Esmé Weijun Wang’s second book, the essay collection The Collected Schizophrenias (Graywolf, 2019), is a rare transformative reading experience. With a combination of deep research and detailed, equally deep insight into the nuances of experiencing psychosis first hand, Wang brings the reader into a totally immersive and gripping memoir.
Most mental illness narratives focus on depression. Depression is a serious and devastating illness, to be sure, and given how many people suffer from some form of it, stories involving depression are fairly accessible and marketable. But narratives about other forms of mental illness, especially severe forms like schizophrenia(s), are fewer and farther between.
Wang carries the diagnosis of schizoaffective disorder, bipolar type. Right from the start, she both appreciates and questions this diagnosis. “[T]o ‘have schizophrenia’ is to fit an assemblage of symptoms, which are listed in a purple book made by humans,” she writes. Diagnoses, like psychiatry and medicine in general, are constructs. At the same time, they can be helpful in creating the structure that humans sometimes need. “Feeling some degree of control over their lives is particularly important for a population of people who are vulnerable to having none,” Wang writes.
The Collected Schizophrenias is a memoir and a sociological exploration, an inside story and an academic examination. Wang was diagnosed with bipolar disorder the summer before she left to pursue her undergraduate degree at Yale; she was diagnosed with schizoaffective disorder while a student. She also met her husband there. But Yale was not empathetic to her illness. She was effectively forced to leave, and the account of this time starkly illustrates how deeply unaccommodating universities, and the world in general, are to people with severe mental illness.
This will likely come as no surprise to anyone. But Wang writes clearly about the myriad of little ways in which the world is not built to accommodate her or her lower-functioning “comrades in the schizophrenias.” For example, a lot of the care organizations meant to serve people with severe mental illness actually center family care, inherently relegating the diagnosed person to the role of “burden.” There is an important difference between patient-centered care and family-centered care, and that difference is one of agency: “For those of us living with severe mental illness, the world is full of cages we can be locked in.” This is true literally, as prisons have become de facto cages for a huge population of people with severe mental illness, as well as figuratively.
While Wang gives a comprehensive overview of schizophrenia diagnosis, treatment, and the history of both, she is also telling her own story. She brings the reader into some of her experiences of psychosis, deftly creating a feeling both fearful and ethereal. She writes openly about questions of life choices (such as whether to have children) and identity that everyone grapples with, but which take on other layers of meaning in tandem with a severe mental illness.
“I’m still trying to figure out what ‘okay’ is, particularly whether there exists a normal version of myself beneath the disorder,” she writes. “What happens if I see my disordered mind as a fundamental part of who I am?…There might be something comforting about the notion that there is, deep down, an impeccable self without the disorder, and that if I try hard enough, I can reach that unblemished self.
“But there may be no impeccable self to reach, and if I continue to struggle toward one, I might go mad in the pursuit.”
In a collection filled with striking moments, one of the most thought-provoking is the idea that many, or all, mental illnesses are a result of autoimmune disorders. Among Wang’s diagnoses stands a controversial one: Lyme disease. In her vast experience with many types of doctors, some who affirm the existence of Lyme and some who don’t, Wang runs across one who believes this to be true. How might our approach to mental illness change if we thought of it this way as a society?
The Collected Schizophrenias is a tapestry of the scientific and the ephemeral. It is a beautiful mediation on meaning and limits, and how we define them. “I have tried to control these ‘oscillations,’ as my psychiatrist calls them,” Wang writes. “But what, if anything, can be truly controlled?” It’s a question we could all stand to ask in relation to ourselves and others.
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