In America, a number of states have legalised cannabis and the same move is being considered here in New Zealand by parliament. In fact, just a day or two ago, the Drug Foundation called for the decriminalisation of all illicit drugs so that addiction can be considered a health issue rather than a legal issue. If this proposal were to be accepted, New Zealand would be following in the footsteps of Portugal, a country that some years ago decriminalised the possession and use of all drugs, with beneficent results for Portuguese society and their justice system.
I suspect that the ordinary Joe Bloggs, who enjoys the occasional reefer with his beer after knocking off work at the construction site, wouldn't oppose this move (and most New Zealanders don't) but that it would be opposed by many doctors. In particular, there is an hypothesis, embraced by I think a lot of psychiatrists, that cannabis use is a major cause of psychosis, even schizophrenia, an hypothesis now supposedly supported by recent research. I have known several psychiatrists who at least pay lip-service to this received wisdom. Of course, I believe this hypothesis bullshit and the point of this post is to say why it is bullshit. I also want to state more categorically the reason I became 'ill' myself.
When I studied in Dunedin, I had an acquaintance, a marijuana user, who had a psychotic episode, during which he shaved off all his hair, including his eyebrows, because he believed his hair was acting as small antennas through which aliens were controlling him. Stories about cannabis-fuelled psychotic episodes, and even more stories about metamphetamine fuelled psychotic episodes, circulate widely through New Zealand society, in the same way that in Janet Frame's day, schizophrenics were all thought to be axe-welding maniacs. If there does seem to be evidence of a causal link between pot-use and psychosis, it is probably the fact that very many young people diagnosed with a mental illness have tried wacky-backy. Doctors, by contrast, tend to be people who have never tried pot and don't socialise with those who have. A significant cultural difference exists between the medical profession and those that they treat, and this culture difference is a part of the reason that there can be conflict between doctors and patients.
The problem with the hypothesis that cannabis-use causes psychosis is that it fails to take into account all the people who have tried pot, or use it regularly, who never become 'ill' at all. During the course of my life, all my friends, all my peers, had at least tried pot, and some smoked it every day; only a couple of them ever experienced a drug-induced psychosis. The stereotype of the stupid stoner dude who likes surfing and talks in a drawl, typified by Sean Penn in Fast Times at Ridgemont High, is only that, a stereotype; Bill Maher, a long time campaigner for marijuana law reform who, a little while ago, after cannabis was legalised in California, brazenly lit up a real joint live on his TV show, is far from stupid, and Barack Obama himself has admitted to smoking pot. Some months ago, TV1 news reported on a survey indicating that 85% of New Zealanders under the age of twenty-five had tried cannabis. If 85% of the patients who show up in psychiatric offices having experienced psychosis have tried pot, one might suspect a causal connection – but only if one discounts the rest of the population, the 85% of people who have tried pot without ever flipping out at all.
The simple equation "Cannabis use causes psychosis" requires fine-tuning. One might say, as many people do, that cannabis-use causes psychosis in the small minority who have a vulnerability to psychosis, a predisposition to schizophrenia that is either genetic or incurred as the result of childhood experiences. There is a problem even with this refinement, however, and, as evidence, I will draw upon my own life-experience. Yes, it is true that just prior to my first psychotic episode, at the Big Day Out in 2007, I smoked a lot of pot (while high on Ecstasy). It is also true that after becoming a patient of the Mental Health System, I vowed never to smoke pot again. But that concert I attended at the age of twenty-seven wasn't the first occasion I had smoked cannabis. I was never a heavy cannabis user but I did smoke it, a couple of times a year, from the age of about fifteen, with friends. The period in my life when I smoked the most was during seventh form, when I was seventeen. My best friend Shannon and I would get stoned, go to the video shop, and wander around lost looking for David Lynch films. If I had a vulnerability to psychosis that was triggered by cannabis use, my condition would have manifested when I was seventeen. Not twenty seven.
I have another reason for disliking the simple formula "Cannabis use causes psychosis". It is another way of blaming the victim. I have a friend, diagnosed bi-polar in his early twenties, who smoked pot prior to his diagnosis and still smokes pot today. I saw him recently and gently tried to gauge his opinion on the possibility that his illness might be in some way related to his drug use; he grew angry and defensive, I think rightfully so, because I was suggesting that his condition might be his fault. He knows his 'illness' better than I do, I think. The simply formula "Cannabis use can cause mental illness" can have other pernicious consequences. I know another patient, also diagnosed bi-polar, who once told his psychiatrist that his manic episodes were like taking drugs. They put down in his notes that he was a drug-user. He had never touched illegal drugs in his life.
