As the niece of a complex man with schizophrenia, I found Lori Schiller’s The Quiet Room: A Journey Out of the Torment of Madness (Grand Central Publishing, 1996) a useful memoir that offers insight into the pain, despair and courage of those living with and those proximate to this illness. In her memoir, Schiller describes her seemingly perfect childhood before her schizophrenic episodes, and the ways in which schizophrenia changed her life. Yet Schiller’s voice is not the only one to unfold the experience of schizophrenia. The voices of her family, friends and doctors also illustrate the effects of mental illness on those who are not afflicted by it. By unfolding Schiller’s story through multiple perspectives, readers gain a more complete understanding of narrative bias and societal stigma, as well as the ways in which love can blind family and friends from offering the best support possible to their loved one.
Throughout the memoir, stigma serves as a powerful deterrent for Schiller’s family and friends, blinding them to “Lori’s” true needs, desires and appropriate treatment. Stigma is the way in which Marvin, Schiller’s father, thinks and acts. After meeting Schiller at Bellevue Hospital, Marvin writes, “The most important help she needed was to make sure that nothing of this incident ever came to light...I didn’t see Lori’s problems as serious. She didn’t need to stay in a psychiatric ward. She wasn’t mentally ill.” Marvin’s perspective reveals how powerful stigma can be; because of his fear of psychiatric labels, Marvin, a mental health professional, turns a blind eye to the signs of one who requires medical and mental treatment. His repetitive use of negations emphasizes his denial and fear. Marvin’s strong affirmation to hide Schiller’s suicide attempt sheds light on stigma’s potency, as even the idea of stigma can result in denying treatment to a mentally sick person.
Moreover, this section reveals that stigma limits critical social support systems not only for sick individuals but also for their families. After Schiller’s hospitalization, her mother Nancy recalls that Marvin forbade her from discussing Schiller’s condition with anyone: “The deception made everything ten times worse for me. I needed to talk, to vent, to get sympathy and support from my friends. Instead, I could confide in no one.” Nancy’s confession offers readers a more complex understanding of how the hardships of navigating mental illness from a familial perspective can be reduced and highlights its similarities to the ways therapy and protective factors can help a mentally ill individual.
The actions and attitudes of the characters in this memoir underscore how addressing mental illness – its stigma and its treatment – is easier in principle than in practice. Steven, Schiller’s younger brother, exemplifies this idea as he ages; in college, Steven pursues psychology, determined to find a cure for his sister. Steven’s journey reminded me of my own—my uncle’s condition and his subsequent treatment by loved ones and the healthcare system led me to major in Neuroscience during my undergraduate training and drives my continuous activism for mental health awareness. Steven’s bandwidth for undertaking this goal, however, changes when he and Schiller witness a patient losing control and causing physical chaos within the hospital. Steven realizes “that if this was the reality, I still couldn’t face it. If someone was going to find a cure for Schiller, it wasn't going to be me.” This realization is a startling but important one, revealing a shift in how one copes with another’s mental illness. Although it may be expected that family members confront the mental illness their loved one experiences, the opposite may also be true; fear of schizophrenia, for example, can drive one to distance themselves from a mental illness rather than approach it.
The experiences of Mark, Schiller’s other brother, also combat stereotypical beliefs surrounding mental illness, showing how familial dynamics can blind one to the gravity of schizophrenia. For years, Mark, like Steven, avoided confronting Schiller’s schizophrenia, actively choosing not to bring his girlfriend home. He recalls thinking that Schiller’s suicide attempts and hospitalizations served to place her in the center of attention, and when she reported hearing voices, he felt “actually angry that she was so smart that she could make up an illness that no one could disprove.” His experience suggests that even after one is diagnosed with a mental illness, others’ pre-formed attitudes can serve as barriers to seeking help. Mark’s honest account creates a more eye-opening read, raising awareness around the realities of dealing with mental illness in a loved one.
Schiller’s depiction of the voices in her head as their own characters, as well as her syntax and sentence structure, help readers gain a better understanding of her inner turmoil, deepening their understanding of the experience of schizophrenia. Schiller illustrates the realness of the voices, even describing one as speaking “directly to [her], in low, gravely tones, hoarse and husky, a true demon from hell.” Other voices join this one: “VOICE NO. 1: She must DIE, and we will take that pussy to hell with us. That trash! VOICE NO 2: Why so soon? Needs to suffer more. Needs to swallow our presence.” Schiller’s evocative imagery and specific language serve as effective tools to paint her story and bring readers into her mind. Her version of reality, then, forces her under the command of the voices for self-preservation. For instance, because the voices offer her peace if she dies, Schiller uses a tranquilizer to overdose and knives to slit her wrists. Schiller shows how schizophrenia controls a person’s mind and body; she genuinely feels forced to physically harm herself as the price for feeling at peace.
Through the numerous voices involved in her storytelling, Schiller offers readers a more complete picture of her experience of schizophrenia. Her loved ones’ accounts raise awareness around the harmful effects of stigma, not only for those with mental illnesses but also for the families of these individuals. Schiller also teaches readers an important lesson: the experience of mental illness cannot be ignored or forgotten. 3 South, one of New York Hospital’s long-term units, teaches Schiller this lesson. Schiller remembers, “I had felt that my problem—when I even accepted that I had a problem—was like a circuit breaker that had flipped off,” until 3 South taught her that solving her problem “wasn’t about flipping switches. It was about understanding your own illness, and learning to live with it.” – Alyssa Sales
Alyssa Sales is an alumna of Columbia University and holds a B.A. in Neuroscience and Behavior with a concentration in Public Health. At Columbia Irving Medical Center, she conducted research on improving depression screening and treatment in primary care clinics serving predominantly people of color. Currently, in her gap years before medical school, she conducts policy landscaping and contributes to preparation for behavioral health-related policies.