The Collected Schizophrenias

Delusions are false beliefs that a person may become completely convinced in. Delusions can be positive or negative, and common ones include the belief that one is being controlled by some outside force; the belief that one is extremely important, a reincarnated historical figure, or a prophet; and the belief that one is receiving messages from some authority such as the government or aliens. This is not an exclusive list, and delusions may be as simple as believing one’s spouse is angry when they are not or believing one can read a language they cannot.

In her essays, Wang describes her experiences with delusions as a result of her schizoaffective disorder. Significant examples include the months in which Wang experienced Cotard’s delusion (the belief that she was already dead), her belief that she could unlock the rest of her mind like in the film Lucy, and her belief as a child that she was a character in a storybook. While these delusions can be relatively harmless, Wang’s experiences, particularly with Cotard’s delusion, indicate that there is a unique terror in believing something unreal and finding it impossible to convince oneself otherwise.

Hallucinations are sensory experiences that are not initiated by the exterior world but instead created within one’s own mind. Hallucinations may be visual, auditory, olfactory, gustatory (taste), or related to physical sensations such as pain, crawling skin, or being touched. Hallucinations can be terrifying for the person experiencing them, as they may sense things that they view as threats to their safety. Furthermore, a person is often logically aware that the hallucination is nonsensical, but because they are experiencing it anyway, the cognitive dissonance becomes severe and distressing.

During the height of her schizoaffective disorder, Wang experienced alarming hallucinations such as seeing corpses, not recognizing her or others’ faces, and feeling as if her mind was being eaten by spiders. Wang’s hallucinations often included the embodied image of her high school boyfriend, John, who physically and emotionally abused her, and this would trigger her PTSD. Wang’s hallucinations have not occurred for several years, but she is still on the road to recovery.

NAMI is an American organization started in 1979 by a group of families affected by mental illness. The organization aims to alleviate the quality-of-life issues that people with mental disorders and their families experience, reduce societal stigma, and create programs and support. The organization also focuses on family education and family support.

Criticisms of NAMI exist both within Wang’s essay collection and from other sources. While NAMI’s overall purpose seems to be positive, they have been accused of spreading misinformation, perpetuating prejudice against certain mental disorders (especially substance use disorders), and ignoring people with mental illness in favor of their family and friends’ experiences. In “Toward a Pathology of the Possessed,” Wang openly criticizes NAMI for ironically adding to the stigma around mental disorders by pinpointing people with these disorders as burdens and sources of suffering that their families must endure. When Wang spoke to a NAMI member, she found that the woman seemed more concerned about her own experience than that of her affected family member.

NIMH is an American institution that was founded in 1949 and researches mental disorders and other psychological phenomena. NIMH’s overarching goals are to improve scientific knowledge of psychological phenomena to raise the quality of life, improve treatment efficacy, and prevent the development of mental disorders. Through scientific research in all fields of psychology, ranging from neuroscience, behavioral psychology, and social psychology, NIMH makes significant contributions to accumulating knowledge every year.

In her essays, Wang does not criticize NIMH in the same ways she criticizes NAMI, though she does mention how popular culture tends to vilify the organization. Instead, she cites NIMH when providing statistics on schizophrenia. She also discusses NIMH’s initiative to change how mental disorders are diagnosed and reframe treatment to focus on symptoms rather than an overarching label that may not be fully accurate. They aim to do this through a stronger emphasis on neuroscience and biomedical science to uncover the underlying causes of mental disorders.

PTSD is a disorder that can develop after a person experiences a traumatic event such as a near-death experience, witnessing death or war, or living in a constantly unpredictable environment. When a person experiences fear of danger, the body becomes autonomically aroused, raising the heart rate, causing sweating and shaking, or causing the person to freeze up or faint. These symptoms are normal fear responses, but when they occur long after the event is over, this is referred to as PTSD. PTSD can be accompanied by nightmares, waking flashbacks, difficulties with daily functioning and relationships, and fear of the outside world.

Wang was physically, emotionally, and sexually abused by a boyfriend in high school, and as a result of this experience, she was diagnosed with PTSD. During the height of her schizoaffective disorder, she began hallucinating her ex-boyfriend in public places, causing immense anxiety. In this way, Wang’s experience illustrates how PTSD often compounds and goes alongside other disorders.

Schizoaffective disorder is a mental disorder characterized by severe and unpredictable shifts in mood and symptoms of schizophrenia such as hallucinations, delusions, and negative or blank affect. For these reasons, schizoaffective disorder is, in many ways, a combination of bipolar disorder and schizophrenia. Schizoaffective disorder is rarer than either aforementioned disorder and is often confused for bipolar disorder during diagnosis, resulting in incorrect and ineffective treatments. This is what Wang experienced during the early years of her psychosis and mood symptoms.

Schizoaffective disorder is usually treated with a combination of second-generation antipsychotic medications and talk therapy, both of which Wang uses. In her essays, Wang details her experiences with schizoaffective disorder during the height of its severity, including hallucinations, delusions, mania, and depression. She also describes the secondary effects of having the disorder, such as being discharged from Yale University and being involuntarily hospitalized thrice, leading to further trauma and pain. Wang’s schizoaffective disorder ruled many years of her life, as she spent several months believing in delusions such as being dead, hallucinations, and going through various treatments to find ones that worked. Although Wang has not experienced hallucinations or delusions for several years, she asserts that her disorder is a part of her and that she still battles the possibility of psychosis every day.