A memoir that reminds us not to take sanity for granted, Divided Minds is a haunting testimony to the horrors of mental illness.  Pamela Wagner and Carolyn Spiro, in this joint-autobiography, take turns recapturing the most significant moments in their lives as twin sisters.  Not surprisingly, the majority of these moments involve each other.  However, the cold irony of the story lies in the way that a minute genetic difference between the two sisters causes them to view shared events in drastically different ways.

The book begins with an account of childhood that one would expect from the lives of identical twins.  Pamela and Carolyn describe both the joys and the hardships that come from sharing such an intimate sibling relationship.  Chronologically experiencing the world at exactly the same age, and stage of development, provides them with a symbiotic dependence that lessens the impact of childhood difficulties and enhances the bliss of youthful triumphs.  However, Pamela and Carolyn are simultaneously confronted with minor deviations in facticity (in the existential sense), which generate an acute form of sibling-rivalry.  This almost assured rivalry is only briefly conveyed–but is still an important foundation of the story.

On November 22, 1963, Pamela's life changed forever.  After being informed that President Kennedy had been assassinated Pamela heard the voices for the first time.  Exerting immediate control over her adolescent mind, the voices convinced her that she was responsible for the President's death.  On that fateful day, Pamela was to begin a new, even more intimate, relationship with a disease of which she was totally unaware.  While schizophrenia was not diagnosed until later, these delusions were a by-product that she would have to deal with for the rest of her life. 

For the remainder of the book, the reader is given a poignant and vivid description of the debilitating nature of schizophrenia.  Although it is interesting to read Carolyn's description of Pamela's trials, the enthralling portrayal comes from Pamela herself.  Throughout her life, Pamela experiences the torments of paranoia, narcolepsy, catatonia, mania, depression, and self-mutilation.  Still, the worst, most prevalent effect of her schizophrenia consistently remains the taunting, ruthless voices emanating from her own mind.  Pamela tries to convey her experience to her sister: "[Carolyn], you have no idea what it's like!  This is how [the voices] torture people–on and on, they never stop.  They want me dead, and they'll keep talking until they have their way…I know you want me to live, but–(p.263)." 

Schizophrenia is a vicious cycle.  Its effects emaciate the normalcy of life, and this deterioration of normalcy, in turn, increases the intensity of the illness.  Exhausted by the endless struggle, Pamela often engages in suicidal, and otherwise self-destructive, behavior.  This behavior leads to countless stays in mental institutions and a plethora of anti-psychotic medications, which lead to numerous other problems.

Of course, a parallel theme of the book is how Pamela's schizophrenia affects the people in her life–most importantly, her twin sister.  In a way, Carolyn's account of her own struggles, rooted in Pamela's illness, is much more emotional in nature.  While Pamela's time was spent either in a state of acute anxiety, fending off the voices or in a state of lethargic numbness produced by the medication, Carolyn was stricken with a life-long ambivalence toward her sister.  Carolyn perfectly articulates her attachment-avoidance relationship with Pamela.  On the one hand, Pamela is Carolyn's best friend, sister, and confidant.  On the other hand, Carolyn has the urge to flee the relationship, afraid if she doesn't, it will ruin her life as well.  She even recounts a dream, without interpreting it, in which she and Pamela were in a boat speeding toward the shore, and their imminent death.  In Carolyn's dream, Pamela was trapped under the tiller of the boat.  Although she tried to help her sister, Carolyn eventually jumped out of the boat, saving herself.    

An underlying idea that is never fully elaborated in the narrative is the obvious guilt that Carolyn feels about her sister's illness.  Carolyn alludes to, but never quite explicates, the fact that she could have turned out to be exactly what she sees in Pamela.  As a psychiatrist, Carolyn has to be aware that schizophrenia is a disorder largely determined by genetics.  With this in mind, it was an arbitrary–but no less malevolent–twist of fate that Pamela was inflicted with this mental disorder while Carolyn was spared.  This, too, could be a reason why Carolyn often kept her distance from her sister.  This guilt, whether repressed or not, is a difficult burden to bear.  To see what she could have been, what she would have been, had she been the unlucky one, caused Carolyn to agonize with culpability almost as if she had chosen Pamela's destiny.  Never was the literary phrase more suited: in a mirror, darkly. 

Divided Minds is so smoothly written that it is easy to forget that one is reading the story and not watching it unfold firsthand.  However, one of its scarce deficiencies lies in its phenomenological precision.  Both Pamela and Carolyn, probably by design, fail to ever enumerate the details of schizophrenia when these details could enhance the story.  They choose instead to leave the reader in the dark about even the most basic facts of the illness–focusing, instead, almost entirely on their subjective interpretation of its effects.  While this is a unique approach, having finished the book, inquisitive readers will find themselves somewhat unsatisfied in this regard.  Perhaps this is to entice the reader to pursue some answers even after the book is finished.

Something else that readers might interpret as a flaw is the fact that the book dwells at times on Pamela.  Not only is two-thirds of the book written from the perspective of Pamela, it also tends to become repetitive about her countless hospital stays.  These visits become predictable, and can seem superfluous to the progression of the story.  While I would empathize with such an interpretation, I am not entirely convinced that this isn't the most ingenious aspect of the book.  The repetitiveness of Pamela's testimony seems perfectly metaphorical of the ceaseless nightmare that a schizophrenic experiences.  While they are inculcated by the voices in their head, minutes can seem like days–and even when they recognize their plight, the same effects envelop them over and over again.  They are passive observers of their own torment–a torment that comes from within them.

The only readers to which I would not recommend this book are those that lack concern for the suffering of others; or, those who are not interested in the perseverance of the human will over the sadistic nature of fate.  During the most torturous moments of Pamela's story, one is forced to constantly reflect on the fact that she survived–because one is reading her eloquent narration of those very events.  This book also leaves one with an unsettling realization that packed away in many psychiatric institutions are people who appear to be detached, even barely human, but underneath are wonderful people, like Pamela, pleading for help.   

© 2007 Michael David Cesal

Michael David Cesal received his undergraduate degree in Psychology (with a focus on Social and Abnormal Psychology).  He is currently finishing his Master's Degree in philosophy–in which he concentrated on social, moral, and political philosophy.  In the fall, he will begin a second Master's degree in political theory and international relations.      

Categories: Memoirs, MentalHealth