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17 December 2005

What can I say to my crazy neighbour? Please consider this as a short story.[More:]

I moved into a new apartment in October this year. My new place is in a very old house, a duplex with two apartments up and two down, in a quiet and safe neighbourhood. I am in one of the downstairs apartments. My crazy neighbour is in the other downstairs apartment. I’d guess she is in her late 30s and she is deeply troubled. The general consensus is that she makes her living hooking out of her apartment. That doesn’t concern me but it is surely relevant. She is as skinny as a pole and doesn’t look too healthy. The other neighbours hate her. The reasons follow...

Here’s how I met her: shortly after moving in I was sitting out back (patio/parking, whole area fenced in) when she emerged hiding a big stick with a nail poking out of it under her jacket. Yer typical home-made mace. She introduced herself (rationally, but obviously nervous and a bit manic in her speech) and to make an intense five-minute encounter short she explained to me that she was looking for the man who is stalking her. She had just seen him out here somewhere. I hadn’t seen anybody and I had been sitting out there for a good 20 minutes. But I am not the most observant fellow at the best of times.

I had been forewarned so this encounter was not unexpected. I took over the apartment from one of my students and she told me about the “stalker” and that the police had been involved and that they had judged my neighbour a crank. So I asked her careful questions about her stalker and she told me some highly unlikely stuff, delusional stuff to be sure (e.g. he was able to sneak through holes in the fence that are plainly too small for a person).

I’ll tell you now that I am intimately familiar with delusional thinking. I had an acute manic episode that lasted for the month of August in ‘97 and I had all sorts of strange beliefs (I bet you’ve never been Frodo, and this was before the movies came out!), and all of it was true to me at the time. I spent September of that year in a locked ward and full of nasty, nasty enforced dope. Risperidone was the worst. Haldoperidol comes in a close second. Ahhhh blessed Ativan! I am lucky that it was a one-off event (I’m not, as it turns out, bi-polar, I'm just alcoholic ;-). But it was a profound and lasting experience. I know crazy. Psychosis is ridiculous.

Anyhooo! Last week the person above her moved out and she became convinced that her stalker was somehow moving around in the vacant apartment above her. In this old house sound travels very, very well from corner to corner. She called the rental agent and the rental agent was so freaked out that she asked me to accompany her up to check out the apartment. Yup: doors locked and no sign of anyone. No footprints anywhere, so to speak.

So this morning I was out shovelling snow and my neighbour peeked out her door and begged me to come into her place. Begged is the correct word. I knew what the conversation would be about. I went in because I had to. Madness is compelling and at my root I am a helpful person, and I was curious and she needed some help. She was in distress in a way, an interpersonal way. It was a shared, psychotic emergency. A strange and upsetting moment for me. I acted.

She had something to show me about the people stalking her. Or the guy. She didn’t seem to be sure. “Them” and “he” were intechangeable and she was more scared and agitated than I have seen her before. But she was "rational". She was reasoning with me and in no way out of control. She showed me some “break away doors” and ceilings that he/they can use to access her apartment. Now, this is an old house with all kinds of panelling covering all kinds of weird carpentry. My tiny bathroom is a work of creative panelling art. I tried to explain this but she wasn’t having any of it, of course. And I must admit that old houses like this can be creepy if you are in a certain frame of mind. Then she insisted that “they” were trying to cut their way into her bedroom from the crawl space below the house. She showed me the spot in the corner of her bedroom where she had heard the sounds from below. She said that the carpet edge below her baseboard heater had been disturbed (indeed it was curled up but I hadn’t seen it before...) and that she had “heard the knives cutting”. So we lifted the carpet in that corner of the room, and then the underpad, and she said, “There! See!” and indeed I did: cracks in the plywood. Straight, parallel cracks, as will happen with plywood. She wasn’t having that either and then it got a bit weirder, at least for me.

She said that there was something (a creature I assume, but one in on the plot) living inside her new mattress. The mattress had no sheets on it (for that I am grateful) and she insisted that I lay my hands on the mattress and “wait, wait to feel the movement”. It was a movie moment, I tell ya. So I spread my hands over the mattress. And I told her, honestly, that I didn’t feel anything other than the springs. She replied, “Wait, I’ll show you.” and proceeded to get up on the bed and jump up and down, trying to agitate the creature into movement. Still no go. So out comes the baseball bat and she starts beating the crap out of the mattress. “No,” I say, “I still don’t feel anything.” I mean, what else can you say at a time like that? She was dissapointed and I told her I had to go (I did have to go) and I let myself out the back door and we kept talking. She kept me as long as she could (as would I if I was that scared and had a sympathetic ear) but I just ran out of things to say.

