Diagnosing Wonderland - University of California, Berkeley

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Diagnosing Wonderland
Diagnosing Wonderland:
A Multiaxial Perspective
On Art and Psychological Disorder
by Andrew Toskin
Senior thesis written in order to complete the requirements for Honors in English, and
under the guidance of Professor Scott Saul and Professor Susan Schweik, at the University of
California, Berkeley, spring 2013.
Licensed under CC-BY-SA 3.0.
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Table of Contents
Abstract...............................................................................................................................................................................3
Dedication ........................................................................................................................................................................4
I’m Trying............................................................................................................................................................................5
Rule 42:................................................................................................................................................................................6
The Wrong Question........................................................................................................................................................9
We’re All Mad Here...........................................................................................................................................................10
Sentence First, Verdict Afterwards...............................................................................................................................11
Diagnostic and Statistical................................................................................................................................................12
Begin At the Beginning, and Go On Till You Come To the End: Then Stop.....................................................13
Case Study: Melancholia...............................................................................................................................................15
Plumbing the Depths Of the Dark Pit Of Darkness,
et cetera................................................................................................................................................................................17
DSM......................................................................................................................................................................................23
Diagnosing Depression......................................................................................................................................................24
Persuading From Suicide................................................................................................................................................26
Danya....................................................................................................................................................................................27
All-Consuming...................................................................................................................................................................29
Case Study: Black Swan...............................................................................................................................................36
Jumping Into a Panic.........................................................................................................................................................37
Becoming the Monster....................................................................................................................................................38
The Smallest Goal Of a Little Self-Control...............................................................................................................44
Wasting Sickness............................................................................................................................................................47
Phoebe In Wonderland...................................................................................................................................................51
Where Things Aren't Quite So Fixed...........................................................................................................................52
Spit It Out............................................................................................................................................................................53
Wrecking and Ruining......................................................................................................................................................55
I Don’t Know Why............................................................................................................................................................56
It’s Just the Way Kids Are...............................................................................................................................................59
Giving It a Name.................................................................................................................................................................61
Delirium.............................................................................................................................................................................64
Let It Go, Then...................................................................................................................................................................64
On the Precipice Of Understanding............................................................................................................................66
Happiness Is........................................................................................................................................................................67
References........................................................................................................................................................................70
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Abstract
This fragmentary thesis explores the apparent relationship between artistic creativity and
psychological disorder. It cracks along a number of lines: It’s filled with autobiographical sections,
and it looks at real and fictional examples from others’ lives. It closely reads 3 film, and makes a
statement about the need for reinvigorated synthesis between academic disciplines. And it straddles
media.
This is a linearized and slightly abridged version. The full version can be read online at
http://www.ocf.berkeley.edu/~andrewt/thesis/map.html .
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Dedication
Luanne gave birth to me.
Marla adopted me.
Jay whipped me, when I needed it.
Catherine pushed me.
Felicia saved my life, and Kimberly kept me alive.
Danya friended me.
Julie hugged me.
And Scott and Susan indulged me.
I’m Trying...
What I hope to express: the bottle of wine.
Myself, my body, my brain: the cork.
Rule 42:
All Persons More Than a Mile High To Leave the Court.
How is a raven like a writing-desk?
I’m curled up in bed, with a mattress under me and a blanket over me. My pillow is soft
against my face. I can feel my bedsheets, the way the mattress bows under my weight,
and I can feel my clothes and the blanket touching me. Everything is dark and warm
and soft — until my arms start to dissolve. Or my legs wobble, like something you see at
the bottom of a swimming pool, and disappear too. Or if they stick around, my legs
stretch miles away from my body — miles
and miles — the enormity of it is
staggering. My forehead swells to the size of a dirigible, until the top of my head pops
open and starts to suck in the room.
The bed vanished at some point, and the blanket is long gone. I’m just floating out in
space, somewhere between Earth and Mars, maybe, and it doesn’t help that the
geometry of my room is all wrong when I open my eyes. The shortest path between
any two points is no longer necessarily a straight line. And in the worst episodes,
everything starts spinning, or I’m falling, tumbling, and looking down at the bed
stationary beneath me does nothing to convince my brain otherwise.
It happens during the day too, but at night, when I’m trying to sleep, I have nothing
else to think about, nothing to distract me from the strangeness of it. I’m always keenly
aware that these perceptions aren’t real — or maybe the perceptions are real, but they
aren’t true — but they are awfully persuasive. It could almost be interesting if it weren’t
also sometimes terrifying.
At times like this, it’s almost enough to make me wish I could abandon my body
altogether. The dualism these episodes inspire is incredibly seductive. Just unzip the
flesh and hang it up in a closet, stack the bones neatly next to my old shoes,
and really drift away — to be not even a floating eyeball, because eyeballs have form
and every little mote of dust stings them — no, strip it all away to a lens, a bodiless
gaze. Maybe a disembodied voice. No more dishonest nerves to try to ignore... I could
be safe and sure then, right?
Right?
I try to settle into it, like Ah now I can finally focus on my work. I try stretching my arm
and leg muscles, and cracking my knuckles, but I don’t have muscles anymore. I laugh
nervously when I realize, too, that I don’t have any sleeves to roll up (nor lungs to
laugh), and it’s hard to move forward without these “getting to work” gestures.
Whatever, though, it’s cool, I’ll just
but without legs it’s also hard to move forward, and my desk is so far away, and without
hands I can’t write anything anyway. I could cry, suddenly, I could run around the
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house screaming, bury my forehead in Julie’s neck, eat some ice cream to soothe myself
...if I could. Maybe these confounded bodies have some use after all.
There are few things worse than doubt: a certain species of doubt. There’s the ongoing
quandary of a riddle you haven’t solved yet — and those can be fun to fondle in your
mind a while — but then there’s the uncertainty of those times where Life leave you
with a cliffhanger, and the writers go on strike before the season finishes. Some
white-knuckle rising action that rises and rises, then suddenly stops and dangles you in
the air. Whatever the opposite of resolution is.
The first psychologist I described these episodes of body and spatial distortions to had
no idea what to make of them. The first psychiatrist speculated that it was a
psychosomatic reaction to stress, which is not necessarily a dismissal of the weird
experiences I was having (and continue to have), but in this case it nevertheless did feel
like a dismissal. She didn’t seem to think the dizzy spells or sensations that my body
was warping and stretching very concerning or interesting. The second psychologist
admitted that she thought, at first, that it might be an early sign of the onset of
schizophrenia. The first neurologist ran some EEG and MRI tests, and finding no
obvious explanations there, shrugged and had me try a few drugs (which had no effect
on the body/spatial distortions).
I didn’t even have an idea of what might be going on until my friend Katherine, while
researching a similar aspect to her migraines, stumbled upon a Canadian Medical
Association Journal article from the 1950s. The condition is called Todd’s syndrome, or
the more colorful name, Alice In Wonderland syndrome. That’s everyone’s current best
guess, at least. In psychology, these categorical labels are mostly useful for convenience
anyway, but in this case the name seems pretty close. Whether or not it’s a perfect fit, I
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can now at least talk about it without having to recapitulate the whole anxiety-steeped
story of You know, that thing where my body stretches or shrinks or vanishes or doesn’t
belong to me, or the room starts spinning... That alone has actually been a tremendous
relief.
The Wrong Question
A writer out of loneliness is trying to communicate like a
distant star sending signals. He isn’t telling, or teaching, or
ordering. Rather, he seeks to establish a relationship with
meaning, of feeling, of observing. We are lonesome animals.
We spend all our life trying to be less lonesome. And one of
our ancient methods is to tell a story, begging the listener to
say, and to feel, “Yes, that’s the way it is, or at least that’s the
way I feel it. You’re not as alone as you thought.”
— John Steinbeck, in a letter to Peter Benchley
There’s something wrong with me.
I don’t know what, but I know something’s missing. The gods could have, with equally
negligible effort, blessed me with intact, complete personhood, but instead saw fit to
hand me this swiss cheese psyche. Bad enough that my own body betrays me. My joints
have rusted over; my eyelids are sticky with glue and threaten to shut me into sleep
after every blink; my lips curl into a smile only at the wrong times; somebody stepped
on the trumpet in my voice, and now it squawks flatly, capable of only one thin note. I
meet people meeting other people, see them speak so easily with each other stranger,
and it’s like watching your neighbor drive home in a sleek new car. It’s enough to make
you want to grab a fistful of pennies, or keys, or maybe a rock.
The intellectual effort involved in writing this thesis has been something like trying to
fold an origami swan with my feet, after both legs have fallen asleep. It might look like
I'm just staring into space or crying, but in fact I'm actually flying around the event
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horizon of a super massive black hole, my body warping along the curve of distorted
space-time, heating and emitting gamma rays, and I don't know if I'll be able to finish
my thesis in time.
I’m not the only broken personality, of course, so at least there’s that. I used to feel
hideously jealous of everyone — everyone— and hideously alone. But I’m starting to get
the inkling that everyone is secretly just as uncomfortable. No one’s skin seems to fit
them quite right.
Funny, that occasional feelings of isolation should be such a human universal.
We’re All Mad Here
I'll assume we are probably all familiar with the concept of the tortured artist, the mad
genius suffering and working alone, the novelist stopping only to grab more paper and more booze.
The Beatles and the Rolling Stones were better before they got clean, and Stephen King was so
drug-addled, he says, that he cannot remember writing his book Cujo at all.
Surfing on this wave of reasoning, a strip from the photocomic A Softer World describes a
hypothetical future...
How can you spin a moving tragedy if you don't know what it's like to suffer, right? Related
to this is the idea of catharsis, of artistic expression being an important release, a way of letting off
steam, of conveying feelings you otherwise don't know how to express to people. Plenty of songs
touch on this: Just a few months ago, Gotye observed — a dozen times every hour of every day from
every radio — that you can get addicted to a certain kind of sadness, and people are still singing
this line with him in their cars and showers.
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So artists don't just need to suffer for their art, they need their art to cope with all the
psychic anguish that inspires their work — which seems like a miserably cyclical existence for those
doomed to move and entertain the rest of us. Is it worth it? Does this even work? Some
psychological studies suggest that seeking catharsis is often not the best way of dealing with boiling
emotion, but bottling it all up isn't good either, right? Where do we draw line between art as
therapeutic and art as self-destructive, and are those the only options?
The answer I present is that these questions are ultimately a red herring.
