Subtle abuse? In fact, I don’t know that the episode I relate here is an example of subtle anything. I can only say that at the time I had no idea that it was abusive. I felt that perhaps I deserved it.  I had no idea that it should have been reported, that someone should have defended me, that anyone…Well, you will get the drift upon reading the following brief description of one incident, among the way-too-many that have happened to me over the past 5-10 years in Connecticut hospitals. All I can be sure of is that if hospital staff do these things to me, I am fairly certain that they must do them to others…In which case, that Hartford Courant article in 1998, “Deadly Restraints” which was supposed to have changed everything both in Connecticut and around the country in terms of in-patient treatment of the mentally ill, that article did little to nothing. I would say, in fact, that treatment has gotten markedly worse over the decade. Compared to my treatment in the two decades before this past one, I was never abused as much in the 80s and 90s as I have been since Y2K and 2000.

For once, what I write of here does not involve restraints per se, at least not immediately, but as you will see it involves abuse, physical abuse, just the same. I have transcribed this from my journal from a few years ago. I have edited it, but most of the edits I made were for clarity or to convert partial sentences to full ones, though in a couple of places I had to flesh things out more. But here ’tis, what happened to me at a general hospital I spent a fair amount of time in, in Fairfield County, where my twin lives:

“After a run-in with Karen again, I apologized and we had a decent talk. I took off my coat for once, went to Wendy’s communication group and did okay. Then I was sitting in the alcove talking with Mark about my dread at every anniversary of JFK’s assassination when a hullabaloo started near room 306 at the other end of the hall. It seems a woman was having a heart attack. I immediately felt the floor fall beneath me: I was to blame, my inattentiveness, my raucous, hyena laughter, my evil had killed her!

I knew that I needed to take my 4 o’clock medication for what little it would do, but no one called to announce them or for me to take them. My ears rang, booming! The air was full of blaming and criticizing voices, so maybe I didn’t hear, but I think they just didn’t call me. I rang the intercom buzzer at 6:45 and was told that Jamie, the medication nurse that night, would be back from supper around 7 o’clock. I rang back at 7:05 but he was still gone, so I waited another 15 minutes since no one told me that he had returned.Finally at 7:20 I pushed the intercom button to ask if I was supposed to skip all my 4 o’clock and 6 o’clock medications. They now said Jamie was waiting for me. But why hadn’t he called to let me know he’d gotten back from dinner? Slowly I managed to shuffle up to the medication door again, zipped to the mouth in my coat and balaclava hood, verging on stuckness, only to find there was no Geodon in my cup.

“So I don’t get my 4 PM medications,” I whispered in stunned panic, too afraid to simply ask for it.

“Nope” was Jamie’s only answer.

I was flabbergasted, completely stunned. My second prescribed dose of BID Geodon was what I’d been waiting patiently for ever since the patient in room 306 had her heart attack. After Jamie ignored me, giving me no explanation, I just turned, took my 6pm Ritalin, then dropped the DIxie cup of water and all the other pills on the carpet. In a daze, it took everything in me to start making my way down the hall towards my room again.

Then I heard footsteps pounding up behind me and suddenly Jamie was in front of me, blocking my way. “You’ll go back there and clean up the mess you made right this instant!” he bellowed and pushed me towards the med station. I stared through him, tried to walk away, but he blocked me again and again pushed me backwards until finally I gave in, relaxed and let myself succumb to his pushing. I didn’t walk though, I merely fell backwards to the floor, saved from injury only because he grabbed the front of my coat as I fell, and lowered me to the floor. I curled up in a ball like a porcupine, hoping not to be killed. Well, he was in a rage and forced my hands down, away from my shoulders, and unzipped my coat. Then he ordered me to get up and clean up the mess again — what mess really? A few pills on the floor, and a little water that would dry? I refused. I curled up on my side and closed my eyes, responding to nothing. He threatened me with restraints. At that, I gave up resisting, knowing resistance would give him the excuse he wanted. I let him pull my coat off my limp body. And I remained limp as he carried me to my bedroom where he dumped me coatless on the bed and thundered away. I was triumphant, however. No restraints! I’d figured it out. If you refuse to resist, if you don’t fight back against their power plays, they have no excuse to justify putting you in restraints. They cannot put someone who is completely silent and limp into 4-point restraints. What would be the point?

