Elissa: A Case of Schizophrenia

The first time she saw it, she was mortified.
A freakishly self-mutilating clown
tearing at its face as it laughed
It giggled like a girl
but that was the only girlish thing about it
Looking at it, watching it, she felt her flesh crawl
the hair at the back of her neck stood on end
this thing wasn’t right
No one else seemed to notice but her
It was obvious they were conspiring.
They paid this clown to scare her.
On the playground they were always laughing
the other kids
but there was never anything funny
She was the joke.
She knew it.
They never looked at her.
They didn’t have to.
There was nothing else to laugh at
Giggling, giggling
Just like the clown
They giggled just like it
All around her, giggling
Mutilating laughter.
The clown stepped closer
she wanted to run
her feet were frozen solid
tried to slap it away
with arms that defiantly hung
limp at her sides
closer
closer

She couldn’t see
Tasted like vomit
Where was she?
Tried to open her eye-lids
but she could only roll
her eyes up into her skull
She couldn’t remember how to open her eyes
It felt like hours passed
before the sickeningly bright light spilled in
Rolled her tongue in her mouth.
Spat out bitter, acidic flecks.
"Are you Okay?"
"Are you Okay?"
"Give her some room. I think she passed out."
"Probably the sun, she should be fine now."
The world swam with faces
colors, lights
Sounds…people talking, asking questions
"I’m Okay." She heard herself say. "Is it gone?"
"Is what gone?"
"The clown."
Confused voices. "What…clown?"
She felt breath on the side of her face
warm, rancid breath
it smelled like vomit.
She rolled her head to the left
That clown.
She wanted to scream but she couldn't
she couldn't force her voice out of her throat
her mouth worked at the words she wanted to say
no voice came
She looked the other way
Still there.
Again.
Still there.
She couldn't move the rest of her body
Couldn't hold her head straight
the clown was making a point.
And then she heard it
A voice like nails
clawing furiously at a chalkboard
There were no words but she understood the meaning
Don't be afraid. I'm on your team.
Elissa blacked out for the second time that day.

It was a dark place.
She wasn't sure where she was
Her chest tensed as she strained her eyes
trying to force her eyes to adjust
Her eyes darted about but it looked the same everywhere
Was it there?
Despite her fear, she felt comfortable, soft
Familiar
As her eyes adjusted she recognized
the blades of her overhead fan
the unique shape and color of her ceiling
Her room
The tense feeling that had gripped her
immediately vanished
She was safe here
Her neck muscles loosened
sinking her head back down into her pillow.
As the minutes passed, she felt them again
those eyes staring back at her
her nails dug deep into her palms
trying to hold back her panic
I changed sides, I’m on your team now.
The clown squealed in its raspy, wordless voice
Why? She asked shakily
She didn’t want to talk to it
She also didn’t want to make it angry
Because I’m just like you.
No you’re not.
Everyone hired me to fuck with your head.
You shouldn’t say bad words like that!
Fuck fuck fuck fuck fuck fuck fuck fuck
Stop it!
They want you put in the crazy plaaaace
Why!? Why does everyone hate me!?
‘Cause you’re lunie ‘lissa, lunie ‘lissa
No I’m not! I’m not lunie ‘lissa! Elissa cried
They want you all locked up so they can stab you with needles til’ you die.
Elissa stared at him in shock.
She couldn't believe it. Who?
Everyone.
Everyone?
Everyone.
At the playground?
In the world.
Everyone in the world?
In the world.
Even mama?
Even mama.
You’re a liar.
Even mama.
I’m not listening to you anymore! You’re still on their team!
even mama even mama even mama
He started yelling it over and over. Elissa screamed.
The clown giggled his girlish giggle when her mother came inside
What’s wrong honey? I heard screaming.
Mama was out of breath.
Get it away get it away! get it away from me! Elissa screamed
Get what away? Honey, there’s nothing here.
The clown hissed Even mama
Elissa’s eyes were wide
the shock of betrayal clawed at her heart
You want me to go away too mama? Even you?
Elissa baby what are you talking about? Come on, you can sleep in mama’s room tonight. You’ll be safe from the boogey man in there.
There was no boogey man. Everyone knew that.
This was proof.
Only a crazy person would believe in the boogey man
Mama was in on it too.
Elissa froze. She understood everything now.
They hired the clown to make her crazy
pretending it wasn’t real
But Elissa was smart
If she pretended the clown wasn’t real
when they were around
they would be the ones who went crazy

Epilogue: Making Elissa Convincing

While replicating the schizophrenic condition in a fictional character with unerring precision might be considered a task far from reasonable, with adequate research as a foundation it is possible to develop a convincing sketch of the condition within such a character, as I sought to do with Elissa.

