Sitting handsomely on its tree-lined street, Grandmother’s three-story house exudes a quiet majesty. It’s still there on the other side of Columbus, out in Bexley. The new owners have modernized it, removing some of its charm although undoubtedly adding to its value. But if you half-close your eyes, it’s possible to imagine what it looked like all those years ago: the side porch with its wicker rocker; the lift of the wood- and stone-framed floors heading toward the roof; the detached garage at the end of the driveway, abutting the back yard and alley. The garage held the wooden scooters that Mom and her brother Buddy used years before, preserved for Sally and me when we visited.
When we got tired from scootering, Sally and I explored the rooms of the house. Each one featured dark wooden floors made from the lumber of our grandfather’s mill in West Virginia. Student boarders at the college a half-mile away rented rooms up on the third floor, heading out the front door to class with a curt nod. Even into her nineties, Grandmother changed their sheets and did their laundry on a regular basis.
Sally and I gazed into a second-story bedroom with its polished floor and heavy woolen bedspreads. We tiptoed in to the room, taking in the smell of varnish on the floorboards and the view through half-drawn shades across Fair Avenue to the Tudor homes on the other side of the street. Mom’s older sister, Virginia—Ginny Ann—had been born with mental and physical problems of some kind; no one knew what to call them back then. She limped with leg braces and called out some barely intelligible words. But her life nearly ended at age nine when she crashed headlong while trying to navigate the steep steps to the stone-floored basement far below, a fall to near-oblivion. Bleeding from her head, immobile, she survived but never spoke or walked again. Once out of the hospital, she lived in that bedroom for the next 25 years.
When friends came over to play back in the 1930s, at the time Mom was in grade school, she heard them warn one another to be quiet. “Alene’s sister is very sick,” they’d whisper, looking down. “Don’t disturb her; she needs rest in her room upstairs.” I didn’t know my sister was sick, Alene thought. It’s just the way life was.
She and Buddy would sometimes go in and sit with Ginny Ann. No one talked about any kind of tragic fate; life just continued. That kind of fortitude, laden with silent denial, provided the model for the responses Mom exhibited throughout her marriage.
By the early 1950s Grandmother had finally needed to send Ginny Ann—a vacant stare in her eyes, wheelchair bound, mute forever—to Columbus State Institute, the massive building on the west side of town for those with feeblemindedness, as it was called, right across West Broad Street from Columbus State Hospital, where insane patients were sent. Miraculously, though, by the early 1970s the institute suddenly downsized and Ginny Ann entered a beautiful community residence. She lived there until the age of 89, having never walked since she was 9. The loving attention of the staff showed that, at least in some domains, respect and dignity have turned stigma on its ear.
On the first floor of the house was a sitting room with a low sofa and reclining chairs that looked directly out to the back yard and the grape arbors in the garden. Grandmother made grape jelly each year. We watched as she poured the deep-purple boiling fluid into glass jars with bronze screw-tops and vacuum-sealed wax. When we spent the night, Sally and I played board games in the sitting room after dinner. On the huge Zenith in the corner, Grandmother watched her favorite shows, Lawrence Welk and Rawhide.
But back in the late 1930s, when Mom was 12, her father spent a year there in a reclining chair after his first stroke. There was no way to transport him upstairs to the bedroom. Drooling, he could no longer speak intelligibly. Mom and Buddy spent time with him but everyone knew he’d never be the same. A year later, he died from a second stroke. Grandmother soon took over the family business. Once again, quiet forbearance was the order of the day. No one moped or complained; life proceeded.
After hearing these stories, I wondered how any problems of mine could even begin to compare to theirs. And if I did wonder where Dad went, or why everyone kept silent about the issue, wasn’t it clear that the only way forward was just to not think about it?
A small breakfast area abutted Grandmother’s kitchen, leading the way into the formal dining room. A large painted mural filled an entire wall of the small nook: a sailing boat on the blue-gray ocean, with billowing white clouds above a rocky coast. Eating at the wooden table, I secretly sailed to faraway lands, the cliffs and mountains beckoning, far from the house’s memories, far from the quiet terror of our own home.
