Madness leaves a mark. Certainly a stain on those afflicted, but also a fainter inscription on those who‘ve watched a family member writhe under the demons of the mind. This mark is as indelible as the blood on Lady Macbeth’s hands, yet as invisible to the world at large as it is screamingly evident to those who perceive it.

”My brother saw the face of God,“ writes Greg Bottoms about the initial psychotic episode his brother Michael experienced at age 14. ”You never recover from a trauma like that.“ Thus begins Angelhead, the stunning memoir in which Bottoms chronicles the nightmare of living with his older brother‘s mental illness and the disfiguring reality that caused his own life to resemble ”a pastiche of filmed cliches in which Michael occasionally made a cameo as the monster.“

Michael suffers from acute paranoid schizophrenia, an illness that went undiagnosed until his early 20s. Initially, his erratic behavior was thought to be the consequence of his extravagant use of street drugs. That first break with reality, in fact, occurred after he’d taken six hits of acid at an Ozzy Osbourne concert. Ten-year-old Greg watched as Michael, just home from the concert, raved that God was accusing him from the windowpane.

I stood in his doorway, a nightlight golden behind me, wearing pajamas, fat-faced and freckled, looking at my brother while he screamed, all open mouth and high-pitched wail. His face was contorted like a snake handler‘s, like a strychnine drinker’s in the documentaries I would watch years later, late at night, with a VCR remote in my hand, slow-motioning the physical tics of madness.

The acid, though, was not the cause of Michael‘s illness. ”Drugs made Michael’s psychosis worse, surely,“ Bottoms writes, ”but they weren‘t his psychosis.“ Looking to the family tree, Bottoms discovered that one branch had been gnarled by alcoholism, depression and suicide. ”If my father had thought about it while watching Michael that night, he’d have realized that the chances of his son seeing the face of God, in some form, were not so astronomical, even without the acid.“

But denial is a strong survival technique. When asked by a psychiatrist if there was any family history, the boys‘ father said that he didn’t know of any. In recounting the episodes in which the family struggled to understand Michael‘s inexplicable behavior while remaining unwilling to recognize the genetic link, Angelhead reads piercingly accurate.

My family, too, is scorched with the inscription ”mentally ill.“ Readers like me who’ve watched a loved one — in my case, a mother — be sucked under the paralyzing effects of mental illness, who‘ve been accosted by the suddenness and the violence of the attack, and who, ultimately, have had to save their own lives at the expense of the loved one, will recognize themselves in the stinging portrait Bottoms paints. He captures the experience of witnessing a family member fragment, of wanting to grab hold of a brother, a mother, a loved one, and pull him or her back, make the person who used to be there reappear. And, ultimately, the emptiness of being left with nothing but pieces.

In spare, sometimes lyric prose, Bottoms corroborates the terrifying occurrences that many families, like his, refuse to discuss. This unnatural silence in the face of derangement spawns a corrosive form of familial disintegration:

[W]e all hid from each other. We lived in separate rooms . . . we had Michael to think about — our brother, our flesh and blood that we could not understand — every time we were together . . . We shared a space, a roof, nothing else.

Collective guilt fuels this loneliness as each family member assumes responsibility; it’s easier, somehow, to have a tangible someone to blame. The truth — that madness happens without our consent or control — is utterly unacceptable. Added to this illogical guilt is the joy the family shares when the afflicted member is removed, if only temporarily. During a six-month period during which Michael was sent away to Florida, the Bottoms family experienced its first reprieve:

I‘d wake up every morning happy that he was gone . . . It was is if he had been erased . . . [W]e laughed and went out and ate seafood and no one stared at us. This kind of happiness was bizarre . . . Heaven, for us, was not expecting a call at four in the morning. Heaven was not having to sleep with your bedroom door locked.

Such joyful release at the expense of a brother foments a guilt that is immutable and long-lasting. And yet, Bottoms acknowledges that ”Michael being locked up in a place with 24-hour care and locked steel doors was a bit like winning the lottery.“ a

This love-hate dynamic — like all the effects of growing up with a mentally ill family member — is never fully exorcised. Bottoms writes of being away at college, missing all his classes, and yet reading obsessively, terrified that if he didn’t make his mind strong, he‘d lose it:

I was afraid that the wave of insanity, the currents of which I knew were already in my blood — I thought I could feel them like an itch at the base of my skull sometimes at night — would close over me if I didn’t prepare myself, if I didn‘t constantly read and spend all my time building up my defenses against unreasonable thoughts.

As Greg shored up his own mind, his brother’s continued to deteriorate. Michael confessed to a neighborhood murder he hadn‘t committed. For a time, he lived on the streets, where he was the victim of multiple rapes. To avoid institutionalization, he leapt from a van going 45 miles an hour. He attempted suicide, first by drinking Drano, next by hanging. Ultimately, he committed a crime for which he’s still doing time in the psychiatric ward of a maximum-security prison: While his parents and younger brother slept in the family house, he disarmed the smoke alarms, poured gasoline in two locations and set the structure ablaze. When the family escaped with their lives, their first reaction wasn‘t horror, but relief. ”He’ll be put away,“ his father rejoiced. ”Now they‘ll have to help.“

Heart-rending in its honesty, Angelhead shows us just how wrong love can go ”when spirits and angels and demons . . . invade your life.“

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