In the literature of mental illness, this is a contentious idea. As Wang points out, psychiatry has a term — “lack of insight” — for the presumption that many people with psychotic disorders will not have the self-awareness to know that they’re sick or reliably convey what’s going on in their heads. During an involuntary psychiatric stay, Wang found that insisting she was “doing okay” seemed to lower the staff’s estimation of her sanity, possibly prolonging her imprisonment on the ward. (Of course, saying the opposite would have had the same result.)
In this collection, Wang demonstrates insight in both senses. Her elegant essays are strongest at their most personal — when she writes, with clinical precision, about what it feels like to believe that she’s dead, or to slip the boundary between our world and a sci-fi movie on TV — but they also confront major questions about psychiatric care with meticulous even-handedness. Wang, who once hallucinated that she was trapped in perdition, is an implicitly trustworthy guide to this netherworld of psychosis and chronic illness. “Having found myself in that crumbling landscape again and again,” she writes, “I now know the signposts. . . . I can describe the terrain.”
As she explains in an essay called “Yale Will Not Save You,” Wang is no stranger to either success or calamity. She was diagnosed with bipolar disorder the summer she finished high school, shortly after being accepted to Yale; because of a forced psychiatric leave, she graduated from Stanford instead. After a months-long experience of psychosis in 2013, her diagnosis changed to schizoaffective disorder, then years later expanded to include late-stage Lyme disease and post-traumatic stress disorder. Meanwhile, she sold a debut novel, “The Border of Paradise” (2016); appeared on Granta’s list of the “Best of Young American Novelists of 2017”; and won the Graywolf Press Nonfiction Prize and a Whiting Award for this collection.
Wang is a sharp critic of the ways we use badges and prizes to decide who is trusted to tell their own story. “ ‘I went to Yale’ is shorthand for I have schizoaffective disorder, but I’m not worthless,” she writes. In another essay, “High-Functioning,” she interprets “other signifiers”: “my wedding ring, a referent to the sixteen-year relationship I’ve managed to keep”; a makeup routine that is “minimal and consistent. I can dress and daub when psychotic and when not psychotic. . . . If I’m depressed, I skip everything but the lipstick.” These are survival skills, but also, she suggests, concessions to a noxious respectability politics, meant to distinguish her from others who share her diagnosis. She is hired to tell her story to patients at a clinic but flinches when one of them identifies too strongly. “I was the one at the head of the table, visiting,” she writes, subtly implicating the reader who has made the same calculation. “She was the one who had come to this clinic every week for the last decade. Not much was changing for her — but everything, I had to believe, was possible for me.”
Wang speaks at clinics like that one on behalf of the Mental Health Association of San Francisco, a social justice organization that opposes certain medical orthodoxies, including involuntary treatment. She has also worked on the other side of the aisle, as a lab manager in the psychology department at Stanford, and she examines the field’s thorniest questions from all angles. At MHASF, she was taught to use “person-first language” — as in “I am a person with schizoaffective disorder” — which “suggests that there is a person in there somewhere without the delusions and the rambling and the catatonia,” she writes. But in her own life, she uses the term “schizophrenic,” reflecting the fact that she sees illness as an irreducible part of her identity: “There may be no impeccable self to reach, and if I continue to struggle toward one, I might go mad in the pursuit.”
Wang’s forays beyond the personal occasionally left me unsatisfied. At times, her cultural criticism — for example, an essay about the Slender Man, an urban legend that inspired two girls’ attempted murder of a third in 2014 — feels underdeveloped, like anecdotes still searching for something to say. In her writings about fraught questions in psychiatric care, I sometimes wished she would lay out both sides of the argument, as when she writes that involuntary commitment “may sometimes be warranted” but “has never felt useful to me” — two statements separated by a gap she doesn’t plumb, which left me feeling shut out of an important conversation she was having with herself. Still, her characteristic nuance more often carries the ring of wisdom, hard won.
Ultimately, there are no simple answers for how to, in Wang’s words, “live with a slippery mind.” But there is surely some power in serving as your own best witness, as she does in these essays. It’s a theme that feels especially current, since so much of public discourse amounts to deciding whose truth deserves to be believed. As a person sometimes abandoned by reality, Wang has always been vulnerable to having her truth discounted, even when she knows exactly what she’s talking about. Maybe that’s why she brought her laptop into the closet in Reno. As she writes, “Perhaps I was attempting to provide evidence for my side of the story.”
The Collected Schizophrenias
By Esmé Weijun Wang
202 pp. $16 paperback