Mental Illness, Recovery, and Creation: a Conversation

In this candid conversation, the husband and wife team of Joseph Fasano and Laura Rinaldi open up about mental illness, addiction, and their goal of offering support to anyone suffering in mind and spirit.  Through poetry, philosophy, psychology, and lived experience, Laura and Joseph hope to help others find their pathways to health.   

Laura Rinaldi:  I really admire your openness to telling your mental health story now. What makes you feel open to it, and what feels right about the time?  If I were to take a guess, I would venture to say being a father has invited you to enter this realm of new, enchanted vulnerability.  Not to mention turning forty, and how that is reflected in your poetry about seasons and mortality.  I think it is a great, important gesture — sharing your unique challenges, not only with me in more detail, but with the world. It is something I think will invite more love into your life, and hopefully into the lives of others.

Joseph Fasano:  I’ve never spoken about this in any public way, ever, and I have to say I feel more than a bit terrified to do so. But the time has come — for so many reasons. During my many hospitalizations, I have seen people crushed not only by their mental illnesses but also, tragically, by the stigma of those illnesses.  Mental illnesses and addictions are diseases, and we must all work together to eliminate the shame that shrouds them.  

Laura Rinaldi:  I’ve seen a lot of that shame with many of my clients, as well.  Stigmas really hold people back from getting the help they need.  Even with this flood of new generations trying to break the cycles and stigmas, mental illness remains one of the most feared and misunderstood forms of suffering, and substance abuse remains one of the most judged by archaic standards of manmade morality.  Judgments and fears imprison us, make us look to others to define who and what we “should” be. I think it might be helpful to ask — when did you first understand you were suffering from mental illness?

Joseph Fasano:  I had my first psychotic break at the age of ten, but I wouldn't say I understood it at all.  In fact, I had no idea what was happening to me.  I was convinced that I had done something that in fact I had not done.  This was immensely distressing, particularly because I had no language with which to express this experience, which is one of my primary reasons for opening up about my struggles now:  If my story somehow helps people, young or old, find a language for their mental illnesses — and the courage to use that language — I will have done my part to break the silence that kills.

Laura Rinaldi: Wow. No language for it. Going through that at ten years old must have been scary — and lonely.

Joseph Fasano: It was, but I knew nothing else. I would say that in my teenage years I started to realize what I was experiencing wasn’t quite the usual course of things.

Laura Rinaldi:  I can’t imagine. The teenage years are particularly difficult for many, especially because that is a time of great transitions.  Any transition and launch into independence can be traumatizing if not guided with love and attention.

Joseph Fasano: My early teenage years were marked by fear, and in particular by the trauma of my father having to stand trial for a crime he did not commit.  The suffering he must have gone through inside his quiet dignity is unimaginable. A fearsome silence had slipped into the family, and even now I remember only flashes from the darkness of those days: my mother crying out once in the kitchen, neighbors whispering about Italian-Americans, a room spinning as the verdict — not guilty — is read. At some point my brothers and I were told to be sure not to take any rides from strangers, as it was thought that there might be a plan to kidnap us and hold us hostage until my father gave a false confession.  This utter madness was the background of my early adolescence.  I have written about this explicitly in my poem "Genesis," but it forms the substratum of a great deal of my work.  As it has been there in the silences of my life, it’s there in the silences of much of my writing.

Despite these troubles, my family persevered, and I had what I consider a successful and happy adolescence, until April 4, 2000.

Laura Rinaldi:  What happened then?

Joseph Fasano:  I had a massive psychotic break.  I woke up as one person, and by the time I fell asleep that night, my entire life had changed.  I would never again be the person I had been.

Laura Rinaldi:  What were the symptoms of that episode?

Joseph Fasano:  I had a sudden, pervasive, and abiding paranoia that I was being sought out for punishment.  Of course I should have understood the causal connection between my father's trial and this paranoia, but the nature of psychosis and delusional thinking is that the sufferer has absolutely no way to judge the reality of the thoughts he is possessed by.  

Laura Rinaldi:  How long did these delusions last?

Joseph Fasano:  Years.  They would wax and wane in intensity, but I was battling them all through my college years, during which I was hospitalized several times, once at McLean Hospital in Massachusetts.  Although at some point the paranoia subsided to the extent that I was no longer living in a consistently twisted reality, the echo of it was always with me.  Even more terrifying, though, was the fear that it would return.

When I was eighteen, just a bewildered kid in the midst of that first major breakdown, I scribbled a few lines that I still remember, lines set in the horse pastures of Goshen, New York, where all my first changes were:

The child walks out to the dark mare,

slips off the tatters of its halter.

Though childhood

goes, once woken,

it leaves you with the great weight of the fear.