And this is what I am concerned about. All through our encounters I have been trying very carefully and gently to explain these “events”—which are of course real to her—as part of the natural, sane order of things: the sounds are our neighbours in this old house; the “access doors” are just panelling covering up structural warts. Etc. But as delusional thinkers will do she just ignores that thinking and goes on to the next worry. My words, beyond comforting her for the few minutes I am talking to her, do her no good. In writing this I am thinking that she is schizophrenic. But she is not currently “a danger to herself or others” so there is little that can be done in terms of medication. I just wonder if I am handling this right. What can I best do to help her?

Sorry for writing so long. I just needed to write to sort this out. Yeah, GYOFB is right in this case. I guess I want feedback from other people who have dealt with crazy people to whom the law at this time does not apply. People tried to talk reason to me when I was manic but I was really, really over the top. She is not. It saddens and disturbs me. Anyways, thanks for reading and here is some great jazz guitar, Joe Pass solo playing Cheek to Cheek.
she really needs a doctor...can you get like a social worker or visiting nurse thing or city psych someone to go to her? (tell them not to say you sent them)
posted by amberglow 17 December | 17:26
i'd get really good locks too in case she starts suspecting you of anything.
posted by amberglow 17 December | 17:27
Thanks taz for posting this. I have been doing a bit of reading and I suspect that she may have a generalized delusional disorder. I do wonder if she is actually hallucinating, though, because she says she has seen the guy and actually describes him. Any thoughts welcome.
posted by Cryptical Envelopment 17 December | 17:27
Ayiyi. I almost got involved with a woman downstairs from me, once. Partly because I was noncommittal, I suspect, she had a freak-out involving self-injury, paramedics, and a likely delusional story about a white glasses-wearing kid who had invaded her kitchen via the back stair, who had caused the injuries to her wrists by slashing her with one of her kitchen knives.

I'm not gonna try to parse the DSM-IV for ya, here, because this is definitely medication territory, not counseling. She needs anti-psychotics, and she probably does have a doctor and a prescription, but just isn't taking them. I would not get as involved as you have; you're just entangling yourself in someone else's fantasy world, in the end, and it will bring you grief. I would caution against any white-knighting, even if it seems to make you feel better.
posted by stilicho 17 December | 18:10
If she isn't and never will be a danger to anyone, I'd ask for help, on the condition that it's done on an informal basis. Otherwise, I don't see that you've got any other choice than to make a professional aware of what's going on. Are there charities that work with people in her position?

It's a situation that would make me very uncomfortable (at both not being able to help, and general fear of the unknown). Intimidated, even. I'd consider arming myself with a big stick, just in case.
posted by flopsy 17 December | 18:23
Thanks amberglow, stilicho and flopsy. I don't feel any threat from her but the mace and that bat got me thinking, for sure. In terms of getting her medicated (she claims not to be on any mediacation, I asked her) the local laws pretty much depend on her being a threat to herself or others. You advice all echoes what a good friend of mine said, which is to avoid becoming a part of her delusion, and I will certainly avoid any conversation that has me supporting her delusions. But at the same time I remember that some people "went along with the ride" with me when I was manic and that they helped to calm me down. They didn't feed my delusions but they also didn't scare/confuse with my own inconsistent beliefs and insist that what I was experiencing was wrong and unreal. I am trying to strike a balance. I have made my doubts clear to her and we have talked about mental illness. I just feel really sorry for her and I'd like to be a helpful friend if that is possible, and to perhaps try t help. But I am afraid that if I get someone else involved she will see me as a traitor, etc. I know I reacted that way when I was insane.
posted by Cryptical Envelopment 17 December | 18:37
If you're consistently a voice of reason in your encounters with her, that's a good thing to have for someone like her I would think. You say you feel no threat but do you feel a burden? If not, well, you sort of sound like you wouldn't mind helping her a little given your previous situation so why don't you continue to do so. At some point (and perhaps even now), when she trusts you a little more you might be able to broach the topic of getting some form of help for her. Does she ever have friends or family (who are sane) visit? If it's possible, you could bring up your concerns with her. But that might be crossing some lines.

