Review: Touched with Fire

Medication. Once you have been on it for a little while, you begin wondering if you need it. Some — like me — fiddled with the dosages. Others stop taking it at all. Those with an artistic temperament, especially poets, don’t like seeing their most valuable kind of intelligence stripped away from them so that exercising their craft becomes harder. Because Art is more important to them than their relations with their families and friends, they step boldly beyond sanity and give themselves over entirely to their illness — until life becomes unmanageable.

It is understandable why people seek to go back to mania, particularly those of us with an artistic bent. Personally, I found writing poetry came easily to me. I not only had the focus, but I also had the sense of association that one needed to choose words to convey specific, charged meanings. If I had had a lover afflicted with the same, my output of love poems would have been enormous.

We all think we are brilliant in mania, but a great many manic artists are at best banal. A few like the poet Robert Lowell needed mania to keep an edge in their poetry. Others like Shelley sought out doctors to get help quelling their mood swings. These famous names — along with that of Vincent Van Gogh and many others — tempt some to

Touched with Fire steals its title from Kay Jamison’s classic book of the same name. (Jamison isn’t mad. She appears as herself in the movie at one point, desperately trying to set one of the characters straight on the issue of whether to take his meds or not.) It tells the story of two young people who meet while locked up in a psych ward. Like many such relationships, there is a wind storm of shared stimulation that transcends sex and common love.

They are bad for each other. They sneak down into the basement of the ward in the middle of the night to talk, write, and make art together. This nightly rendezvous makes them wildly orbit each other, like two Kuiper Belt objects stuck in mutual admiration. When they are separated, they grow wilder at first, then crash into depression, their bodies digging out craters of morbid, energy-less, angst. When they get out, they stop their meds again and head out on an extended road tour which nearly costs them their lives when he drives their car into a river.

Both Katie Holmes and Luke Kirby deserve praise for their portrayals. She is the intellectual, the one who retains the ability to reason while he is the wildman who chants rap. It is Holme’s character who eventually sees the light; Kirby’s cannot resist bipolar disorder’s attraction. Griffin Dunne puts in a great performance as Kirby’s much maligned father whose bipolar wife abandoned the family. He and Holmes’ parents show part of the damage that unrestrained mania can have on families. Kay Jamison is a surprise appearance, as the goddess to who Kirby and Holmes turn when they must confront their mania. It is clear who understood Jamison’s message better in this confrontation. Jamison is often portrayed as an apologist for medications by anti-psychiatrists, but here she makes the case that too much medication is a bad thing and cites her own experience.

Touched with Fire gets it right. Nowhere have I seen the excitement of mania so brilliantly exhibited. We’ve needed films like this just as we have needed the recent Infinitely Polar Bear and Homeland because they tell the truth about us and show that we are human. We are not Jasons — we are children of the light.

If you miss it in the theaters, rent the dvd.

Crossing Zones

Travel is one of the greatest dangers facing someone with bipolar disorder. The majority of medical evacuations from overseas happen when someone enters a manic or a psychotic state. I am no stranger to these issues: I have noticed that when I cross the country to attend DBSA conventions, the combination of the excitement of the convention and the messing up of my sleep cycles — especially when I am compelled to wake up earlier — often conspire to pushing me into a slightly manic and obnoxious state.

So when we made plans to visit my brother-in-law in Senegal, I took the time to confer with all my doctors but especially my GP and my psychiatrist. In addition to the necessary shots such as typhoid and yellow fever, we bought medical evacuation insurance for me. I also discussed my plans at length with my psychiatrist, particularly since I would find myself not merely in one different timezone, but four — Salt Lake City, Paris, London, and Dakar. Together, we hatched out a plan which involved my taking an extra tablet of carbamazepine while I was gone. Two days before my departure, I began taking the increased dose — two first thing in the morning, one with dinner, and one at bedtime.

Not even the hint of mania afflicted me. I kept my temper, didn’t laugh too much, kept my bearings, and didn’t engage in compulsive spending. We stuck to our plan in London and Paris, not doing too much in a day and always discussing our expenses as we went along.

When I came back, I felt so good on the new dose — who in their right mind misses the rages? — I asked my psychiatrist if I could stay at that dose. She let me under the condition that my drug and white blood cell levels were closely monitored at least in the beginning to be sure that they didn’t destabilize me. Four months after my trip, I continue to do well.