Mom finished high school in 1942 and then continued to live at home while taking the streetcar all the way down Main Street and then up High Street to Ohio State. For her last years, she lived in a sorority on campus. Dark haired and beautiful, she was an honors student as World War II raged overseas. Despite the losses she’d experienced, she persisted. A few years later, as a grad student, she would meet a new philosophy professor, changing the course of her life forever.
* * *
Sally, with her light-brown hair cut just above her shoulders. Sally, with the small gap showing between her front teeth, once her baby teeth were gone. When I was two and Sally one, she would bite my arm if I bothered her too much. The wet sting of her teeth and the tiny tooth marks indenting my skin lingered for hours. But while growing up, we were mostly inseparable.
One day back on Wyandotte Road, I heard Sally’s screams from upstairs. Running through the bathroom, she’d slipped, and her forehead had crashed straight down on the rock-hard porcelain rim of the toilet. Mom and Dad rushed in. I hurried behind, my eyes huge when I saw the pale towel coated with fresh red blood. Suppressing the frightened look in his eye, Dad stayed with her as Mom ran to call the doctor, arranging for the stitches Sally soon got. The horizontal half-moon of the scar marked her forehead for years afterward.
Many days, Sally and I played together, petted our hefty black-and-white cat Slim, and huddled together when it was cold or stormy outside. As we got older I showed her how to throw a spiral and helped her with homework. But when Dad was gone, we never talked about him, not once. Maybe it would threaten his ever coming back if we spoke. We were co-passengers on the same plane, flying to unknown destinations, strapped into our seats and staring straight ahead, neither of us able to steer.
The difference was that when Dad returned from his mystifying absences, he spent private time with me, discussing his family out in California—but not with Sally. It’s as though he didn’t quite know what to do with a daughter. Far more than I, Sally was left to fend for herself.
In her bedroom Sally built a make-believe world of small plastic animals on the bottom layer of her nightstand, with tiny trees, a beach area, and a blue-colored mat serving as the ocean. We played with the animals in their land, where they spoke their own special language, which we called Hossareeneum. It sounded like English but with different words: “lea” meant “please”; “dip, tonk” meant “yes, thanks.” Some days, Sally and I spoke to each other in this dialect. Perhaps we needed a special language amid the silence surrounding us.
Sometimes I could see it in her eyes: a hint of fear, a need to stay close at home, to protect Mom. Maybe I’d be the one, when the time came, to explore the world further.
* * *
First grade had ended. I noticed that Dad wasn’t home. The air outside was warm, the pavement baking in the noonday sun. I asked once or twice but Mom said that he’d return from his trip pretty soon, maybe a few more weeks. What trip? I inquired as softly as I could, but she said nothing more.
One afternoon in the early summer, crossing the living room toward the back porch, I stopped short. Something seemed to be hovering nearby though I couldn’t figure out what. My skin grew cool. Soon, my eyes were pulled upward as though by a magnet. With a start I saw them, near the ceiling: a string of balloons.
Incredulous, blinking, I looked outside through the porch, where another strand hovered over the back yard. All those different colors!
Had there been a parade nearby, or maybe some kind of celebration? Limp and deathly still, their tight skins glistening, they floated there without a sound. As I continued staring it dawned on me that the balloons were filled with poison gas. Hidden by the stretched plastic skins, the molecules inside were pressing for release. The danger was huge. Thoroughly frightened by now, I scurried upstairs to my bedroom.
Was this a vision of some sort? To this day I’m not certain. But I told myself back then that if I kept my eyes focused right in front of me, my gaze pointed straight ahead, I might never see them again.
I rode my bike more than ever that summer. Tearing down the streets and sidewalks, I felt the wheels under me vibrate as the asphalt whizzed by, the rush of wind on my face. At least I felt something. For a few moments I could forget about Dad and where he might be. One day in the vacant lot half a block from our house, I met up with a boy I didn’t know very well, Howard, who lived on a side street. As we rode down the sidewalk, the air was stifling, streets and trees bleached in the white sunlight. We stopped in the parking lot behind the stone church a couple of blocks away, where we got off our bikes and walked down a shaded stairwell, where it was cooler. Eventually we hopped back on and pedaled, single file, up the gentle incline toward Wyandotte Road.
