On Farrah and Treatment

I swore when my shoulder cramped, which was interesting, because I’d kind of assumed I was nonverbal at the moment, based on the way my thoughts flowed, or didn’t, and a familiar feeling somewhere in my throat, though I hadn’t tested it. 

I couldn’t blame my shoulder for cramping; my disorientation at speaking came with the realization that I’d been lying on my office floor staring at the very bottom of my bookshelves again. 

Against my back, I felt Farrah, my recurring puppy hallucination, slump, and heard her whimper for attention, wet nose near my neck. The theme of the morning’s tactile hallucinations seemed to be—weight. Farrah’s dense little body in my hands, slumping against my back in the same manner the cats did, cold paws pressing at spots on my lap.  

Just to spite my saying to my therapist yesterday that the tactile and visual hallucinations didn’t line up and Farrah teleported away if I tried to get close, the hallucinations started to line up, and she started wanting to cuddle.  

She’d been clingy all morning, and while she didn’t talk, I felt or knew her thoughts in a way that was hard to explain—the way you knew the facts in dreams that were never presented in a sensory manner. She was disheartened by my therapy video chat yesterday that came to the conclusion—I might need to go back on meds. Probably, in fact. 

I’m not trying to get rid of you, was what I thought at Farrah, because this was stupid. She wasn’t real, and so wasn’t sad that I was trying to stop seeing her—and honestly, she was the least of my issues I was trying to stop seeing. Her behavior was just the manifestation of my own mixed feelings about likely going back on meds. 

My old psychiatrist’s office wasn’t open on weekends, though, and there were no calls to be made just yet. So Farrah—claws pattering on the hardwood and somersaulting clumsily down the stairs and getting stuck in the legs of my desk and trying to eat the real cats’ food—kept me company all morning and into the afternoon.  

I found myself editing a picture I’d found online that kind of looked like her, to get the image closer to right, as if trying to appease her—see, you’re not going away, you can live in a picture, I can still know what you look like, even if it’s in a healthier format. 

I also have developed a bit of an obsession with where Farrah came from. I only have two specific recurring hallucinations currently; one is straight out of a PTSD flashback; I’m very aware of where it came from. The other is Farrah. Any others are not coherent enough to be called recurring. Those little imaginary flashes of light, flips of still objects, white noise I can’t pin down. 

The only real dog I see regularly looks, sounds, feels, and acts nothing like Farrah. I can’t figure out if Farrah is my mental manifestation of dog or puppy or golden retriever or… what word my brain might have decided to attach to, that conjured this particular image. I’m not much of a dog person; that’s why my two real pets are cats. Google told me what Farrah meant—I know no real Farrahs and have no personal associations with the name, its origin in a language I don’t speak. I keep staring her down, thinking: Why are you here? 

I get at most a wag of the tail or a yip back. 

It’s a big question for a little puppy that’s not even real. 

Talking about it in therapy was strangely disheartening to me, too, because those closest to me are very used to the quirks of my physical and mental health, or at least know reacting strongly isn’t going to change it. I forget how concerning certain things sound to the average person, and I’d been out of touch with my therapist for a bit there, when I’d been doing well. 

Also disheartening was the fact that, as my psychosis spikes up again, my therapist, an MFT, is not really qualified to treat it. Therapy is not the front line treatment for schizophrenia as it is—medication is. It’s an issue we’ve discussed before. I used to have a second therapist, the psychologist who initially diagnosed me, who my therapist referred me to shortly after I started seeing her in 2015, but the psychologist sadly passed on less than a year later, and I haven’t had that second person to treat that side of my illness since. 

I can write up new medical files and go back to meditation and read more psychology books and call my psychiatrist and go to my current therapist and do some therapy workbook activities and all, and I have—but having a qualified professional to talk to is a good resource.

But, hard to find. The only name my therapist came up with off the top of her head to bring in didn’t take my insurance. I’ve had many nightmare therapists and I’ve had many who were good people who admitted they were in over their heads. The web told me that my old psychologist, the one who passed four years ago, is currently accepting new patients. 

The only real thing to do is maintain routines and wait, and wonder if it would work if I carried clumsy Farrah down the stairs. 

