The point is that I am in here, somewhere: cogito ergo sum.
September 16, 2014 2:23 AM   Subscribe

"Let’s note that I write this while experiencing psychosis, and that much of this has been written during a strain of psychosis known as Cotard’s delusion, in which the patient believes that she is dead. What the writer’s confused state means to either of us is not beside the point, because it is the point. The point is that I am in here, somewhere: cogito ergo sum." (via)
posted by hat_eater (20 comments total) 55 users marked this as a favorite
Extraordinary. (I can see how watching Dr Who while in a fragile state like this might not have been the best idea.)
posted by Segundus at 3:17 AM on September 16, 2014

Thank you, this is one of the most fascinating things I've ever read on MetaFilter.
posted by jaduncan at 4:08 AM on September 16, 2014 [1 favorite]

Other questions: if I am psychotic 98% of the time, who am I? If I believe that I don’t exist, or that I am dead, does that not impact who I am? Who is this alleged “person” that is a “person living with psychosis,” once the psychosis has set in to the point that there is nothing on the table save acceptance?

When the self has been swallowed by illness, isn’t it cruelty to insist on a self that is not illness? Is this why so many people insist on believing in a soul?

I have experience being in a relationship with a mentally disordered person, and the question of the identity of that person including or not including the person they were caused to be by symptoms was hard for both of us. This was especially so when the symptoms were caused by a personality disorder (BPD) and when being given information that "recovery" could only ever be management in this particular case. It was almost impossible to deal with, especially given that it was impossible to know when the symptoms were in operation and when not. Is it the person who loves intensely, or the person who attacks to release their own stress?

I came to the conclusion that it tended to be labeling good times as the actual person and bad times as symptoms to protect the self-image of the person concerned. I'm still unsure how a stable identity can be formed when the person's understanding of the world is so much in flux from day to day and moment to moment.

I sympathise profoundly with people feeling that issue within themselves; even looking from the outside in it seemed an impossible thing to deal with. Regardless of the fact that the actual resulting behaviour was extremely abusive, I felt a lot of sympathy for the profound internal crisis that generated it. Indeed, I still still find myself unable to say that person was morally culpable even for things we could both rationally state were abuse. I'm still not sure how to know who that person actually is, and I'm sure that person doesn't know either. It's tragic.
posted by jaduncan at 4:25 AM on September 16, 2014 [26 favorites]

Hugs jaduncan.

What a brilliant article
posted by Annika Cicada at 4:41 AM on September 16, 2014

Incandescent. Thanks for posting this. (Also: more hugs to jaduncan.)
posted by GrammarMoses at 5:25 AM on September 16, 2014

jaduncan: I came to the conclusion that it tended to be labeling good times as the actual person and bad times as symptoms to protect the self-image of the person concerned.

I was also in a relationship with a person with BPD, and this asymmetric labeling led to a dependence on prescription amphetamines for a couple of years. The amphetamines led to good feelings, so that must mean they're a cure, right?

As you can probably imagine, the crash, when it came, was doubly spectacular and heartbreaking. I was outside the blast radius by that time, but I felt the reverberations.
posted by clawsoon at 6:12 AM on September 16, 2014 [2 favorites]

Some of my greatest personal philosophy work came at a time when I was most depressed. I wonder how much of philosophy in general that can be said about. There's something about this mode of life that really brings the philosophical questions - who am I, what is this even - to the forefront.
posted by rebent at 6:27 AM on September 16, 2014 [4 favorites]

Unstable self-image is one of the diagnostic criteria for BPD, which makes the questions asked in this piece even more difficult.

Who am I, indeed. :/
posted by feckless fecal fear mongering at 6:59 AM on September 16, 2014

That was wonderful. Thank you.
posted by you must supply a verb at 7:08 AM on September 16, 2014

Chuck Klosterman mentioned Cotard's in one of his books, I forget which.
posted by jonmc at 7:48 AM on September 16, 2014

BPD=bipolar disorder, or BPD=borderline personality disorder?
posted by amtho at 7:57 AM on September 16, 2014

Borderline (at least when I was using it).
posted by jaduncan at 8:29 AM on September 16, 2014

“What would you do if you were actually dead, and the life you were living right now was your second chance?”

That's... really profound. It reminds me of buddhist meditation on death: you viscerally imagine your own death until you experience and pass through the mortal terror of non-existence. Then the peace follows, as you have faced the most biologically terrifying fear. According to Buddha we are all delusional, it is just a matter of degrees.

