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The ultimate in DIY mental healthcare: Running the Trouble Coffee cafe

This American Life always has compelling and unusual stories – even my 9-year-old son will stay in the car to listen, even if we’ve reached our destination but the tale isn’t over. Ira Glass picks a theme for each weekly show and there are three or four acts. Each one tells a story about the […]

This American Life always has compelling and unusual stories – even my 9-year-old son will stay in the car to listen, even if we’ve reached our destination but the tale isn’t over. Ira Glass picks a theme for each weekly show and there are three or four acts. Each one tells a story about the theme. The show has been on the radio for almost 20 years and its stories are equally likely to make you laugh or cry.

Act 3 in the “No Place Like Home” episode was incredible. The story is about a woman who runs a coffee shop in San Francisco and originally appeared in Pacific Standard Magazine. At first you think the author is making of fun of the latest foodie trend in San Francisco: artisinal toast. John Gravois is actually telling the story of a woman who has built a cafe to keep her schizoaffective disorder in check. After years of an absolutely frightening life, Giulietta Carrelli has created a business and a daily routine to help herself survive.

The radio clip is about 18 minutes and the magazine article is several pages, but it is worth every minute of your time. It is amazing to hear how a woman figured out a sophisticated mental health care plan and then built her own support structure from absolutely nothing. These excerpts show why she built her system and how it works:

THE TROUBLE COFFEE & Coconut Club (its full name) is a tiny storefront next door to a Spanish-immersion preschool, about three blocks from the Pacific Ocean in one of the city’s windiest, foggiest, farthest-flung areas.

Trouble’s owner, and the apparent originator of San Francisco’s toast craze, is a slight, blue-eyed, 34-year-old woman with freckles tattooed on her cheeks named Giulietta Carrelli. She has a good toast story: She grew up in a rough neighborhood of Cleveland in the ’80s and ’90s in a big immigrant family, her father a tailor from Italy, her mother an ex-nun. The family didn’t eat much standard American food. But cinnamon toast, made in a pinch, was the exception. “We never had pie,” Carrelli says. “Our American comfort food was cinnamon toast.”

The other main players on Trouble’s menu are coffee, young Thai coconuts served with a straw and a spoon for digging out the meat, and shots of fresh-squeezed grapefruit juice called “Yoko.” It’s a strange lineup, but each item has specific meaning to Carrelli. Toast, she says, represents comfort. Coffee represents speed and communication. And coconuts represent survival – because it’s possible, Carrelli says, to survive on coconuts provided you also have a source of vitamin C. Hence the Yoko.

At first, Carrelli explained Trouble as a kind of sociological experiment in engineering spontaneous communication between strangers. She even conducted field research, she says, before opening the shop. “I did a study in New York and San Francisco, standing on the street holding a sandwich, saying hello to people. No one would talk to me. But if I stayed at that same street corner and I was holding a coconut? People would engage,” she said. “I wrote down exactly how many people talked to me.”

EVER SINCE SHE WAS in high school, Carrelli says, she has had something called schizoaffective disorder, a condition that combines symptoms of schizophrenia and bipolarity.

Carrelli tends toward the vivid, manic end of the mood spectrum, she says, but the onset of a psychotic episode can shut her down with little warning for hours, days, or, in the worst instances, months. When an episode comes on, she describes the experience as a kind of death: Sometimes she gets stuck hallucinating, hearing voices, unable to move or see clearly; other times she has wandered the city aimlessly.

Carrelli also found safety in simply being well-known – in attracting as many acquaintances as possible. That’s why, she tells me, she had always worked in coffee shops. When she is feeling well, Carrelli is a swashbuckling presence, charismatic and disarmingly curious about people.

This gregariousness was in part a survival mechanism, as were her tattoos and her daily uniform of headscarves, torn jeans, and crop tops. The trick was to be identifiable: The more people who recognized her, the more she stood a chance of being able to recognize herself.

At bottom, Carrelli says, Trouble is a tool for keeping her alive. “I’m trying to stay connected to the self,” she says. Like one of her old notebooks, the shop has become an externalized set of reference points, an index of Carrelli’s identity. It is her greatest source of dependable routine and her most powerful means of expanding her network of friends and acquaintances, which extends now to the shop’s entire clientele. These days, during a walking episode, Carrelli says, a hello from a casual acquaintance in some unfamiliar part of the city might make the difference between whether she makes it home that night or not. “I’m wearing the same outfit every day,” she says. “I take the same routes every day. I own Trouble Coffee so that people recognize my face – so they can help me.”

After having struggled as an employee in so many coffee shops, she now employs 14 people. In an almost unheard of practice for the cafe business, she offers them profit-sharing and dental coverage.

Most of us dedicate the bulk of our attention to a handful of relationships: with a significant other, children, parents, a few close friends. Social scientists call these “strong ties.” But Carrelli can’t rely on such a small set of intimates. Strong ties have a history of failing her, of buckling under the weight of her illness. So she has adapted by forming as many relationships—as many weak ties—as she possibly can. And webs of weak ties are what allow ideas to spread.

In a city whose economy is increasingly built on digital social networks — but where simple eye contact is at a premium — Giulietta Carrelli’s latticework of small connections is old-fashioned and analog. It is built not for self-presentation, but for self-preservation.