, or am surprised by an insight during discussion, I try to mute my reaction and refrain from comment. Instead, I may take out a slip of paper and write a bit about it down for a poem, later when no one is looking. As I’ve found myself to be more poet than physician. So I try to keep my response to triage—and leave the rest for those professionals who sign up for this sort of thing. Our minds truly are a tar pit, and our reason like one crab trying to pull the other back into the pail.

       When I try to think of helping someone troubled with issues—that is, someone ‘mental,’ the memory of Ted is the one I return to. It’s real, and solid, and cut and dried and a situation where I have been of actual use. We were just two people on this earth with a practical problem I could help solve. No issues really. Nothing ‘mental,’ actually, about it.

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Carl Nelson has recently published his newest Self Help Book, The Poet’s (30 Year) Marriage Plan, which is a useful collection of interlarded poems and prose advice (schemes), all celebrating the hallowed institution of marriage. To learn more about the author and peruse his work, please visit here.

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