If you live with bipolar disorder, you can learn this from my trip. First, talk to your psychiatrist and consider raising your dosages of your mood stabilizer. Second, take pains to adjust your sleeping schedule. For two weeks before I left, I starting setting my going to bed time an hour ahead of when I usually woke until I was getting up at Paris time, about mid-afternoon. When I arrived at Orly, I felt fine. When we arrived in London that evening, I went right to sleep and woke up shortly after dawn. I wore a sleep mask and ear plugs to minimize disturbances. I used an alarm clock to wake myself and it worked. I jumped out of bed and I enjoyed each day. My regimen kept my mind stable. My sanity never wobbled.

Madness in Senegal

I wasn’t able to arrange any interviews. The doctors in the Senegalese mental hospitals were defensive, fearful that I would paint a bad picture of conditions, or busy. The assurances of the State Department staff who were helping me didn’t sooth this naive patriotism or persuade them to give me half an hour, but I learned a little. There’s no social security in Senegal, so the mentally ill either rely on the care of their family or begging. I didn’t see many people who struck me as being afflicted on the streets (unlike London and Paris), so I assumed that they had been assimilated into the crowd and received care of sorts from other dwellers of Dakar’s streets.

The luckier among the mentally ill receive support from their families who send them to mental institutions where they receive treatment in the form of psychotropics. These help as long as the money holds out — a familiar story to those of us who remember the dark days before Obamacare. I can’t tell you about the conditions in the hospitals; so, I don’t know if they followed the best standards of care or if they were dank prisons where patients were chained or locked into padded cells.

Mental illness is recognized even in the more remote and traditional areas, which refutes the myth that people in Africa regard people living with schizophrenia and bipolar disorder as holy. Instead, they are ostracized and feared — as they have always been.

Most of the mentally ill disappear into the mass of people walking the streets of this city. They are ignored and forgotten, their symptoms shrugged off which is not the reverence of the myth makers. There’s rumor of an American in one of the suburbs who is in episode; there is no retrieving him and taking him home, however, because he will not come into the embassy for evaluation.

If I stayed around, I might see more; time is running out, however.

The Flatland Dilemma in Interpreting Bipolar Mania.

People in mania are known for flights of fancy and the rapid association of ideas. Of all the forms of intelligence that we may possess, it is only the ability to recognize analogies and build associations that suffers when we go on mood stabilizers. I think it can be a mistake for outsiders to believe that this ability leads to wild, random, and unusable linkages in our mind. I find that my ability to write poetry — meaningful poetry — suffered after I started taking lithium; I lost insights. Of course, many other more negative traits like my irritability, grandiosity, and racing thoughts disappeared so I consider it a net gain.

The things we bring back from our adventures in mania land aren’t all rubbish. Poets such as Shelley and Byron depended on their manic states to generate compelling material. Some scientists have conceived startling new concepts. Isaac Newton is a classic example of a maniac whose insights transformed the science of his day and enabled him to revolutionize mathematics with his invention of calculus. The trouble comes when we try to bring our insights back from the fine and private place of our sickness.

William Knowland’s Flatland — which was written to explain the difficulties inherent in Faith — presents a useful allegory for our struggle to explain what we have found. Imagine a two dimensional figure, say a square. Imagine that it is you. Your perceptions are limited to two dimensions, so while you can make out one dimensional figures such as lines and points, you cannot appreciate three dimensional ones. If you were one dimensional, squares would appear as lines to you. Angles and other aspects of the square would invisible.

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The Fallacies of Stigma: A Primer

Stigma is often masked as reasonable, but a closer examination shows that the arguments supporting it are flawed. We who live with mental illness have good reason to object to it: Prejudice costs us jobs, friendships, and self-dignity. The isolation which we live in worsens our state of mind. Stigma is not only evoked by people who do not suffer as we do, but also by anti-psychiatrists who oppose treatment and who deny mental illness. Both are often clever in hiding tactics, but I have written this article so that you might recognize and confront them successfully.

Herein I shall describe many logical fallacies that are used by people who invest in stigma either to promote an agenda or directly attack those of us with mental illness, giving examples for each. Remember these the next time someone uses them, identify them for what they are and let them know that they are standing on shaky ground.

