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PARTISAN REVIEW
problems and can be handled simply with good medical manage–
ment." Dr. George A. Mann, then an anaesthesiologist, now Director
of the program, remembers Berryman's withdrawal as being vigorous.
His state of nutrition was very poor. He stayed in withdrawal for a long
period of time, and was physically ill for at least three weeks after
admission, with cold sweats, insomnia, tremulousness, nausea, inabil–
ity to eat, and severe anxiety. John Baudhuin remembers Berryman
sometimes pacing up and down most of the night, threatening suicide
if he did not sleep.
He was so toxic that he would hallucinate a great deal. In this
connection, one of the cogent differential diagnoses that must perhaps
be made about Berryman is whether or not he was psychotic. Dr. Mann
thought him psychotic only when toxic. When he was not toxic, he
would express most of all an overriding anxiety, a terrible sense of
inadequacy for which he would overcompensate with a loud voice and
bragging. This, what the jargon would call "input," was basically a
self-protective device, preserving the defences which were his very
enemy. Berryman himself knew in the back of his mind the cause of
this mechanism: in his edition of Trollope's
Last Chronicle of Barset
which he had read only a few months before, he marked for particular
attention a line that speaks of "the arrogance which so generally
accompanies cowardice." Berryman was probably not then truly
psychotic except when drinking. Dr. Mann was left with the impres–
sion that Berryman had a great fear of insanity and of suicide. He felt
he was insane or was going insane. He seemed in fact more fearful of
his insanity than of alcoholism; perhaps alcoholism was even a
manifestation of his insanity. Above all, life was totally threatening to
him. He experienced great difficulty in coping with his day-to-day
existence. The difficulty created in him an overwhelming, all–
encompassing feeling of anxiety, what Dr. Mann called "an existential
anxiety."
Two days after his admission, Dr. Clifford O . Erickson wrote of
Berryman:
After admission he became severely grossly tremulous, insom–
nic, experiencing some frightening dreams, and was obviously
on the verge of delirium tremens. He was, of course, then
placed on tranquilizing drugs, vitamins, and, also, anticonvulsaOls,
and within a couple of days appeared to be beginning
lO
seule down
somewhal. . . .
Berryman continued to experience symptoms of sickness for some
time after admission, and was kept in the room next to the Nursing
