ROUND ROBIN

by Sally Clay

 

The following fragments reconstruct events in my life during the years 1967-1971. I have pieced together excerpts from my own round robin letters and clinical records from the Institute of Living. At the end of this period I submitted to 30 shock treatments.

 

Sudbury, Mass., August 1967

Dear Friends and Relations,

I realized just the other day that Meg is no long a baby. She has grown it seems inches since we moved, and is beginning to say a number of real words, so that her gibberish seems to be turning into sentences. She is currently absorbed in digging a lovely hole (the dirt from which is being deposited on her face, arms, legs, and clean clothes). She loves to go on "nature walks" through our woods, helping me pick blueberries and swinging on the baby swing which we discovered back where the fort is. I wish I could find my camera (it must be in one of the unpacked boxes)-the woods are so lovely in the early evening with the setting sun sending splinters of gold through the trees. If the rays by chance fall on Meg at this time of the day, they make a bright frame of her hair around her face. I must get a picture of it.

We have also done some "adventuring" around the surrounding country. Bill and John are planning to climb Mt. Washington--an overnight trip--later this month, and I am hoping to go with them if I can. Also, a couple of weeks ago we rented a canoe and spent a few hours paddling up the beautiful Concord River to Old North Bridge, where the Minute Man statue is. Perhaps by next year, when Meg is a little older, we will be able to do that sort of thing a little more extensively.

Meg is now wandering off into the Unknown--she has a tendency to do that, unfortunately. So I must give chase.

Spring 1968
The children are both fine. John is doing very well in school now and is also back to his joyous Frog Days. At one point last week we were the proud possessors of something like 500 polliwogs--all of whom expired, despite (or possibly because of) generous meals of goldfish and turtle food (dried flies). John is now an enthusiastic member of Little League and next fall will be joining Cub Scouts (with guess who as the reluctant Den Mother).

Meg, as we all anticipated, now wakes up talking and doesn't stop until bedtime. She even tells jokes now: "Knock, knock," she says. "Who's there?" I reply about twenty times daily.

"Knock knees," she says, laughing with delight, or for variation, "Knock me!" Where she got all this I don't know. She can also cross her eyes--that she got from her brother! I am constantly amazed at her sociableness-she now knows the names of all the children on the street and loves to play with not only the children her own age but also the "guys"--when they will have her! She loves nothing better than to have a baby-sitter Saturday nights. When it comes to hiking, she is a real trouper-she huffs and puffs cheerfully up hills and takes delight in just marching along with the rest of us. Like most two-year-olds, her favorite word is "no," but for her the word is actually an affirmative. Ask her if she wants a lollipop and she will jump up and down screeching, "No! No! No!"

Note to my mother:
We had a lovely weekend on the Cape, aside from a bad scene when Meg, who was supposed to be sleeping, appeared at the door to the porch almost literally covered with blood. She had climbed out of the small crib, gotten into my razor, and tried to shave as she had been watching her father do. She cut herself just below the lip (not too badly as it turned out), and instead of crying got the box of Band-Aids out of my suitcase and tried to repair the damage herself! When she finally came to the door, she still did not cry-just looked slightly baffled.

Autumn 1968
Dear Friends and Relations:

This will be a short letter just to fill you in on the "developments" this past summer--mainly the fact that I spent August and the greater part of September hospitalized with what is known as a "nervous breakdown."

As you may or may not know, I was hospitalized eight years or so ago for the same reason. The nature of a nervous breakdown is hard to describe even for me, and I know that most people are confused and even embarrassed at the thought of such an illness.

Suffice to say that personal pressures and the pressures of modern living combined to knock me psychologically out of commission. As a matter of fact, I'm still not in full "working order," although I am home and will, I hope, gradually get things straightened out.