Argument by assertion describes the belief that the more you say something is true, the more true it is. No matter how many times what you have said has been refuted by psychological studies, you continue to say that it is true. This you believe overwhelms any real evidence. The idea that the mentally ill are violent or the notion that medications are dangerous or that vitamins have no side effects are examples of this kind of logical fallacy.

One of the reasons why I count antipsychiatrists among the purveyors of stigma is that when they argue that the medications cause violence, they are implying that everyone who takes the medication will be violent. This means that those who take an SSRI are violent (as well as corporate shills — see below). I have often pointed this out to them. The best argument they can muster is that they really didn’t mean it — which is moving the goalposts, a type of argumentum ex culo or, simply, lying.

Related to this is the tactic known informally as bullshit. The evidence can’t be right, so you keep asserting without proof that it is wrong. Your arguments amount to little more than ill-formed, unsubstantiated opinions.

When someone cites a popular movie or television series or novel as evidence that the mentally ill are dangerous or incapable, they are employing a generalization from fictional evidence. Those who deploy this kind of reasoning believe that Jason from Halloween is typical of people like us. Of course, this does not constitute as valid information because the source is fictional and a product of some writer’s imagination.

Those who attack advocates for the mentally ill often depict them using straw men. One particularly vicious proponent of Murphy’s Law used to claim that anyone who didn’t support that dubious measure didn’t care about the mentally ill. Of course, that was just plain wrong: it was our concern that the mentally ill would be forced to undergo harsh treatments such as ECT that they did not want and lose their HIPAA protections that motivated us to oppose the law. It’s a cheap trick and nothing more.

Argumentum ad hominem is something that we all have experienced. Because we suffer from mental illness, our criticisms and opinions are by default invalid. Stigma causes us to lose authority in the eyes of some. The use of this logical fallacy defines the center of stigma, namely the idea that we are crazy and incapable of logical thought. I, however, have noticed that even people in the throes of mania and schizophrenia can make rational arguments. Many people hide their mental illness because they want to be taken seriously.

When you proceed from the assumption that the other person’s opinion is wrong and then go on to explain why they held it, that is known as Bulverism. Bulverism is almost always associated with some kind of psychological condition. Such arguments are cheap shots and an end run around the burden of proving that the idea is wrong. Sometimes there is an actual diagnosis, sometimes the attacker just makes one up. I have known anti-psychiatrists to employ a version of this wherein because my thought process is distorted by medication, my views aren’t worth considering. Of course, there are also legions of armchair psychiatrists who think they can recognize a mental disorder in anyone. Consider those who try to come up with insanities for prominent politicians. I often tell them that when they use my diagnosis they are associating me with people with whom I do not agree with. Their views are not the product of insanity, but of ideology. And it is the ideology which logic demands that we focus our efforts. You argue with the argument,not the person. (If a person is in episode, you may decline to argue with them. But this has nothing to do with the validity of their argument.)

The Shill Gambit is a particular favorite of anti-psychiatrists. Defend the use of psychotropics? You are obviously a thrall of pharmaceutical companies. Once again, you are avoiding making a case by capitalizing on prejudices and conspiracy theories.

Sometimes people try to accuse us of distorting the numbers because we are mentally ill and we just don’t want to take our meds or we want special treatment for ourselves. This is appeal to motive. The idea is that you imply that the person making the argument has ulterior reasons for making the argument like they want to cover up the fact that really are the way that stigma claims they are. It can have its place, however, as in when the NRA suddenly becomes interested in promoting Murphy’s Law so that the whole gun question isn’t being discussed, but you have to prove this connection. Most of the time, you know where to stick this one.

Many of those who want to take the discussion away from the ownership of guns point to the head of the NRA as an authority. He claims that mental illness is what is behind the mass killings, not gun ownership. So his followers lick up the talking point and spit it out again. When you point to a famous person and say something is right because they said it, it is argumentum ad verecundiam. (What kind of authority is the head of the NRA on mental illness? Not one we can count on.) Needless to say, famous people cannot be cited as authorities just because they are famous. (This applies to politicians, too.) If they don’t cite evidence for their arguments, there is a good chance that they made it up. There’s a difference between mentioning studies that show that people with mental illness aren’t dangerous and flat out just saying that they are. The former uses empirical evidence and the latter just makes a statement without the backing of such studies.

