CHAPTER TWO: EXPLORING THE ABYSS OF MADNESS
The girl with four imaginary children in her bedroom
I saw a 19 year-old woman a great many years ago, hospitalized,
who refused to speak except to say that there were four children
living in her bedroom.
According to her parents, she had been
entirely normal, reportedly perfectly delightful in fact, until just a
few weeks before, but now she was in prolonged silence.
psychiatrist assigned to her gave her a diagnosis of schizophrenia,
and she was begun on a course of antipsychotic medications.
behavior remained the same: long stretches of silence, very
occasionally interrupted by short statements that four children were
in her room.
She would not describe the children, explain their
origin, or otherwise engage in any further communication on the
When asked if she believed the children were real, actual
human beings, a look passed across her face of confusion and
The doctor, after a period of weeks, recommended shock
therapy, and a course of 12 electroconvulsive treatments then took
Following these, she spoke just once to say there were now
no children in her bedroom; otherwise the reign of silence
Finally she was discharged and her family took her
We never saw her again.
But I was haunted by what had
occurred and always wondered about what happened to the young
woman and what her behavior could have meant.
In the following,
I offer some hypotheses about this patient, and her story becomes a
point of departure for a journey into the nature of madness.
Looking back on this experience from the vantage point of all
that I have seen since, there are five items that stand out: first, that
she was, according to her parents, a “perfectly delightful” child
prior to the transformation in her behavior; second, that the
primary change was one of lapsing into silence; third, the sporadic
statements regarding there being four children sharing her
bedroom; fourth, her apparent confusion in response to being asked
about whether she believed the children were real; and fifth,