Sentence First, Verdict Afterwards
Watching Black Swan was what first got me thinking about the relationship between
creativity and psychological disorder, and whether perhaps it was an unhealthy connection — does
“madness” cause art, or is it the other way around? The film had me desperate to find examples of
tortured artists who were/are able to recover, or examples of art as therapeutic, or else maybe
proof that psychological disorder and creativity were mutually independent — all of which, in
hindsight, was off target. These are not the right questions.
Talks about the relationship between madness and art seem to assume that art and the
psyche are more or less independent things which may then act upon each other, the way two
people may have an impact on each other through combat or conversation. And this is
not altogether wrong: eating breakfast and running a mile are distinct acts, yet one clearly
influences one's ability to do the other. But really, art and psychological disorders are two limbs on
the same body — they are literally just behaviors of the same person in different contexts. The brain
itself is likely not as modular as researchers have assumed while designing their studies: every
neuron is connected to approximately 30% of every other neuron, which by some estimations
makes for about 1014 synapses — that’s 100 trillion intercellular connections. Art and psychology are
similarly hopelessly tangled together in the same person, and so susceptible to the same failings and
victories of the mental, biological, and socioeconomic context the individual lives in.
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My thesis is, in a sense, a rejection of dualism: you cannot separate the mind and the body
because the brain is just another organ, and as the popular psychology adage goes, “the mind is
what the brain does.” Likewise, you cannot really separate creativity from disorder since they are
spawned in the same brain in the same body of the same person reacting to the same larger
environment.
The “biopsychosocial perspective” (or “model,” or “approach”) is not a new term to health
science. George Engel proposed the term in 1977 while writing a critique of the purely biomedical
model of healthcare, and while the ensuing discussion has yet to produce an irreducible scientific
model in the strictest sense, the evidence for such a triple dialectic between a person’s biological,
psychological, and social circumstances is compelling. Your physical health affects your mood , and
your mood affects your physical health. Your social circles and culture determine1 which aspects of
the human experience require attention and treatment in the first place, or which get bad
enoughthat they become problematic.
The descriptive usefulness of the biopsychosocial perspective seems almost self-evident at
this point, even though no one seems to know quite what to do about it.
Diagnostic and Statistical
The health sciences have also, so far, failed to produce other models as well. Belluck and
Carey quote Dr. Thomas R. Insel2, director of the National Institute of Mental Health, as saying that,
while the Diagnostic and Statistical Manual of Mental Disorders (the DSM — the so-called bible of
psychiatry) is still currently the best tool available to clinicians, “As long as the research community
takes the DSM to be a bible, we’ll never make progress... People think that everything has to match
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In Japan, depression is often seen a normal part of life, and in America, there are cross-sections of society
which would refuse any help with their depression even if offered because it require admitting that they
felt sad
2 Pam Belluck and Benedict Carey, “Psychiatry’s Guide Is Out of Touch With Science, Experts Say,” New
York Times, May 6, 2013, sec. Health,
http://www.nytimes.com/2013/05/07/health/psychiatrys-new-guide-falls-short-experts-say.html?
src=recg&_r=2&.
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DSM criteria, but you know what? Biology never read that book.” As of this writing, the DSM is
about to publish its fifth major edition, the DSM-5, and the controversy surrounding it has been
enormous. For decades already, for example, it has been argued that diagnoses should be based on
cause rather than symptoms, or at least that diagnoses should be based on points in multiaxial
spectra — i.e. describing the psychological conditions with a set of sliding scales — rather than
picking and lumping clients into discrete categories depending on the number of checkboxes you
can fill. But we still do not know what causes most psychological disorders, and the closest we have
to the latter is opening up a spectrum within the discrete categories — e.g. there may be degrees of
depression or autism instead of types — which is not exactly the same thing.
However, the solution Insel proposes — disregarding the DSM’s categories and
investigat[ing] the biological underpinnings of disorders instead — means retightening the focus on
biomedicine. I am not the director of NIMH, but this seems a little short-sighted too. The names
associated with the practice of categorical diagnoses are convenient — it’s easier to
discuss attention deficit hyperactive disorder (or even more convenient, ADHD) than to discuss the
set of affected numbers for the scales which quantify the attentional and other cognitive deficits —
and this verbal convenience may even facilitate the formation of support groups. But that’s about
where their usefulness ends, and as Insel suggests, researchers ought to be looking beyond
categories. Similarly, I think, progress depends on collapsing the divisions between academic
disciplines. Some amount of specialization is probably inevitable, and even more efficient, but if
biopsychosocial factors are in dialectic, then biologists, neurologists, psychiatrists, psychologists,
sociologists, and humanists need to be in dialogue.
Begin At the Beginning, and Go On Till You Come To the
End: Then Stop
Since a film is what got me so worked up in the first place, 3 films is where I’m hacking a
crazily winding path to soothing truth. Melancholia struggles ambivalently with the connection
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between art and disorder. Black Swan embraces the connection, and dramatizes a talented woman's
disorder and art spiraling downward together. Phoebe In Wonderland manages to both accept the
terms of psychiatry and show that aspects of disorder can also be “normal.”
I’m not just arguing for how these films should be interpreted, though — I’m talking about
how life should be interpreted, and I hope that this will prove interesting for all the scientists and
humanists who study life.
I’ll try to keep everything smooth and flowing, I’ll try to avoid redundant digressions into
stream-of-consciousness digressions, but I
think my paws are getting furrier, my face feels scruffier than normal. How long have I been
here...?
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Case Study: Melancholia
Written and directed by
Lars von Trier
The main character: Justine
Kirsten Dunst
Claire (Justine’s sister)
Charlotte Gainsbourg
John (Claire’s husband)
Kiefer Sutherland
Michael (Justine’s fiance)
Alexander Skarsgård
Leo (Claire’s son)
Cameron Spurr
Jack (Justine’s boss)
Stellan Skarsgård
Melancholia is the story of Justine and her sister Claire, who come together
after Justine’s wedding falls apart in the middle of the reception. Justine sinks into a
deep depression, then slowly starts to climb back out of it. And all this time, a rogue
planet called Melancholia has been slowly drifting toward Earth...
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It runs a little slow for a film ostensibly about the apocalypse: Viewers who, like
some of my housemates when I first streamed it on Netflix, sit down expecting to see
some thrilling disaster porn will be surprised, if not disappointed. Viewers who come
in expecting gorgeous cinematography, fine acting, an exploration of art and
psychology, brilliant crushing amazing stupendous wrenching staggering depressing
genius, et cetera, though — they might like it. Certainly, the film won me over, if you
couldn’t tell. I mean, it’s not bad; it’s alright.
Watch the movie. Really! Then come back and read this.
Plumbing the Depths Of the Dark Pit Of Darkness,
et cetera
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— Allie Brosh, Hyperbole and a Half
My first year in Berkeley was everything I could have hoped for, and everything I was
afraid of. I’d never felt so intellectually stimulated in my life, but I’d also never felt so
lonely, and even before I transferred from community college, loneliness was
something I was an expert in.
Then I ran out of financial aid and had to take a year off. My parents made just enough
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money to screw me out of most financial aid, but not enough to help me pay for school.
I didn’t even have anyone who was qualified to cosign a loan. Which maybe turned out
to be a good thing — waiting till I turned 24 to finish my undergrad has put me in much
less debt. But after a long and difficult first year, taking a break somehow smacked of
defeat — perhaps especially because by then I was relieved to take the forced holiday.
When I was first coming to grips with having to take a year off from Berkeley, during
the summer of 2011, I sank into an even deeper depression. I kept grumbling about the
awkwardness of being out of school for no more or less than one year, the impossibility
of finding a job and the general feeling of impermanence, of floating out in space — but
it was heavier than that: it's more like drifting deep in the ocean, thousands of
pounds-per-square-inch squeezing in. It was dark, and slow, and heavy, and I wasn’t
sure which way was up anymore, but I guess I could have my fill of krill whenever I
wanted, and the occasional sparkling jellyfish, nature’s lava lamps, wobbled past.
Mostly, it was awful, though.
One day, during the summer session, I hit rock bottom. I slept through all my classes
that day, only dragging myself from bed because I was starving. Everything felt like it
was moving in slow motion. Trudging from my room to the kitchen was like swimming
under the intense gravity of Jupiter — my hands and feet, each little scoops of dark
matter. Do you get it? Heavy. The weight of it was practically paralyzing. The cupboard
and microwave were on opposite ends of the kitchen-cum-living room, and still only 15
feet apart, but slogging across that space to make myself some instant oatmeal took
me literally half an hour. Hoisting my hand to the cupboard for a bowl took tremendous
effort. At the time I was too lost to consider the strangeness of it; I just readied the
mental heavy machinery necessary, craned my fingers toward the blue plastic rim of an
appropriately sized bowl, and filled the apartment with the smell of diesel by the time I
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had lowered the bowl to the kitchen counter. I stared at it for a moment as I tried to
remember where we kept the spoons. There used to be this thing, I think, it might have
been called a drawer? I calculated the effort it would take to extract a spoon, sighed
wearily, and proceeded. Actually filling the bowl with oatmeal and water required
forming a committe and focus group to assess whether the local economy could handle
it. Actually making it all the way to the microwave meant clearing an application with
City Council, passing a constitutional amendment. They don’t normally allow civilians
access to the equipment necessary for such things. And after all that, I could hardly eat
it. I stood in the kitchen for — I don’t know how long — just thinking Death Death
Death until I couldn’t take it anymore.
My hands were shaking as I thumbed a message to Danya into my cheap little cell
phone. I said, Is there a chance you could get away for an hour or two? Her parents were
visiting or something at the time, as I recall.
She said, I dunno, they're staying here tonight too. I'm not sure if I'll be able to
sneak out...
Hm.
I'm anxious today, had a series of vivid disturbing dreams last night. Meaning
she'd like to get away too. I have to be at work early tomorrow, though...
I almost let it go at that. But then, I'm trying not to let fear be the deciding factor. I'm
trying to reach out. I might go to the Tang Center, but I really need to be with someone...
She said Are you okay? Okay, I'm going to get over there. How are you feeling
right now?
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Not good. I'll be okay until whenever you can get here.
Okay. Leaving soon.
When she showed up, we looked for a small side room in the apartment common area,
because people only ever went there during the block parties. She took my hand — and
her hold gradually tightened as I told her about the knife, how I held it experimentally
to my wrist, lightly scratched an artery, just to see if I could do it, just to see how long
it took before I freaked out. And I wept, and she held me close while she searched for
the right words, tried to figure out how to tell me it would be okay without just
saying It’ll be okay.
And that’s what depression is like.