“C’mon,” someone might say to you, “everyone knows that the mentally ill are dangerous. Look at all the newspapers, the media, politicians, etc. who say that it is.” Just because an idea is popular, it does mean that the idea is right. People can be wrong in scores. The insistence that this proves the correctness of the feeling is Argumentum ad populum or bandwagon. It is the usual short-cutting of proof using a flimsy pretext. I think many climate-change proponents make this mistake when they talk about the scientific consensus for the idea. What matters is not the number of scientists who have been convinced by the evidence, but by the evidence itself (and there is plenty of it). Likewise, the evidence shows that we who live with mental illness are not any more violent than those who don’t. Many years ago, most geologists laughed off the Wegener Hypothesis which showed that the continents have been moving. As the evidence came in, geologists started to look at landscapes anew, not because it was a popular idea but because strong findings came in from the field showed that Wegener was right! Likewise, we don’t just assert that the mentally ill aren’t more prone to harming others: we have information that shows so. Always concentrate on what the evidence says.

The composition fallacy and the related division fallacy are the particular favorites of those who use stigma to advance their agendas against the mentally ill. I have seen it used by both advocates of forced medication and anti-psychiatrists. They are defined like this:

The logical fallacies of composition and division are a pair of fallacies which are based on a confusion between what is true of the part and what is true of the whole. The fallacy of composition is an incorrect inference from what is known of the parts to asserting the same of the whole; and the fallacy of division is the reverse, from the whole to the part. Comparing the fallacy to the figures of speech called synecdoche (as when one says “wheels” to refer to an auto), one might say that the fallacy consists of taking the figure of speech literally.

So, the forced medication advocates reason, if we can show that one person committing a well publicized shooting is mentally ill, they all must be mentally ill. Or, if we can show that one psychotropic medication can be shown to cause people to be violent, then all such drugs cause people to be violent.

Overgeneralisation is a subset of this attack. I see it happen in support groups sometimes when people hear that some people experience a certain side effect, they assume that the drug is going to cause the same side effect for them. You’re taking a few experiences and insisting that they are true for everyone. It is a fact that many people get fat and diabetic on olanzapine (Zyprexa), but it is also true that not everyone does. To point to one or the other end of this continuum — to focus on the negative or positive personal experiences of some of the population of those who take Zyprexa only and then insisting that this is what happens to everyone is to overgeneralize. To say that because some people instigating highly publicized shootings are mentally ill means that all these shooters are mentally ill is another example.

Stigma users like to spotlight. They will focus on one example — e.g. the Aurora shooter — and use this as their proof that the mentally ill are dangerous. You can also perform this trick by focusing on one patient who has a bad reaction, say your sister-in-law or yourself. If they got sick with disastrous side effects, the reasoning goes, so will you. The burden of proof requires double-blind studies and empirical rather than anecdotal evidence. Much of the time you will find that the people who use this tactic don’t have the evidence to back themselves up.

There is a rise in violence, goes another argument, and a rise in the number of people being medicated. The logical conclusion is that medication causes people to be violent. Right? Wrong. False cause means that you draw an assumption based on a perceived relationship. There was a man named Francis Galton who pointed out that when you see a correlation between A and B, it can mean a few things: A might cause B. B might cause A. C might cause both A and B. Or there is no relationship between A and B: it’s just a coincidence. Anti-vaxxers see a rise in the cancer rate that correlates with the rise in vaccinations. Based on this, they say that vaccinations cause cancer. But when we apply Occam’s Razor, we find a better explantion: because of vaccines, people are living longer — long enough to get cancer! As for the argument that I mentioned at the start of this section, I have not seen evidence showing that the people committing the violence are taking medications. It is only an assertion (see above) and a composition fallacy at work here.

The genetic fallacy holds that you trust or don’t trust an idea based on where it comes from. But the reality is that sometimes E. Fuller Torrey and D.J. Jaffe have a good idea, sometimes the antipsychiatrists make a reasonable point. As stigma, it holds that because a mentally ill person or one on medication offers the idea, you can’t trust it. Logical discussion is about the arguments and whether they are valid and truthful, not who made them in the first place.