Laura Rinaldi:  Yes, and as you’ve written in another poem I love, it’s a matter of “What will you do / with the great fear that was entrusted to you,” isn’t it?

Joseph Fasano: Yes.

Laura Rinaldi: I recognize this fear, and the ability to alchemize it into growth, in your work.  Somewhere in your words and characters the fear is trying to repair its wounds.  As you always encourage your students to ask, how did your fear shape you?

Joseph Fasano:  Baudelaire has a haunting line: "I have felt the wind of the wing of madness pass over me."  I feel that in my bones.  Every day of my life, I have asked that wind to pass over me.  Sometimes it has stayed.

Laura Rinaldi:  I recognize that feeling in you. These are the times you get caught up in delusional thinking?

Joseph Fasano:  My diagnoses are many.  Unfortunately, if not checked, they all seem to work together toward catastrophe.  My severe obsessive-compulsive disorder brings up ruminative thoughts, so that I can find myself obsessing about something for most of the day and night, exhausting myself with various compulsions that are meant to alleviate the anxiety around the obsession.  In this state of mind — which I am rarely not in — the seemingly smallest act can be excruciating: taking a sip of water, walking through a doorway, closing a book. Unfortunately, these symptoms are exacerbated by my other illnesses; I have also been diagnosed with bipolar disorder, and for me that means that in my times of heightened mood, I have a tremendous amount of energy that can feed the obsessive thoughts and compulsive symptoms.  Thirdly, my obsessions and ruminations, fed by manic energy, can develop into full-blown psychosis, a state in which I believe something that is not "real."  What a word, "real."  Who knows what that is?  Perhaps it's better to say that in my psychotic states I believe things that do not quite align with the facts as others understand them.

Laura Rinaldi: Many people grossly misunderstand OCD, mania, psychosis, and other disorders. They can be crippling. Counseling is critical for those connected to someone with these afflictions, and of course for the individual who suffers from them. Without understanding or compassion for the diseases, it can become very easy to take things personally. One of my greatest lessons has been to not take things personally. I know it has helped me navigate our relationship and find the depths in it.

Of course those depths — in ourselves and in others — can be as frightening as they are magnificent. I keep thinking of Baudelaire’s quote and his word “madness,” which you just mentioned. That word, that concept, is also aligned with creativity. Can you share more about what a connection between “madness” and creativity means to you?

Joseph Fasano: That’s an oversimplification at best, a romanticization of suffering at worst. Certainly there have been many cases of artists whose pathologies seemed to contribute to visionary, ecstatic, or otherwise profound experiences — just think of Van Gogh’s roiling starlight; Georg Trakl’s blue deer stumbling through his poems; Munch’s Scream; Goya’s late, savage nightmares; Sylvia Plath’s “blood-jet” of poetry — but pathology is not what created any masterpiece. Those artists sublimated their subjective experiences into something transcendent. They found the form or forms necessary to bring the artistic work to completion, and form — whether it comes from a cultural construct or an archetype in the collective unconscious — is always more universal than individual subjective experience, and certainly more universal than pathology.

There’s a well-known anecdote about Lucia Joyce, James Joyce’s daughter. In 1934, the great healer Carl Jung met with Lucia in an attempt to treat her schizophrenia. “Doctor Jung,” her father asked the physician after the meeting, “have you noticed that my daughter and I seem to be submerged in the same waters?” “Yes,” Jung is said to have replied, "but where you swim, she drowns.”

What Jung meant, of course, is that the artist may have pathologies, disturbances, afflictions, but attending those is the ability to give form to — or find form in — the material, whether or not its source is in pathology. “Madness” may indeed be a source of some psychological content that the artist might not have otherwise mustered from the unconscious, but the hand of the artist is not mad.

In any case, an artist can only go so far with the material of internal, subjective turmoil. The dark hymn is finished with me. What I’m more interested in now is the world as the healthy mind finds it: the mystery, the risk of sunlight, the daily bread and the commonness between us. There are great songs howled in the dream-world of the wild darkness. But the greatest song is the song of the real.

Laura Rinaldi:  Sharing a life and a home with you — and being on my own artist’s journey — I can heartfully agree that health is what can lead us all to our fullest creative potential. Bringing buried psychic dramas into the light is one of the keys to treating cases of mental distress. In other words, we must face the scary parts of ourselves. This allows us to face the scary parts in others as well. One of the gifts we’ve given each other has been to illuminate and help each other confront these parts. I remember when we first met, we spent a lot of that first evening talking about mental illness and different treatments, and we discovered that we both have a passion for helping others understand themselves in their struggles.  To help them navigate the dark night of the soul.