June 1969
John's latest acquisitions are one chameleon named Liz (for lizard) and one garter snake. Liz isn't so bad, it's just what she eats. Her dinners consist of mealworms, which cost twice as much as the chameleon herself and which must be kept in a jar in the refrigerator else they turn into beetles. I have visions of mealworms crawling in and out of leftover mashed potatoes. In a moment of weakness I told John he could keep his snake in his room, provided he kept it tightly enclosed in its terrarium. Well, yesterday the inevitable happened and the snake escaped. We searched high and low for over an hour with no luck-and the vision of a snake crawling into my bed that night grew stronger and stronger. Finally, however, I found it. It was slithering around in my sewing bag.

Meg has turned into a real little girl--she much prefers wearing dresses and "buckle shoes" to wearing slacks, and she constantly carries her purse around with her. She loves to cook play meals and to "help" with the housework.

Autumn 1969
On Saturday, July 26, with much trepidation and despite second thoughts, we set out on our month-long cross-country expedition. On Monday we arrived in Chicago, where we stopped briefly to call some of our friends in Arlington Heights. On Tuesday morning at Wisconsin Dells we allowed ourselves to be herded onto a large sightseeing boat. The Dells are some unusual formations made by water in the sandstone along the sides of the river. Had it not been for the traffic congestion, mostly sightseeing boats, the Dells would have been quite interesting. It was disconcerting, however, to have the natural beauty distorted by our young guide, who recited names to all the formations, such as "Milk Bottle Containing a Cow," and sold autographed pictures of himself. Another feature, at two tall pillars of sandstone, was an unfortunate dog who, every ten or fifteen minutes, had to jump the five feet between the two formations. As we departed, Bill labeled the whole enterprise "plastic," meaning commercialized and artificial.

Thursday we visited with my cousin Susan in Minneapolis, and on Friday afternoon after six days of driving, we at last got our first glimpse of the mountains and soon arrived in Estes Park. It was for me an exhilarating feeling to be back in the area where I had spent two summers at camp and one at college. I had fallen in love with the Rockies thirteen years ago--but until this trip I had brushed aside this feeling as merely "youthful fancy." Not so. The feeling hit me again like a ton of bricks as soon as we reached the 7522 foot level of Estes Park and could see the enormous mountains all around us. There are for me no words to describe their majesty, and no picture of them can convey their presence. To live in their shadow is like existing in a completely different world.

We took a good five-mile hike up and around some glacial knobs to Loch Vale, a clear mountain lake right at the foot of three or four mountains and several glaciers. It is the most beautiful place I have even been, and I could spend days just sitting by the side of that lake. On this hike also we enjoyed drinking the icy water from mountain streams--this water is the most delicious drink in the world. We all spent a morning at Trail's End, my old camp, which John may attend next summer.

Early Sunday morning, Bill flew home from Denver, and the rest of set off for Ozark country to visit my Uncle Bro and Marian in Cherokee Village, Arkansas. The last Cherokees who were there passed by decades ago on the nearby Trail of Tears. Everyone there now seems to come from Iowa, Illinois, and Ohio. One night we feasted on a huge catfish (it must have been at least three feet long) that had been caught in a lake nearby.

On Thursday, August 14, we pushed on for a leisurely drive to Kentucky. Later that afternoon we took the Bluegrass Parkway over the gentle rolling countryside filled with tobacco fields and cornfields, arriving in my hometown of Mt. Sterling, Kentucky, to visit my father and stepmother.

The next week we visited in Cincinnati with my Aunt Faye and cousins Mark and Paul, and finally set off on our last leg home.

There really is something about driving long distances on the open road that, to my mind, beats plane travel. In a plane you travel hundreds of miles within just a few hours--you really know only where you were and where you are now. Driving, you know not only where you were and where you now are, but also all the other places in between. It somehow keeps things in perspective.

We have been home over a month now, but I must confess that I am still not able to get back into the old routine of drudgery. I find myself stopping in the middle of my morning chores and just reflecting wistfully about how nice it would be to have a drink of clear mountain water or to just commune with Nature beside that exquisite lake.

January 1969
Letter from my mother to my father:

I'm sorry to bother you, but I suppose you know by now that Sally is back at Valleyhead.

