Smoking cigarettes, eating glass

The local Tampa Bay Psychoanalytic Society was privileged to host the author of Smoking Cigarettes, Eating Glass (2015) Annita Perez Sawyer who read excerpts from her humorous and poignant book about the perils of misdiagnosis and treatment and the iatrogenic harm they cause.

Being read to in her soft, melodious voice transported me back to childhood memories of bedtime stories read aloud by my parents, but in conjunction with the painfully disturbing content it was a disorganizing experience to have disparate elements: voice and words, juxtaposed. Perhaps that was the point, for her memoir tells of her dissociative experiences resulting from childhood trauma. Hospitalized in the 1960s with symptoms of derealization, depersonalization, and suicidal behavior desperate to communicate what was happening at home, and no understanding yet of PTSD as a result of childhood trauma, she was misdiagnosed with schizophrenia-- a diagnosis which, at the time, dictated treatment with ECT (shock treatment). Thus, Sawyer’s memoir makes a plea to clinicians to see, not symptoms or diagnosis, but the individual. Sawyer writes that the admitting psychiatrist during her first hospitalization at the age of seventeen had read aloud her diary to her as evidence of her need to be hospitalized. Her memoir states this intrusive authority had been “defiling what might have been mine but now was his” -- prescient of the much later recognition of her childhood incestuous sexual abuse.

Also welcome in this memoir is more anecdotal evidence of relationship over technique: despite having been hospitalized in the heyday of classical Freudian psychoanalysis, it was not neutrality, abstinence or anonymity, nor interpretation and insight which jump-started her recovery. Instead it was her (eighth) psychiatric resident who had the courage to see her as a person, and to be authentic, spontaneous--he laughed at her puns-- as well as attempt to understood that her disruptive and self destructive behavior was a communication of her history of childhood trauma.

This resident’s supervisor was Harold Searles who -- as Philip Bromberg now so elegantly elaborates -- shared his feelings evoked by Sawyer (the patient) with her. He noted that Annita as a patient was so innocent, so frightened like a fawn and so shy, that he felt like a dirty old man, and that bad feeling about himself had made him want to kill himself, just as the Sawyer herself had also been suicidal. Later, as a clinician, she decided this had been a kind of projective identification. She felt Searles had made contact [with her guilt], and she felt her [heretofore helpless] self able to have an effect on others.