Although it seems an simple (even dismissive) explanation for the cause of a person's 'illness', in my own case, the primary cause of my psychosis wasn't in fact the drugs. In the post, "My First Psychotic Episode", I summed it up. The causes of my illness has always been people thinking I'm gay when I'm not. The belief a person might entertain that others around him think him gay when he isn't sounds like a paranoid delusion but I have adduced evidence for it that this happened with me. In the post I just mentioned and the post "My First Psychotic Episode and bFM" I showed that there must have been a misperception of me at the radio station at which I worked; in "Concerning Dreams" I showed that something like a rumour about me must have even found its way into my flat. (In that post, by the way, I said that the party I talked of was held after I left bFM. I think now that it happened after the Big Day Out but before I left bFM.) For the longest time, I couldn't work out why people around me thought I was gay. Was it a rumour? Or was it something about my voice and body language, or even the brand of beer I chose to drink? I can turn off and on a gay voice almost at will, and in the early years of my 'illness' was paranoid mostly about how others perceived me. Recently, I discussed this problem with a good friend. During our conversation, he conceded that, in all likelihood, a rumour about me must have existed prior to my first episode. My friend, who is straight, also reassured me that I didn't give off a gay vibe, saying "I'm camper than you are."
I believe that something like a rumour did circulate about me and, if this did occur, it started as a result of a short film I wrote in 2001 at the age of twenty-one as part of a screenwriting paper, the gay spy film I have described in "My First Psychotic Episode and bFM." I believe that the English faculty at Auckland University decided I might be gay because of this film – and I want to adduce some evidence for this. I studied for my MA between 2001 and 2003. During a class on Joyce, I gave a presentation about "The Dead" in which I focussed on the idea of 'performance' as a theme in this story. When I named the theme, the lecturer flinched. I sensed that he thought my presentation was going to tackle this story from a gay perspective; I sensed this but didn't know why – I now realise that he thought I was going to relate "The Dead" to Judith Butler's theory of gender-performativity. When he realised that my presentation had nothing to do with queer theory at all he showed signs of visible relief. (In fact, I knew nothing about Judith Butler's theory of gender-performativity at all until just last year.) In another class, another lecturer, Alex Calder, who has a high voice, exhibited his anxiety about others' perceptions of him, an anxiety common among many academics in this country, by saying, "The reason I talk this way is because I had prostate cancer." Many lecturers in the Humanities have been made uncomfortable by the rise of queer theory and feminist theory. In 2004, I wrote an essay about the poet John Ashbery, having decided, after reading his incredibly long and difficult poem Flow Chart, after I had made the decision to write about him, that he was gay. My supervisor, Wystan Curnow, asked me what I liked about Ashbery and I was only able to say that we shared a similar world-view. That year I applied to do PhD at several American universities; Wystan sarcastically suggested I go to Berkeley.
Although I knew that the English department thought I might be gay, none of them was brave enough to ask directly, and so I was never able to set them right. For many years, this was also my experience of the Mental Health System (and then, when I finally was asked, in Easter 2013, I wasn't believed). Back then, though, it didn't cause me to go mad. Knowing that my lecturers thought I might be gay impacted corrosively on my self-esteem but I didn't go nuts until 2007, when it seemed that everyone in the world thought I was gay, including I think members of my own family.
I believe. now, that the cannabis I smoked at the Big Day Out exacerbated the psychotic episode I suffered about a month and a half later, but that it wasn't the cause. The cause we know. The only 'crime' I committed in my life, if you can call it a crime, is that I wasn't homophobic enough. Over the course of my life, I have known many gay men, both before and after they came out, and have several close friends who are lesbians. I had known gay men prior to writing the film in 2001. I remember, when I was seventeen, I went to the Hero parade with my girlfriend of the time. I wore an extremely tight t-shirt that belonged I think to a kid sister, because I thought it would be fun to pretend to be gay for a night. Unlike John Nash who, if reports about him are to be believed, behaved badly in many ways when he was young, the reason for my 'illness' was that I was too good, too left-wing.
I should bring this essay back to its original topic. A problem in psychiatry is that there is this thing, this condition, called 'schizophrenia' and it simply must have a cause, but no one knows what the cause is. Because schizophrenia is literally considered an illness, it is assumed it must have a physical cause, and a leading candidate today for this cause is 'cannabis use' (even though, in Janet Frame's day, schizophrenics existed but cannabis-use didn't). In reality, there is no such thing as 'schizophrenia'. People go mad for a time and then recover. The causes are different for every different person. But the reasons are seldom something simply physical. Often the madness has a spiritual dimension. And, in order to recover, the person needs to make sense of his experiences and talk about it with people. This is what I've learned, and what I am trying to share.
I might finish with a line from a song by the fantastic Kurt Cobain. "Just because you're paranoid, don't mean they're not after you." Perhaps not the best sentiment to end this post with but a wonderful line anyhow.
[Note: I have included my interpretation of "The Dead" in this blog, under the title "Exhuming James Joyce's The Dead.]
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