Joseph Fasano:  I’ve tried to do that through my teaching and writing, but I really admire your contributions as a mental health counselor.  Can you talk a little about what led you into the field of mental health and what kind of work you hope to do with your clients?

Laura Rinaldi: Well as you know, in college I was studying English, Communications, and Linguistics, but what I really found pulled me to my center was connecting to stories and expression.  This was a common thread in all my studies, and even my art. Through my own interest in art, writing, practicing holistic nutrition and spirituality, I understood all I wanted in my career was to integrate these loves and, if I may say so, “talents” of mine.  It wasn’t until my grandfather passed away and I recognized how fractured our healthcare systems are that the lightbulb glowed for me to follow the path of becoming a sort of creative therapist. I found that path through clinical mental health counseling. My graduate study internship was spent with individuals suffering from substance use disorders and behavioral issues, a diverse population I continue to work with.

I learned so much through these studies, and I’m so thankful I did. They have helped me to understand myself and others with so much more grace and patience than I could have imagined.  They have helped me to understand you as a partner, and how to be a more effective mother.

Joseph Fasano: You really are such an amazing mother to Leonardo, and I think that’s largely because you’re able to be your whole self, and in doing that you’re sending him the message that he doesn’t need to be afraid of any part of himself. It’s beautiful.

Laura Rinaldi: That’s what I hope for every day. All the parts of ourselves are connected, sometimes in ways we don’t know yet.  I have tried to integrate my passion for spiritual practices, holistic healthcare, art therapy, and most importantly a love for nature and all it does in the work I do.  Integration of all that I love has been the greatest gift I could have given myself — and I think others feel that in my work. All the pieces I collected to form myself give me a unique perspective and offer a wide stratum of clientele with whom I can connect.

Joseph Fasano:  Your work with substance use disorders is a real inspiration, as I know the deep compassion you bring to that calling.  It strikes me just how much addiction is a great equalizer.  You and I can speak about it endlessly, but that awareness, in and of itself, can’t stop the disease of alcoholism, which, as you know all too well, has plagued me for years.  Cormac McCarthy once called alcoholism the “occupational hazard” of writers, but I don’t romanticize it at all.  It affects people in all walks of life, and it’s a terrible disease.  Although I’ve never written a word of my work while drinking — for me, creation requires the almost prayer-like attention of one’s whole life and death — whiskey was often there to quiet my mind and calm the nerves after I’d risen up from the good, clear depths of my writing.  As you know, when I’m in my writing-self, all seems clear, precise, calm, balanced, right.  But this other self, the man whose shoes I walk around in, he has a lot of trouble living through the day.  I drank to get some relief from the mental and spiritual pain, but at some point I was just drinking myself into more mental and spiritual pain, not to mention serious physical consequences.

I often speak of the different parts of myself — some healthy, some troubled. Much of my spiritual and psychological work in recent years has been to integrate those varied parts of myself, but it has been a battle.  Recently, I had to tear myself away from you and our son Leonardo for a rehab stay.  It was terrible to be away from you two, but I’m so glad I got the help I needed.  

Laura Rinaldi:  It took a lot of courage to do that, Joseph, and you know how proud of you we all are. You’ve been such an amazing and loving father to Leo, and now you can truly be the role model who also shows him he does not need to fear any part of himself. Being honest and accepting your struggles will help you be your whole self — and will allow him to be himself, too. I love watching you be the best Dad to him, now more than ever.

It was hard for all us and we missed you so much while you were away, but I understand how beneficial treatment can be. I have spent hours helping clients before and after their inpatient referrals.  However, the professional perspective I have is vastly different from my personal experience going through it with you.  Tell me, though, what “addiction” means to you after this hospital stay.  As a mental health counselor I have my answers, but as your partner I have experienced the pain of watching it unfold.  After looking deep into my eyes, the eyes of our son, knowing your liver was showing early signs of failure, having withdrawal symptoms, facing death in many ways — what kept pulling you back to drinking?  It’s a question I think a lot of loved ones might want to ask. It’s something many of my clients have needed to ask themselves, as difficult as it is.

Joseph Fasano:  Can I tell a story?

Laura Rinaldi:  Of course. How did I know you were going to say that?

Joseph Fasano:  Because you know me better than I know myself.

Laura Rinaldi:  Go ahead, you poet, you.

Joseph Fasano: Some of us remember the explosion of the Space Shuttle Challenger, right?

Laura Rinaldi:  Well, I remember you showing me a Youtube clip. 

