This is an incredible excerpt, albeit completely unorthodox. It comes from a short section entitled, “Saying Goodbye to Satan,” in Lewis Mehl-Madrona’s book, Healing the Mind Through the Power of Story: The Promise of Narrative Psychiatry.
As you read, note the utter left-handedness in Mehl-Madrona’s approach: he allows the patient to tell her story and enters that story with her, totally devoid of judgment or correction. This example of narrative psychiatry in real-life shows, first of all, that the stories we tell ourselves can be damning; second, that denying those stories won’t restore us to sanity. Instead, acceptance (and more importantly: acceptance by Someone else) allows those stories to develop into something totally new, something healthier.
“Beth” was a forty-three-year-old woman who believed she was possessed by the devil. She believed that angels and demons followed her around, laughing at her and trying to poison her food. They made ongoing, running, derogatory comments on her activities, thoughts, feelings, and behavior. The worst of the voices (the most negative) came from the devil himself. Beth felt so cursed that not even the church could save her. She had been diagnosed as having paranoid schizophrenia seventeen years previously and had been “channeling” the devil for the past fifteen years.
[…] I came into contact with Beth when I was on psychiatry emergency call. She came to the hospital because she couldn’t go home. The devil was occupying her living room, and she was too terrified to open her apartment door. Beth needed a place to sleep. When the resident called me, I agreed that we could give her some lorazepam (Ativan, an antianxiety drug) and just let her sleep the night in the emergency room, as long as we didn’t need the room (we had two designated psychiatry rooms at the hospital). Then I’d see her in the morning in my office or at the emergency room if she couldn’t get to the office. In the morning, the ER nurses were ecstatically glad to be able to send Beth by taxi to my office.
Beth was an interesting-looking character. She had tattoos up and down her arms, although I couldn’t tell whether they were patterns like Maori tattoos or poorly drawn pictures. She wore multiple layers of purple, red, and orange clothing, which was actually refreshing against the background of solid white snow that Saskatoon saw for months. Beth was aboriginal—Cree from Manitoba—and had been in Saskatoon for as long as she remembered. I didn’t intend to interfere with her treating psychiatrist, who only saw her for medication, but I thought we could do some interesting work together (in Canada, I had that option; I was on salary).
I began asking Beth to tell me about the time the devil had first appeared in her life. It seemed logical to return to that time to hear about what was happening in her life.
“I was watching my mom die of cancer,” Beth said.
“Wow,” I said. “That must have been awful.”
“No,” she said. “The devil was worse.”
“So tell me what happened.”
“Well, my mom always took care of all twelve of us kids. My mom was a really strong woman. We lived on the reserve, and we had a small house. My dad had died when I was twelve. He went out fishing and never came back. They never found his body, but the boat was found capsized and wedged up against some trees. So we figured he had drowned. He had been drinking, and there were beer cans floating near the boat, so maybe the boat turned over and he was too drunk to swim or whatever, and so we had a funeral for him even though no one ever found his body, though lots of people looked when the weather turned warm.”
“Did you ever see his spirit?” I asked. Beth smiled.
“I did. Many times. But the doctors told me that was just a hallucination.”
“But we know differently, don’t we?” I said. Now Beth was truly relaxing. “You really are an Indian doctor,” she said. “I didn’t know Indians could become psychiatrists.”
“Well, I come from the U.S.,” I said. “We had a different kind of Indian Act. It sort of read, ‘kill them all,’ but anyone who survived wasn’t prohibited from getting an education and going to college. My grandmother only made it through Grade 3,” I said, “but my mother, to her credit, got through college and blazed the trail for me to follow. She went to this cool college that was free except that she had to work, so she quilted her way through college.”
“That’s awesome,” Beth said. “My mother quilted, too.”
“I’ll bet your mom was an amazing woman, just like mine,” I said.
“She sure was. I was so devastated when she died. It was like a big part of me died with her. And I had all my younger brothers and sisters to look after. And I was number four so there was help, but the older ones were busy with their own families, and I just couldn’t do it. I tried so hard to help the younger ones, but I broke down.”
“Is that when you first met the devil?” I asked.
“Yes, he was the one that gave my mother cancer and killed her,” Beth said.
“How did you know?”