Behind me I heard a muted crash. I stopped and turned. Howard was lying still on the sidewalk, his bike half on top of him. He must have hit a bump; he couldn’t move. I stared at his face, partially covered by the bike but numb with pain. He didn’t cry out. He didn’t say anything.
Time slowed. My legs turned to lead. The street was empty, no cars or pedestrians anywhere to be seen. Any breeze had stopped as the searing sun beat down. I looked at the houses behind the lawns, the air wavy in the heat, curtains drawn. Maybe I’d get blamed for all this, even though it wasn’t my fault. Was it?
Ever hotter in the stillness of the afternoon, I staggered to the door of the closest house and knocked, but no one was there. With all my energy now drained, I couldn’t imagine trying anymore. Strangely inert, I felt paralyzed.
I then did something I’ve never understood. Back on the sidewalk, I looked down at Howard again—immobile, silent—jumped up on my bike, and rode home. I went inside and found something to play with. For the rest of the afternoon, I tried to clear my mind of all thoughts. All I could remember was that feeling, outside in the oppressive heat, of being unable to move, my ears filling with a strange static.
The next day, Mom asked if I’d been riding bikes with another boy the day before. Looking down, I meekly assented. She’d heard something from a neighbor. Apparently Howard had been injured pretty badly.
“And what did you do, Steve?”
How could I tell her that I’d just left him there? Like venom, the shame spread to each cell of my body. “I didn’t know what to do,” I replied, a flush rising to my face. Looking confused, Mom stared back at me. Neither of us said another word.
I heard a few days later that Howard had ended up all right, even though he’d hit his head after falling from the bike. But I couldn’t escape that I’d left him there. During the school year I saw him occasionally but never played with him again. The humiliation was overpowering.
I still feel it today, the shame like dry ice, frozen fire.
I’d learned, by instinct, to place anything frightening into an airtight, vacuum-packed bag. I had no language for discharging negative feelings. Any failings pulled me down into a region of self-hatred so deep that I wasn’t sure I could ever climb back out. Turning my back on Howard was part of the pattern, created by the shame and silence, of how I approached anything outside my usual rigid routines. Walling myself off may have seemed the ticket to survival, but—though it’s hard to admit—I’d turned my back on someone who was clearly suffering.
Throughout my adult career, I’ve fought a dual battle: trying to understand, dispassionately, the causes of and treatments for mental illness, while nourishing my humanity at the same time. The struggle continues to this day.
One day a couple of months later Dad was back. No announcement from Mom, no discussion with Sally or me. “Can we throw the football?” I asked timidly as I saw him walk through the house. “Certainly,” he replied. After trudging out to the back yard, he patiently showed me how to hold the ball correctly and coached my weak passes into longer throws. But should I ask about where he’d been? No one else was making any kind of fuss about it, so maybe I shouldn’t either.
We renewed our play-acting. I co-wrote the script and performed the lines every day.
* * *
Resuming our talks, Dad said he missed much of his twelfth-grade year because he was ill and needed to make up the work later. It wasn’t until the bombshell discussion in his study during my first spring break from college that I understood the reason why. When younger, what I often sensed were gaps.
From our periodic conversations I pieced together his continuing trajectory. After graduating as valedictorian, Dad spoke at the Rose Bowl in front of thousands. Admitted to both UC Berkeley and Stanford, he chose Stanford, deciding to double-major in philosophy and psychology. His voice swelling with memory, Dad said that his father wished for him to return to Southern California after he graduated to help with Quaker causes, such as international famine relief related to the tragedy of World War II. But his own passion was philosophy, and at Iowa he earned a Master’s degree with Gustav Bergmann, a member of the Vienna Circle who had escaped the Nazis. A conscientious objector because of his pacifist and Quaker background, Dad received a fellowship to attend Princeton’s doctoral program. He overlapped for a time with his older brothers Randall, a grad student in economics, and Bob, in psychology, who’d already started there. Dad also had a 4-F deferment, given his half-year as a mental patient, though that issue never came up in those early discussions when I was young.