Do you realize that for the past weeks Bill C has been indulging in a form of mental bludgeoning which I have seen and heard him use before, so I know what I am saying. This takes the form of loud and peevish haranguing and violent yelling, and of keeping the household in a terrible uproar. It is continuous and unrelenting and it goes on for hours. Are you aware that this was brought on because Sally decided to put the money you send her into her own account rather than a joint account?

Bill has always spoken of his house and his money, whereas Sally had always said "ours." Sally has been so loyal to Bill that she says even now, and has said for a long time, that it must be understood that Bill "isn't the way he acts." Well, the bulk of humanity, I'm sure, would be delighted to be excused for heinous behavior on such grounds.

I feel like a voice crying in the wilderness. No one will believe me or take seriously the fact that Sally has been living in a really terrible situation for a long time; mainly, I suppose, because of the fact that she will not, or has not until now, even admitted that this has been going on. Because of what happened during her childhood Sally is so passionately determined to have a real home that she is apparently willing to sacrifice her very life rather than jeopardize her home.

Bill, can't you do something to help our poor little girl? And those children. Oh, please. I have great confidence in your ability to handle such things.

My God, I've just called Sally and found that she is locked in the dormitory and has been in solitary confinement.

Institute of Living, Clinical Notes, March 5, 1970 - Mrs. C is referred to the Institute of Living for long term treatment of recurring psychotic illness, manifested by thought disorder, mood disorder, and paranoid ideation. After discharge from Valleyhead Hospital in April 1969, she was seen to remain fairly well until Christmas, when, in apparent reaction to a disagreement with her husband, and in concern over financial problems, she developed grandiose beliefs, and was hospitalized on January 10th.

Her illness has failed to yield to psychotherapy or multiple medication approaches. It is tentatively suggested that a significant, but sometimes subtle family psychopathology is deterring effective treatment.

March 19, 1970 - Evaluation: The patient looks rather older than 28, is very slightly obese, and rather elated. Associations are loosened and affect is occasionally inappropriate. There is a tendency towards paranoid misinterpretation without any clear evidence of delusional thinking. There are no grossly evident disorders of perception. Predominant affects include anger, anxiety, and elation, all subject to rapid shifts. There is no evidence of impairment of orientation or of memory.

The patient had had a disturbing call from her husband, during which he had reportedly indicated to her "I can tell you are going to get very sick."

Diagnosis: Schizophrenia, chronic undifferentiated type.

Treatment Plans: It is being recommended that Mrs. C remain here for a period of 6 to 12 months. Of great importance will be her family's involvement in Social Service work. Medications will necessarily play a role in the patient's treatment, but can hopefully be reduced somewhat to the status of a side issue, since the patient has come to view them as so important that even a minor dosage modification makes her very fearful indeed. Given further decompensation it is conceivable that a course of electro-shock treatments might have to be recommended.

July 23, 1970 - The second 4-way session tended to focus upon the marital relationship and was by and large poorly taken by Mr. C, who became extremely defensive, feeling especially focused upon. He had a very low tolerance for his wife's anger towards him, and more or less implied that it was "sick." Being very suggestible, Mrs. C tends to take this quite literally, believes she is sick, and acts "sick."

September 23, 1970 - At this time Mrs. C does not exhibit gross depressive stigmata. There is no convincing evidence of a depressive illness in the patient at this time, but there is the impression of a lack of predictability, in that her responses to slight reverses can be exaggerated. That is to say, without feeling depressed or moving to an actual depression, the patient seems very vulnerable to being "put down" in a one to one or group situation. Her own feelings of personal inadequacy and personal unattractiveness persist, and are undoubtedly directly related to this vulnerability. When she feels "put down" she generally does not verbalize her feelings and, unfortunately, does not really strive to even recognize what is going on. She tends to lapse into an apathetic, somewhat fatalistic, and very passive position.