DSM
But I don't know what it is I'm without
Guess I'm in love with always feeling down
— Electric Guest
As of this writing, the Diagnostic and Statistical Manual of Mental
Disorders (the DSM for short), the so-called Bible of psychiatry and psychotherapy, is
wrapping up its fifth and latest round of revisions. In fact, the DSM-5 is due for publication
this May, making my thesis doomed to obsolescence almost immediately after it’s turned
in for review. The changes we can already confidently expect to see, from the last public
drafts, shouldn’t make too much difference for this part of our discussion, though;
hopefully the APA won’t make me backpedal too much here.
At present, the current version of the psychiatry bible, the DSM-IV-TR (i.e. Text
Revision of the 4th edition), matches a patient to a diagnosis first by running through a
checklist of symptoms, then makes any subcategorizations or rules out other possible
explanations. This is an imperfect practice, but if you couldn’t guess from the
title,Melancholia is about depression, and clinicians still use the DSM’s method
of differential diagnosis. The film is exemplary of both a particular psychological
experience as well as a the cluster of symptoms used clinically to define or identify it, and
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therefore, at different levels, a compelling and particular example of possible aggravators
and coping strategies.
Depression is one in the broader group of mood disorders (which also includes the
various instances of mania), and depression itself is broken down into various
classifications. The different flavors of depression are presented in in Chapter 6 of the
DSM as just a flat list, but at bottom, the grouping starts with the symptoms of a depressive
episode, and then subdivides the mood disorder according to timing (e.g. chronic vs.
episodic), intensity (major depression vs. dysthymia), or, let’s call it vicissitude
(cyclothymia, bipolar, unipolar)... It’s hard to judge the timing of symptoms in the film:
The first half of Melancholia takes place in a single evening, but the second half could be
several days or several months. Still, considering just the basic symptoms of an major
depressive episode, the portrayal of depression here is pretty much textbook.
Diagnosing Depression
Five (or more) of the following symptoms have been present during the same
2-week period and represent a change from previous functioning; at least one of the
symptoms is either (1) depressed mood or (2) loss of interest or pleasure.Note: Do not
include symptoms that are clearly due to a general medical condition, or
mood-incongruent delusions or hallucinations.
depressed mood most of the day, nearly every day, as indicated by either subjective report
(e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
1. markedly diminished interest or pleasure in all, or almost all, activities most of the
day, nearly every day (as indicated by either subjective account or observation
made by others)
significant weight loss when not dieting or weight gain (e.g., a change of more than
5% of body weight in a month), or decrease or increase in appetite nearly every day.
1. Justine unable to keep happy during the wedding, dragging along in the garden
2. Justine comes to the table for her favorite dinner, meatloaf. But spits it out, starts to cry,
saysIt tastes like ashes. (1:12:38)
3. She doesn’t seem to care about riding Abraham even though she says at the beginning
that she’s his mistress — Claire having to tell her to take him out... and later Claire lies
about John riding Abraham ...since you never ride him anymore...
4. Until the moment when she eats a bunch of blueberry jam straight out of the jar.
2. insomnia or hypersomnia nearly every day
1. When Justine first arrives in Part 2, she just lies in bed all the time, then later spends her
nights lying naked on a bank, staring up at the planet.
3. psychomotor agitation or retardation nearly every day (observable by others, not
merely subjective feelings of restlessness or being slowed down);
fatigue or loss of energy nearly every day
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1. When she first arrives in Part 2, Justine is practically catatonic, can’t seem to move from
the car or even take a bath unassisted
4. feelings of worthlessness or excessive or inappropriate guilt (which may be
delusional) nearly every day (not merely self-reproach or guilt about being sick)
1. Arguably, when Justine says The Earth is evil. We don't need to grieve for it... Nobody
will miss it. Life exists only on Earth. And not for long (1:31:18).
2. The sorts of justifications suicidal people might make...
5. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
without a specific plan, or a suicide attempt or a specific plan for committing
suicide
1. Justine doesn’t spend much time thinking of suicide, at least not in any way that we can
observe, but she is awfully fascinated by Melancholia, in a way much more seductive
than Claire’s anxiety attacks... She says No one will miss the Earth after it’s gone, and
some seem to think she’s masturbating when she’s naked on the bank.
6. The symptoms do not meet criteria for a Mixed Episode (see Criteria for Mixed Episode).
7. The symptoms do not meet criteria for a Mixed Episode (see Criteria for Mixed Episode).
8. The symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
9. The symptoms are not due to the direct physiological effects of a substance (e.g., a
drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
10. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a
loved one, the symptoms persist for longer than 2 months or are characterized by
marked functional impairment, morbid preoccupation with worthlessness, suicidal
ideation, psychotic symptoms, or psychomotor retardation.
It’s interesting that several of the potential symptoms are opposite pairs — e.g.
increased or decreased appetite — which might seem like a contradiction, except
Justine displays decreased appetite and then increased appetite, particularly for the
sweet blueberry jam. This speaks both to the incredible variety of individual difference
reacting to different situations, and to the problems of subjective diagnostic methods.
Clinicians make their diagnoses based on patient’s apparent or reported symptoms
because there aren’t yet a lot of reliably proven causes of a given disorder.
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Depression may, like a stomach ache, be one potential symptom for a host of
root problems. There are even not a few scientists who contend that depression isn’t
even a problem, in and of itself, that depression may be a normal reaction to stressful
circumstances, or an evolutionarily beneficial urge to think deeply, which can lead to
problem-solving, invention, or other insights. This fits in with the idea of psychological
disorder, not as inspiration for artistic creativity, but as giving rise to the same
tendencies of thought which allow for creative thinking. Based on my own
experiences, it seems there must be at least a grain of truth to the idea, and there are
those who would happily read such interpretations as a sign that the very
word disorder has become obsolete; if disorders can actually make you more
productive — certainly it seems to have worked out for Lars von Trier in his latest
movie, yes? — the concept of a psychological disorder would be an ironic and untrue
anachronism, indeed.
The notion of depression (or any other disorder) as a substrate conducive to
creativity is complicated by the fact that while the deep ruminations characteristic of
depression may lead to new insights, the immobilizing effects of depression also
hampers one’s ability to actually act on those insights. There is less debate about the
reality of people’sexperiences with depression. Potentially useful or no, psychic pain
is no more pleasant than physical pain, and von Trier’s work of fiction powerfully
captures this reality.
Persuading From Suicide
How do you persuade someone away from suicide? How do you convince them that,
no, really, things aren’t so bad after all?
I mean, the suicidal person is sort of an expert in misery, while I still
haven’t really figured out this whole life thing... I’ve been puttering around
the libraries of Life like This looks interesting, wait no, I don’t even — this
is a little over my head, and I wedge the tome back into place on the shelf
and look for a slimmer volume, preferably one with bigger brint and
smaller words and lots of pictures.
While they, they’ve got it down to a science. They’re ready to present their
suicidal dissertations. They’ve been fiddling with the LaTeX a while and
now they’re good, they’ve practiced the timing to keep the talk under an
hour. Nobody understands me and Nobody likes me were rightly edited
down to footnotes, and Everyone would be better off without me
anyway was confined to one of the appendices, which is fine, which makes
sense. Better to keep the flow and structure of the main prose smooth and
tight. Endlessly rolling chapters and chapters of sweet, exquisite misery.
Depression is the emotional equivalent to phantom pain.
I could write a book on it...
Danya
This is a wonderful and terrible place, an inspiring and soul-crushing
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Andrew Toskin
experience. I’m starting to wonder if psychology clinics spring up around
college campuses for the same reason oncology clinics grow around coal
plants.
I’m really plummeting now. Starving for some contact. Like the way
cooking shows on the Food Network take on an almost pornographic
quality when you’re hungry, I see people holding hands as they walk to
class and something in my chest wrenches. I’ve daydreamed all day about
past and future friends visiting me, surprise-announcing their
surprise-vacation as they kick open my door, singing, singing Andrew
it’s been so long! and jumping into the room and draping themselves
over my shoulders before I can get up and hug them properly because I’m
too stunned to too stunned to
what’s that you’re working
I can’t even, I can barely
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27
Tell me a story, she says, tell me a story, my plane’s flying through some awful
turbulence right now and it sort of feels like the end of the world and I need
to think about something else, she says.
Okay, then.
All-Consuming
the allegory of the planet
Maybe I’ll go outside today.
...Nope. I hate myself too much.
— Allie Brosh, Hyperbole and a Half
I’m surprised not to see more film critics and reviewers talking about this: Lars von Trier’s
2011 film Melancholia is an allegory for depression. Plenty acknowledge that for a movie ostensibly
about the end of the world, it deals more with depression and family relationships, but depression
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isn’t just one of the themes — it’s central to the whole film. This one theme blankets itself over any
other layers of symbolism in every scene, every shot. This is not to say that Melancholia is a
nursery rhyme or a heavy-handed, high-minded apologue, or even that depression is the only flavor
of this layered wedding cake; rather, von Trier has a primary objective which he sets out to
accomplish before all others: to encapsulate what depression is really like. As someone with chronic
depression myself, I must say the resulting film hits very close to home indeed.
Just consider the title of the film itself, and the imagined rogue planet it’s named after. This
may seem the most obvious move on von Trier’s part, but it should be noted that melancholia is an
old, literary word for depression, and in fact melancholia used to be used as clinical terminology by
early psychologists. The film, of course, follows Justine as she spirals downward in a depressive
episode, hits rock bottom at the start of the second act, and then seems to recover somewhat only
as the apocalypse approaches. But the planet is telling — the massive, blue gas giant carries the
most symbolic weight. Melancholia is huge, it dwarfs the Earth several times over. Our first view of
it, the fourth image in the overture, is of the blue sphere drifting through space, slowly blotting out
the sun, and with it all hope, perhaps for the audience as much as for the film’s characters. The next
two shots of Melancholia show it sliding past the Earth and then the two celestial bodies drifting
toward each other in a sort of planetary dance before the end. The opening sequence concludes
with the collision.
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Melancholia dents at the impact site, it ripples all over, but the Earth is obliterated and completely
consumed, swallowed up by the gas giant. It’s perfect. Combine this about the planets with the
extreme slow motion of the opening sequence, and you have a striking analogy for how it feels to
experience clinical melancholia. Depression is comprised of feelings of hopelessness and
worthlessness, a loss of energy and motivation, and a loss of pleasure in things once enjoyed. The
second image in the overture shows an enormous sundial on the golf course, and a tiny,
unidentifiable figure in the distance, moving, but imperceptibly, suggesting the feeling that time has
ground to a halt. Every moment drags on forever for the compulsively ruminant depressive person.
