‗DEFINED NOT BY TIME, BUT BY MOOD‘: FIRST-PERSON NARRATIVES OF BIPOLAR DISORDER by CHRISTINE ANDREA MUERI Submitted in partial fulfillment of the requirements For the degree of Doctor of Philosophy Dissertation Adviser: Dr. Kimberly Emmons Department of English CASE WESTERN RESERVE UNIVERSITY August 2011 2 CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We hereby approve the thesis/dissertation of Christine Andrea Mueri candidate for the Doctor of Philosophy degree *. (signed) Kimberly K. Emmons (chair of the committee) Kurt Koenigsberger Todd Oakley Jonathan Sadowsky May 20, 2011 *We also certify that written approval has been obtained for any proprietary material contained therein. 3 I dedicate this dissertation to Isabelle, Genevieve, and Little Man for their encouragement, unconditional love, and constant companionship, without which none of this would have been achieved. To Angie, Levi, and my parents: some small piece of this belongs to you as well. 4 Table of Contents Dedication 3 List of tables 5 List of figures 6 Acknowledgements 7 Abstract 8 Chapter 1: Introduction 9 Chapter 2: The Bipolar Story 28 Chapter 3: The Lay of the Bipolar Land 64 Chapter 4: Containing the Chaos 103 Chapter 5: Incorporating Order 136 Chapter 6: Conclusion 173 Appendix 1 191 Works Cited 194 5 List of Tables 1. Diagnostic Criteria for Manic and Depressive Episodes 28 2. Therapeutic Approaches for Treating Bipolar Disorder 30 3. List of chapters from table of contents 134 6 List of Figures 1. Bipolar narratives published by year, 2000-2010 20 2. Graph from Gene Leboy, Bipolar Expeditions 132 7 Acknowledgements I gratefully acknowledge my advisor, Kimberly Emmons, for her ongoing guidance and infinite patience. This project existed in a constant state of flux for the better part of three years and through it all, she remained optimistic and responsive. I also thank my committee members—Kurt Koenigsberger, Todd Oakley, and Jonathan Sadowsky—for their careful attention and thoughtful feedback to various drafts of this project. I thank Aarti for being an excellent sounding board and confidante. I thank Angie and Mya for being extraordinary cheerleaders and for providing much-needed mooo-tivation during my most difficult days. I thank my family for always answering the phone, for offering an endless supply of encouraging words and Cheetos, for forgiving me when things went awry, and for loving me through this challenging time. It is an absolute truth that I could not have completed this without you and I will never be able to thank you enough. I thank Levi for being the other half of the Munts and for giving me something to look forward to. C‘est fin. 8 ‗Defined Not by Time, But by Mood‘: First-person Narratives of Bipolar Disorder Abstract by CHRISTINE ANDREA MUERI This dissertation explores the ways in which bipolar narratives attempt to compensate for the chaos inherent in the illness they document. After defining ―the bipolar story‖ as it appears in the texts, the project examines 20 corpus texts in detail, identifying how they cohere as a sub-genre and pointing out the primary features and themes of the group. My analysis then considers how, in seeking to define and describe bipolar disorder, bipolar narratives encounter rhetorical problems with credibility and textual problems involving causation, coherence, and closure. These problems are partly a result of the texts‘ ongoing negotiation of the paradox of mental illness (that people with severe mental illness are simultaneously ―too crazy‖ to be believed and ―not crazy enough‖ to be reliable). The project looks at two specific strategies, framing and embedding, used by the texts to offset the disruptive power of the bipolar story. Close attention to both the texts and the bipolar story itself promises to shed light on a sub-genre of illness narratives that is rapidly growing but not well understood. 9 Chapter 1: Introduction A recent episode of Fox Television‘s mega-hit Glee featured guest star Gwyneth Paltrow as substitute teacher Holly Holliday. Halfway through the hour-long episode, Holliday appears before her class dressed in 19th-century clothing. The script, quoted in full in the National Alliance on Mental Illness‘ (NAMI) ―StigmaBusters December 2010‖ newsletter, reads: HOLLY HOLLIDAY. Mary Todd Lincoln in the house! My husband was probably gay and I‘m bipolar, which makes me yell things like [pointing to a teapot], ‗That teapot is spreading lies about me!‘ Or, ‗that can‘t be my baby because I don‘t love it!