During Dad’s initial year as a grad student, the chairman of the philosophy department informed him of a weekly, one-on-one tutorial arranged at the home of a visiting professor from Great Britain. Asking about his host, Dad learned that he was to have those sessions with Bertrand Russell. Wait! I thought. Weren’t those Russell’s books right there in Dad’s library, small ones like Why Men Fight and the huge one, Principia Mathematica? Dad said that Russell gave him many insights about philosophy.
Three years later, while finishing his Ph.D., he was introduced to Albert Einstein, at the Institute for Advanced Study. Pulling a book from his library shelf, Dad showed me the final chapter of an edited book on physics, about Einstein’s social and moral philosophy. The author was Virgil Hinshaw, Jr. I was in awe.
It would be well over a decade before I knew that soon after completing his dissertation, he ended up in a mental hospital outside Philadelphia, called Byberry—named for the district north of the city in which it had been built. As a grad student, Dad had followed the Allied war effort, sometimes leaving campus to pack boxes of supplies in support of the fight against Fascism. Yet he became convinced that he’d gained the power of telepathy to predict the war’s end. Early in 1945, with his degree in hand, he became acutely paranoid, believing that others might discover his powers. Agitated and raging over a failed relationship, he took the train to New York to seek out his ex-girlfriend. After he banged on her apartment door and windows in the bitter cold and yelled up to her room, neighbors called the police. Dad was booked and ended up being transported to Philadelphia on an involuntary psychiatric hold. He would spend five months in the huge, overcrowded institution, where inhumanity, beatings, and early death were daily occurrences.
Why was Byberry located in the countryside, far from downtown Philadelphia? Even Norwalk, when it had been built in the early twentieth century, was well outside the downtown Los Angeles area. Indeed, large public mental facilities were typically built a day’s carriage ride from major cities, supposedly to provide refuge from daily stress but actually to protect the populace from insane patients—and, too often, from the barbaric practices that occurred within their walls. Clearly, stigma was part of the formula. By the 1950s, nearly 600,000 Americans were held involuntarily in such large state-run facilities.
I wouldn’t know of the details of Byberry for some time. But when released in the summer of 1945, Dad took the train, along with his older brother Randall, back to Southern California. Unsure as to his future after his second bout of madness, he found whatever work he could. With a doctorate in philosophy—and his half-year at Byberry intentionally omitted from his résumé—he applied for teaching positions around the country. Ohio State’s philosophy department was growing. He had published several articles from his graduate work in prestigious journals and received an offer. With a starting salary of $2,000, he could move from instructor to assistant professor and eventually receive tenure. He moved to Columbus, beginning his new life in the Midwest.
* * *
By my late twenties, Mom had learned that Dad and I had been speaking about his life for nearly a decade. It hurt her, she told me, that I knew far more about many aspects of his history than she did. But she didn’t exude bitterness. Long before, she’d learned that there were major parts of his life that would remain walled off from her. Stigma and its consequences can impede the closest of relationships, eroding chances for mutual support.
By that time Mom and I had started our own private conversations. During one, she talked about an episode of Dad’s when Sally and I were young. As her alarm peaked back then, she once again sent us to Grandmother’s for the weekend.
“Dad was having a terrible time,” she said. “He was irate over something, I don’t know what.” She said that, one afternoon, he stormed out of the house and into the garage, where he kept his golf clubs. Dad liked golf back then, often playing at the OSU course. Afraid of what he might do next, she peered out from the kitchen window.
“Steve, he hauled his golf bag onto the yard and was pulling out the clubs one by one. You should have seen the look on his face.” He took each club, she continued, and snapped it over his knee like a matchstick, ranting the whole time. He grabbed the broken pieces and flung them into the neighbor’s yard, screaming at some unseen threat to his well-being. Concluding, Mom added that he never really played much golf much after that.
What else had I missed, all those years ago? From what else had I been shielded?
During our discussions, her most vivid story concerned an early-fall evening in the 1950s, which I’ve reconstructed from her words and from my adult understanding of how bipolar disorder appears when it’s unchecked. Remarkably, I knew nothing of the event until 25 years after it occurred.
