Schizophrenia Bulletin Advance Access originally published online on March 21, 2005
Schizophrenia Bulletin 2005 31(3):618-622; doi:10.1093/schbul/sbi019
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The Mind Will Follow
Center for Psychiatric Rehabilitation at Evanston Northwestern Healthcare e-mail: RKLundin{at}aol.com
So subtle yet so savage was my descent into madness that my friends and neighbors, looking for a cause, thought I must have done something terribly wrong. It was 1979. I was 23. In the community where I had lived since I was a small child, many people believed God would not inflict such painful and irregular behavior on someone unless he or she deserved it. If I were not personally culpable, surely my mother had raised me improperly. Or was it my father's fault in some psychoanalytic way? To the small college town of Sewanee, Tennessee, finding a scapegoat seemed to take on more urgency than finding a way to treat my humiliation and pain.
I was born Robert King Lundin to Margaret and Robert W. Lundin. My father was a college professor of psychology and an author of several books on behaviorism. He had studied under two luminaries in the field, B. F. Skinner and J. R. Kantor. Of the two, Skinner seemed to have a more lasting influence on him, though he spoke glowingly of Kantor and his kindnesses. My mother was a beautiful woman whom my father met when she worked in the office of the dean at Hamilton College. They had two children: my older sister and me. When I was 8, in 1964, the family moved to the University of the South, in Sewanee, and we all experienced somewhat of a culture shock. We adjusted—we had to—though none in the family ever really picked up Southern mannerisms. I could never force myself to say "y'all."
High school and college were both successful experiences; I was always energetic and, like my sister, shared my father's drive. I joined numerous clubs and organizations, perhaps because I had a little less talent for academics than for extracurricular activities.
Kenyon College in Ohio was a lovely and challenging school, but as my college career drew to a close, I remember having a terrible time deciding where to go and what to do. Sensible career plans just eluded me; I only wanted a powerful, glamorous, and influential job. Nothing less would suit me. As I dreamed of becoming a diplomat or famous actor, finally my sister intervened and persuaded me to go after an MBA, the "in" degree at the time. At the last minute I found Vanderbilt, in Nashville, and enrolled in the Owen Graduate School of Management in fall 1978.
Life was difficult in those days, a portent of things to come. First, I was bedeviled with unrealistic career goals. This was a school that placed middle managers; I felt I deserved more, much more. Added to this stress was the fact that most of the courses were completely unfamiliar to me: accounting, finance, marketing. My social relationships began to deteriorate in those months, so that I could count only a few friends among all the students in the school. I began feeling unrealistically superior: I had come from a more elite college than my classmates. I belonged to a socially and intellectually exclusive group: I had higher standards of conduct and greater academic potential. (My actual performance wavered evenly between a lack of motivation in some courses and good performance in others.) But by the first semester of my second year I began to have serious grandiose delusions. On one particularly bad night I lay in my bed thinking that God was communicating to me through a lightbulb in the closet. I was being told of a nuclear attack that was assailing Nashville, which, in fact, was no more than a lightning storm. I was able, by a fluke, to admit myself to Vanderbilt University Medical Center, where I was hospitalized for a week and started on Navane. When I was discharged, the school counselor was eager to reintegrate me into classes, telling me I simply had an adjustment problem. She was unsuccessful. I had to go home. The stress was too great; the Navane, too deadening: My ability to concentrate was gone.
At home I tumbled into a fierce depression. My parents were shaken, my sister was irritated. In those days, I was not accustomed to failure, and I knew no good way to cope with it. Leaving graduate school, even for medical reasons, was failure. As I mulled these thoughts over and over in my mind, the depression persisted. In these days neither my family nor I realized the physiological nature of my illness; instead, the most sagacious advice I received was to exercise every day and stay in good physical shape; the mind would follow. I did; these were days when I still had athletic skill, so I "worked out" to recovery. Over time the depression lifted. Whether my physical prowess had an effect I don't know, but I suspect it did speed up my recovery. In some ways the depression spent itself out; in other ways I believe that in reaching recovery it is important to act in faith, to believe that a therapy or intervention will be efficacious even though immediate results may not be evident. Act with certainty, conviction, and determination, and the mind will follow. I remember for years, when my illness was particularly difficult, I would say to myself, "I'm not going to not recover." I didn't know how I would—sometimes I would despair—but I would try never to give up hope and expectation for recovery.