Nevertheless,  I was cold and felt exposed in only my T-shirt and jeans, and with no coat to protect me, nor others from me. So I got up and grabbed a sweater and started bundling myself into hat and  hooded scarf. Suddenly Jamie barged in again. I backed away and fell onto the bed behind me. In a fury that was unbelievable to me, he leapt onto the bed and pinned me down, knelt so his knees trapped me and I couldn’t move. Then he unbuttoned my sweater and tore it off me, ripped off my hat and scarf, then without a word proceeded to empty the room of any clothing that could possibly cover me, including my shoes.

This was too much to bear. But I said and did nothing in protest. How could I? I had no words, no sense that I had rights of any sort. All I did was huddle against the wall under a blanket and whimper, “I didn’t mean to kill her. I didn’t mean to cause a problem.” Jamie, who had left with all my things, stormed back in and angrily lectured me on how I was guilty of  “just wanting attention!” I wept silently. All I’d wanted that entire afternoon had been my 4:00 pm medication, and to be left alone to deal with repercussions of having killed the  patient in 306. I was too stunned to respond and could only whimper over and over, “didn’t mean to kill her, didn’t mean to cause a problem.” Still furious, but getting nothing from me and spent, Jamie finally left for good.  After a while, I looked around at the nearly empty room, and there on the night table was the pen Lynnie had left behind that afternoon. Jamie had overlooked it in his rampage. I had no energy to get off the floor, and no paper to write on, so I did the only thing I could, and  I began writing on the wall. “I didn’t mean to kill her, didn’t mean to cause a problem,”  I wrote and wrote. I wrote until I physically could not write any longer, I wrote until my hand gave out.

That was not the end of the evening, but it was the end of the interchange with Jamie, RN and it’s all I wanted to go into for tonight as it is getting late, very late and I needs must go to sleep.

New Working Definition of ‘Recovery’ from Mental Disorders and Substance Use Disorders

Perople have died in this restraint chair -- in Guantanamo, yet they made me sit in one in Manchester Hospital in Connecticut, 2009

Some memories are returning. Not a great many but this one was triggered by something I heard briefly on television the other day, simply the mention  in some other context, of the words “restraint chair” and in an instant I flashed back (and I use those two words advisedly, since I do not actually know what is meant by a “flashback”) on something that happened when I was a priso…excuse me, patient, albeit involuntary, at Manchester Hospital in the fall of 2009.

This had been an extremely brutal stay up till then. When I was admitted the psychiatrist I was assigned to Dr BZ — I have written of this elsewhere so I won’t recap the whole thing, as memory is fickle and I may have misremembered it by now — stopped most or all of my meds, saying that if I was there, clearly they didn’t work. Then he swore I would take the one drug I refused to take: Zyprexa, and he scheduled a forced medication hearing, which naturally I would lose, having no power and only my word against his as to whether or not I needed it. Well, I did lose it, but inexplicably, and sadistically, instead of forcing on me a drug that by all accounts helped me, he changed this to TRILAFON, an old drug that did nothing for me and only made me completely miserable.

The upshot was that every time they came to me with medications, I flatly refused to take the Trilafon, even under the threat of a Haldol injection, The goon squad was called, and since I refused to quietly accept my punishment, they assaulted me, stripped me, and  forcibly injected me. This got to the point that they started four point restraining me to the bed, just to inject me…And it because such a routine that to avoid the “tiresome process” of getting out the restraints they simply left them attached to my bed. I know this not because i remember it but because my friend Josephine told me she saw them.

Me? I was so snowed by Haldol most of the time, that I could never even find my room, and had a sign in large letters taped to the door so I would simply recognize it when and if I managed to find it. Also, I was so dazed that I had to wear red slipper socks as a fall risk…but no one ever decided that maybe this was due to the drugs they were giving me!

Anyhow, one day, one day…and here is where memory kicked in after hearing those awful words on TV: one day the nurse who was most in charge of the daily torment, came to the door with another nurse pushing this large chair, and i recognized what it was at once. I had seen them before, having reviewed a book a long time before for the LA Weekly on the treatment of the mentally ill both in hospitals and prisons, a book, moreover decrying “barbaric treatments” of the past.

“You aren’t going to put me in that, are you? I’m not coming anywhere near it!” I shrank away from them and ran to the other side of my bed.