Mrs. C has tended to look towards her husband to supply initiative on visits. She has attacked him, in a hostile way, apparently without realizing so, for being, as she saw it, passive and uninterested in interpersonal relating. She has, when pressed for details of his behavior towards her, related that he has said to her on several occasions, "I can seeI can understand how you might want to kill yourself. I can understand that things look bad. I can see how you would come to consider suicide as a solutionThings would be easier for me in some ways if you were dead" In talking with Mrs. C about this kind of communication from her husband to her, it is clear that she is only somewhat dimly aware, consciously, of what I would see as the immense hostility involved. She does, however, feel "put down" in a passive, rather unthinking way. Such a state of mind, it seems, takes relatively little to shift it to a fairly actively suicidal frame of mind. This, among other things, would be likely because of the poverty of interpersonal relationships in Mrs. C's life, and the highly dependent nature of the very few relationships she sees herself as possessing.

Mrs. Hewitt, who has been seeing Mr. C, has, like me, seemed much impressed by his lack of awareness of his own reactions to his wife, especially his hostile ones. She has discussed with Mr. C the possible reasons for this, and he has confessed to her feelings of inner emptiness, lack of meaning.

At this time I find myself rather in doubt about the long range benefits of electro-shock treatments. It seems to me that she would still run, in a relatively short time, into the same interpersonal problems in her marriage and, obviously, into the same sense of vulnerability in herself.

October 23, 1970 - In recent weeks both Mrs. C and her husband began to ask me about a course of electro-shock treatments. The patient put this request in the framework of her being convinced that she could not get better, ever, through any psychotherapeutic endeavor. Her husband had wanted a course of electroconvulsive treatment because of his financial concerns and impatience to see his wife get out of hospital. Electroconvulsive treatments will probably begin early in November.

November 18, 1970 - Mrs. C has to date received seven electro-shock treatments. As she displays less evidence of subjective sadness, objective depression, she manifests more evidence of boredom and emptiness.

November 25, 1970 - My sessions with Mrs. C are shorter just now, due to a gross poverty of therapy material. I see her on days that she has not received an electro-shock treatment. She feels empty, and her affect looks rather bland. Depressive stigmata per se are less in evidence.

December 2, 1970 - Mrs. C is continuing to receive electroconvulsive treatments. She continues to appear quite flat in her affect, and there is very little spontaneity in therapy sessions. I feel, at times, when I am with her, that I am witnessing the very undisguised schizophrenic core of her illness. In terms of affect, there is only the flatness. There is neither elation nor depression. I feel inclined to continue the program of electro-shock treatments.

December 9, 1970 - Mrs. C has now received fifteen electro-shock treatments. She is neither elated nor depressed, displaying continuing flatness of affective response. In my individual meetings with her, two or three times weekly, she is showing hardly any spontaneity. She asks questions about the course of shock treatments but in a rather automatic way. There is no evidence of any interest in anything. I am not optimistic at all about the long term outcome for Mrs. C. I have communicated my reservations about this to her husband, this coming as no surprise to him. Although Mrs. C is not clinically depressed at this time, the almost terrifying emptiness within her is such that I can visualize her, under even moderate stress, moving rapidly to a conclusion that she should end her life.

January 13, 1971 - Mrs. C is experiencing considerable disorientation and memory impairment associated with electroconvulsive therapy.

January 20, 1971 - Mrs. C has completed her course of electro-shock treatments, having received, in all, thirty treatments. She is still disoriented for time and for place. She has obvious impairment of memory for recent events and intermediate events. She claims impairment of remote memory, back to the teenage years. This I find somewhat unusual, and I have been questioning her much more closely on this phenomenon. It seems that it is a "patchy" phenomenon, within which she remembers some events quite well but cannot remember when she last saw her father, or her mother, or how she met her husband.

I eventually recovered memory of events in my life up until 1967. But, starting in 1967, my memory remains patchy, and the two years immediately prior to the shock treatments are permanently lost. Perhaps it is just as well that I don't remember the misery that I lived with in my marriage. But lost along with this are the years when my daughter Meg was an exuberant three and four years old, and when I was a dedicated mother to my stepson John. Lost are the happy hours that I spent on the trip we all took across the country to Colorado and to the clear water of Loch Vale.

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