Eventually, I was well enough to teach part-time at a nearby prep school. My family and I both assumed, with a wellspring of hope, that the illness was in complete remission and I was free of it. This was a time for cautious celebration. My doctor was optimistic: I had yet to be diagnosed with anything serious, like schizophrenia—nothing more than an "adjustment" problem. So, thirsty for success, with only a single blemish on my record, I applied for a plum job in Sewanee's admissions department. During interviews, mindful of stigma, I covered up my reason for leaving graduate school. The deception worked. The admissions director picked me over many qualified candidates. Secretly, I was certain he would; I had been groomed for this job for years.
So now as I prepared for a career in college administration, and life was ordered and moving forward, back to the easy and privileged success to which I had been accustomed. The summer before I had worked at a lovely girls' camp in the mountains of western North Carolina where I plied my skills in backpacking and rock climbing. It had been the most fun of my life. I was introduced to many young attractive counselors. Surely a wife would come from this association. Life was smiling on me, and I couldn't imagine ever having a depression or a psychosis again.
My story has a familiar ring. Predictably, the psychosis did come back. First it was gradual, and then, acute. The grandiose delusions were preceded by the same feelings of superiority and arrogance. This time it was worse. I began to think I had ESP and that I was an angel or a religious being. At the beginning of fall semester, my psychiatric problems caused a crisis in the admissions department. I had a fierce falling out with the director when, because of acute anxiety, I had to break off a recruiting trip to South Carolina and return home. He summarily fired me. I was out of a job, and my life was terribly disrupted. I was humiliated before the whole community.
In the months following, as the days ticked by, I was despondent. Every day, I would get up only to watch television, smoke cigarettes, eat snacks. My psychiatrist was determined that, still, my only problems were "adjustment" and a family that drank too much. One time, he suggested I might join the Army to get the discipline I evidently lacked. For reasons I cannot fathom, I was never started on antidepressants. My parents were increasingly dissatisfied with him; I hardly had a say. I didn't care: nothing really mattered.
One day there was a fateful call on the telephone. It was my father's cousin Saranne, who lived in Tucson. She disclosed that her retired husband, Charlie, a well-regarded psychiatrist from Connecticut, had had a stroke. My father told her about my intractable depression. What a coincidence: she needed someone at her home to help care for Charlie; my father needed for me to get away from Sewanee and find better psychiatric help. Within a few weeks I was packing my Honda Civic to leave for Tucson. As a relative, Charlie was not able to treat me, but he did refer me to a psychiatrist who finally made a diagnosis of bipolar disorder. (Much later this would be changed to schizoaffective disorder.) I was put on lithium, and within a few months I showed improvement, now having some good days.
Eventually, it was determined that I should have a gainful job, so I was made a bellhop at a fashionable hotel down the street: the Arizona Inn. Psychosis seemed a long way away for me now; moreover, depression was starting to abate. I fell in love with a beautiful girl, Bridgit. We enjoyed the stars, the sun, and road trips to Mexico. But she had another, more favored beau in Phoenix whom I couldn't unseat. Perhaps it was my mental illness; perhaps not. I had little chance of a lasting relationship.
In the spring, I was called back to North Carolina by the director of Camp Merrie-Woode. Disappointed in love and longing for the verdant forests of the East, I left Arizona for North Carolina and began my second of three summers at Camp Merrie-Woode. I arrived at the camp in early May, weeks before anyone but the caretaker, and lived alone like a hermit in one of the small houses in the woods. My mood tumbled. My days were filled with fatigue, and my lonely nights, with insomnia: I thought camp would never get under way.