“We won’t restrain you, not  if you behave. But we want you to sit in it for today. There are no restraints on it now. It is just a comfortable chair. Come, sit down. The student nurse will be with you all day today.”

Then they essentially forced me to sit down and stay in the chair. Or else…I was terrified. and the student nurse knew it. Luckily, she would turn out to be a kind and wonderful young woman (her experience at Manchester almost drove her away from psych nursing, but  as it turned out she discovered Natchaug Hospital, and became one of their most beloved nurses). As she told me later — because memory mostly fails me here, but for her reminders — she did Reiki with me, the practice of nearly touching a person but not quite, and moving her hands along my body, not sure how it works or worked, but she later told me, at Natchaug, that I responded well to it, and stayed calm all day. I even as she said, took my meds. Which means I actually swallowed the Trilafon, probably because I couldn’t bear to have another fight in front of her.

Whatever was the case, if Reiki is as I described it, no wonder I responded well, as it was a NON-physical therapeutic way of dealing with me, non-assaultive, gentle, non-trespassing and non-brutal. Why the rest of them could not have followed suit or come up with some other way to treat me as she did, I will never know. Clearly they learned nothing from her; she left and likely they are back to treating others as they did me.

I believe they would indeed have used that chair as a restraint chair on me. I do not think they brought it in just as a comfortable chair, I believe it was to intimidate me, to cow me, but I think too that they were in fact prepared to use it. I do not have the slightest doubt. I would put nothing past those people who so brutalized me as to put me in four point restraints over and over during more than 8 days. For all I know it might have been more than eight days. I simply do NOT know, as amnesia has sealed up much more than memory preserved.

Enough for now. I need to write tomorrow about the Versatile Blogger Award that DogKisses gave to me. I am shamefully late in thanking her. And I do not know how to place the badge on my site, but she was such a lovely blogger to do so, that I do owe her her own post of thanks and appreciation.

More tomorrow.

If you want to know someone else’s arguments on the subject, read THE ANATOMY OF AN EPIDEMIC, by Robert Whittaker. I do not agree with everything he writes there, but it certainly was a springboard for my thinking.

So! This post deals with what I see as a gross failing in 21st century psychiatry, the over-prescription of psychotropic drugs. Sometimes driven by psychiatric practitioners who have neither the time nor interest or training to do “talk therapy” or even basic counseling, sometimes driven by the desires of consumers/patients themselves for a no-trouble, “quick fix” for their problems (not all of which are strictly speaking pathological), it is driven certainly by the demands of pharmaceutical companies for profit.

This last, Big Pharma’s requirement for increased profit, has led to massive advertising campaigns and the legal and not so legal encouragement of “off-label” uses, a band wagon upon which both practitioners and, I would add, eager consumers leap. It is not without consequence that both the drug companies and many if not most psychiatrists / prescribers would have consumers believe that psychotropic drugs “treat” illness, that is to say that the drugs target a specific neurotransmitter that has been conclusively shown to cause a given condition and to be measurably “out of balance” compared to levels in so-called normal persons.

THIS IS NOT THE TRUTH. I repeat: It is not true that psychotropic drugs treat illness, not the way antibiotics treat infectious diseases. An antipsychotic or antidepressant drug is NOT a silver bullet specifically targeted at a pathological culprit. These drugs are prescribed to alleviate symptoms, to alleviate, for instance, hallucinations or delusions, and maybe, sometimes, to elevate a person’s mood when pathologically depressed. They may be prescribed for other “reasons” as well, though to call a drug that is used by a doctor/patient for a presumed condition a “treatment” is not the equivalent of saying that the drug is either indicated or effective. It only says that someone has decided to use it as if its purpose were to treat a supposed condition.

What do I mean? Well, take, for instance, antibiotics. Most of us know by now that they are useful and indeed curative in many cases of bacterial infection. We also know that sometimes ABs are prescribed i.e. used, in cases of viral infections and illnesses. But antibiotics can neither treat nor alleviate conditions caused by viruses. So if a physician gives a person a prescription for penicillin in the case of a cold or flu, (and for whatever reason) he or she may be said to “use” the drug for such and such, yes, but it says nothing about whether the drug is useful or effective or necessary. Which of course in such cases it is not.