Von Trier collects the major themes of his film and slowly simmers them into a
bittersweet syrup in the first ten minutes or so. I’ve seen this sequence referred to as the
film’s overture, which is fitting since this collage of extreme slow-motion shots is set to the
prelude of Tristan und Isolde, the overture to one of Richard Wagner’s most famous
operas. Melancholia’s overture is also where von Trier shows some of the most (for lack
of a better term)intertextuality. The musical choice is partly an homage to Wagner, who was
unusual in his day for writing both the music and libretto in his operas, a level of creative
Andrew Toskin
30
control which the auteur von Trier also apparently strives for. There is even a loose parallel
in Tristan und Isolde, where in the final act the titular characters die — Tristan from
wounds sustained in a fight, and Isolde apparently from grief over her lost lover — while in
Melancholia, Justine sabotages her marriage to Michael, who, wounded, retreats and leaves
her alone with her family, and Justine herself dies as her melancholic planet swallows the
world in what feels by then almost like a suicide-by-apocalypse.
The overture also dwells on one of the most famous images of the film: an overhead shot of
Justine lying in her wedding gown in a pond, holding a bouquet of flowers and surrounded by lily
pads. This shot references the famous paintings of Ophelia drowning — you can actually see a copy
of the John Everett Millais painting of Ophelia in one of the artbooks in the film (0:43:18) — which
themselves are references to the poetical death announcement of Ophelia in Hamlet... which a
sexton in the play also later speculates was suicide. This further colors the impression that even if
Justine didn’t cause the crashing of the planets, she’s at least ready for it, and seems even to
welcome the dramatic end. Everyone notices that von Trier’s imagery in the pond shot closely
matches one of John Everett Millais’s paintings of Ophelia, with all the flowers and greenery; Millais
depicts Ophelia singing before she drowns, and all the lush vegetation contrasts with the subject’s
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imminent death; however, actress Kirsten Dunst’s pose more closes matches the darker
painting The Young Martyer, the so-called Christian Ophelia by Paul Delaroche. Likewise for the
film, Justine is always about to die: In the widely circulated movie poster, Dunst looks up, directly
into the camera, the rich greens and her direct gaze perhaps keeping her character alive long
enough to invite viewers to watch the film. But when we see the image in the overture, Justine’s
eyes are closed, seemingly in death, and she slowly drifts downward, out of the frame: her
garments, heavy with their drink / Pulled the poor wretch from her melodious lay / To muddy
death (Hamlet, Act IV, scene 7). Justine might well have drowned herself to end her melancholia, if
the arrival of Melancholia didn’t take care of it for her.
What does front-loading all these images in the overture at the beginning do? Like any good
overture, it distills the story’s overall tone (glacially slow, heavy, melancholic), but it also instills a
feeling of inevitability. From the beginning, we know the world is going to end — as Justine says
later in the film, [We] know things — and we see the planets collide around the tenth minute of
footage. The overture erases most of the anxiety for the audience, as anxiety is primarily a feeling of
concern about what could happen. In a way, it’s soothing to know how something will end, even if
that ending dooms you. This also parallels von Trier’s insight (stated in the film’s DVD commentary)
that people with depression tend to stay calmer during catastrophes because they already expect
everything to end badly. Justine never panics, in the overture nor the rest of the film. This insight
makes up a secondary layer, another sheet of cloth, in von Trier’s blanketing metaphor.
It’s also interesting that Justine’s marriage, which inevitably unravels during the wedding
reception in the first act, is front-loaded in the film. Many comedies or otherwise more positive
stories end with marriage, suggesting the renewed cycle of life, new beginnings, and forthcoming,
literally new life as the married couple are likely to soon have children. Melancholia is about death,
the film luxuriates in it, so in the first act we watch Justine’s marriage disintegrate, and in the
overture, the wedding is cut to pieces and scattered throughout the sequence. Justine goes away
from wedding for a bit by herself, and music starts up again (0:22:35). She looks up at the night sky
a lot while riding around in a golf cart... (023:20). Her dress snags on the gas pedal, and she rips off
Andrew Toskin
32
a little piece — this is perhaps when the wedding has died in her mind.
The story proper stays strictly chronological in its presentation, but the second half of the
overture alternates between images of Justine wearing her wedding gown and wearing a loose black
shirt. In the first shot of her wearing her wedding regalia, Justine stands on the golf course with
Claire and Leo, and they eerily march toward us with Melancholia, the moon, and the sun veiled by
clouds and hanging directly over each of their heads, trading a wedding’s normal excitement for an
unsettling feel. In the next one, Justine plods in her wedding gown through a thicket of trees,
struggling with ropes of heavy gray yarn straggling at her feet — literalizing her own metaphor
when she later in the film tries to describe feeling stuck in her depressive mood. And then comes the
image of Justine, dead as Ophelia in a pond, finally killing any hopes at renewal or rebirth the initial
wedding scenes might have had.
Which brings me and von Trier to the crux-of-the-crux of all this. You are probably familiar
with the idea of the mad genius, the tortured artist — the idea that you must not only suffer for your
art, but you must suffer to be an artist of any worth. I think part of von Trier’s project was to tear
apart this assumption. The planet Melancholia, its staggering looming size, the way it swallows up
our entire world, embodies depression. Jack, later in the film, talking about the passing of
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Melancholia as the most beautiful thing ever, parallels the notion of psychological disorder as a
either a catalyst or substrate for brilliant inspiration, which Justine’s actually bleak condition seems
to contradict. In the overture and throughout the film, von Trier seems to say No, this is what
depression is really like. It paralyzes Justine so she can barely walk or take a bath on her own, and
ruins her ability to take pleasure in things, makes even her favorite food taste like ashes. As the
planet approaches, Justine regains enough vigor to move unaided once more, but she doesn’t put
this new energy to painting or composing a symphony or writing a novel; she just finds acceptance
in the inevitability of death. Thanks to the overture, we get to watch the end of the world twice,
reminding us that melancholia in the lower case is destructive rather than constructive. Jack is right,
that watching the two planets slide past each other is incredibly beautiful, but the problem with the
situation, and with the idea that transient misery kindles the creative process, is that Melancholia
returns and lays waste to everything in its way.
...The case I make here is perhaps confounded somewhat by the fact that this movie really is
so stunningly gorgeous. The film was in fact made partly in reaction to von Trier’s own bout of
depression, which seemingly contradicts his contrarian argument. I would say, though, the film’s
beauty lies not in its autobiographical origins but in von Trier’s skill and vision; he was already an
artist before that depressive episode and before he began working on this latest project. To
understand his depression and art, we would be better served looking at von Trier’s biopsychosocial
history, because there are limits to the autobiographical nature of this film — and von Trier is a little
too glib to get far there. The remaining 2 films will be prove more fruitful as we apply the
biopsychosocial perspective.
Art so often deals with the human condition, and depression or other psychological
disorders can certainly happen to anyone, even the members of Justine’s wealthy and insular
in-laws. The depression von Trier suffered, or intermittently continues to suffer, provides a topic
for his work, perhaps, but only after it leeches his drive to do the work, or anything else; it appears
in the artworks which so define his creative and public life, but only after it nearly kills him.
Andrew Toskin
Case Study: Black Swan
Directed by
Darren Aronofsky
Screenplay by
Mark Heyman, Andres Heinz, John McLaughlin
The main character: Nina Sayers
Natalie Portman
Lily (Nina’s rival)
Mila Kunis
Thomas Leroy (the ballet director)
Vincent Cassel
Erica Sayers (Nina’s mother)
Barbara Hershey
Beth Macintyre
Winona Ryder
Black Swan is the story of Nina Sayers, an up-and-coming dancer in a
world-renowned ballet company, and her struggle to win and perform
the leading role of Swan Lake. As she stress and tension build, the film
follows Nina to some pretty dark places in her mind, and we’re spurred
along the way by her creepy mother and ballet director.
The film begins with an overture, introducing imagery and musical
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35
themes that will recur throughout the film, the camera moveing swiftly
and fluidly among dancers. This introductory sequence is Nina’s dream
of a production of the ballet. Nina sits alone in a pool of light on an
otherwise dark stage until Rothbart comes and transforms her into a
swan, complete with seemingly magical costume changes...
Watching it first, if you can, if you haven’t already.
Jumping Into a Panic
Darren Aronofsky’s Black Swan scared me, though maybe not for the same reason as most
people. There’s enough body horror so that you could burn the nightmare fuel a while, certainly —
lurid images of Nina’s legs bending backwards, of peeling a long strip of skin from her finger like all
her flesh might just slough off, plucking the wedge of glass from deep in her belly... But more than
that, it was the mixing of her madness and her art that freaked me out. The first couple times I
watched it, the film’s thesis seemed to be that that the creative process is dangerous: Nina struggles
with some terrible inner demons as she struggles to find transcendence on the stage — and it
destroys her. What did that mean for me, as an artist with my own monsters to quell?
I started searching, desperately, for an opposite example. Please, please, let there be
something, somewhere, about an artist who wins, who recovers. The abyss can’t swallow everyone,
every time, can it? Cognitive-Behavioral Therapy, the biggest psychotherapy technique in use today,
is so much about recognizing negative thinking, rationalizing your way out of an emotional crisis —
but the arts are all about emphasizing feelings, evoking an emotional response from artist and
audience alike. What is the difference between luxuriating and wallowing in the experience? When
does it move from therapeutic to exacerbating? I seriously began to worry that the artistic endeavor
could be as enticing yet dangerous as amphetamines or opioids, and my quest for counterexamples
was not turning up a lot of compelling cases. The story of an artist who suffers, but then gets better
Andrew Toskin
36
either was unpopular or it just didn’t happen.
But then, it occurred to me: Wait. Darren Aronofsky hasn’t talked much about his own inner
demons, but it doesn’t seem as if his art is destroying him. I was asking the wrong questions. Once I
calmed down, I looked it over again, and it seems the real danger, then, is not so much in the mix of
the artist and her own fragile psyche — for there’s nomixing involved there; you can’t combine
yourself with yourself because they’re already combined, continuous, contiguous; stir a pitcher of
water and you’ll still just have water — no, the danger lies in the dialectic between the individual and
the unhealthy situations she finds herself in. The danger isn’t between Nina and ballet, but between
Nina and the people around her.
Becoming the Monster
...I know who I was when I got up this morning, but I think I
must have been changed several times since then.
— Alice (in Wonderland)
Jason didn’t last very long. Still, he was mine, for a while.