Whereas I had been outgoing and popular my first summer at Merrie-Woode, this second summer my mood stayed low—but worse, I had so little energy. Camp life was an energetic life; depression was a true disability. Hugh was very supportive of my disability yet mystified by the change in my behavior. I couldn't communicate what was wrong with me, that after so many months of depression I was despairing. Then, by good fortune, I was led to a fine psychiatrist in Asheville whom I saw on my weekly day off. He was the only one able to reassure me that the depression would lift some day—all I needed was to hang on. I did. By the end of the summer, I was feeling great. This was a harbinger of things to come: not feeling depressed but feeling great—too great.
By now, hypomania had become my long-term psychiatric malady. I did manage to keep a grounds crew job at Sewanee for four months before being dismissed. In the following years I was fired from a string of jobs, the culprit always being mania—and psychosis, which now crept into my thinking daily, giving me a steady diet of referential delusions to lighten my load. I would tell no one about them because they were usually reassuring and secretive, but my subsequent behavior would often be bizarre or asocial enough that I would be terminated from jobs. I would think that God was communicating with me through animals or that my "timing" was perfect; or I'd see special relationships in the environment—synchronicity—or believe I had special and weighty missions given to me by the Almighty. I would think that I could do nothing wrong, that my decisions were backed up by spiritual perfection. The delusions were fairly benign—in fact I liked them: they emboldened me, so I guarded them diligently. Invariably, they put me at risk, through either business failures, failures in relationships, unrealistic expectations, or legal trouble.
In 1983 I was hired by Sewanee again for what would be the last time. I was hired as a system operator with the tasks of running the high-speed line printer and backing up the computer on weekends. I was able to hold this job for a year. Then one Sunday afternoon when I was very delusional, thinking I was in the ghostly company of British royalty, I entered the high-security computer room and moved equipment and unpacked equipment from boxes that were supposed to be left alone. I sealed my fate by divulging to the custodian the combination to the door to the computer room. The next day, I was very solemnly fired. That was the end of my working career at the University of the South.
Although I had been referred to one of the leading psychiatrists in Nashville, nothing seemed to work to soften the edge to my personality. When my illness didn't make me arrogant, I was defensive. If I weren't unrealistically self-assured, then I was down in the mouth and glum. My social skills were impacted: few people liked me, many distrusted me, and if I had any poise, it left me. The next event in my life changed all that.
The Enterprise was a small weekly newspaper that came to life in Winchester, Tennessee, in 1984. This was the seat of Franklin County, where Sewanee was located. One afternoon when I was in Winchester, near the offices of The Enterprise, I had an impulse to go into the newspaper and apply for a job. I did, and as luck would have it, I was hired on the spot as a reporter. Over the next few months I wrote a series of well-received human-interest stories and reported the local school district. Then one day, for a reason I couldn't fully understand, the managing editor called me into his office and fired me. I asked why. It just wasn't going to work, he replied. That evening, I returned home. Though I had been fired many times, this one especially hurt. At dinner, my mother asked how my day had been, and I told her and my father I had been fired. She paused and didn't cry as I thought she would; she asked me if I would like to see another doctor. That was music to my ears. I did not like the doctor I had been seeing one iota, so the idea of changing doctors was thrilling. Yes, I told her, I would love to see a new doctor.
It was arranged that I would see a Dr. Spaulding in Chattanooga. I'd have to drive 100 miles round-trip to see him. The doctor was quiet, middle aged, balding. His office was in a renovated Victorian house near the University of Tennessee. Dr. Spaulding ordered a battery of psychiatric tests, and after a few days the diagnosis was the same: bipolar. During one session, he asked if I had tried Tegretol. I hadn't. He replied that the psychiatric literature had been recommending Tegretol in conjunction with lithium for treating manic depression: Would I like to try it? I'd try anything, I told him, I could not live the way I was living. And so I tried Tegretol, and my life changed forever.
At first it came to me as nostalgia. I felt nostalgic for my college days, before I was ill—days of doing simple and relaxing tasks, such as shopping at the local K-Mart. Then some of the stress in my head, which had felt like a grimace, was relieved. My whole attitude was more relaxed. My ability to socialize and make small talk seemed better, and people in my group therapy responded very positively. They wanted to know what had happened. I was a changed person, though I would soon discover that my delusions had not been abated.