Ditto some prescriptions for APs and ADs. Ditto maybe ALL such prescriptions: yes, they can use APs and ADs as if they targeted a “mental illness” but just because one takes a pill “for something” does not mean or definitively indicate that the drug is useful, helpful or harmless.

I know, I know, many people who will object that such drugs have helped them function in life much better than before, when they were self-described (or otherwise) “basket cases.” I cannot take that away or even deny that a couple of APs seem to have helped me more than they harmed me. Although I now swallow the APs Abilify and Geodon together (I cannot take them separately without ill effect) taking one AP, Zyprexa, seemed to me to have near miraculous consequences in my life –I have detailed these elsewhere but “take my word for it” I felt like life’s lights had been switched on in my brain. At the same time, Zyprexa’s other effects were devastating: obesity, high cholesterol and triglycerides, pre-diabetic blood glucose levels yada yada yada. (By the way, why is one effect a “treatment” and the others “side effects” and therefore discountable? Aren’t all effects of drugs effects of the drugs?)

So I am not saying that the drugs do “no good” ever or at all. And I am emphatically not advising anyone to stop taking whatever they have been prescribed. For one thing, abruptly stopping medications, particularly psychotropic ones, can be a prescription for disaster. Not only could the physical consequences be unpleasant, but to suddenly stop a med only sets one up for what looks like “relapse.” If your body is used to taking a drug, and it is abruptly and completely withdrawn, doesn’t it make sense that you will feel untoward effects similar to those the drug is supposed to treat? I used to take Inderal for headache prevention and akathisia, but another effect of it was that it lowered my blood pressure and slowed my heart rate. In one hospital, for some unknown reason, they stopped giving me Inderal (propranolol)  — one day I was taking 40mg three times a day, and the next day I was taking, well, zilch.

Is it any wonder that within the next day or two, my “vitals”, though normal before I ever took the Inderal, rebounded way over normal limits, my heart racing painfully and my BP sky-high? Of course not. This was no proof that my heart-rate was pathologically rapid nor that I “had” high blood pressure. Of course, the doctor tried to tell me so, but in fact all it proved was that carelessly and rapidly stopping a beta blocker drug resulted — like a rubber ball dropped onto the pavement – in what was essentially withdrawal and temporary rebound.

So if you abruptly stop your meds because you think my argument here “holds water” you will be setting yourself up for two things: 1) apparent relapse of illness even if it is really just withdrawal or rebound symptoms, 2) possibly mistaken evidence that you need the drug. However, if you and your doctor decide that you might do okay without the medication, and you very, very slowly reduce it, then you have a much better chance of not inducing a relapse, and/or “proving” that the drug is essential to your mental health.

Note that whether a given medication really helps or not is up to you and your doc to ascertain. All I mean to say is this: do not drop any AP or AD without considering all the consequences of stopping it without a gradual taper.

Now I want to segue into some information from “reputable sources” so-called so you can see where I am coming from. Please continue below the following if you already know all this. I neither endorse it nor argue with it. I am just providing this official “information” – true or not so true — in order to further my argument below it.

For the purposes of the discussion, I deal only with antipsychotic drugs (APs) and antidepressants (ADs) of the SSRI, SNRI and tricyclic variety. I know there are other important medications used in psychiatric settings and treatment but for space and energy’s sake, I will limit this post to those two categories because for good or ill they are often prescribed together.

__________________________________________

Forgive me, NIMH, but I need to crib a short section from your website on the side effects of various psychotropic drugs http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml before I begin my discussion about them. Any emphasis (italics) or bracketed word/s are my own.

First NIMH (National Institute on Mental Health) has this to say about “anti-psychotic drugs”:

“Some people have side effects when they start taking these [antipsychotic] medications. Most side effects go away after a few days and often can be managed successfully. People who are taking antipsychotics should not drive until they adjust to their new medication. Side effects of many antipsychotics include:

• Drowsiness
• Dizziness when changing positions
• Blurred vision
• Rapid heartbeat
• Sensitivity to the sun
• Skin rashes
• Menstrual problems for women.

“Atypical antipsychotic medications can cause major weight gain and changes in a person’s metabolism. This may increase a person’s risk of getting diabetes and high cholesterol.¹ A person’s weight, glucose levels, and lipid levels should be monitored regularly by a doctor while taking an atypical antipsychotic medication.

