Demons and Despair

**I would warn you ahead of time; this story is not funny or amusing. It is serious and sad beyond measure.**

I had a gentleman in my office talking to me about his issues at home. When you are far from those you love, with no prospect of coming back soon, thoughts of family and what is happening without you are consuming. When you are in prison, this is obviously multiplied many-fold. Most people understand they have put themselves there through their own behavior and bad choices. I often hear the tales of birth, death, betrayal and abandonment. Unfortunately, there is little I can do but listen.

Have I mentioned that my caseload is mental health in nature? Some of the guys are seriously mentally ill with Bipolar Disorder or Schizophrenia. Both disorders that can warp your understanding of the world and can sometimes lead to horrendous misperceptions and reactions.

Mr. O., is college educated. He had a solidly middle class job as an investment broker. He had a wife and three daughters entering and into their teens. It is unusual to develop schizophrenia when a person is this far into their life. But he did. He began hearing voices and suffering the paranoia that is a specific type of schizophrenia. Of course, he didn’t want to believe what was happening to him. He talked to his wife and doctor a bit about it, but denial is a powerful force, and his concerns were written off to stress. He was not sent to a mental health professional for treatment or assessment. He got the message, and tried to hide the symptoms, the voices, the fears. And one day, it all became clear to him. He wasn’t crazy; there was nothing wrong with him. Rather his wife had been taken over by demonic forces. They had taken her soul, and in its place left a creature of evil, bent on the destruction of him and his three children.

I’ve often thought what I would do if those I loved were threatened. It is clear in my head: anything necessary, including destroying the threat. I do what I can to stay safe and avoid this type of confrontation. When I worked at the hospital, I watched on my long drive home through the country to make sure I was not followed. I’ve not had my phone number listed in decades. I don’t show up on the internet in any sites that locate me and I’m clearly blogging with anonymity.

Mr. O. came home from work, took the largest knife in the kitchen, and stabbed the demon in the chest repeatedly. He is incarcerated for attempted murder, and will be with us for many years to come.

On medication, he is controlled. In fact he is a likable and insightful person. He suffers true remorse for what he has done. But without warning, his symptoms can surmount his medication, and again, the demons are present and threatening.

Mr. O. sent me a note, stating he wasn’t feeling well and needed to see me. I called down to his unit and had him sent to my office. We are a Level 1 Security prison, so the yard is open and people move freely. My office door is left open, but there is not a guard present through the course of my day. Instead I have a PPD, a personal protection device, which I wear on my hip or clip to my desk drawer handle. It has a GPS system and my name attached. Should I press the large recessed button, people in uniform come at a run to my location. I’ve not yet done this, and I hope never to resort to such a move. I hope it works. I also have a strong diaphragm and voice control. Should I shout for assistance, nobody would mistake my intent.

He enters my office, inches taller than me and many pounds heavier, and sits heavily in the chair. His blue eyes are vibrating and practically shimmering inches from his face. His is pale and sweating, clearly terrified.

In my years of working with people who suffer from Paranoid Schizophrenia, I’ve notice a strange phenomenon. Their fear is contagious. It is felt so strongly, that if an empathic person gets in a certain physical range, she absorbs the fear. I’ve seen this time and again, although I’ve never read of it. As a therapist, you are considered a person of strength and safety. A patient that is already scared becomes even more so if their therapist is frightened. And if you get sucked into this cycle of fear, the situation becomes out of hand horrifyingly rapidly, with the fear bouncing, cycling and intensifying as it is passed from therapist to patient. It can, and does, result in cataclysmic responses if unchecked.

Mr. O. had come to a blinding realization. He would never leave the prison. Seven demons, taller than the buildings, were patrolling the fence, intending to stay there forever to prevent his egress. The demons had entered the compound and his fellow inmates, and some of the staff. He had walked to the building with his head down, eyes averted from the rays of evil pulsing from the eyes of others. He was doomed. He was cornered.

I was new, just a couple months into this job. Had I been at my last job, the answer was simple. A large shot of Haldol mixed with Valium. It would have been administered with 20 people standing at ease, a show of force, a suggestion of what would happen if the patient did not relent. The threat of this many people usually is so frightening to the paranoid individual, the shot is a better choice. However, even though we are in a prison, we are an outpatient facility. My only back up was guards; people in uniform who are much more threatening than the rag-tag bunch of medical people called in when a problem brews in a hospital. To get them to my office I would either press the button, which would bring them at a run, or vocally call over the patient’s head to my secretary. I couldn’t imagine which would be less frightening and less likely to push him to a violent acting out.

He continued to spin out his paranoid ideations. I became unfocused and felt his surge of fear ripple through me. My blood pressure went up and my breathing became shallow. I broke eye contact with him.

“See,” he said to me, “I’m sucking all of the oxygen out of the room and we’re both going to die.”

I grabbed at a sense of grounding and tried to funnel the fear down into the earth from my body. “I’m bringing the oxygen back,” I said.

He became very still. “I can’t feel it.”

“Of course you can, we’re still both breathing.”

“I don’t think I can keep you safe…”

“Mr. O., why don’t you step out of my office, so I can talk to the doctor?”

And he does. Things move swiftly then, and custody (the guards) quickly swarm the area, handcuff him and take him to segregation. I’m left with an office empty of demons and the task of sending him off to the forensic hospital. I’m left with an empty office and the feeling that I have betrayed him.