The Protection of a Facade

There are ups and downs to trying hard to appear normal (whatever that may mean). One downside is that it’s easy to convince even yourself that nothing is wrong, if you look in the mirror and all looks well. Especially if the facade thoroughly convinces others, who voice that very thought. It’s easy to think you’re exaggerating or lying even to yourself, especially when you have a real disorder that skews reality just like that. 

A thing about schizophrenia is that it sets you in the frame of mind of questioning things. Reality gets tricky easily. Maybe one hallucination is obvious, but you know there are others that aren’t. When something is real, and you do think it’s real, but in any way off, you still give it a close examination in skepticism. One thing out of place sets off a spiral of—well, if that’s maybe not real, what else am I missing? Knowing you see things that aren’t there means you question the things that are—always.

I’ve speculated that the reason I have so many lucid dreams compared to many people I know is because the key to lucid dreaming, according to most how tos, is reality checking. Looking for something out of place enough you realize you’re in a dream, and that you can control dreams. You have to set that habit in the waking hours for it to occur to you in a dream, though. And I’m used to doing that in my life so much that it slips into my dreams.

The same goes for mental constructs. You know that you get on the wrong thought trains, delusions, and if you’re thinking about having schizophrenia itself, you question that thought train, too, especially when the evidence you’re more sure of looks so… normal.

On the upside, it means that unless I’m having a really bad day, when I want to play it down, I can, and when I want to not talk about it, I don’t have to. I’m very open about my schizophrenia and pretty much everything else in my life, very out about all of my identities, but I also feel lucky to frequently be able to pass as neurotypical, because the stigma around psychosis and mental illness is very real.

Sometimes I want people to look at me and wonder, but not pin me down as psychotic immediately. To be somewhere on the spectrum where I am validated in my illness, but not obvious and discriminated against or worried about. Sometimes I want people to be able to look at me and maybe see the psychosis—but see the rest of me, too. And being known as having a psychotic disorder frequently overshadows everything else.

This does mean a bit of an obsession with maintaining those appearances, in various forms. Physical presentation standards—and the ability to keep that up even when there are hard days. I wear only one outfit, the same thing every day, carefully chosen. When I fear I’m slipping mentally, I develop another cycle of particular obsession with making sure my clothes are clean, in good repair, sized appropriately, not too eye catching. The same ideas extend to all parts of my appearance, to my online presence, and to my small mannerisms. And I’m not always able to keep the appearance up—though I’ve improved with time.

Recently, before a video chat with my therapist, I asked my fiancee to help me trim my bangs so I could actually see my therapist and not the backside of my own hair, and an observing friend said something like, “So, ‘I had a psychotic break, but not so much I couldn’t get my bangs trimmed.’”

And on the one hand, I wanted to be able to see, and on the other hand… well, yes.

In some ways, I talk about my mental illnesses very openly. There are few cases where I won’t mention the diagnosis itself. There are a lot more cases where I play down how troubling it is, or laugh it off. Most of my friends know I hallucinate, but they hear about the flashes of light and the white noise and the echoes and the objects that get flipped in my vision, and less about the corpses and voices. More still hearing random things while wearing noise cancelling headphones, and less sleeping on the couch because beds are a trigger. 

It’s been a hell of a year (tomorrow) since the PTSD began and brought a fresh wave of psychosis with it. It had been fairly easy for quite a while, before, to live with and ignore the odd white noise or flash of light, and easy to sink into the comfort of maladaptive style daydreaming. After, there were the night terrors that we mistook as seizures, the waking hours’ blurred line between flashback and hallucination that eventually leant far towards the latter. 

Those are the pieces I try to keep to discussing only within the right context for it, and those are the pieces I can tuck away when I’m able to look normal.

If I didn’t keep up those appearances—the question of the full extent of illness would come up a lot more, whether I wanted it to or not—something that’s hard, mixed with my own trauma, and external stigma and worry—more for the psychosis than for any other condition I have.

So I understand the idea of the facade protecting you.

It’s a little wall between you and the possibility of never being able to have a (seemingly) normal moment.