A recent alliance between the likes of E. Fuller Torrey, D.J. Jaffe, and the NRA is founded upon the “my enemy’s enemy” fallacy. Given that the NRA is promoting the idea that we have to do something about the mentally ill, we can draw the conclusion that they have the best interests of the mentally ill at heart because the people who oppose its solution are antipsychiatrists goes this illogic. People all along the spectrum of opinion can be drawn into this, so it is always important to return to the heart of any discussion.

The Nirvana Fallacy is currently being used by the proponents of Murphy’s Law. It is refusing reasonable solutions such as more commmunity mental health clinics and demanding that we impose forced treatment and bring back mental hospitals because the community mental health solutions don’t help 100% of the mentally ill. Of course, they ignore the expense of their proposals and the fact that many people with mental illness will likely go undiagnosed because they don’t have clinics. But the main problem is that their proposal is fantasy and that there are more realistic solutions out there.

Colorblindness or rather something similar to it affects discussions about mental illness. This is used by people who deny mental illness from many fronts, beginning with antipsychiatrists and extending to those who tell us just to get over our depressions. It is a false equality that states that all people have emotional problems, but some people are big whiners. This type of stigma colors us as fakers of our illness who should be ignored.

The same people are often guilty of the fallacy of relative privation which is also called “whataboutery” or the “not as bad as” fallacy. You who live with mental illness know the song: “What do you have to be depressed about? Your cousin Leonard broke both his legs and had to have twenty nine stitches. He’s not depressed, so why are you?” It is little more than a guilt trip, one of the cruelest forms that stigma takes.

Emotional appeal is often what is left when you have identified and refuted all the tactics above. Fear is a powerful emotion. We do not like the unknown and we don’t like being bothered to take the time to understand it. If any fallacy is central to stigma, I think this is it.

When we have become exhausted refuting these points, we may choose to retreat. We do not have to argue with fools. Yet there is a snare that trolls and stupid people use to attempt to trap us known as the Chewbacca Defense. This tries to declare a win by several fallacious principles:

  • If you can prove the other side wrong (even if they are wrong about something totally irrelevant), it makes you right.
  • If you can word your statements and arguments in a way that is too confusing, intelligent-sounding, or nonsensical for the opponent to respond to, it makes them wrong and it makes you right.
  • If you can shock or confuse your opponent and make them think you are a lost cause and not worth arguing with, you are right.
  • If you can make your opponent give up on arguing with you, because you appear too crazy to understand them and/or don’t seem to be listening, then they must be wrong and you must be right.
  • If you can make an opponent look bad, their logic must be equally bad, and therefore you are right.
  • If you are more popular or have more support than your opponent, it makes them wrong and it makes you right because more people agree with you.
  • If you just keep arguing and shouting, even if everyone else (not just everyone else in the debate — everyone else in the world) thinks you are not just wrong, but insane, until everyone else just gets tired of listening to you spew nonsense, you’re the last man standing, and, by default, you are right.

Realize that they will continue to be wrong no matter when you choose to end the “discussion” and be satisfied that you have mastered them.

We must not only out these when we see our opponents use them, but we must also be aware of them in ourselves. The facts and how they are to be interpreted are what are relevant. Plenty of studies show that the mentally ill are not as dangerous as the promulgators of stigma hold, so we should use these as our principle sources for our defense. It does not help us to use anecdotal evidence and slippery slope reasoning. The truth is our aim.

In all things, be a Credible Hulk.


See also Misleading Vividness

Two great sources for information about logical fallacies:

Review: An Angel at My Table

Janet Frame endured eight years as a mental patient before she went on to become the poet laureate of New Zealand. She was misdiagnosed. While she was incarcerated she underwent electro-convulsive therapy without anesthesia and was lined up for a lobotomy until her doctor learned that she had won a prestigious literary prize and took her off the list. This movie is the story of three periods in her life. Her time in a mental hospital is the second.

I would guess that social anxiety and, perhaps, depression were the demons that afflicted Frame. She would hide in corners. She failed at her work as a teacher. When two of her sisters died, she crashed into a frozen despair.

If Angel at My Table is accurate, Frame was most certainly not schizophrenic. An early scene in the second part of the film shows her riding to the hospital in a car with two women who are severely impaired by their illnesses. She stands out as unafflicted by whatever is troubling her fellow passengers. Things were done to her while she was in the hospital just because they were the latest treatment. Her mother desperately signed the papers for the lobotomy: if Frame had been trapped in a mindless system, we would have lost a great author. Fortunately, a doctor noticed in time and helped her win her release.

