January 1st, 2010

The Luckiest Man in the World

I just met the luckiest man in the world or at least, that’s what he told me. It turns out I have known him for many years, but like so much that we are learning about one another in the last days of the hospital, his disclosure came as a surprise. You would not think that a person who has suffered from a particularly virulent form of schizophrenia for over 30 years could consider himself lucky. That kind of self-assessment would surely be the mark of delusional thinking that would seal the diagnosis, if there were ever any doubt in the first place. There never was.

The luckiest man in the world is a pleasant fellow although I have heard that he has not always been so. We first met when I interviewed him 17 years ago for an annual progress review and his rapidly shifting focus of attention and discourse made it clear that my work in an outpatient child and family program was indeed over. This was the state hospital and the fellow in the chair on the other side of my desk was introducing me to my new professional home.

I didn’t know he was the luckiest man in the world but I sensed both his intellectual curiosity and his optimism when he asked me if it was true that there were positive symptoms of schizophrenia. He reasoned that a condition that had caused so much disruption in his life must have some redeeming qualities. If only it did. In the months and years that followed, I would see this fellow in passing, have him as a member of a creative writing group and an emotion management group and serve as the psychologist on his treatment team. I learned about his early successes and how close he had come to graduating from college, trying again and again to complete his studies even after he started to develop symptoms.

The voices were the worst. Even when they were benign, their constant chatter made it hard to concentrate on anything else. When they were harsh and critical, he took their reproaches to heart. And so the luckiest man in the world started wearing headphones, filling his head with his favorite music to drive out the soul killing noise that shattered his peace of mind. He enjoyed the music and the lucid conversations he would have with anyone interested in talking about the rock bands of the 60’s.

The luckiest man in the world loved a good story and he liked to write. He gave it his best effort in a creative writing group but, at first, all he could do was take dictation from the voices that had highjacked his thought processes. In time, he learned to segregate his thoughts from the message of the voices, separating one from the other with a bold line slashed across the page. On his best days he could resist the verbatim dictation and incorporate the gist of the message into a coherent narrative.

Perhaps you can understand my surprise when this fellow began a recent group session by saying he is the luckiest man in the world. As always we waited to see if he was beginning to express a straightforward, logically constructed message or if a grandiose delusional assessment of himself would trail off into unrelated fragments of thought. He said that he knows he has a mental illness which he certainly never wanted. Nevertheless, he also knows he is getting the care he needs in the hospital from staff he respects, trusts and likes. The grounds are beautiful, the sun is shining, and he is sitting in a room with people willing to listen to what he has to say. The luckiest man in the world went on to say that he knows the hospital is closing, that he is not sure where he will go, but that somehow he will wind up where he is supposed to be. He also said that he does not always believe any of this, but he does today and that is good enough for now.

What are we to make of the luckiest man in the world? His self-assessment is certainly delusional, clearly exaggerated, but unquestionably true. Philosophers through the ages have grappled with the very issues he boldly addresses: the mystery of individual existence in one set of circumstances and not another, the process of recognizing and accepting those circumstances, the challenge of finding a calling in our own version of life’s struggles and the discovery of a completely unjustified hope in an unknown future. As young children we realize that we are different from everyone else and later, that we are stuck with being who we are. As time goes on, we may come to see that who we are isn’t so bad after all. Finally, if we are lucky, we may conclude that our particular life was the best one we could have had. Our best thinkers and writers have expressed all of these ideas with more thought and grace but, in my experience, none more simply, honestly or memorably than the luckiest man in the world.

Alan Bodnar, Ph.D. is the Co-Director of Psychology Training at Westborough State Hospital, Mass. and a consultant in the field of leadership development.

By Alan Bodnar Ph.D.

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