Elissa is an undifferentiated schizophrenic. However, in writing Elissa’s story, or a similar case, one is immediately faced with an overwhelming obstacle. Assuming the writer is not incredibly familiar with schizophrenia, he has little true to the condition to offer the reader as evidence. Even if the writer contains some general knowledge on the subject, if all the misconceptions he might possess are not removed and/or replaced, the knowledgeable reader will quickly become “wise to his game”. This was my position when I first began writing “Elissa”. I knew nothing true of schizophrenia, and as a result, my initial character had nothing in the way of schizophrenia to offer the reader. If I had created Elissa without first delving into the subject, anyone who read my work with knowledge of the disorder would have been left thoroughly unconvinced that Elissa was “real”; and when writing a character driven story, if the main character fails to be adequately convincing, the story will almost always fail as a result.

It is necessary to take all information about a subject, in this case schizophrenia, into account when developing a character that will interact with or contain these traits. As I began to research the nature of the schizophrenic disorder, quite a few peculiarities that I was not aware of sparked my interest. A schizophrenic may or may not suffer from all of his or her symptoms continuously. When creating Elissa, this was something to consider. Would her symptoms be continuous, episodic, or a combination of the two? Which led to more questions: what symptoms would she be capable of suffering from realistically, and what is the nature of these symptoms?

The symptoms of schizophrenics can differ greatly. These differences lead to various "types" of schizophrenia: paranoid, disorganized, catatonic, residual and undifferentiated. In the case of undifferentiated schizophrenia, episodes might contain symptoms from various or even all of the other types. After carefully reviewing all of the possible symptoms that Elissa might suffer from, I decided that a combination of the symptoms regularly associated with catatonia and paranoia described her best, making her diagnosis “undifferentiated schizophrenic”.

Elissa does not suffer from all of the symptoms of catatonia, paranoia, or schizophrenia as a whole. This is because after consulting several first-hand accounts of individuals with the schizophrenic disorder, it became apparent that symptoms vary greatly but rarely if ever include all known symptoms. It would also be incredibly difficult to create a functioning main character that suffered from so lengthy a list. While this is true, there is also a minimum number of symptoms for an accurate diagnosis. To make Elissa’s condition as convincing and accurate to the schizophrenic disorder as possible, I placed her in the middle of the minimum and what I determined from my research to be a realistic maximum.

Next, unfortunately for Elissa, came application. During Elissa’s schizophrenic episodes, she consistently suffers from visual hallucinations of a frightening, clown-like figure coupled with auditory hallucinations similar to those of nails on a chalkboard. Another curious element to her illness that isn’t uncommon to paranoid schizophrenics is that she suffers from delusions of reference. That is, she sometimes believes that events, objects, the behaviors of others, and other stimuli have a particular and unusual significance to herself. There are two definite instances in which Elissa suffers from this. She believes that because children are laughing, and she doesn’t know what they are laughing about, they must be laughing at her. She also perceives special meaning from the sound of nails on chalkboard. Although this is an auditory hallucination, she is still deriving special meaning from it which simply is not there. Elissa also suffers from two other symptoms of paranoid schizophrenia which, in her case, go hand in hand: delusions of grandeur and irrational fear. Elissa believes that, for whatever reason, it is on the agenda of “the entire world” to drive her insane through a clown that “they” hired, after which “they” will proceed to lock her up and stab her with needles until she dies. The symptom which makes Elissa’s “type” of schizophrenia undifferentiated rather than paranoid is her body’s motor functions are prone to shut down – a symptom of catatonia. During her initial episode, she is unable to lift her arms and then loses consciousness completely. After she regains consciousness, she begins moving her head in a repetitive manner – another common trait of catatonic schizophrenics. Aside from this, she speaks irrationally, suffers from social withdrawal, and is beginning to experience deterioration in her personal relationship with her mother. These are secondary traits caused from the primary symptoms, but nonetheless they are characteristics taken into account when making a diagnosis so they are important to be aware of when considering the actions of the character in question.

“Elissa” is a depiction of what it might be like for an undifferentiated schizophrenic child suffering from symptoms of catatonia and paranoia in the early and most frightening stages of the disorder. However convincing Elissa’s symptoms might appear, they are the result of research on both scientific studies and victims’ personal experiences with the disorder.