The scent of burning leaves infused the air while living room and bedroom lights illuminated the neighborhood on Wyandotte Road. Inside our house, I was four and a half and Sally three, fast asleep in our bedrooms upstairs. After the dishes had been dried and stacked, Mom stole a few minutes with her husband in the living room to watch a popular variety show on the giant black-and-white television set. Such a break was a real treat, but the way he’d been acting recently had placed her on full alert. On the 10:00 p.m. program, live from Cincinnati—a hundred miles away—an attractive entertainer sang a show tune, swaying her hips to the rhythmic beat of the studio orchestra. Dad had seen her before but tonight he glowered at the screen. He suddenly sprang from the couch and fixated on her sequined dress. “Come here,” he commanded his wife, kneeling directly in front of the screen. “Listen—can you hear it?”
Wishing desperately to support him but terrified of what was coming, Mom dared not answer. “She’s sending messages to me,” he whispered with reverence. But the only thing Mom could hear was the song and its bouncy melody.
For several days he’d been awakening at dawn, rushing to his basement study to scrawl incomprehensible notes on his legal pads. He saw coded signs everywhere, in looks from people on campus, in the supposed patterns of cars parked at the curb. Essential messages were being transmitted, but only to him. Such occurrences are initial signs of paranoia, called ideas of reference, when special meanings are ascribed to everyday events—a stepping stone on the path to delusions.
Where was the scholar who courted her before their wedding in Columbus seven years before, the handsome, intellectual figure with whom she fell in love so deeply? Had anyone else seen this different, peculiar Virgil? Far too loud, Mom recalled, Dad played religious music on the phonograph and burst into Spanish, the adopted language of his mother and his stepmother from their missionary days. Its sensual sounds transported him back to California, as he launched into its rapid rhythms: “Yo soy yo y mi circunstancia,” from the philosopher Jose Ortega y Gasset (“I am myself and my circumstance”); “el mundo tiene una belleza rara!” (“the world has a rare beauty”).
In the living room that night, more excited by the second, Dad became entranced by the singer’s words and dance moves. It was a personal semaphore, with hidden meanings encoded in the lyrics. “We must go to the station!” he cried. “Right now, before she leaves!”
Frantically, Mom calculated. If she let him drive off alone, what would he do at the station, if he even got that far? And she couldn’t just plop Sally and me in the back seat: We would wake up terrified and we certainly couldn’t see our father in this condition. What’s poorly understood—even now—is that when full-blown mania hits, irritability and anger are part of the picture just as much as euphoria and expansiveness. Impulse control vanishes, judgment disappears, and irrationality takes over. No one dare stand in the way of the plans and snap judgments getting made.
Heart pounding, she decided to go along and try to contain him, praying that we would remain asleep upstairs until they returned. If not, she might never see her husband again. What kinds of choices were these, which she now had to make?
She longed for someone to call. But who would understand her impossible story? How could she keep her conversation private from her agitated husband? Alas, there was no time; he was grabbing the car keys and heading for the door. Dashing up the stairs to check on Sally and me, she heard our soft breathing. “Please, God, keep them asleep,” she half-whispered before pulling herself away.
They rushed outside to their 1956 Ford Victoria with its V8 engine. Clearly, he must drive; she would never go fast enough to make it to the station on time. He forced the key in the ignition and, as the engine turned over, punched it into reverse before jamming the lever into first. They screeched down the street.
Once outside the city limits he managed to stop for signs and lights on the two- and four-lane highways but it was torture. “We must get there!” he shouted, though Mom was right next to him. “Can’t this car go any faster?” But he mainly remained silent, determined to receive his messages from the singer, who intended them only for him. The speedometer’s thin, blood-red dial glided past 60, 70, and 80 on the open road. He muttered each time they reached the next town.
Once back in the countryside, the car hurtled through the darkness. Mom felt that she had entered a different existence. With every ounce of effort she could muster, she tried to stay in control and urge him back home when the opportunity arose.
