When the Make-Believe World Is All too Real

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For my son Jonas’s first Halloween, when he was 5 months old, I dressed the two of us as matching lumberjacks. For the second, we were characters from the movie “Up.” I was Carl, the old man, my wife was Ellie, and Jonas was Russell, the enthusiastic Wilderness Explorer. We tied a dozen balloons to our bulldog’s collar, to make him the house. In our version, the wife didn’t die at the beginning of the movie, and we all lived happily ever after.

The next Halloween, Jonas wanted to be an elephant. He loved the scene in “The Jungle Book” where Mowgli tries to march with the elephants. We resisted, since we like family costumes and didn’t want to buy three elephant outfits, but conceded. We displayed his elephant costume in his room the week before Halloween so he could look at it in anticipation of the big day.

My wife, Giulia, wasn’t there for the lumberjack Halloween. She was in the hospital.

Giulia was there for the “Up” Halloween.

But as we approached the elephant Halloween, I suspected she wasn’t going to dress up. Because, once again, she was going psychotic.

Giulia was 27 when the first psychotic episode happened. It came out of nowhere. She got nervous about her new job; she lost her appetite; she stopped sleeping; she began having delusions. The first delusions were encouraging. She said she spoke to God, who told her that she was going to be fine. Giulia had never been very religious, so I was alarmed, but at least she was hearing things that were comforting.

But then the delusions turned on her. The voices said she wasn’t going to make it, there was no point in even trying, she was better off not being here. That’s how she ended up in the hospital the first time. They gave her medication. The delusions eventually went away. She was depressed for a long time afterward. They gave her more medication, and then she got better.

Our son was 5 months old when the second episode happened, just as unexpected as the first. My wife was on medication, she was seeing a therapist, everyone thought that the psychosis was a one-time thing, but it still happened, right on the eve of Halloween. They now called it bipolar disorder. I took my son out to explore the neighborhood in our improvised lumberjack outfits.

I read somewhere, maybe in a pamphlet from the hospital or on a forum online, that you shouldn’t engage a psychotic person’s delusions. Talking about the delusions might breathe more life into them, and will only get the person more agitated. Acknowledgment of the surreal is akin to nurturing it.

So when my wife was in the hospital for the second time, and found it reassuring to talk about her idea that heaven was a place on earth, I changed the subject. Her delusion was pleasant, but it wasn’t real.

And yet, as a parent, I love imagination. I constantly make believe with my son, to make the world more exciting and interesting. There’s Fred the Friendly Coyote, whom we sometimes hear at night in the hills nearby; the monster broom in our closet to sweep the scary monsters out of the house; the tree on our favorite hike where we leave acorns wrapped up in leaves for the friendly forest monster Totoro.

In my vision of parenting, the laws of logic, gravity and time don’t matter — all that matters is that the world feels safe and loving for our son. Which I guess is a way of saying that heaven should be a place on earth.

The third episode of psychosis crept in slowly. It began the same, with a loss of appetite, sleeplessness and anxiety, but we tried to avoid taking Giulia to the hospital. We thought maybe she could ride it out at home. But the night before Halloween, long after Jonas had fallen asleep, our plan came crashing down. Giulia’s psychosis pulled her in different directions — first, she said I was dangerous and needed to get away; then, she was the dangerous one. I called the hospital and they said they wanted to admit her.

Giulia was calm, resigned to the fate of a third hospitalization, but I felt so torn. Her focus this time was on the interconnectedness of all life on earth, a beautiful concept, one I too believe in. I was taking her to the hospital because of an idea I wanted to pass on to our son. But the way Giulia fixated on the idea and spoke of it over and over again made it clear she wasn’t well.

I spent all day at the hospital, until I had to leave to take Jonas trick-or-treating. Thankfully I tagged along with other families, because I couldn’t muster the effort to match his energy. We went home and fell asleep on the couch in front of the TV. Jonas was still in his costume.

The next morning, Jonas and I got dressed and took our dog out for a hike to our favorite tree. We gathered acorns and leaves along the way, so we could leave them as gifts for Totoro. In the Japanese anime movie, Totoro comforts two young girls whose mom is in the hospital. They exchange acorns as a sign of their affection. This morning, more than any other, I needed Totoro to wrap Jonas and me in a cocoon of protection and affection. So we went out to offer acorns for a friendly forest monster that doesn’t exist.

It’s been three years since Giulia was last hospitalized. We have never known why her illness recurred at Halloween. Jonas is 5 now — he is dressing up as Harry Potter this year. I’ve continued to try to build a world with him where he feels included and comforted, even though I know that the world can be anything but. I put on costumes, and invent magical creatures, all in the aim of building that sense of safety for him.

We hope that psychosis never returns for Giulia. It’s a terrible, disorienting experience, and I’m relieved that we know which medications help her weather that storm. But if it does, I’m going to listen to her more as she wrestles with her conflicting thoughts. Maybe there’s more that I can do than just shutting down the things that aren’t real.

Maybe just as the make-believe world is a place of delight and refuge for Jonas, there’s something profound or even helpful in what Giulia envisions. Maybe.