‘ [throws imaginary baby over shoulder] Mr. Schuester knocks on the door and asks Holly Holliday to speak with him for a moment. HOLLY HOLLIDAY. Guys, practice your bipolar rants. See, history can be fun! This episode caught the attention of NAMI and generated pages of negative responses on Glee‘s online community boards. The missteps are numerous: misinformation about the symptoms of bipolar disorder (which do not commonly include hallucinations or problems with attachment), the association of mental illness and violent behavior,1 and the trivialization of bipolar disorder as something ―fun‖ that can be practiced. This example may be recent but it is far from unusual; NAMI‘s monthly ―StigmaBusters‖ newsletter is full of similar examples. From television commercials to print 1 Severe mental illness is often linked to violent behavior, despite the fact that research has shown repeatedly that people with mental illness are not prone to violent acts. Despite scholarly evidence disproving the link, it remains one of the most ingrained cultural stereotypes about people with severe mental illness. The mass media does much to further this stereotype, as we saw in the recent coverage of the shootings in Arizona. The suspect, Jared Loughner, had a history of mental health issues and his mental illness featured prominently in the media coverage of the shootings. For more information on the association of mental illness and violent behavior, see Wahl, Chapter 4. 10 advertisements to Disney movies, it seems mental illness has become part of the cultural conversation. That conversation can sometimes feel somewhat one-sided, dominated by offensive comments and stereotypical assumptions akin to the Glee episode. But the last ten years have brought another voice to the conversation: that of people actually living with a diagnosis of severe mental illness. This is especially true in the case of bipolar disorder. A mere ten years ago, only a handful of published bipolar narratives existed.2 But in 2009 alone, 35 bipolar narratives were published. The publishing boom of the past decade suggests that people living with bipolar disorder and other severe mental illnesses do not want Glee and Gwyneth Paltrow to have the last word about mental illness. Despite growth in publication and popularity, scholars have yet to attend to these important texts. As I will show, publishers, the media, and consumers seem to be paying attention to these texts and to bipolar disorder generally, but the bulk of the publicity around mental illness is negative (as seen in the Jared Loughner case, and, to a lesser extent, in the situation with Charlie Sheen3). There are exceptions, of course; the ―CBS Cares‖ public service announcements provide one prominent example of positive media attention regarding mental illness.4 This project originates from a desire to give bipolar 2 In this dissertation, I will use the term ‗narrative‘ to refer to ―the representation of a series of events‖ (Abbott 13). I have also chosen to refer to the texts under discussion as ‗bipolar narratives‘ rather than ‗bipolar books‘ or ‗bipolar texts.‘ This decision echoes pathography scholars‘ use of ‗illness narrative‘ to refer to ―writing about the episode of one‘s illness‖ (Couser 6). For my purposes, a bipolar narrative is a text that focuses on the experience of bipolar disorder. 3 Sheen has been in the news lately after he was fired from his television show for erratic and irrational behavior. Despite concerns about his mental status and the possibility that the behavior was the result of a manic episode, the media has focused almost exclusively on the irrationality as part of Sheen‘s personality and star quality. Sheen has capitalized on the negative attention by recently embarking on a multi-city comedy tour. A recent MSN.com article reported that people bought tickets in hopes of seeing Sheen‘s ―colorful rants‖ (―Crowd boos Sheen‖). As one member of the audience put it, ―He's a wreck. That's half the draw.‖ Instead of expressing concern about Sheen‘s fragile mental state and increasingly erratic behavior, media outlets are focusing on how the ―crazy‖ version of Sheen can fill theaters. 4 As part of their ―CBS Cares‖ campaign (which began in 2000), CBS airs public service announcements on a range of topics, including bipolar disorder. To view the ads, visit the CBS web site at http://www.cbs.com/cbs_cares/. 11 narratives the careful and focused scholarly attention that they deserve, ensuring that these key voices don‘t get lost amid the media chatter about mental illness. Accordingly, the purpose of this dissertation is to explore this group of unattended and understudied narratives as a sub-genre of pathography, paying special attention to how bipolar narratives attempt to compensate for the chaos inherent in the illness they document. Pathographies tend to focus on the experience of physical illness as written by ill people and sometimes by their friends, family, or care providers. Although bipolar narratives can be categorized as pathographies, physical illness and mental illness produce very different kinds of stories. For example, cancer is a recognized illness, even if the illness experience of cancer differs from person to person. That is, there are established treatment protocols, studies and statistics about mortality and recovery, and doctors who specialize in diagnosing and treating cancer.