Unimaginably, an hour and a half later they arrived in the outskirts of Cincinnati, the station’s huge broadcasting tower providing a beacon. It was nearly midnight. They swerved into the parking lot, gravel shooting out from the spinning tires as he slammed on the brakes. “Stay in the car; I’ll find her,” he ordered, leaping from his seat and rushing to the fence. Mom feared an ugly confrontation with the station personnel.
But wait! The gate was locked and the lights were off in the station’s brick building. Even with the windows rolled up, she could hear the clanging as he shook the fence, hard. Would he climb it and jump over? Emerging calmly from the car, she left the door open, a soft dome of light in the dark lot. Approaching him, she saw his chest muscles heaving, his shirt soaked despite the cool night air.
“Honey, the station’s closed,” she said in a quiet voice. Hands clinging to the chain links, he peered ahead, panting. Careful, she thought, careful. “Remember, Virg, Stevie and Sally are still in their bedrooms. Maybe we should head back. The singer is sure to be on the air again in another few nights.”
Wiping his face with a handkerchief, he was clearly torn. He shot another glance toward the station. “Yes,” he said, abruptly changing course, “we must go.” Doors opened and slammed shut. They flew back onto the highway and retraced their path.
Somehow, no one seemed to be following. In the silent world of the car’s interior, the roadway, fields, and trees approached at blinding speed before disappearing off to the sides, headlight beams glued to the onrushing pavement. What would have happened, Mom asked rhetorically as she recounted the endless night, if a highway patrolman had pulled them over and he resisted? Would Dad have tried to prove his strength? If things got ugly, who would have come to the house to get Sally and me? Where would we have been sent?
But the only sound was the rush of the tires spinning madly over the highway. Foggy with adrenaline and exhaustion, she silently prayed. Please, no accident; please, no police.
They slowed as the car miraculously reached Columbus sometime around 3:00 a.m. and stopped with a jolt in the driveway. The block was eerily silent, the houses dark and remote. Departing the car, she heard their footsteps echo faintly off the stone walk, the only sound for miles. She finally grabbed the keys from his hand and raced up the stairs to our rooms. There we were, fast asleep, our mouths slightly agape, oblivious to the night’s events. Within moments she nearly collapsed on the bed she and Dad had shared since their wedding, the bed she’d be sharing with a stranger tonight.
Stilling her breath, she began to drift. The last thought in her mind following the terrifying midnight drive to Cincinnati was that the evening’s events, and others like them, must stay locked inside her for the rest of her life. For the sake of the family, and because of doctors’ strict orders, the pact of silence must remain in place.
Forever.
* * *
Some nights after dinner Dad would sit me on his lap at the kitchen table on Wyandotte Road, the air still warm from the oven. My knees and elbows would be covered with Band-Aids from falling off my bike as I continued to race around the neighborhood. At the table I might wear a construction paper crown, a single Indian feather sticking up, as Dad told me of Nickershoe, the Indian boy, and his adventures in a canoe or on the plains.
“Indian boys and girls didn’t go to school the way you and other modern children do,” Dad said. “But they learned all the time. The tribe’s elders taught him how to carve from wood, how to fish. As he got a bit older and approached manhood, Nickershoe learned to hunt, using only his bow and arrow. He practiced and became extremely skilled. This is how Indians existed; the tribe lived off the land.”
“Please, Daddy,” I begged, “the great hunt in the fall!”
With a small grin, sitting erect at the table, Dad continued. “It was time for the great autumn hunt. The young braves had been preparing all summer. On glorious days, Nickershoe went with the other boys, plus an older guide, to gather food before the snows arrived. The journey took them into the forests to find bear and deer.” Each detail became imprinted in my mind. Dad went on to say that Nickershoe had to prove his courage with his bow and arrow. In an early snowfall, he might find shelter in a cave and wait out the storm. He would then ride like the wind on his Appaloosa for the final hunt.
“Finally, the braves returned, with their kill draped over the horses in back. Everyone gathered to welcome them. As the braves headed into the camp, the elders were proud. The new group had done a fine job; Nickershoe might one day be their leader. What a feast they had, to celebrate the end of the great hunt.”