Hugs to the author, and to everyone reading this thread.
posted by St. Peepsburg at 8:42 AM on September 16, 2014 [4 favorites]

Borderline in my use as well. I seem to recall seeing a comparison of the criteria for the two diagnoses which made the case that borderline is basically bipolar plus an overwhelming dose of abandonment fear. I'm no expert, though, so I don't know how valid that is.

Fascinating article, BTW. It makes me wonder if there are less spectacular versions of delusion that are more common but nobody notices because of their mundanity. Is there something that I'm deluded about but don't notice because it occupies such a matter-of-fact position in my brain? And never comes up in conversation, so no-one is in a position to correct me on it?
posted by clawsoon at 10:10 AM on September 16, 2014 [1 favorite]

I think they've come down on the side of the disorders being very separate, not even 'basically' the same; none of the medications effective for bipolar are effective for BPD, for example. And there are many diagnostic criteria that don't overlap. If anything, it seems like BPD and PTSD are linked more closely.

Bipolar is often comorbid with BPD though, as is depression.
posted by feckless fecal fear mongering at 11:38 AM on September 16, 2014 [5 favorites]

jaduncan you're clearly a very compassionate person. I have BPD myself, mostly recovered, and I used to ask myself a lot "who am I outside of this disorder?" I was unable to come up with an answer that felt truthful so I just stopped asking. Instead (in my case) I look at my pattern of behavior, patterns of choices, what likes and dislikes have remained consistent in my life, and so on. I also rely on the occasional spontaneous and unsolicited feedback from others who know me, since they may have a clearer picture of who I am than I do. Though I would recommend to anyone to choose your mirrors wisely!

Even though I understand and respect the tendency to separate the person from the disorder, in some cases it does not always make sense, and in my case I never felt comfortable looking at myself that way. Maybe I am a slightly moody person prone to ups and downs. And I feel insecure many times. Maybe that's just my personality - though my personality may have formed differently if I'd had different formative experiences. Is there some unchanging being that is me? I've met plenty of other non-BPD people who are insecure. I've never felt ok saying that me being snappy is the disorder. No. Me feeling snappy may be the disorder; me choosing to snap is ME.

Maybe that's an answer. Who you are is what you choose?

You can't really control how you feel, and you can only impact your circumstances so much, so who you are is what you think and what you do with what you think? Cogito ergo sum.

clawsoon, my description would be relationship-based PTSD + childish ego functioning. You may have highs and lows, but you're not racing thoughts / hyper at night like biploar.
So maybe: abandonment trauma, unstable moods + immature coping skills + immature defense mechanisms
posted by serenity soonish at 11:51 AM on September 16, 2014 [2 favorites]

Caden Cotard; Synecdoche, New York.

(great article)
posted by standardasparagus at 7:39 PM on September 16, 2014

That was a remarkable essay. Thank you for posting it.

I've been struggling with major depression for 35+ years and credit finding Buddhism with why I'm still here. (Cheri Huber's books saved my life.) No idea what it would be like to practice with something like bipolar, BPD, Cotard's, or similar issues, though. Much compassion to everybody who's suffering.
posted by Lexica at 9:07 PM on September 17, 2014 [1 favorite]

It was neat that although she was behaving like a person considering suicide might, she felt that she had no reason to consider it as an option.

And this part was very sweet and full of love:
Like a child asking for a bedtime story, I crawled into bed with Chris at six in the morning. I said, “Tell me about what is real.”

I asked him about everything. I asked him to tell me who I am, what I like, where I am from, what I do. I asked him about my parents. I asked him if they are real, even though I don’t see them. I asked him about the President, and about the Vice President. He told me about our house. He told me about our neighborhood and the city in which we live. He explained where the furniture is from. That I picked all of it myself. He told me about the farm table in the dining room.

I listened as he employed logic to tell me that I am alive.

“When people die,” he said, “they are buried, and then you don’t see them again. That’s what happened to Grandpa this year. I don’t see him anymore, but I see you.”

None of this solved the problem, but it did help. It was as comforting as a bedtime story would be. I thanked him. He went back to sleep, and I went back to my studio.
posted by aniola at 9:57 PM on September 18, 2014

Great piece of writing, thanks for posting it.
posted by Diablevert at 8:34 AM on September 22, 2014

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