My brother cut his wrists last night. When I came home, it was already done. The ambulance came and drove him to the hospital. I followed. I went by myself; I told mom to stay home, because she would have been emotional and crying, and I needed for that not to happen. At the hospital, while waiting to be transferred to the psych unit, my brother told me stories from his delusions. They are nothing new. It is almost as if he was reciting an old poem. He blames us, his siblings, for not being there for him in high school. High school was when his symptoms started. He was always socially awkward to begin with, but in high school, this got worse, and his behaviors got him transferred to an alternative school. He recounted everything that has happened since then, the many times he was disappointed and felt heart broken when attempts at love and friendships failed.
He used to volunteer with this group in town. It started well, but then it got bad and his interactions dwindled. He would say things that made people cringe, say what others would keep to themselves, so they started to keep distance. I don't know if he could, can, help himself, but saying things that people don't want to hear, inappropriate observations, unsolicited opinions, make them avoid him. He does not acknowledge that this is a problem. He sees this failure to establish connections with other people as a conspiracy on the part of the "collective" to oppress him.
About a year ago he went on a dating website and found the profile of a girl. He sent her emails, short ones, to say hi, I'd like to get to know you and such. He did this everyday, for 3 straight months. Needless to say, she did not reply. Until finally she sent him an email, telling him not to ever contact her again.
Before, with previous breakdowns and relapse, I would be like mom, emotional and upset, frustrated and depressed because we could not help him, and we would feel guilty because maybe he was right, maybe if we had been there, taken him along when we went out with friends, maybe he would not have felt so lonely, his spirit would not have hurt so much, and he would have been better today. But this time, it was different. This time, something in me had changed.
For once, I do not blame myself for his illness. I did not cause it or contribute to its exacerbation. My interactions with him are not ideal, sometimes not helpful to him, true. I have my own issues to work through, also true. But daily interactions are daily interactions. For people who are mentally healthy, or at least not mentally ill, these moments of frictions are perceived with perspective and received as part of normal daily life. They are not reflective of one's self worth or values. But for my brother, this is very difficult to achieve. I believe it is a constant battle for him, to deflect these words and actions that are perceived as purposefully hurtful. At times when he is vulnerable, when he experiences relapse, he loses this battle, and it becomes a full blown episode.
I do not feel frustrated in my attempt to understand him. I feel calm. I think I am beginning to have a hazy understanding of the progression of his illness. What I'm trying to figure out is the event that caused this cascade. What happened that knocked him off balance? What was the blow to his already damaged ego that caused him to break down and relapse? Or was it a gradual accumulation of disappointments, rejections, cold stares, and silences?
This is what I see emerging over and over again in my conversations with him:
He is lonely. He seeks connections with other people. He needs and seeks positive affirmations, praises, assurances, not just in words but also in socially significant results such as money, job, friends, etc.
He sees setbacks (acquaintances who begin to ignore him, being fired from a job, his stocks losing in value, criticism or harsh words from family, as well as when people don't reply instantly to his email) as coordinated efforts to keep him from achieving his potential. And his battered ego has constructed massive, grandiose possibilities for this potential--he aspires to be god, he aspires to instant wealth and fame.
It has also become ok for me to withdraw myself from his illness. I used to take it in, bit by bit, let it torment me as it torments him, as if doing so would help me understand. I used to think that if I wanted to understand him, I had to take on his broken self and battered ego. But now, I don't. Now, I realize that I have to be my own healthy self first. I cannot be hurting if I want to help. The idea of the wounded healer depends on one crucial element: that you must have healed your own wounds before you can help others heal theirs. Now I can say without feeling guilty that I must save myself first. Save myself. If I can say, I owe no one except myself, then I think I can begin to walk a more balanced line. I can take deeper breaths and look at everything with clearer eyes and a calmer mind.