Dad told me that he’d learned about Nickershoe when he was a boy, while camping in the mountains of Southern California. I wasn’t sure that I could ever be as brave as Nickershoe, but if someday put to the test, I might try. I felt sure that a test would come one day, when I would need to be braver than I’d ever been. But what the test might be, and when it would happen, remained a mystery.
All these events took place in the silent 1950s, an era that seems lifetimes ago. Haven’t we traveled a vast distance since then, especially regarding attitudes about mental illness? Isn’t the stigmatization of people with mental disorders receding at a fast clip, just like fast-improving attitudes toward gay marriage?
If only such were the case. On the one hand, the general public knows far more about mental illness than previous generations. After all, psychology courses are routinely taught in high schools, and mental illness isn’t the secret it once was. Many more people in the United States can correctly identify symptoms of mood and anxiety disorders, psychotic conditions, and childhood forms of mental illness than ever before.
Yet at the same time, several large-scale investigations reveal that public attitudes toward mental illness, dismal during the 1950s, have stayed essentially flat since then—meaning that the desire to keep one’s distance remains high. And three times as many people believe that mental illness is inevitably linked to violence today than people did 60 years ago. In key respects things are actually going backward.
A major factor is the intensive media focus on horrific acts of gun violence. Photos of deranged-looking killers have become the public face of mental disorder, conveying the image that mental illness automatically produces aggression. In reality, individuals with mental illness are far more likely to be victimized by violence than others—but with rare exceptions, no more likely to commit aggression. Yet this point is almost never publicized.
Cycles abound in the history of mental illness and its treatment. Back in the late 1700s and early 1800s, a movement occurred in Europe, soon spreading to the United States. The goal was to release those with chronic mental disorders—often believed to be possessed by evil spirits—from chains and shackles within inhumane “madhouses” to retreat-like, rural settings, staffed by sensitive, well-trained caregivers. This practice was termed moral treatment, a clear attempt to humanize people who had lost their way, through calm, therapeutic settings far from everyday stresses.
As so often happens with even the best-intentioned reforms, these retreats became ever larger and more medicalized. As the nineteenth century progressed, with the full onset of the Industrial Revolution, state legislatures aimed for cost savings and protection of the general public by re-creating huge institutions, usually far from urban centers, under the supposed edict of moral treatment. In the aftermath of the Civil War, such massive public facilities came to dominate treatment for severe mental illness. Dad experienced the full horror of the “care” they offered. Although he’d been raised in a middle-class, Prohibition home and attained the status of professor, involuntary mental hospitalization knew no class distinctions. Brutality was widespread.
By the 1970s, deinstitutionalization had finally led to the closing of nearly all public mental facilities, to promote community care and humanization. Who could argue with such a trend? Yet these community-based alternatives were never funded adequately. Indeed, many contend that deinstitutionalization was actually reinstitutionalization, as huge numbers of people with mental illness began to flounder in jails and prisons or in poorly staffed, isolated, urban “community” centers. In addition, too many of today’s homeless population have chronic forms of mental disorder, fueling fears of contagion—as though a serious mental disorder can be transmitted by close personal contact—and promoting the view that everyone with mental illness is incompetent and potentially exploitable.
What about deeper currents regarding attitudes toward mental illness? One view is that when people encounter individuals who struggle to maintain psychological balance, their own stability is threatened. When reminded of the fragility of life, or of their own imperfect self-control, many observers try to keep the source at arm’s length. Even more, illnesses enshrouded in mystery, like cancer several generations ago or leprosy before its bacterial origins were uncovered, become highly feared and stigmatized. Today, breast cancer is a “cause,” the subject of huge fundraising campaigns. Leper colonies are a thing of the past, as people with Hansen’s disease receive state-of-the-art antibiotics. Yet mental illnesses—still viewed as the result of irrationality, weak personal will, unpredictability, or maladaptive parenting—receive contempt and outrage rather than compassion. As noted by Princeton social neuroscientist Susan Fiske, those with mental disorders are typically viewed as the “lowest of the low,” perceived to be deficient in both warmth and competence.