Plenty of children make up imaginary friends. Jason was perhaps unusual in how
deliberately I chose to create him; out of boredom or loneliness or whathaveyou, I
consciously decided to make up an imaginary friend. But I suppose he served the same
purposes. I named him after the (original) Red Power Ranger, and we played games
together and I made sure no one took his spot on the couch, or else I moved him before
they could sit on him, and I told him everything — because even 5-year-olds can have
secrets.
And when Jason wasn’t enough anymore, I made things up about myself instead. I was
an alien from another planet, an Andalite, trapped for now among humans. Little did
37
my parents know, I was actually a proud member of an advanced race of
scorpion-tailed blue centaurs, intelligent and beautiful and agile. I only wore my human
body as a disguise, and periodically had to change back to my true self for at least a
moment, or my worthless human form would stick and I’d lose my morphing ability
forever. Looking back, I'm not entirely sure how sincerely I believed this, but for a
while I would go to the bathroom or the garage or whatever, someplace private, several
times a day, to morph in and out of my exotic, true body. To anyone else, it might have
looked like I was in a trance; and the process was in fact highly meditative, for it took a
little concentration, and soothing.
Turning into a therianthrope is easier than you might think.
Black Swan provides one recipe: an obsessive personality nurtured by a support system of
competitors and authorities. The monsters begin as projections of Nina’s internal conflicts onto the
outside world — she superimposes her face onto other dancers and on strange women on the
streets — and it moves out before moving back inward again when the transformation actually
happens.
Everywhere, the movie is fragmented and reflective, and Aronofsky sprinkles in hints of
swans or other birds throughout. This was a point which drew complaints from those who did not
Andrew Toskin
38
enjoy the movie, decrying Aronofsky’s ham-shaped fists, arguing that Aronofsky always overstates
everything, and also saying that Aronofsky isn’t very subtle. But the difference between a clever
stylistic move and a tiresome gimmick is only a matter of taste, and Black Swan is brilliant in its
adherence to its themes of subjectivity and transformation.
The reflections are inevitable, even, as mirrors are everywhere in the world of ballet.
Wherever a dancer practices — and at least with Nina, this is both at home and in the studio — there
are mirrors to gaze into, to inspect one’s own body and bodily movements. And the plurality of
mirrors splits the reflections as her image moves across the edge between panes of glass, or as
the mirrors reflect reflections of mirrors with reflections of reflections.
Inspection becomes introspection becomes outrospection and circumspection as Nina’s
drive for a perfect performance leads to a neurotic level of attention to her body’s appearance, both
its position and form, both its movement and its physical attributes, both her performance as an
artist and a woman in a male-controlled dance troupe and her value in meeting expectations. Judging
herself means judging the image in the mirror means judging herself, and all these broken reflections
have a dissociative effect, so it seems as if her reflection itself is mocking her, tormenting her, trying
to kill her. All the self-criticism divides herself from herself. It’d be enough to drive anyone crazy.
39
Like my thoughts of my secret extraterrestrial history, Nina’s hallucinations turn her into a
monster, but with a couple exceptions, there’s nothing escapist or fantastical to her visions.
One of the only instances I can find that really may have functioned to offer a release from
psychic stress comes about two-thirds of the way through the movie, when the lights go out in the
middle of Nina’s late-night practice session. She calls out into the darkness for someone to turn the
lights back on, but there’s no response. She glances around nervously, the dim mirrors wavering
black and gray behind her, and she steps out into the shadows. Moving through darkness and
spotlights, she stumbles across Leroy and Lily, stripping and kissing and straddling each other back
stage. Nina stares, transfixed, and when the camera flashes over again we then see Nina having sex
with Leroy, grinning smugly. And then Leroy turns into the ballet’s evil wizard Rothbart, and Nina
panics and runs out. This scene could be read as a moment of dissociation for Nina, trying to find
some way out of the situation as her director molests her again. The other moment would be the
drunk love scene between Nina and Lily — purely imagined, apparently — or hallucinated. Even
outside the suspense-carrying tropes of thriller movies, it can be hard to tell the difference. Both
instances, interestingly, are highly sexualized moments, but in one, the sex provides the escape and
in the other it’s what she’s trying to get away from — an ambivalence that her mother and director
collaborate in creating.
Otherwise, however, Nina is trapped in her world. This is part of the pathology of the film —
Nina can’t ever get away, she can only dive deeper and deeper into her dual roles as the white and
black swans, until it consumes her. This is the body horror of the film: We first start to notice the
scales around the shoulder scratches (0:52:07), scales on her hands (1:03:57), scales on her legs just
as she's having mind-sex with Lily (1:09:01), her eyes turn red and she plucks a black feather like an
ingrown hair from her shoulder, and her knees reverse (starting 1:24:19). This stage of the
transformation nicely juxtaposes with the broken ballerina figurine (1:25:23). Transformation
continues on the ballet’s opening night, with toes fusing into beginning of a bird talon (1:28:24), and
the metamorphosis completes to a standing ovation, Nina spreading her elegant wings with a bow to
her dazzled audience (1:36:37).
Andrew Toskin
How she felt:
What they saw:
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There’s a sudden shift in tone at some point in this progression. Nina is repulsed by the
monster she’s becoming, glances around in each scene like she’s afraid someone will catch her as
she tries to cover up the cuts on her fingers or the scratch marks on her back — right until she
dances the black swan scenes on opening night. Then, there’s something beautiful about the weird
bird-human hybrid pirouetting on stage, so different from growling, gurling bird-man that is
Rothbart. She’s, after all, not just any bird, but a swan, an animal whose association with
Tchaikovsky’s most famous ballet has itself become a symbol of grace. As editor Andy Weisblum
noted, One of Darren [Aronofsky]'s biggest interests in filmmaking is subjectivity, and making sure
you're always telling a story from the point of view of your main character. The film is a fable in a
lot of ways.The aesthetic difference between this final transformation and all the buildup leading to
this moment — and the contrast between Nina’s final transformation and the other monster,
Rothbart — therefore show that Nina has come to accept her role. She is the swan queen; she is a
ballerina; she is the impulsive sexual figure Leroy has been pushing for. This doesn’t leave much
room for Nina.
Just before the ballet begins, Leroy tells Nina, The only person standing in your way is you.
It's time to let her go. Lose yourself. (1:27:39) -- And she does. Nina’s absorption into the role of the
black swan is absolute. So total that she doesn’t realize when, between dance numbers, she smashes
the mirror in her dressing room (finally breaking the divide between herself and her double) and
stabs herself in the belly with one of the shards. Her saturation in ballet is so thorough that, as she
lays bleeding to death, Nina can only revel in the wild cheers of the audience and say I felt it.
Perfect. It was perfect.
She bleeds out — until she’s empty.
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There’s nothing left.
Fade to white.
The Smallest Goal Of a Little Self-Control
“But I don’t want to go among mad people,” Alice remarked.
“Oh, you can't help that,” said the Cat: “we're all mad here. I'm
mad. You're mad.”
Black Swan, and the other films I discuss, needn’t be only allegories or illustrations of
psychological etiology, but they do serve that purpose, vividly, and in a way that audiences can
understand at an emotional level. Which can help to reduce stigma.
One article in Advances In Psychology Study diagnoses Nina with obsessive-compulsive
spectrum disorder, and goes so far as to say the film could be very useful for triggering discussion
of the OCD spectrum among mental health professionals and those in training (Vanier and Searight,
2012). An obsession is a recurrent intrusive thought which causes stress or anxiety, while
a compulsion is a repeated behavior (a common example is hand-washing). These definitions are
simple enough, but can by themselves lead to a variety of actual behaviors when trying to describe
real-world cases, and the working draft of the DSM-5 (still in development, as of this writing) is
reconsidering how the disorder is categorized in relation to others in the manual. Most people are
already
familiar
with
even
the
acronym,
OCD,
but
the
expanded
term
Obsessive-CompulsiveSpectrum Disorder would demonstrate this restructured categorization,
grouping obsession/compulsion with frequently comorbid symptoms of eating disorders,
self-mutilation, and even delusions.
Sick to death of my dependence, fighting food to find transcendence Fighting to survive,
more dead but more alive. Cigarettes and speed for living, sleeping pills to feel forgiven All that you
contrive and all that you're deprived... — Me and Mia, by Ted Leo and the Pharmacists
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Eating disorders: The two times Nina vomits in the film could be interpreted just as a
reaction to stress. The first time, the camera is set down on the floor by her feet as she stands in
front of the toilet, so we actually only hear splashing, and then she kick the handle. However we can
confirm that she eats very little: a typical breakfast apparently consists of half a grapefruit and one
egg. When her mother buys the cake to celebrate Nina winning the lead role, Nina resists actually
eating any cake as long as she can. When she goes out with Lily, she hardly eats her burger. And
when getting measured for her costume, the other woman notes "You've lost weight," and Nina has
just the tiniest littlesmile, like she's proud (1:16:31).
Self harm: Nina develops a lesion on her shoulder — Vanier and Searight call it psychogenic
dermatosis (i.e. lesioning of the skin caused by stress), and Aronofsky a couple times refers to it as
a rash in the behind-the-scenes featurette, and Nina even insists it’s only a rash; however, when
Nina’s mother sees it she says You’ve been scratching yourself again... I thought we were done this
disgusting habit, and rushes Nina to the bathroom to trim her nails (0:38:30). And other times we do
see Nina or her reflection scratching (1:16:50) — and slicing her finger (0:52:20), and fantasizing
about slowly, almost luxuriously tearing off a long strip of skin (0:32:44). For a person on the
obsessive-compulsive spectrum, mounting distress may swell until finally bursting to self-injury,
providing a calm relief — much the way compulsive ritual may be a way to self-soothe (Vanier and
Searight, 2012).
Delusions: There are plenty examples of this — too many to list every instance. A major part
of the movie, after all, is following Nina’s descent into madness, to use the more literary term.
Because this aspect of the psychology is the most dramatic or exotic, perhaps, Aronofsky and
screenwriters Heyman, Heinz, and McLaughlin most thoroughly weave delusion and hallucination
into the plot of the film.
...People with eating disorders or problems with self-harm are frequently scolded in
condescending and reductive ways by people who don’t understand what they’re going through, so I
feel I must be extra clear here: It’s important to point out the aspects of Nina’s disorder because of
just how common extreme diets and obsessions and compulsions are in the world of ballet.