One of the eccentricities of Camp Merrie-Woode was that their horses were leased for the summer from a South Carolina foxhunt. The man who was charged with caring for them also cared for the hunt's hounds. Each summer he brought about 30 or 40 hounds with him. One summer I became quite enamored with the head of the riding program. Several times she took me riding; once we went out in the early morning with the huntsman, exercising the hounds. We were hundreds of yard from the pack when a fox scampered from the woods by our horses. The fox was panting and terrified. I think the sight of it turned me off forever on blood sports. Fortunately, the hounds did not get its scent. But I did keep an interest in horses, one that propelled me to the highest levels of the sport.
Sewanee, which has 10,000 acres of land, has an award-winning riding program that exploits the back woodsy area of the tract. The head of the program was aware of my psychiatric difficulties and, knowing I had some interest in riding, reached her hand out and offered me a place in her group lessons. I rode several days a week and quickly advanced from the beginner class to the advanced class. Over the months, I became entirely infatuated with riding, so much so that I arranged to take lessons every weekday. My exuberance for riding began to wear down the program director, who couldn't satiate my appetite for harder courses, higher jumps, and more riding time. It culminated with one gaffe, when I brazenly jumped a horse by myself without wearing a helmet. I was out of the program.
I remained tied to equestrian sports. I bought my own horse, which I kept in a local pasture. He proved a great joy, and I kept him fit, riding him every day some weeks, until I sold him a few years later. I had some skill in woodworking, which I developed at Kenyon in its theater workshop. I applied this to constructing jumps, which I sold at horse shows. Then I added equestrian gifts and some apparel to the mix, and "Bob's Equestrian" was born. There was no business for me in Sewanee, so I took Bob's Equestrian on the road to steeplechase events and horse-jumping shows around the region and, eventually, around the nation.
At a trade show in King of Prussia, Pennsylvania, I purchased a line of U.S. Equestrian Team (USET) souvenir merchandise—hats, T-shirts, polos, jackets, and so on—and found myself hawking it at shows far and wide. I grew to be the largest retailer of USET clothing in the nation. But expenses on the road were fierce, and I was frequently manic. If I had been realistic, I would have brought the business home before losses became too great, I might have saved thousands of dollars. As it was, I thought I had a lofty God-given mission to "save" the equestrian world in some nebulous way, a notion that pushed my business over the edge. For instance, in a symbolic act to "unify" the country's regional equestrian sports (which were in fact quite divided), I took road trips, with a USET banner, to Seattle and Alaska. The positive spin was that I was on the road looking after myself, taking my medications, and gainfully employed. The flip side was that my judgment was terribly flawed: I was ridiculously optimistic, financially irresponsible, and seriously distressed by delusions, about which I would tell no one.
One day I announced that I was moving to Glen Ellyn, Illinois, after I had been there for a steeplechase event. My parents were none too happy about my moving to the Chicago area, but the apartment lease was signed, and I persuaded them I had no future in Sewanee. With their blessing, I was starting a new life in Illinois. Without a job and just hanging out at a local café, Spice ‘n’ Easy, I deteriorated. I still could not settle on a reasonable or rational career—this had been my bane since college. The equestrian business, with its reputation for class and society, had appealed to me. The USET? That was even better.
I was hospitalized after that—my fourth hospitalization. I went through intensive individual and group therapy, but still, no doctor was able to gain insight into my delusions, only to address my mood swings. I was kept on lithium and Tegretol. In only another 9 months I was again acutely psychotic. I acted out a long and intricate yarn that involved my being flown to the Middle East as an envoy to settle a hostage crisis. In the midst of the delusion, I was lucky: I had a glimpse of reality. Many people with mental illness do not. I recognized that I was very ill. My parents were abroad, but I still decided to drive to Sewanee, hoping I would get better attention down there—I'd call on our family friends for help.