Little wonder that teaching factual information about mental illness may actually increase social distance. “Facts” promote stereotypes, while the information that needs to be conveyed is the great potential for coping and recovery if treatment is made available. Emphasizing the fundamental humanity of those affected must be the main objective of any outreach. With greater openness and discussion, mental illness can take its rightful place on the national agenda. With access to effective treatment, people within the entire range of mental disorders can thrive. Still, the road ahead is long and steep.
* * *
By the end of the fifties, Mom had reached a crossroads. When Dad would return from an episode, she’d know nothing of the details. What if he didn’t come back next time? Where would the family go, whatever was left of it? Once she and I began speaking in earnest, Mom told me that Dad had divulged very little about his past during their courtship, saying only that he’d had “some trouble” back in high school and at Princeton. This phrase was the sum total of what she knew. “Steve, no one ever talked about mental illness back then,” she said. The stigma was supreme.
After they were married, the truth became clear, especially when Mom became pregnant with me and then with Sally. Each time, before her eyes, he escalated into full-blown mania. It’s well known that women with histories of mood disorder show high risk for postpartum depression. In fact, this diagnosis is now recognized as a key public health problem. Far less understood, however, is that men with genetic risk for bipolar disorder often become symptomatic when their partners become pregnant. Obviously, a direct hormonal link does not exist here, the way it does for postpartum depression in women. Is the lack of sleep a trigger—or perhaps an existential fear related to bringing a child into the world after experiencing years of cyclic madness?
By my after-the-fact count, Mom experienced at least six of Dad’s episodes during the first ten years of their marriage. Each time, her fear grew. At the end of the decade she took stock of the situation and scheduled a meeting with a lawyer. Although keeping it private, she wished to explore the possibility of divorce, in case Dad never returned or became too debilitated. She was also making plans to return to graduate school and find a job, in case her income would become the sole support for the family.
“This was a high-priced attorney,” she told me. Yet when she got to the well-appointed office near downtown Columbus, she froze. She’d planned out just what to say, but once her hour began she could hardly speak. She knew that the talk was confidential because of attorney-client privilege but still couldn’t describe the actual problem: her husband’s periodic plunges into serious mental illness. Instead she spoke in vague, general terms about the potential for separation.
“The attorney must have wondered what was wrong with me, fumbling around as I did,” she said. “I’d wasted the appointment.” She summed up by telling me that back then, mental illness was off limits. Her bitterness permeated each word. It’s hard to think of a clearer example of stigma.
Over the ensuing months, as the fifties wound down, Dad stabilized once again. Mom and he contracted with an architect to design a new house, and Mom gradually let go of her silent idea of the need to separate. The new home was a vote, made from blind faith, for the family’s continuation.
When I was in second grade we sometimes drove to the building site. Nearby, like a giant spaceship, its spindly legs holding a vast mother ship to earth, a huge cylindrical water tower loomed over the farmland. Pretending to be explorers, Sally and I walked on top of the house’s foundation, crossing through the wood-framed doorways and skeletal walls.
Heading back to Wyandotte Road in the car, we saw strings of colored lights next to the vast parking area for the new shopping center near the water tower. “Can we see, Daddy?” we cried out in unison. As he turned the car around, we made out silhouettes of carnival rides and begged to go. The makeshift fair smelled of dust, metal, sweat, and the gasoline that powered the rides. Like pink and purple glue, cotton candy stuck to our hands as the rides twirled and spun.
In mid-summer, the enormous van arrived, men packing up everything. Our new house on Kirkley Road was a split level, fresh white paint against the jet-black driveway. Inside was Dad’s new study, which he’d asked the architect to design, with golden-hued shelves built right into the walls. Our new high school was to be constructed on the large city block right behind our own.
But just before school started, I noticed that Dad was missing once more. I calculated that he’d be back in a couple of months, like last time. But I had no real idea, only hope. Third grade began at my new school, and I came home each day vaguely wondering about him. Yet no phone call ever arrived, no letter. Dad had entered a void.
Ever so slowly, my world began to cave in. It was a fight to keep up my morale.
Maybe I’d done something to make Dad disappear yet again, but what? As the weeks wore on, I needed some answers. I had to figure out how to ask Mom.
Looking for the right moment, I braced myself.