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Living With This Thing We Call Psychosis

January 31, 2023


This post is a review of Zig-Zag Boy: A Memory of Madness and Motherhood. By Tanya Frank. W.W. Norton & Company. 224 pp. $28.95.

Late one night, in the fall of 2009, Tanya Frank found Zach, her 19-year-old son, in the laundry room, rerouting the wires of an unused telephone circuit board. Pressing his mouth against his mother’s ear, Zach whispered, “I’m scared the bad people will hear me talking to you.” Mike and Josh, he announced, were not really his friends; they were members of the Russian Mafia. Zach’s computer and cell phone were bugged; UCLA was a “network” set up to spy on him.

In Zig-Zag Boy, Frank, whose creative nonfiction has appeared in The Guardian, The New York Times, and The Washington Post, provides a candid and compelling account of her struggle to help Zach cope with his schizoaffective disorder, and the stresses his illness put on every aspect of her life.

Like so many caregivers and patient advocates, Frank confronts changing diagnoses, virtually all of them stigmatizing; disagreements about the efficacy of antipsychotic drugs; and lots of unfamiliar terms (like akathisia, akinesia, and polypharmacy). She encounters broken health care systems in England, where she and Zach were born, and in the United States, where she lived with Nance, her wife, for many years. Frustrated and afraid, Frank concludes that “no one seems to know for sure” what causes psychosis or how to treat it. “It is guesswork, trial in error, more like a game of spin-the-bottle than science.”

Readers of Zig-Zag Boy, in all likelihood, will be familiar with Frank’s critique of the diagnosis and treatment of psychosis. Few of them, however, will fail to be moved by the book’s unflinching and heartrending description of the impact of her son’s affliction on those who cared about him.

Timur Weber/Pexels

Timur Weber/Pexels

Attendees at a group therapy meeting under the auspices of the National Alliance on Mental Illness, Frank reveals, “are all middle-aged and tired looking.” As people tell their “uncannily similar” stories, Frank digs her fingernails into the heels of her hands to “fend off the feeling of grief” in the room. When some folks remain in the parking lot after the session ends, opening their notebooks and sharing information, she is “strangely” comforted. But the moment does not last: The thought of being in their situation over the long haul gives her heartburn.

Anxiety haunts Frank when Zach is living with her, when he’s in the hospital or a halfway house, when she’s hundreds of miles away, and when he asks her a specific question about the past to prove that she really is his mother, not a robot. And she knows that her commitment to Zach is taking a toll on her relationship with Nance.

Frank worries about bargaining with Zach to get him to stay with her or take his meds, “because of how wrenching it is for me to hear those words.” She is struck by the contradiction she perceives between psychiatrists who blame the “mother, always the mother,” for bringing on relapses, and the biomedical model that insists the illness is nobody’s fault. Frank thinks she spends too much time wishing Zach finds peace, lamenting that he hasn’t, “waiting for a new answer, a new doctor, a new accommodation, a new insurance… that might just suddenly happen because I read it could.”

She fears that sitting with Zach and patting her hand on his arm, is akin to acknowledging that “he really is already dying.”

In the early months of his illness, Zach asked his mother to sit on his bed to help him get to sleep. “I’m scared about how it will end,” he confessed. “Please tell me if you know.”

“It won’t end badly,” she declared. “You will live for a long time, a good life, doing things that fulfill you.” Even though she, too, was petrified by the uncertainty.

More recently, Frank has thought about an injured elephant seal. Having left California and returned to England, she realizes she might never see the wounded seal again. “He would have to continue to face danger in the water, whether I saw him again or not,” Frank concludes, “and I knew that being with him today was the best I could do. It was the best he could do, too, this wounded warrior beast.”



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