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The problem is that there’s a payoff for Nina’s obsession: All her practice does in the end
make for a stupendous performance in the ballet. Nina’s dancing, Natalie Portman’s acting, and
Aronofsky’s directing are exquisite. This maybe brings me back to my original paranoia from
watching Black Swan — I can’t get away from it. It makes relenting to obsession / eating disorders
and the transformations those entail, to becoming the monster, seem attractive. After all, as Leroy
muses when talking to Nina about another dancer who jumps in front of a bus, ...everything Beth
does comes from within, from some dark impulse. I guess that's what makes her so thrilling to
watch. So dangerous. Even perfect at times, but also so damn destructive (0:41:37). Beth’s inner
darkness is apparently what makes her a good dancer.
I don’t want to be a monster. To the literary scholar, madness may often be reduced to an
intriguing aesthetic quality, a method, genre, or topic in the creation of art. To others, it may often
be reduced to the tyranny of the norm. But it’s suffering for the person experiencing it.
Not every talented artist shoulders the burden of a psychological disorder (or the burden of
its diagnosis), though.
The problem is that for many, art is a coping strategy, while for Nina, the relentlessness of
her ballet practice is a symptom, and she’s surrounded on all sides by enablers.
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Wasting Sickness
(the toxicity of some relationships)
It’s a funny thing, feeling empathy for a fictional character. But I do empathize with Nina,
though — I can feel the pressure. It’s a volcano under my seat. If you think I’m sweating through the
night just because of nerves or approaching deadlines, take another look at the magma burbling
beneath me. I start to drift off toward or crave distractions, but the smell of sulfur brings me back.
What if I can’t finish this thesis in time? What if I never finish it? What if I never accomplish
anything and people publicly laugh at how worthless my life was but I can’t hear them over the
rust-throated wailing murder of crows overhead as the sky turns red with blood and the earth
between us cracks open to swallow me whole? It really does seem like armageddon, sometimes.
I contrast with Nina, however, in that I don’t have a mother or coach cracking the whip; I
tend to flagellate myself just fine without any encouragement. Where does that come from? My
binary ambitions apparently allow me either to attain transcendental deifying englightenment, or
suffer absolute, total, utter doom. There are no other options. Why? Why am I like this?
Fiction is useful for this sort of situation, because, when done well, all the elements are
known and in place, and we can study their combined effect. Writing a screenplay is no substitute
for collecting empirical data, obviously, but it’s great for visualizing a scenario.
I wonder if the people Aronofsky studied with while researching Black Swan regret their
frankness. The professional ballerinas working on set do (jokingly) admit to beingmasochists in the
DVD extras, but Aronofsky maybe doesn't portray their world in a very positive light.
Nina would have enough problems to deal with even at a regular ballet company. Ballet
dancers are already more prone toward eating disorders, because of the pressure for dancers to be
rail thin, both for the aesthetics of the dancer’s body and because the females are lifted into the air
many times throughout a given work’s choreography. And ballet is already a competitive arena —
add onto that the apparent prestigiousness of the Leroy’s dance company, and the situation very
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quickly grows fierce. Perhaps even unhealthy? (I know some ballet dancers who might resent such
an implication — but they aren’t professionals, which makes a difference.)
Our first shot of the other dancers is in the dressing room, as the women talk about how
Beth, who is about to retire, is already a long over the hill, and that no one comes to see her
anymore, the company needs to try someone new, someone who's not approaching
menopause (starting 0:06:19). When Nina says It’s sad... Beth’s such a beautiful dancer," one of them
scoffs, So is my grandmother (0:06:54). Yet, at 30 years old, Beth’s retirement would be incredibly
young in most other careers. This only feeds into any anorexic self-consciousness: The need to be
young and fit and beautiful always supersedes even the need to dance well, apparently.
The results of the pressure to be thin is evident in just about every shot. It’s visibly apparent
on the screen that Natalie Portman lost weight as well, in preparation for her role in the film. We can
see her ribs sticking out through her practice clothes (0:26:45), or in her dress during the scene of
the ballet’s announcement party (0:33:07). We see a lot of her lean back and shoulders throughout
the movie, her pinched face, the sweat on her sinewy neck. We actually get a pair of shots
juxtaposing Nina's back with her choreographer's back, and can see the lurid movement of the
muscles in both women's shoulders as Nina learns the choreography (0:28:27).
Doesn’t help that the men in this film are all creeps: An old man on the subway makes kissy
faces and mimes masturbation at Nina (0:55:28). The waiter at the bar/pub/tavern/restaurant
brings an extra bloody cheeseburger suggestively telling Lily, Let me know if it's juicy enough for
you (0:58:45). The two guys Lily picks up at the bar aren't overly aggressive, but seem mostly
interested in them as pretty girls (~1:04:00). And the ballet director Leroy of course: He twice
instructs Nina to masturbate, gropes and kisses her during a private practice session and then walks
off chiding, That was me seducing you, when it should be the other way around. It’s curious that, for
an art form so strongly associated with femininity, ballet (at least this particular company) is
manipulated by men so much, from the male dancers who physically lift the females, to Leroy
himself, the brilliant director with a reputation for sexually bullying the artists he works with.
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Leroy conflates Nina’s sexual performance with her dancing performance: When trying to
push Nina to find transcendence during one rehearsal, Leroy turns to the other (male) dancers and
asks not whether her dance moves are correct or convincing or beautiful, but whether they
would fuck this girl. In fact, Nina does reach a peak sexual and dance performance, for after her
stunning performance before a real audience, she rushes for Leroy for a spontaneous kiss. As in
other situations where men control women, Nina’s sexual commodity takes precedence over her
skillful artistry. She isn’t allowed to perform ballet without also performing sexuality and gender.
Nina doesn’t have much of a support network either. She doesn’t make close friends with
any of the other dancers, because they are competition, and her mother is no help either. If Leroy
aggressively sexualizes her, her mother infantalizes her. Nina's room is so pink and frilly — the
wallpapers are smattered with butterflies, the bedspread has huge flowers, the bed frame looks like
a tiara the Swan Queen might wear, and one wall lined with stuffed animals, including a black
swan... All this and the way the mother tends to her split toenail (0:17:40), helps her out of her dress
at bedtime (0:38:09), makes Nina seem very girly and childish. Nina calls her Mommy (0:23:33) and
everything. The mother is a lot like the moms in Toddlers in Tiaras, in a way. Controlling, overly
concerned, living vicariously through her daughter. Going back to her quiet apartment might
otherwise be the one time Nina can feel in control of herself, but at home she is allowed little agency
either.
So what's the point again of establishing Nina's diagnosis and etiology?
Here we might apply the biopsychosocial perspective. The film itself emphasizes the social
aspects: Nina’s social circle is more conducive to phantasmic metamorphosis and self-inflicted
violence than it is to a long career of continuous productivity, say, or successful stress
management, or a positive body image, or a sense of one’s own progress and agency, or even just
basic survival (the psychological and biological consequences). The interconnectedness of the three
biopsychosocial aspects of Nina’s life makes the negative effects of her social life inevitable.
The effect of such power differences, as presented in Black Swan on women’s bodies is a
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common enough point in feminist social critiques, but the case is less often made, either in criticism
or scientific research, that this social power difference may be either the cause of or an
exacerbation to psychological disorder. This is what I mean by a more complete biopsychosocial
perspective: I suspect that future research will show that self-perpetuatingly destructive behaviors
or social environments such as Nina’s are equally relevant to a person’s bodily and mental health as
are contact with bacteria, exposure to carcinogens, or the insufficient consumption of vitamins —
and for the same reasons.
If the plot of Black Swan had happened in the real world, the discussion would take on a
different character — talk of how scary or thrilling it was, or whether that sex scene between
Natalie Portman and Mila Kunis was hot or gratuitous or interesting, would all fall to the wayside in
favor of topics like the ubiquity and availability of proper healthcare and safe spaces for women,
and what might keep people from seeking or attaining help. The advantage of fiction is that we don’t
have to wait for a world-renowned ballet dancer to actually die by suicide on the opening night of
her greatest performance yet. We could start thinking about these things now.
Phoebe In Wonderland
Written and directed by
Daniel Barnz
The main character: Phoebe Lichten
Elle Fanning
Miss Dodger
Patricia Clarkson
Hillary Lichten (Phoebe’s mother)
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Felicity Huffman
Peter Lichten (Phoebe’s father)
Bill Pullman
Jamie (Phoebe’s friend)
Ian Colletti
Principal Davis
Campbell Scott
Okay, so Phoebe In Wonderland is a small independent film, produced and
distributed in part by Lifetime. Let’s just get that out of the way. Admittedly, the
dialogue is nettled with a few false notes, and the actress who plays the mother
chews the scenery when the screenplay allows her a monologue, but most of the
dialogue is good, Elle Fanning’s performances was splendid, and the film was
beautifully photographed.
Phoebe In Wonderland is a movie about a young girl named Phoebe who joins the
school musical, a stageplay adaptation of Lewis Carroll’s Alice In Wonderland. Her
powerful desires to both perform and fit in at school are at odds with the almost
ludicrous rules of the school (Silent Jane says don’t ask questions!), the occasional
childish cruelty of her peers, and her own singular habits.
Watch it!
Where Things Aren't Quite So Fixed
It’s revealed at the end of the film (because her mother resists the diagnosis up until that
point) that Phoebe has Tourette’s Syndrome. According to the current version of the Diagnostic and
Statistical Manual (DSM-IV-TR), Tourette’s is mainly characterized by motor and/or vocal tics, but
also frequently correlates with obsessions and compulsions — which Vanier and Searight (2012)
point out are being considered for reclassification with Tourette’s; the two conditions may not be
merely separate-but-related syndromes, they may lie on a continuous spectrum. This
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reclassification would explain the complexity of Phoebe’s repetitive rituals, and the blurring of the
line between fantasy and hallucination.
Of the films I discuss, Phoebe In Wonderland probably does the best job balancing the
biopsychosocial perspective in its presentation and in the questions it poses. The film both
ultimately vindicates the psychiatrist's diagnosis — Tourette’s is a neurological disorder — but at
the
same time
it juxtaposes Phoebe's symptoms
with similar
idiosyncrasies in the
other normal characters.