Joseph Fasano:  [Laughs]  As child of the ‘80s, I remember it well.  Just a few weeks ago, I was sitting in a group session in a rehab facility, and we were talking about why we go back to our substances, which for me has meant alcohol.  Suddenly the image of the Challenger breaking up above the upturned faces of America flashed before my eyes.  I couldn’t make sense of why I would have remembered that image, until I reflected for a few moments.

In the aftermath of the disaster, sociologists came to develop the term “normalization of deviance,” which I like to modify to “normalization of risk.”  You see, those in charge of launching the Space Shuttle missions had understood for a very long time that a certain crucial element of the Shuttle would have a high probability of failure if the launch took place below a certain ambient temperature.  There was simply no doubt about it: the part would fail (it was an O-ring in the fuel tank), fuel would leak and ignite, and the entire Shuttle would be lost.

Well, what happened?  One Shuttle was launched, and no disaster happened.  Then another shuttle, without disaster.  Then another.  You get the idea.  After every successful launch, the probability of disaster was actually increasing, until it became all but inevitable, but those in charge of the launches, motivated as they were to keep the program going, wished to believe that every successful launch merely proved to them the safety of launching a Shuttle.  They wished to believe it until they did, in fact, believe it.  They had normalized the risk of launching, even as that risk was increasing.  The only possible end was disaster.

This is what it’s like to pick up that next drink.  Sooner or later, if you continue to abuse, the disaster will happen: You will lose everything.  And yet you tell yourself, again and again, “Just one more.”

Laura Rinaldi:  I see.  It takes so much to finally admit a problem.  Especially after years of work on yourself.  That is exactly what I feel from this example.  I know how hard it is to admit something just isn’t working.  I imagine much of this has ruled your life, and maybe your loved ones at different times. Mental illnesses and substance or alcohol use disorders are family diseases, meaning they impact the entire family unit. I know you’ve sought help for your conditions for decades, but what feels different about this time?

Joseph Fasano:  I’ve had decades of treatment — psychotherapy, medication, hospitalizations — and they have all been profoundly helpful, especially my current therapist and my current regimen of antipsychotic and other medications. But of course now I have the greatest motivation and healing of all: you and our beautiful son, Leonardo.  Something one learns in recovery is that giving to others is the real salvation, and these days when I wake in the morning, I have not a second to waste indulging any obsessive, delusional thoughts or any cravings for alcohol.  I have to be there for my son and my wife, and that’s exactly what I want.  I have always preached, in poetry, that we must all find the place where form and freedom are the same.  Now I can embrace and be embraced by you and Leonardo, and feel the bonds that set me free.  

Laura Rinaldi:  I love your teachings on form and freedom. One of the many elements that make you a great teacher. It must feel good and cathartic, but also frightening, to let yourself be visible and vulnerable in this way. You’ve mentioned that you’re scared of sharing these parts of yourself, even with those who are close to you.

Joseph Fasano:  Yes, I am.  But I have seen firsthand how much shame contributes to suffering, and I feel called to help others find help.  Of course I’m afraid that I’ll be judged, defined by my illnesses, or just plain hurt.  But it’s not really about me.  It’s about any person who might read this and feel slightly less alone in what they’re going through. I’m ready and willing to open myself to pain to help that person. 

I’ve spent many years trying to set these troubles aside and let my work speak for me, but anything hidden from oneself will always emerge somewhere else.  Although these issues speak in the silences of my poetry and fiction, I want to be very clear about them outside of my writing, as well.  I want to sing this message loudly so people can join in and not fear themselves.

You, too, have been devoted to giving that kind of help.  I love your vision and your openness, Laura.  Would you like to talk a bit about some of our goals for the future?

Laura Rinaldi: Of course. Leo kind of postponed a few of the logistics, and I really wouldn’t have it any other way.  But what we hope to soon develop is a healing/creative center.  It’s been my dream for years. This is a unique combination of mental health services and a place to unearth creative potential.  They are intimately related.  Connecting to creativity means connecting to the core of yourself as a human, and we do that by means of being in nature, poetry, and various other forms of movement and art that are clinically proven to heal mental distress.  We hope to develop this creative therapy center in the next year or two, and hopefully this conversation will invite others to collaborate and connect.  As you said so well, our aim is simply to help people feel slightly less alone. If we’ve learned anything through the pandemic, I hope one of the most salient lessons has been that we need community to survive.  And our goal is to do our part to help create that community. 

Joseph Fasano:  I join you in that hope that we can do our part to help others in their struggles. Thank you for helping me open up about these issues, Laura.  Thank you for being you.

Laura Rinaldi:  One day at a time.  Keep singing your song, Joseph.  We love every draft of the music that is you.  

Joseph Fasano can be reached at joseph.fasano@gmail.com.  Laura Rinaldi can be reached at lauraantoniarinaldi@gmail.com.