“I could see him inside of her as she was dying. He was eating her alive. He finally ate her heart, and then she died.”
“That’s terrible. Were you ever afraid that he would eat you?”
“All the time,” Beth confessed. “I fear for my life—that he’ll take me just like he took my mother.”
“What do you do to prevent that?” I asked.
“I pray to Jesus and Mary. I pray to God. I smudge. I sacrifice.” Beth showed me all along her arm where she had cut herself as a sacrifice so the devil could not possess her.
“Like a flesh offering,” I said.
“Exactly,” she responded. She was obviously relieved that I understood this custom.
“So, here’s my question,” I said. “It’s been seventeen years that Satan has been stalking you, and he hasn’t gotten you. You must have some incredibly strong protection. Who is it?”
“What?” she asked. I guess no one had ever posed this question to her before.
“Who protects you?” I asked again.
“What do you mean?”
“If you didn’t have protection, you’d be dead. So I’m wondering who protects you?”
“Wow,” she said. “I never thought of that.”
“I’m guessing Jesus and Mary must like you, or maybe it’s the spirit of your mother, or may it’s another ancestor, or maybe an animal out in the bush took a hankering to you and wards off evil for you.”
“Maybe,” she said slowly. “I never thought of that.” I had her attention.
“It’s worth thinking about,” I said, “’cause maybe you’re scared for nothing. You know, it’s been seventeen years, and if Satan were going to kill you, I think you’d be dead by now.” Beth had no way to dispute my unassailable logic. “Of course,” I added, “don’t stop doing what you’re doing. I’ll bet you tie prayer flags in trees also.”
“Sure do,” she said.
“Well, don’t stop,” I said. “But maybe we could stop worrying. I’m guessing that even if Satan is sitting in the middle of your living room, that your protectors will chase him out before you even unlock the apartment door.”
“Wow,” Beth said. “Maybe so.”
“Let’s do an experiment,” I said. “Let’s see if you can relax a bit and still be safe. I’m betting you can. I’m also betting that Satan will protest. His voice will get louder and louder inside your head when he finds out he’s powerless to hurt you. It might feel like he’s powerful when that happens, but it’s really because he’s powerless, and the only way he can hurt you is to get you to hurt yourself. You see, the death of your mother may have given you a powerful medicine against Satan that not even he can counteract. So let’s relax and be less fearful and see if the voice gets stronger and if, even then, nothing bad happens.” Beth agreed.
We spent more time talking, and before she left I told her a story to take with her. “If you get scared,” I said, “just remember this story and tell it back to yourself and then my spirit and the spirit of the story will be with you.” I was able to use our shared aboriginal beliefs for her benefit, an example of why therapists form the same spiritual perspective or culture or worldview as the client can be more effective.
For the next three months, I continued to see Beth at intervals of about every seven to fourteen days. My predictions had come true. When Beth relaxed, Satan’s voice had gotten louder, but nothing bad happened. She proudly reported to me at the next visit that she had told Satan the story I told her, and it had quieted him down. She had redoubled her efforts at prayer and at smudging, and was still alive. After one month, she was really starting to relax. “You know,” she said. “Satan can’t kill me.”
[…] The symptoms of all of my patients who have been labeled with psychotic disorders have a sort of logic, a meaning within the context of their lives. That enables me or the other healers who work with them to construct a narrative from their symptoms even if they can’t. We create a zone of proximate development to make stories together when the person cannot make stories on his or her own. Within that zone of proximate development, he or she learns from us and by example how to structure experience into a quality narrative. It is like putting up a temporary scaffolding, then slowly removing it while helping to build a new narrative. When the scaffolding is gone, the new story stands on its own…
The healing process involves realizing that many of the truths we hold about ourselves are merely stories, learned through experiences in a social network, and changeable. As we begin to find better stories for life, our old stories gradually drop away. Through finding healthier social networks—often with the aid of spirituality and traditional culture or other immersion in longstanding teaching tales that communicate good values for life—we mature and solidify our changes. We gain control over the voices and internal characters of our mind, finding ways for them to negotiate and live well together. Slowly our suffering and pain melts away, and we find more happiness and well-being. This is the power of story for healing the mind and the promise of narrative psychiatry.
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I love this!!