Also, I totally would not have touched that matress. Freaking scary!
posted by panoptican 17 December | 18:43
That's good advice, panoptican and the course I am following for now. She is not a burden as I only run into her every few days. After our last encounter (three days ago) I reminded her that she had my card and if she ever felt like she was really in trouble to give me a call or knock on my door. She hasn't been in touch.

She sees me as someone she can talk to (obviously) and I make sure that every time I talk with her that I (gently, elliptically, carefully) bring up the possibility of mental illness and that maybe she is not well. She will not acknowledge this as a possibility currently but maybe, if I keep steady with a gentle argument, she will think about getting help to end her fear. She has no friends or family that I have met. Just a few inconsiderate johns. *sigh*
posted by Cryptical Envelopment 17 December | 19:57
In writing this I am thinking that she is schizophrenic

i'd say! any chance you could get her to go to the local hospital? no one should have to live like that.
posted by Wedge 17 December | 23:35
If she's seriously ill, she may begin to perceive you as a danger, so be very wary. Pay attention and see if she seems to have family or friends; anyone who might care about her. In the US, access to mental health care is worse than access to other forms of health care. Look in the phone book community pages to find public mental health care. Call and ask for advice, and be prepared to come away discouraged.

She should call the police as often as she needs to. They may not like it, but she's a citizen and deserves protection. A Women's Shelter may be able to help, and may know of other help available. Good luck.
posted by theora55 18 December | 00:21
I suggest you call the Ottawa Distress Centre, and get advice from them. This page has their info, including phone number.

In terms of your immediate personal interaction, it sounds like you are pretty much doing the right stuff.

In the case of an emergency, some advice I've heard regarding dealing with people in an acute state of psychosis includes: Do not maintain constant eye contact; do not stand too close or "hover" (make sure the person has a "safety zone" of space); do not stand between the person and the door (exit); don't show a lot of emotion. If the person doesn't seem to hear you, just continue to repeat what you are trying to tell them, in short simple sentences without raising your voice. Don't allow the person to be hedged in by a group of other people, avoid arguing with the other people (about what to do, whatever).
posted by taz 18 December | 02:13
Oops. Second link should go here for the crisis line number.
posted by taz 18 December | 02:18
Cryptical Envelopment, you are a good man.
posted by Five Fresh Fish 18 December | 02:42
Thanks again, all, and thank you, taz, for that number. I will give them a call just to find out what resources are available if she goes down hill. I've been living here for three months and I haven't noticed any progression for the better or for the worse. I will be very careful and keep my own safety in mind.

She did call me last night and asked me to come over and feel the ceiling in her closet as it was "pulsating". It wasn't, of course, and of course this frustrated her. I talked again about the tricks our brain chemicals can play and told her a little, very little but enough, about my own experience with delusions and that treatment had helped me to sort myself out. And I told her again that I understand that this is very real to her even though I have my doubts. She appreciated that. We laughed a bit and I promised to keep my eyes and ears open while she is out of town for a few days.

It may be schizophrenia and it is certainly some kind of delusional disorder. I wonder if she has actually visually hallucinated seeing this stalker and if the sounds she has heard are auditory hallucinations and not just the early-winter transitions of an old, old house. The way she describes him leads me to believe that she is actually visually hallucinating, which, paired with her thinking, meets the diagnostic criteria for schizophrenia. But there are all kinds of possibilities short of real hallucinations: what I don't (can't) know is if she is hearing or seeing things that really aren't there at all or if she is interpreting real shadows and light and sound within the context of her delusional thinking. That being said and assuming she is hallucinating she is the "paranoid" subtype of schizophrenic described here. She seems incredibly earnest and I don't get the sense that she is attention-seeking so I am leaning towards thinking that she is schizophrenic.

I appreciate your kind words, fff. Psychosis can be as scary for those on the outside as it is for the sufferer, and my mania forever destroyed several of my relationships. But when I was psychotic there were some people who listened calmly to my hyper rants and asked questions. Just being able to rant and rave freely often had me poking holes in my own mad beliefs. That was upsetting, to say the least, but I think those people helped me in the end by simply being calm and honest and non-confrontational and that is what maybe what I can be here. And this whole experience is making me very, very grateful that my psychosis was not chronic.
posted by Cryptical Envelopment 18 December | 14:49
I give you || "May God damn this newspaper

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