Tourette’s is classified as a neurological disorder — it’s biology. Hillary’s dispute of the
diagnosis places her in an ongoing argument about the validity of the biomedical model of health, a
critique which makes some fair points. A purely biological perspective is indeed complete. However,
perhaps because Daniel Barnz isn’t interested in producing a work of art that argues facts, Hillary
doesn’t speak to those issues. She might have pointed out the problems of discrete diagnostic
categories and the awkwardness of the inevitable fuzzy borderline cases this produces, or the
clinical focus on symptoms instead of causes (because the causes aren’t yet understood), or at least
the fact that in spite of being a disorder of neurology, Tourette’s is generally diagnosed based on the
client’s behavior rather than neuroimaging or other measures of the brain. Instead, Hillary reacts
emotionally, saying You are all so ready to label, medicate, and move on, as if a name means
something, as if all the answers are in a bottle. I have seen that solution, I have seen it all around me,
and it is a life of side effects and dulled minds. Your profession just doesn't like kids to be
kids (0:45:06).
This is in fact the argument Hillary makes throughout the movie — that adults in general
are too tuned into [their] kids (0:09:52), and that diagnosing childhood disorders is either pointless
or counterproductive: When I was a kid, I counted telephone poles from the car; if I missed one,
we'd crash. No one labeled me. It's just the way kids are(0:40:52). And the film doesn’t entirely
disagree with her, it seems; Hillary wants to normalize Phoebe’s abnormal behavior, and throughout
the film we are presented parallels between Phoebe’s symptoms and the idiosyncrasies of
her neurotypical peers and the adults in her life.
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Spit It Out
Emotional outbursts and echoes are a recurring theme. Once you know this is a movie about
a girl with Tourette’s, it should come as no surprise that Phoebe blurts out inappropriate things or
things which don’t make sense; it happens throughout the film. However, we aren’t given to know
about the syndrome right away, so it might seem strange or strangely rude at first when we see
Phoebe arriving late to her audition for the play and echoing Miss Dodger in a mock voice, but
covering her mouth, like she’s trying to hold it in (0:16:50). Or while trick-or-treating, when one
woman answers the door with raisins, Phoebe snaps, Raisins bite. You’re fat... Fat, fat, water
rat (0:40:20). Phoebe even bursts out at her close friend Jamie once, in the middle of rehearsal,
shouting Fag! (1:12:14).
At the same time, though, Phoebe isn’t the only one who has outbursts — nor even the only
one who calls Jamie a faggot because he plays a female role as the Red Queen (0:47:30). After
Phoebe is removed from the play for disciplinary reasons, Miss Dodger argues with Principal Davis
that Phoebe should be allowed to resume her practice, and when he insists that his hands are
tied, Miss Dodger blurts out Oh please before she can stop herself. Realizing she has just lost the
argument for herself, Miss Dodger walks back out of the office (0:59:22). And there’s the moment
where Phoebe and her sister Olivia say they want a brother, and run around the dining room
chanting We want baby!and Peter, tiring of the noise, finally blurts out You think your mother could
handle another one like you? (1:04:08). Peter later apologizes, [I've never been so ashamed][] of
myself. The words just came out. And Phoebe, without looking up at him, replies Yes, that's what it's
like (1:08:05). She’s lying in bed, in the dark, during the apology, and Peter sits in a chair next to her,
talking to her shoulder. But the slow movement of the camera from his face to hers suggests the
way they take turns listening. The video then cuts to a brief shot of the two of them, seen through
the bedroom doorway, as if we’re leaving them to talk some more in private.
The blocking of characters in the dark room, each alone in the frame in the first
slow-moving shot, suggests isolation, while the movement of the camera suggests a sort of flow of
understanding. The contrasts in the cinematography of this scene work to build on the hurt feelings
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and beginnings of reconciliation which the actors already express. The scene as a whole also places
Phoebe’s and her father’s behavior together on a continuum. Peter has an outburst and feels
remorse, and he doesn’t know how to explain what happened. Phoebe has outbursts and feels
shame and fear, because she doesn’t understand her own actions.
Phoebe: I can see myself wrecking and ruining, but I can’t
stop myself. (1:18:35)
Wrecking and Ruining
It still gives me chills, thinking about this. I was once looking after my little sister
Emily. She was maybe 5 at the time? I don’t remember too many details of the buildup,
but my parents and siblings were all out, so it was up to me to put her to bed that
evening.
Emily of course had other plans. I tried to get her to brush her teeth, tried simply
telling, tried cajoling, coaxing, ordering, bribing, commanding. The more I tried to
persuade her, the more stubborn she grew, and the more frustrated I became. I was
boiling, eventually. So I just put the toothpaste on her toothbrush for her, seized her by
the arm, and said Open your mouth. Open your mouth. Open your mouth. The first
time, I spoke in a voice heavy with forced, unconvincing calm. The second time, I
leaned down toward her and shouted. The third time, it sounded to me like someone
else, *something* else, *roaring*, as far away and as tremendous as thunder overhead —
even I flinched at the sound of it.
Emily started sobbing.
I immediately set the toothbrush back down and scooped her up into my arms and,
since this was in my parents’ room, curled up with her on the bed. I said I’m sorry —
hoarsely. My throat already hurt. I’m so sorry. I’m so, so sorry. I begged her to forgive
me.
What a stupendously minor and domestic instance, you might be thinking. But as
someone who grew up with plenty of shouting all around, I was mortified at myself.
What did I care if Emily brushed her teeth? I was a teenager myself — still young
enough to occasionally wax philosophical about the reasons why I was morally
opposed to the idea of bedtimes. Why did it matter? What drove me to this point?
Long after Emily had finally calmed down and actually agreed to go to sleep, I
wondered about how I was transforming, becoming my father at his worst, turning into
a monster, something. After this early little taste of blinding fury, I’ve tried my best to
contain the wolfman inside me, but it doesn’t always work. I’d never been so ashamed
of myself before, but I can’t always stop it. It’s terrifying not to be able to control your
emotions and compulsions, to lose control over your own mind, your body, yourself.
The angriest I ever get is almost always over some petty frustration, for some reason,
and I want to break things until identity crisis can catch up with me again, and I don’t
know why.
I don’t know why.
I don’t know why.
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…
I Don’t Know Why
Similarly, Phoebe’s compulsive rituals are paralleled with superstitions in the other
characters, serving basically the same purpose as the parallel outbursts. Even though they both
claim not to believe in God, during one of their rooftop chats Jaime tells Phoebe if you want
something a lot, you have to pray. Or do something you hate, and God will say you deserve
it (0:19:41). A ritual can be comforting in its own right, even if you don’t believe in the magic behind
it. So after this talk with Jamie, Phoebe intensifies and complicates her rituals. She develops her
practice to include counting, clapping, spinning clockwise and counterclockwise and specific
footwork as she moves her way along the tiles around a tree in her yard. She can't come inside until
I've stepped on all the squares in the right order (0:20:20). And seeing the lovely shots in this scene
of Phoebe twirling around in the yard, it’s easy to see how the rituals might be soothing. Even
Principal Davis dismisses Phoebe from his office with a clap and wave of his hand, almost like he has
his own little incantations (1:17:40).
Then again, the development of Phoebe’s rituals is where things start to get disturbing. For
one thing, the fact that she intensifies her routines in response to Jamie’s tip about doing something
you hate in exchange for something she wants is a sign that she doesn’t like the rituals. Or there’s
the time Phoebe shows up late to the audition, sayingSorry, I'm so sorry. I was washing my
hands. We don't see her hands clearly right away, but upon reflection, it’d be strange for just
washing hands to make her 20 minutes latefor something... Then she admits I have to wash my
hands a certain number of times, and her hands are cracked and red and raw (0:17:42). The
hand-washing only gets worse as Phoebe stresses about the play too, so she comes to dinner one
night and her hands are completely bloody (0:22:52). It’s only at this point that Hillary decides to
take her daughter to a psychiatrist, and after this first appointment, Phoebe adjusts her ritual to
counting and chanting as she jumps up and down the stairs in a certain pattern instead, frequently
slipping and banging her knees in the process (0:30:02).
Phoebe calls her mom in the middle of the night, scared of
something. Hillary comes in and says it's okay, then looks at
Phoebe's knees and
Hillary: Let me see.
Phoebe: No.
Hillary: Let me see.
Tears nightgown a little while trying to look, spots more
self-injuries and
Hillary: Oh no, no, no, I thought we were done with that
and Phoebe starts crying
Phoebe: It was the stair-stepping... I had to do three stairs at
a time.
Hillary: Why?
Phoebe: I can't help it. I don't know why. I just, I want you
know. I want you to know why I do these things, I don’t know
why, Mommy.
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It’s Just the Way Kids Are
Which parts of Phoebe’s condition are and are not a real problem isn’t exactly
an unambiguous matter. Throughout the film, Phoebe sees and speaks with characters from
Wonderland. In these scenes, the color saturation turns up, and then turns back down as she gets
pulled from her revery — a visual effect which may just as well be used to illustrate her vivid
imagination as it may to show hallucinations. When a visit from the Red Queen gets cut short,
Phoebe sits dazed for a moment, mumbles a little incoherently about Looking Glass Land, and then
asks her mother You do believe I was talking to the Red Queen? (0:35:25). The psychiatrist prompts
Phoebe to admitting that the Red Queen is only an imaginary friend, and she concedes I
guess (0:35:55), but this seems less convincing when later girls at school catch her asking Humpty
Dumpty for advice and they say Who are you talking to? (0:56:52).
It’s possible Phoebe isn’t entirely sure of how to differentiate her imagined companions from
reality either. The anxiety Phoebe feels — the anxiety Elle Fanning portrays in the film — is
incredibly powerful. This is why I’m taking so much time to write about a few movies: I don’t expect
to persuade you of anything with facts alone, because I don’t thinkI’ve ever been persuaded to really
think in a different way through logic and facts alone. The psychology I’ve been discussing, you
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could just as well read it all on Wikipedia and get most of the same information — but it wouldn’t be
real to you. Certainly, the subjective experience of Tourette’s syndrome was nothing to me before I
first saw Phoebe In Wonderland; it was a total non-question; it didn’t penetrate, because I had no
emotional understanding of the emotional experience. And Phoebe goes to some pretty dark places:
Phoebe: Sometimes, I get this feeling... This feeling to jump off
a roof.
Jamie: You wanna die?
Phoebe: No. It’s what I feel like, all the time. I know I shouldn’t,
but I can’t help it. It’s like being on the edge of a roof all the
time (0:30:34).
Most disturbing of all is this conversation, which incidentally takes place on a roof. In light
of how long Hillary waits to get her daughter some help, and then how long she refuses the services
the psychiatrist offers, her speculation that parents are too tuned into [their] kids starts to look a
little ironic.
