Originally published in the Journal of the California Alliance for the Mentally Ill.
The commotion seemed to last an eternity. I stood aside, helpless, frightened and exhausted from the destructive fantasies and terrors of this woman-my mother-whose mind I had watched disintegrate over the past two years. I slumped against a lamppost, wondering how all these people-one of them a physician-had materialized in the seconds after my mother jumped from a moving taxi headed for Toronto General Hospital.
In a blur of flashing lights and sirens and under police escort, we eventually made it to the hospital. At 50, my mother was certified and committed for psychiatric treatment. In Canada, police officers have more power than doctors to get mentally ill people certified. They are usually the ones called, after all, when someone harms himself or someone else-the foremost criterion for certification-or demonstrates the capacity to do so. For my mother, the act of jumping out of a moving vehicle rendered her dangerous and certifiable in the eyes of the law. That was the technicality. But her decline into the morass of mental illness had been terrifying and protracted. The harm she had already inflicted upon herself and me, her only child, was immeasurable.
Diagnosis was quick. No stranger to the psychiatric ward of TGH, she had been wandering its corridors for several weeks before being committed, and had even been admitted once. But without being certified, no one could stop her from walking out when the voices in her head told her that the psychiatrists were not real doctors, but agents of Satan bent on poisoning her to death.
The diagnosis was devastating-acute paranoid schizophrenia. Doctors called her a "textbook case," displaying a wide range of classic symptoms, including suicidal impulses, hallucinations and obsessions. She fixated on a local radio announcer she believed spoke directly to her. She publicly announced she was engaged to marry him, even though she had never met him. Ironically, his wife was one of the psychiatric nurses who attended her in hospital once she was committed.
The litany of symptoms wasn't news to me. I'd lived with them for years. In those final months, she filled every space of her home with crucifixes, rosaries, holy water, and religious statues. She prayed non-stop, attended mass daily, and accosted priests and nuns in the street, insisting they find her an exorcist to rid me and her sister-her only living relatives-of demonic possession. One night, she destroyed everything that I had ever given her, including diamond earrings, a Christmas gift the year before, and a two-month-old kitten. During those horrifying weeks, she shredded every photograph of me she had, including baby pictures and my recent university graduation portrait. She found pictures of me in a wedding party, and ripped my face out of each shot.
Despite her laundry list of symptoms, the complexity of her case baffled psychiatrists. They believed there was more to it, but no one seemed to know what it was. Obsessive and controlling, she plunged into profound depressions that lasted years at a time, then fell into periods of frantic activity and overspending that finally bankrupted her. Bipolar disorder was added to the diagnosis, although specialists admitted it was rare to find both schizophrenia and manic-depression present in one person. Later, her condition was labeled "schizoaffective."
As is so often the case for the mentally ill, diagnosis was both blessing and curse. On one hand, it was a confirmation, a validation of my experience in a severely dysfunctional family environment. Having lived for 25 years with a demanding and perfectionistic single mother who weighed onerously on me to provide the emotional anchor she craved, I knew that her attachment to me was neither normal nor healthy.
On the other hand, diagnosis was the start of a long and treacherous road. Reticent medical professionals shrouded information about her condition and prognosis under the cover of patient confidentiality. Legislation and regulations made support to family members almost non-existent, and, in fact, impeded efforts to get treatment and appropriate follow-up care. As for me, anger, grief, guilt, terror, frustration, sadness and self-doubt were as much a part of the process as her drug therapy and counseling sessions were for her.
For most people, dealing with chronic debilitating mental illness is outside their realm of experience. So much so, that I hear myself explaining to people that my mother is a diagnosed schizophrenic. I'm not just another daughter who complains about her "crazy, paranoid mother." I deal with the real thing, day in day out, year after year.
Since 1980, my mother has been hospitalized twice, each time suffering from severe psychosis. Her second hospitalization came barely a year after the first, when she stopped taking her medication and failed to attend regular psychiatric appointments. During that year, she came under the care of half a dozen psychiatrists. In an effort to gain insight into her illness, I dutifully met with each doctor she consulted. Without exception, they all told the same story: my mother was seriously ill, she would never totally recover due to the number of years she was untreated, and the fact that she was drug and therapy resistant.
Like many schizophrenics, my mother's technique for stonewalling is flawless. At times, she can even appear quite lucid. As a result of her verbal acrobatics, she has managed to evade treatment with every psychiatrist she has ever consulted.
In her view, she doesn't need a psychiatrist. There is nothing wrong with her. She isn't crazy. She can't even remember the word schizophrenia, let alone suffer from it. Her eyes sparkle and her speech is dazzling as she describes her privileged and satisfying life-a life that she has fabricated and embellished beyond recognition and reality.
The intervening years have not been kind to my mother or our family. Fifteen years after her original diagnosis, she plunged into a psychotic episode that has lasted longer and been more devastating than ever before. It has also irrevocably shattered the fragile relationship she and I have endured for so many years. This new phase has marked the end of a manic high that began in 1987, during which she indulged in a spending spree that has left her with over 3,000 outfits, 400 pairs of shoes, 300 handbags, years of unpaid property taxes, and broke.
As she spiraled into mental deterioration, I tried frantically to get help, starting with her family doctor, a Toronto physician who risked severe disciplinary consequences for his openness with me. He, too, had recognized the symptoms of severe psychosis, and attempted to prescribe medication and refer her to a psychiatrist. Not only did she flatly refuse treatment, she abruptly stopped consulting him and reported him to Canadian medical authorities for misconduct on the grounds that he was not a "real" doctor and was attempting to poison her with medication.
As ill as she is, my mother has now avoided medical treatment for over 20 years. There is nothing I can legally do to force her into assessment or therapy-unless, of course, someone gets hurt.
Although medical records substantiate my mother's illness and assorted police files document her disturbed behavior, she is, apparently, entitled to deny both her illness and treatment. Unsupported by the medical community or the legal system, there is nothing more that I can do.
Sometimes, when I am alone and quiet, I still battle anger and overwhelming sadness at the lives that no ethical, legal or moral code was empowered to rescue.