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Low-Grade Depression?

I have been trying to discern if I have been in a low grade depression or not. It can be tough to recognize these borderlands. The signs can be subtle. While I do not have negative thoughts coming at me and trying to carry me off on the backs of lemmings flooding over a cliff, I have found it harder to complete tasks and sleep less than 11 hours a day. If I am not in a depression, I am very near one, I think.

Two things in particular seem to be helping at this point. The first is my Vyvanse. The second is exercise. Vyvanse is known for raising people out of funks. Exercise is a remedy that I have used for a long time. But it only helps when I am gasping at the surface of that great ocean of drowning. So if I am down, it is not very far.

The Beast

I think it is important to make a separation between ourselves and the disease. This, I think, is a state of mind more than anything else. I give mine a name — The Beast. Sometimes The Beast is ravenous and chews on my rib cage; other times it is rabid and tears out the sinews of my self control. I do my best to tame The Beast and part of that taming is taking my meds. But The Beast is only part of what makes me, me. I feel that The Beast, properly leashed, is part of the “essential and precious character” of my person, but not the only one to be acknowledged, reviled, or celebrated.

What Makes for a Good Caregiver?

When one takes aim at a system of privilege, some jump to the conclusion that you hate the people who stand to gain from that system and have no compassion for their struggles. Caregivers can make it hard on themselves and on the patient. They give twenty four hours a day seven days a week looking after people in severe episode. They neglect their own health. They grow weary and cross from all their over-involvement.

Our DBSA chapter feels that caregivers need their own place where they can talk about their issues and we have provided one. We do not tell them what they can and can’t talk about. We do not ask them to support certain laws or advocate for changes that they do not want. We don’t have a patient monitor the group to be sure that they act according to some unbearable standard of political correctness — people need to vent. We shelter them from people who may have an ax to grind (I have heard about other groups where caregivers were roasted over hot coals by angry patients) and who don’t appreciate how hard it is. We encourage them to talk to peers who know what it is like. We always ask them how they are feeling when they come to our patient-family support groups, reminding them that they, too, are important. We feel that their mental and physical health is as important as the patient’s and we tell them so.

I’ve been hit with some innuendo from some online caregivers who imply that I don’t care about the mentally ill. What I believe they are really saying is that I don’t care about caregivers. I do. It aches when I see a caregiver overburdened and I do my best to relieve that. Many have been the times when I have had a couple in a group and told the patient that she or he needs to realize that her or his manic state of mind is creating an extremely stressful environment for her or his spouse. How does this make me a foe of caregivers? I think much of the misapprehension stems from my opposition to Murphy’s Law, which I have explained at length elsewhere. It scares caregivers to hear me talk about sane privilege– just like it scares white people when we are talking about black people — where we who live with mental illness are left out of decisions about our treatment.

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Review: Love and Mercy

I’m always a little on edge when I sit down to watch a movie about someone living with mental illness, particularly if it is a true story. Did the actors, writers, and director get what it is like to live with mental illness or did they make a caricature of it? Did they romanticize it? Did they put a hockey mask over the face of the sufferer and an ax in his hand? Is it another ECT scene out of One Flew Over the Cuckoo’s Nest? Or do we get the truth?

Bill Pohlad’s Love and Mercy had me worried about romanticization before I saw it. I dreaded that he would render the illness of Beach Boy Brian Wilson as cute and fuzzy, something that would make us wonder whether we were too cruel when it came to the mentally ill. It did do that, but there is a right way to go about it and a wrong way. The wrong way declares that there is no such thing as mental illness; it diminishes the impact that the illness has on those closest to the sufferer and suggests that the illness that afflicted the likes of Brian Wilson was little more than a personality quirk. Pohlad and his cast did it the right way: it acknowledges the severity of Wilson’s illness, but also turns a harsh eye towards his guardian/therapist, one Eugene Landy and his sadistic oversight of the musical great. Paul Giamatti’s performance was so to the T that when Wilson watched the movie, he experienced a severe dissociative state where he believed for several minutes that Giamatti was Landers come back to haunt him.

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