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Giving It a Name
Strangely, the film frames the revelation of Phoebe’s diagnosis as if it were some sort of plot
twist: We cut to the psychiatrist’s office apparently right after he names the disorder, and Hillary
fervently answers No, she doesn't have that (0:45:06). And when she finally admits to her husband
Peter that she fired the psychiatrist for the diagnosis he offered, she recapitulates the symptoms but
doesn’t name it herself, and Peter dances around the word too as he observes this is a condition
most commonly associated with compulsive cursing, at least in popular conception (1:28:30).
Perhaps Daniel Barnz wanted to save the line for Phoebe herself, for she stands in front of her class
to explain everything in the next scene. Hillary taying so mum about the word may also serve the
purpose of preventing the audience from latching onto any preconceptions of their own; we are
forced to see Phoebe’s case as the unique instance that it is.
Either way, Phoebe is the first to break the taboo, announcing her diagnosis very near the
end of the film: Gilles de la Tourette syndrome. It's a beautiful name, I think. I was born with it. It's
starting now, and it'll get worse before it gets better... It's a voice in your head that makes you do
the opposite of what you're supposed to do. It makes you break rules. But sometimes breaking rules
is good, so I like to think about it that way (1:28:30). Her speech sounds rehearsed, confident, her
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face is bright, eyebrows raised. This positive reframing of Tourette’s syndrome — something with a
beautiful name which makes you a rebel, and being a rebel can be good — is very nearly the
optimistic view of Phoebe’s quirks which her mother had hoped to instill from the beginning, as
when Peter asks Do you think that something’s going on with Phoebe? and Hillary
answersSomething's always going on with Phoebe. She's different; that's good... No, I think it's just
the way they are (0:09:52). Phoebe’s speech changes anxiety-inducing compulsion into a challenge
to authority, a challenge which seems all the more necessary at a school that ridiculously reminds
their students at the start of every year not to ask questions. So it’s ironic that this changed
perspective comes only at the first announcement of the diagnosis. The labels which Hillary tries so
hard to avoid can be used to shame others, but as Phoebe seems to realize in this scene, the
convenience and the concretizing of ideas that a name offers can also be a relief, especially when it
follows confusion and anguish. Phoebe happily accepting her Tourette’s is also representative of
another movement in the discussion of how best to interpret and frame the study of health sciences
— the advocates of neurodiversity — which does a better job of instilling pride in her own
uniqueness than Hillary’s earlier denial.
As Hillary fights on her daughter’s behalf throughout the majority of the film, she is, every
step of the way, only half right, or right for the wrong reasons. As she repeatedly argues, and as I
have tried to show, a purely biomedical model is an incomplete view of human health / humanity,
and may spur to rash actions; however, a perspective that neglects biology must also be incomplete.
I worry about sounding almost like a cliched undergraduate 5-paragraph essay here: Given two
persuasive arguments that take opposite positions, probably the best answer is somewhere between
them. But it’s more than that — the best answer requires synthesis. The best answer requires
recognizing the dialectic between factors. The best answer requires juggling more concepts than we
might normally like doing or normally need to. The best answer, in short, requires work.
The cost of avoiding this work could well be jumping off a roof. That sounds dramatic, but
real people’s lives are impacted by any authority figures, parents or otherwise, who neglect or
refuse the intellectual rigor necessary. The payoff, at least for Phoebe, seems to have been an
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enriched and more coherent worldview and sense of self. Watching these movies, and the things
they have made me think about, have given me an enriched and more coherent worldview and sense
of self.
Maybe they can for you too?
The Caterpillar (to Alice): You? Who are you?
Delirium
Let It Go, Then
What are you letting go of? Stephan said quietly.
The helmet’s strap squeezed my jaw and terror squeezed my throat. Gravity, I said,
looking up at the cables spanning the trees. The ground. My intact bones.
Come on, Stephan said, not giving me an inch. What are you letting go of?
I sniffled. I guess fear. My clam shell.
That’s good. Let it go, then.
The air was getting colder, I was sure.
You’ve got this, Stephan kept saying. You’re amazing, you’ve got this. He had a longer,
more inspired pep talk for me than that, but my memory has boiled it down to a litany
of affirmations.
I faced the tree and reached for a staple at about eye level, and when I touched it, the
electrified loop of metal jolted my stomach. A dead taste rose up in my mouth. I stood
there for a moment, gripping my handhold, until I remembered I needed to lift my foot
too. My poorly chosen boots, heavy and dirty and slippery, thumped on and slid off the
lowest staple with a satisfying scratchy ring. I stepped up again. I’m doing it, I’m doing
it, I thought—as well as, I’m going to die, I’m going to die. Good-bye, Earth, I’ll miss
you.
I refused to look down. I felt for the next staple with my thighs and blindly stepped up.
Hand over shaking hand, it wasn’t so different from climbing a ladder for one of the
high boxes in the rafters of my garage. Still, I took my time, and the climb seemed to go
on for hours. This wasn’t the hard part, though.
Two cables stretched out into space toward the next tree—one dangling short ropes
overhead to hold for balance, one tied lower on the trunk for me to walk across. I
couldn’t see the opposite tree; for a moment green splotches on black fear blinded
me. What are you letting go of, Andrew? Stephan called from the ground.
I looked down at him and the rest of my hiking group. I stared with dry eyes, but still
stared down, ossified. I announced to them: my clam shell, my fear, whatever. Okay.
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Andrew Toskin
On my way up, the rope on my harness had hung slack at my waist, but now our
taciturn rope-climbing instructor held his end taut, nearly lifting me into the air. I
hadn’t even started to sidle across the cable yet, and he nearly plucked me from the tree
tops. Death, death, death…
Stephan said, Look at your goal.
I clutched to one hanging rope as long as I could before snatching at the next.
Tumbling, tumbling, tumbling… I looked out again—I couldn’t stop looking now: they
were so small down there, and tumbling, I am going to fall, I am going to fall i can feel
it already neck crunching femur snaps like ginger snaps i can already feel the tumbling
down to the down but whoa these trees are more beautiful seen face to face instead of
from their knees and
in spite of everything, I started composing a poem in my head.
The far tree stood on a slant and was not as good for hugging as the first, but I hugged
it anyway. I’d have liked an elevator at this point, but all my hiking buddies who’d gone
before me had returned in the same way: along the cables back to the midpoint between
trees—and jumping backwards.
Lean back. I’m not sure I can. Lean back. I leaned, kicked out into the air. Our hired
instructor slowly lowered me to the ground. I gripped the rope looped to my harness.
Let go, Andrew, Stephan said. Spread your wings. You’re an eagle!
So, reluctantly, I flapped my skinny arms, and cawed.
62
On the Precipice Of Understanding
Thus grew the tale of Wonderland: Thus slowly, one by one,
Its quaint events were hammered out — And now our tale is
done And home we steer, a merry crew, Beneath the setting
sun.
— Opening poem, stanza six, Alice’s Adventures In Wonderland
Sort of like my time in Berkeley in general, writing this thesis has been a wonderful
opportunity, but it’s been destroying me. I’ve already done so much more and so much
less than I’d originally hoped. I’ve spent the last year or so trying to wrap my brain
around all the concepts here, and spent pretty much this whole time feeling like an
amoeba trying to swallow an elephant.
I hope, after you’ve read this, that I’ve managed to cram at least one of the elephant’s
legs into your head, that you can feel its weight, and see the important other parts
there, protruding from your open cranium — I also hope you don’t feel like I’ve
snapped your neck under it all, or at least that you don’t resent me for it.
63
Andrew Toskin
64
Happiness Is
A
Softer World, #830
I’m tempted to write silly, lofty things about the human condition now, as I finish things up,
which I know will sound painfully corny to me later. But I can’t help it. These thoughts are spilling out
of me anyway. All this talk about the purpose of fiction and the possibilities of psychology and the
biopsychosocial perspective, and art and artists, has rekindled a fierce appetite in me. My heart dances,
my fingers twitch with the possibilities — or maybe that’s the sleep deprivation and repetitive motion
injuries catching up with me. It sure feels like inspiration.
Personal experience tends to make for a very small sample size, so I will try to keep this framed
in my experience.
I had this idea a couple weeks ago: Happiness is doing things — and the corrollary, misery is
having nothing to do (or too much). Generally, this has been true for me. The times that I have really
hated myself have not grown out of boredom, per se, but they have been times when I had little to do
and therefore little to feel proud of. Almost immediately after thinking up this adage, though, it
occurred to me just how delicate and durable is the happiness that relies so much on ambition. Because
when your plans go wrong — and they will — it is all the more crushing; at the same time, though, if
you’re truly devoted, you’ll figure out a way to carry on.
65
Still, relying on your own drive to accomplish is too variable a thing to aim for when trying to
assure overall long-term life satisfaction. Life is already an acquired taste to begin with, and fluctuates
without adding the risk of best laid plans of mice and men. So then I thought about the temptation of
dualism I mention — to really be just a floating eyeball? a lens, a bodiless gaze? — what an untenable
existence it would be, and yet it continually seduces me. In times of frustration, I often wish to abandon
material existence; in such moments I crave not just the comfort of solitude, but the reprieve of floating
in the ether.
Which is silly, because alone time rarely ever cheers me up. In fact, usually the opposite of this
nebulously ghostly existence is what picks me up. The hot-and-cold taste of chocolate lava cake with
ice cream, that strange soothing electricity of touching and being touched by someone else, the thrill of
a joke well told — these have done a better job exorcising my inner demons than have any flapping
ascetic attempts to abandon all of my atoms. My appetite for solitude is very small, but my appetite is
wonderful and bottomless. Art and ambition have brought me rapture, but only sensual/social
experiences have been able to save me from perdition.
I have a powerful need to be useful to other people, to exercise empathy. I don’t know what yet,
but I want to do something big and important for Humanity... Which is veering off toward ambition
again.
In keeping with the biopsychosocial perspective, maybe we can combine these into a more
coherent answer:
Happiness is absorption in a cause, but only partly. Happiness is thinking, feeling, and doing as
deeply as you can. Happiness is doing, with and for people — even if for now, because you’re tired, so
very tired, doing mostly just consists of thawing butter and joking with housemates at 2 in the
morning, guestimating the other ingredients and joking with housemates because it’s 3 in the morning
and everything is funny again, and mixing, eating, baking, and eating cookies with housemates, because
it’s 4 in the morning and everyone is about to go their separate ways for the summer, just as soon as
Andrew Toskin
66
the sun comes up, just as soon as their planes take off, just as soon as you finish licking the melted
chocolate chips from your fingers.
Because for now, that’s okay too. I’ll save the world tomorrow.
67
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Diagnosing Wonderland - University of California, Berkeley

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