Falling Into the Fire: A Psychiatrist's Encounters With the Mind in Crisis by Christine Montross

Author:Christine Montross [Montross, Christine]
Language: eng
Format: epub
Tags: Biography & Autobiography, Diagnosis, Medical, Mental Illness, Non-Fiction, Psychology, Psychopathology
ISBN: 1594203938
Google: I_bsRceArwMC
Amazon: B00AFPVT50
Publisher: Penguin Books
Published: 2013-07-31T23:00:00+00:00

(CHAPTER FOUR)

I’ve Hidden All the Knives

I will not let them live for strangers to ill-use,

To die by other hands more merciless than mine.

No; I who gave them life will give them death.

Oh, now no cowardice, no thought how young they are,

How dear they are, how when they first were born—

Not that—I will forget they are my sons

One moment, one short moment—then forever sorrow.

—Euripides, Medea

I’ve hidden all the knives,” Anna said quietly. She and I had just sat down together in a small interview room on the inpatient psychiatric unit, where Anna had been admitted the night before. I hadn’t even had the chance to ask my standard opening question about how it was that she had come to be hospitalized. She looked into her lap as she spoke, and she looked miserable. “My son is fifteen months old,” she began. “And lately we’ll be in the living room and he’ll be watching cartoons and I’ll see myself . . .” Her voice grew fainter, then trailed off. I urged her to go on.

“See yourself what?” I asked gently. She glanced up at me, and I could see that her eyes had reddened and filled with tears. Her right thumbnail was digging deeply into her left index finger’s nail bed. There was a small, bright spot of blood. She took a deep breath and looked straight into my eyes.

“Drowning him. Or taking a knife,” she said, still quiet but now firm. “Slitting his throat.” Her gaze stayed on me. My stomach turned; I hoped my face did not betray the way I felt.

Over the years of my training, I have learned the potency of the first words I say to patients after they tell me their central concern. Even the most psychotic patients can retain the human capacity for gauging their listener’s response. Often it’s a test. A delusional patient may tentatively reveal that the same black van has been behind him in different cities, morning and night, to see whether his fears are dismissed or taken seriously. A pedophile may explicitly describe his fantasies to see how easily you can be shocked, or scared away and led off course. Regardless of the literal content that is disclosed, it seems to me that in such situations the real question these patients are asking is almost always the same: How well can you tolerate my suffering? How well can you sit with the pain?

Nothing about Anna made me feel as if she were trying to shock me. In fact, to the contrary, she seemed as if she had summoned up enough courage to tell me the truth and now was terrified about what I might think of her and of the horrific vision she had conjured. I imagined that if Anna were to tell her family members about these thoughts, they would immediately and appropriately shift their concern to the child. My own thoughts reflexively ran toward him, too. However, it was my job as Anna’s psychiatrist to focus on how these visions were affecting her.

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