On the way my psychosis was perfectly wild, the worst it had ever been: I had visual hallucinations of tiny spaceships entering my car. Though it was dark I was wearing sunglasses to keep a hideous creature on the moon from sucking my soul out through my eyes. At one point, I threw my wallet out the window so that I could remain incognito to the Red Cross agents who were to fly me to the Middle East. In Evansville, Indiana, I was stopped at a traffic light because I was driving erratically. A policeman walked up to the car, looked at me for just a few moments, and then asked if I'd like to go to the hospital. Yes, I said, I really needed to go to the hospital.
Again my life was transformed. Thus came the first time I was begun on the mix of medications I still take today: lithium, Tegretol, and an antipsychotic. At that time it was Navane, which I had taken years before when I first became ill in Nashville but had stopped for some reason. Like Tegretol, this changed my life in a most profound way. First of all, the psychosis was stopped. Prior to this I did recognize psychosis and had begun to "scan" my thoughts looking for traces of delusional thinking. Now I didn't need to. The medication stopped the psychosis without my intervening. Second, and perhaps best, I could settle on reasonable and attractive jobs in which I have had continuing success.
In the ensuing years, much has gone well for me. Medications have left me nearly symptom free, and as in my earlier years, I've had a strong desire for success. I've been willing to start at the lowest levels and work my way up. Shortly after I came back to Glen Ellyn, I began working as a contributor to The Glen Ellyn News. I started as a cub newspaper photographer. (I had learned some valuable photographic techniques while working on high school yearbooks. As my new career unfolded, I still had the camera and developing equipment I had used nearly 15 years before.) Initially I was too shy to approach the editors directly, so I took photos of newsworthy Glen Ellyn scenes and shoved them under their door. They ran them! What a thrill that was. This began my career in journalism. I later won a "Best Spot Photography" award from the Illinois Press Association. I worked myself up the ladder as a freelance reporter, and I began reporting for the Chicago Tribune in 1995, covering various committees and city councils in Cook and DuPage counties.
In these years I became involved with the National Alliance for the Mentally Ill (NAMI) and earned good experience in leadership and public speaking. NAMI is a group with which I still spend hours of my free time. Today I'm on the Board of Directors of NAMI of Greater Chicago; I've been on the boards of NAMI of DuPage County and NAMI of Illinois. This experience led directly to a full-time job at the Center for Psychiatric Rehabilitation at the University of Chicago, now at Evanston Northwestern Healthcare, where I am a research assistant. Recently I've become a public reviewer for the National Institute of Mental Health. I am also coauthor, with Dr. Patrick Corrigan, of the book Don't Call Me Nuts! Coping with the Stigma of Mental Illness (Recovery Press, 2001). And I'm the managing editor of a professional journal, the American Journal of Psychiatric Rehabilitation, which is published by Taylor & Francis in Philadelphia. Between the University of Chicago and Evanston Northwestern Healthcare, I've worked steadily in competitive employment for 7 1/2 years.
In 1996, with Irene O'Neill, I founded the Awakenings Art Show through NAMI. It is now an IRS 501(c)(3) charity, and we renamed it the Awakenings Project in 1998. It includes a respected literary journal for people with mental illness, The Awakenings Review; studio space for artists; and art exhibits and shows. Awakenings has gained regional and national attention for its work; and a very closely bonded group of people has grown together with it.
Recently, I have gone back to my college roots and have begun working with Kenyon's alumni fund-raising programs. I'm the agent for my class, and my fellow alumni awarded me the "Distinguished Service Award" in 2004. I go back to Sewanee on the occasions of my high school reunions. As a touch of irony, my parents, who for so long cared for me while I was sick, now allow me to care for them in their old age. Seven years ago they moved to a retirement community in Wheaton, Illinois, 15 minutes from my apartment in Glen Ellyn. I see them often.
It's become popular these days, when telling recovery stories, to say how you are in some ways grateful for the whole experience. I won't dispute that. I have a very supportive family, which like me went through its own denial and pain but has made my life, in the least, tolerable and, in truth, blessed.
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