When Cohen Miles-Rath walks into his father’s house, the history of his psychosis is right there in front of him.
There is the place where he was standing when he received a cryptic message on his phone: The devil had entered his father’s body. There is the drawer where he spotted a knife whose handle was white — the color of God!
There is the floor where, as they grappled over the knife, Cohen bit off part of his father’s earlobe, and blood spattered over both of them. There is the spot where, pinned to the floor, Cohen reached up with the knife and slashed wildly at his father’s throat.
The violence lasted seconds but changed his whole life. With voices still racketing in his head, Cohen found himself in jail, facing charges of second-degree assault and criminal mischief, felonies punishable by up to 10 years in prison. Stunned and bleeding, his father had pressed charges, and taken out a restraining order against him.
But Cohen hadn’t killed him. In the years that followed, he had the feeling that he had walked right up to the edge of a chasm. About 300 times a year in the United States, a child kills a parent, making up around 2 percent of all homicides.
A large portion of these cases involve people like Cohen: young men with severe mental illness who are living at home. When mounting symptoms of psychosis make school or work impossible, parents are the support system of last resort. Paranoid delusions can cruelly invert that logic, turning people against the figure closest to them.
Cohen fell into that category; he adored his father. At 11, he had asked to move out of his mom’s house and into Randy’s tidy double-wide in Cohocton, N.Y. For Cohen’s sake, Randy, a fuel transport driver with a pierced ear and a leather jacket, became a Cub Scout leader. He beamed from the sidelines at every one of Cohen’s track meets.
Now, in their small town, their family became the subject of tabloid headlines — “Man Bites Off Father’s Ear in Knife Attack,” read one. In jail, Cohen’s hallucinations flared up into terrors; the date of his college graduation came and went.
What would weigh on him for years afterward, long after the psychosis had receded, was whether his father could forgive him.
“I had still attacked him,” Cohen told me. “It was still my hands on the knife. It was me who was doing that, right? Like, I remember the moment. It was me. And it wasn’t me.”
The tearing of the veil
I’ve reported on mental health for much of my career, and frequently find myself writing about crimes committed by people in psychosis.
These make up a small percentage of violent crimes — around 4 percent, researchers have found — and the vast majority of people in psychosis are never violent. But they are the kind of crimes that newspapers cover: inexplicable, horrifying in their suddenness. Sometimes they are random; a commuter is shoved into the path of a subway train. But often they occur within the four walls of a home, as with Nick Reiner, who was charged with the fatal stabbing of his parents earlier this year. (Mr. Reiner, who had been diagnosed with schizophrenia and schizoaffective disorder, has pleaded not guilty to two counts of first-degree murder.)
It is rare, though, to hear about these bursts of violence from the people who were directly involved.
So I was intrigued, last year, when I received a manuscript of a memoir from Cohen, chronicling the spiral of delusions and hallucinations that led him to assault his father. How, I wondered, could his state have deteriorated so gravely when he was surrounded by people who loved him? And afterward, would it be possible to mend their relationship?
Cohen’s story began with an ordinary disappointment his senior year at SUNY College at Geneseo: An injury had ended his career as a distance runner. Freed from that regimented life, Cohen began smoking pot daily. That spring he sensed something changing about the world; it shimmered before him. He glided around campus, his senses exquisitely heightened.
Signals began to jump out at him in the form of colors; red meant danger, blue meant safety. Sitting in his humanities classroom, he saw — or thought he saw — his professor climb up to the podium and announce that he, Cohen, was a prophet.
Cohen was experiencing psychosis, the break with reality that the psychologist Carl Jung described as a “tearing of the veil.” Some scientists believe these symptoms emerge from changes in the neurotransmitter dopamine, which labels sensory experiences as unusually vivid and meaningful. Hallucinations, this theory suggests, occur when the brain mislabels internally generated phenomena — say, a harsh internal voice — as real, coming from the outside world. Delusions, the most common symptom of psychosis, may result when the brain identifies trivial things — say, a black car — as intensely meaningful, clues to a momentous, underlying story.
As March turned into April, an otherworldly presence began giving Cohen instructions. He turned on the television and saw the pale, naked bodies of dancing gods; he saw gold blood sparkling through the veins in his feet.
He drove to a local diner and threw a rock through its window, followed by a series of red objects — a message to Satan. Randy rushed home, still in his work clothes, and found Cohen in the kitchen.
Cohen’s mind was racing; he felt the moment that would forever define him had arrived.
“I felt like I had completely gotten rid of my identity,” he said. “Like I wasn’t even Cohen. I was this separate being that knew all things.” He paused, looking for words. “It’s hard to describe what it feels like, but it feels like you’re — it feels like you’re God.”
He glanced at his phone and saw a cartoon, one boy smashing another boy’s head. Cohen felt that a truth had revealed itself to him: The devil was inside his father. He paced in the living room. “I don’t want to kill him,” he said aloud, to no one. “I love my dad. I can’t kill him.” He walked into the kitchen, opened a drawer and withdrew a knife.