We are all a little crazy.

... Rather than behaving sanely, rather than being in touch with our present realities, we human beings--all of us, myself included--are too often simply run by losses and hardships long gone by, and by our stockpiled fears. Our collective history, our individual lives, our very minds, bear unmistakable testimony.

... I have been told more than once by the survivors of trauma that it would not be worth the struggle merely to go on surviving. And that is exactly what most of the rest of us do: we do not choose to die, or to live; we go on surviving. We do not choose nonexistence; nor do we choose complete awareness. We slog on, in a kind of foggy cognitive middle-land we call sane, a place where we almost never acknowledge the haze.

... And we feel our insanity, and sometimes a near-frantic sense of being out of control of our lives, in the misunderstandings and rifts in our most cherished relationships, in the same emotionally muddled arguments that go on for years and years. The conflicts never quite kill the love we feel, but they never quite end either. And as a society, we feel incompetent, and sinkingly helpless...

... Too many of us walk on eggshells around our life partners, theoretically the very person whom we should know the best. We do this because we are never certain when that lover or that spouse is going to become aggrieved, or fall silent, or fly into an impenetrable rage at something that happens, or at something we have said, and become a distant stranger, a different person altogether whom, in all honesty, we do not know at all.

Or we look at our parents as they grow older, and seeing that time is running out, we long to be closer to them, to know them as friends. But when we actually try to think about accomplishing this, our thoughts skitter away from us like frightened deer from an open meadow, and in the next moment our minds are elsewhere--anywhere else--the rising price of gasoline, a memo at work, a spot on the carpet.

Many of us find it difficult, and sometimes impossible, to stay in one "mode", to be constant and recognizable, even to ourselves...

Perhaps worst of all, as time passes we often feel that we are growing benumbed, that we have lost something--some element of vitality that used to be there. Without talking about this very much with one another, we grow nostalgic for our own selves. We try to remember the exuberance, and even the joy, we used to feel in things. And we cannot. Mysteriously, and before we realize what is happening, our lives are transfigured from places of imagination and hope into to-do lists, into day after day of just getting through it. Often we are able to envision only a long road of exhausting hurdles, that leads to somewhere we are no longer at all certain we even want to go. Instead of having dreams, we merely protect ourselves. We expend our brief and precious life force in the practise of damage control.

... I have come to believe in the possibility, for all of us, of staying in touch with reality, of becoming truly sane. If these people can learn to remain present with the reality of their memories, if they can make a commitment to live their lives consciously and meaningfully, so can we.

For the mental universe of the extrme trauma survivor is so full of violence and violation, demons and unnatural acts, that one wonders--I wonder every day-- how such people find the courage to decide to go on living. It is a place where trusting someone is not an option, and where the genius of one's own imagination becomes an inescapable stalker. In such a landscape, whenever the inhabitant becomes so bone-weary that she lets down her guard a little, another memory cabinet door swings open to reveal precisely the thing that she cannot endure. This thing is different for each person, but always hovers at the outside limit of terror. Letting down her guard is at once what she most achingly desires and what she most vigilantly avoids. It is a universe of fear and exhaustion---especially exhaustion--and people will try almost anything, however irrational, to make it stop.

... My new patient Marcie starved herself to death when she was twenty. She wonders why she did not see bright lights and hear the angels. But more than that, she wonders why the doctors saved her.

"Do you like my new shoes?" she asks me now. "I got them for four dollars and ninety-eight cents in Harvard Square. I haven't had new shoes in three years."

"Why, Marcie?" I ask.

"I don't like to have so many things for myself, you know? Some people can have lots of things, but it just makes me nervous, you know? I don't need too many things for me."

"I'm glad you bought the shoes."

"Do you really like them?"

"They're very pretty, Marcie."

Marcie is my height, five feet five inches tall, but when she first arrived at the hospital in Boston, after her "deaths" in a New York hospital, she weighed sixty-eight pounds, a fetus in fetal position in a psychiatric seclusion room. Today, two years later, she weighs 115 pounds--according to the charts, a reasonable weight. But pale, troubled, looking out from behind her large round glasses, and feeling that she is fifty pounds overweight, she is still more spirit than body.

No more seclusion room now. Marcie takes the Red Line, and the Green Line. To Harvard Square. To Boston, to see me. To see The Tin Drum.

Why why why why? she asks.

Why are people like that? Why do people have to be like that? She asks me, over and over. Why? She asks Gunter Grass.

Why?

Oh yes, survivors' hearts and histories are torn and scarred, in all the ways one would expect, and in a multitude of ways one could never imagine. And by now I could own a macabre collection of potential suicide instruments--nooses, pills, hypodermic needles--given up to me by survivors, often quite ceremoniously, as they begin to recover.

But after recovery, after they have chosen to live, these same people often truly live--passionately, in a way many other people never achieve. Survivors embody extremes of human experience, such that everyday misery is a near-stranger to them. At first, their pain is much worse than our everyday misery, by a factor so large that it would be difficult for most to conceive of it. And then later, after recovery, everyday misery is simply unacceptable. Life must be a passionate, conscious journey, or it is just not worth the survival effort.

In the context of their own personal experience, and their struggle to come to terms with it, survivors inevitably address certain questions. Does anyone ever truly care about anyone else? Is love just a word? On this planet, is it possible to be in control of anything? Is is all right not to be in control? Does human life, in its pain and vulnerability, contain something that makes it worthwhile? And these questions are not addressed philosophically, from the relatively detached stance the rest of us may enjoy at times, but rather from a position of intense and consumingly personal relevancy every day.

... Marcie is from Albany, New York, where the fantastical pink granite State Capitol stands at the head of State Street. In Marcie's house in Albany, she was repeatedly beaten and raped by her crazy father and her crazier brother, until she was old enough to get out.

Marcie's voice is flat when she speaks of Albany.

I have already heard that her father abused both his children, and that her brother, in his turn, abused Marcie. Rape handed down from father to son. I have already heard that Marcie's helplessly depressed mother would rock in her rocking chair for hours at a time, intoning "Oh no, oh no," over and over to no one in particular. On the day Marcie's father finally abandoned the family, that was what her mother was doing. I have heard that Marcie's brother eventually received a diagnosis of schizophrenia, in an Albany hospital I cannot contact because Marcie cannot remember its name.

"I remember once I locked myself in my mother's room and called the police. When the police came, my brother went to the door and told them everything was fine. They went away. I climbed out the window and hid for a long, long time. It was dark when I came back. I knew how mad they'd be."

I look up at the abstract painting that hangs behind Marcie's chair in my office, and in my own mind I repeat Marcie's question--why? And will you decide to stay with us anyway, Marcie? I silently ask her. Will you choose to continue your life, or will you keep trying to end it?

She looks over at me in my chair, and as if reading my mind she asks, "What do people do with all that time? I mean, people other than me. They must do something. All those nights and weekends for years and years. I can't even imagine what I'm going to do with all that time. Don't people get awfully tired after a while? I mean, won't I get awfully tired? And is there something that makes it okay in the end? Is there something that makes it worth it, being so tired, going through all this?"

I don't know, Marcie, I think to myself. One day you will walk in here and you will tell me.

-The Myth Of Sanity,
Divided Consciousness and the Promise of Awareness
by Martha Stout.
First published in the United States of America by Viking Penguin,
a member of Penguin Putnam Inc. 2001.
Published in Penguin Books 2002.