The shopping cart

The left coast is chock-a-block full of peculiar people. My word! A supposedly HIV infected guy approached me on the street in Vancouver. Uh, oh, I thought, here comes the pitch. And what a pitch it was.

“Excuse me,” he began, “Thank you for at least speaking with me. Most people would not. Do you know that you look like the ex-wife of that billionaire whose last name is – I can’t think of it but it begins with a ‘T’.”

“You mean, Ivana Trump?” I gushed. I looked over at Ian, who is definitely not The Donald. “Ian, give this good man five dollars.”

Watching The Soloist on the plane to Vancouver was a great opening act for what was to come. The running theme of the Vancouver and Victoria leg of our August vacation was the shopping cart. At one point in the movie, Nathaniel Ayers refuses to leave his shopping cart behind when he is invited to give a solo concert.

The shopping cart would be an excellent place to begin to learn to treat schizophrenia holistically by understanding what is essential for the individual’s sense of survival, which surely must have something to do with his or her past. To me, the shopping cart represents life’s laundry. Everything that is important to the person is found within. The cart is wheeled everywhere, often with a plastic bag attached to pick up bottles, which presumably are redeemed for money.

Vancouver, being a laid back west coast city with good weather, has lots of street people driving life’s laundry around. I wonder if social service workers have bothered to ask them, piece by piece, what their life is about?

In Victoria, Ian and I were given an interesting perspective on street life by an old friend of Ian’s who has had a reversal of fortune. Jim is now out there with the best of them, “binning” as he calls it. He is in hot competition with Victoria’s street people for bottle collection and redemption. He waits until after dark, when no one from his previous life will see him, and then heads to the neighborhoods where he knows he can get the most bang for the buck. As we drove around Victoria’s streets in broad daylight, Jim gave a thumbs up to a few guys and gals pushing shopping carts, and occasionally pointed out that so and so over there was his main competition for that tax free income.

I know a lady from work who, judging from her appearance and quirks, has extreme mental health issues, but she plays the game of life, none-the-less. She walks to and from work dragging a shopping trolley, but is also occasionally seen trundling a piece of luggage to and fro. She sports bright red earmuffs when it’s not even cold outside. To talk to her, she seems normal enough, but her appearance and that trolley set her apart. I wonder what is so important to her that she takes it with her on a daily basis.

I know nothing about her, whether or not she has received treatment for mental health in the form of psychotherapy and/or medication. I suspect, because of her age, that she had not spent a lot of time in psychotherapy. It has only been relatively recently that psychotherapy for schizophrenia is promoted as a treatment that can work for schizophrenia. Since the advent of the typical (first generation) antipsychotics in the 1950s, the benefits of psychotherapy have been downplayed in the rush to pharmaceuticalize treatment. Four years ago when I began my search for other options beyond simply medications, the standard view put out by pharmaceutical companies and the big mental health organizations was that psychotherapy was not considered helpful for schizophrenia.

I am still unclear, from watching The Soloist, how that hospital/shelter, whatever it was that the patients milled outside of, was helping the street people it was supposed to be helping. How about starting with some individual psychotherapy? How about talking with them about what the contents of their shopping carts mean to them?