Diagnosing Louie’s Troubled Kid
If I lost my kid on the subway, I would probably collapse into complete hysterics almost immediately. I’d love to pretend that I’d keep my wits about me and would calmly take steps to locate whichever member of my brood had gotten separated from the rest of us. Sadly, the more likely outcome would be my shrieking loudly at the nearest uniformed officer I could find until the whole of the NYPD had been enlisted in finding my lost child.
So I have to give credit to Louis C.K. In the most recent episode of Louie, his younger daughter Jane steps from the train onto a subway platform and the doors close between them, whisking him off to the next station while she is left behind. He keeps his cool a lot better than I probably would have. (The amount of swearing would have been roughly the same.) As a pediatrician, I admired the family’s clearly-communicated and followed “subway rules” (essentially “stay put until I find you”), which allowed Louie to find Jane with relative ease.
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As distressing as being separated from his daughter must have been, however, there was an element to the episode that I found even more disconcerting.
The show begins with Jane waking from a nightmare and being reassured that it was just a bad dream, only to have her reply that she is still dreaming. She continues to insist that she is still in a dream the next day, right up through the subway incident; it seems some kind of dream logic was the reason for her stepping onto the platform in the first place. She placidly tells people she is dreaming until her frantic father finds her again and loses his temper. When her mother angrily confronts her about the incident, she finally replies that she isn’t dreaming any longer.
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I don’t catch Louie that often (I am woefully familiar with other, lesser entertainments) but from what I know of the show, Jane doesn’t typically display quite such erratic behavior. I don’t know if there will be more to come, but it’s not made entirely clear during the span of the episode if she truly believes she is still dreaming or if she’s just doing some really committed pretending. I took it to be the former.
If a parent came to me describing similar behavior, I would be concerned.
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Children typically begin to recall and describe their dreams around preschool age. (Nightmares can become more common at this point, as well.) Pretending and imaginative play also flourish, and imaginary friends are common companions to young schoolchildren. But an inability to differentiate between imagination and reality (the term of art is “impaired reality testing”) can be a sign of mental illness, and I would be worried by reports of a child as old as Jane (the actress who plays her is 10) who could not tell waking life from dreaming.
However, I am not a child psychiatrist. I strive not to be an alarmist in my real-life practice, and worrying that a child is displaying signs of incipient psychosis is an alarming prospect. So, I decided to consult a specialist.
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Luckily, one of my best friends from medical school is a child psychiatrist. (She politely declined to be quoted directly.) In all the time I’ve known her, I don’t think I can ever remember her watching a television program, and I wasn’t surprised to learn she’d never even heard of Louie. But she listened patiently as I described the events of the latest episode.
She wasn’t concerned.
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Children can have very vivid and intense pretend experiences, and the line between imagination and reality can be pretty blurry to observing adults. From my description, Jane’s behavior was a level above having an imaginary friend, but that was about it. In the absence of other signs that she was losing touch with reality, my friend wouldn’t consider her behavior particularly worrisome.
I felt relieved for the character, and slightly abashed for rushing to diagnose her with a mental illness. (I really am loath to do so in real life. Really.)
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So be reassured, fans of Louie: Whatever other travails he may be facing, a psychotic daughter doesn’t seem to be one of them. Unless Jane becomes more unhinged in coming episodes, she was just an imaginative kid being a kid.
But those subway rules are still a good idea.
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