“Typical antipsychotic medications can cause side effects related to physical movement, such as:

• Rigidity
• Persistent muscle spasms
• Tremors
• Restlessness.

“Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements a person can’t control. The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be cured. Sometimes people with TD recover partially or fully after they stop taking the medication.

“Every year, an estimated 5 percent of people taking typical antipsychotics get TD.”

ANTIDEPRESSANTS

Antidepressants are common psychotropic drugs frequently prescribed. Here

is  a block of quotes from the NIMH site regarding the use and side effects of SSRIs, SNRIs, and tricyclics. MAOIs are also mentioned, though they are far less often prescribed than in the past.

“Depression is commonly treated with antidepressant medications. Antidepressants work to balance some of the natural chemicals in our brains.* [see discussion that follows] These chemicals are called neurotransmitters, and they affect our mood and emotional responses. Antidepressants work on neurotransmitters such as serotonin, norepinephrine, and dopamine.

“The most popular types of antidepressants are called selective serotonin reuptake inhibitors (SSRIs). These include:

• Fluoxetine (Prozac)
• Citalopram (Celexa)
• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Escitalopram (Lexapro).

“Other types of antidepressants are serotonin and norepinephrine reuptake inhibitors (SNRIs). SNRIs are similar to SSRIs and include venlafaxine (Effexor) and duloxetine (Cymbalta). Another antidepressant that is commonly used is bupropion (Wellbutrin). Bupropion, which works on the neurotransmitter dopamine, is unique in that it does not fit into any specific drug type.

“SSRIs and SNRIs are popular because they do not cause as many side effects as older classes of antidepressants. Older antidepressant medications include tricyclics, tetracyclics, and monoamine oxidase inhibitors (MAOIs). For some people, tricyclics, tetracyclics, or MAOIs may be the best medications.

What are the side effects?

“Antidepressants may cause mild side effects that usually do not last long. Any unusual reactions or side effects should be reported to a doctor immediately.

“The most common side effects associated with SSRIs and SNRIs include:

• Headache, which usually goes away within a few days.
• Nausea (feeling sick to your stomach), which usually goes away within a few days.
• Sleeplessness or drowsiness, which may happen during the first few weeks but then goes away. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects.
• Agitation (feeling jittery).
• Sexual problems, which can affect both men and women and may include reduced sex drive, and problems having and enjoying sex. [Note that this side effect is NOT listed as temporary, as indeed it is not, and this is extremely important to understand...]

“Tricyclic antidepressants can cause side effects, including:

• Dry mouth.
• Constipation.
• Bladder problems. It may be hard to empty the bladder, or the urine stream may not be as strong as usual. Older men with enlarged prostate conditions may be more affected.
• Sexual problems, which can affect both men and women and may include reduced sex drive, and problems having and enjoying sex.
• Blurred vision, which usually goes away quickly.
• Drowsiness. Usually, antidepressants that make you drowsy are taken at bedtime.

“People taking MAOIs need to be careful about the foods they eat and the medicines they take. Foods and medicines that contain high levels of a chemical called tyramine are dangerous for people taking MAOIs. Tyramine is found in some cheeses, wines, and pickles. The chemical is also in some medications, including decongestants and over-the-counter cold medicine.

“Mixing MAOIs and tyramine can cause a sharp increase in blood pressure, which can lead to stroke. People taking MAOIs should ask their doctors for a complete list of foods, medicines, and other substances to avoid. An MAOI skin patch has recently been developed and may help reduce some of these risks. A doctor can help a person figure out if a patch or a pill will work for him or her.”

___________________________

First of all, do ADs treat a chemical imbalance? Is that statement even true, or just a fiction made up to “prove” that ADs work? If true, what does a “normal” balance consists of? Does anyone know how to measure the levels of these neurotransmitters, and if so, please let me know — give me numbers — where and what the “imbalance” ADs are correcting is.]

So all right, thems the “facts.”. Note that I say nothing about efficacy in what follows; I speak only of the side effects. But what about these so-called side effects? It seems to me to be hardly inconsequential when an AD, taken to improve the quality of one’s life and increase ones ability to feel pleasure, which is often absent in depression, simultaneously blurs ones vision (so you cannot read), causes weight gain (as tricyclics tend to do) and has sexual side effects that include reduced sex drive, and problems having and enjoying sex. For many people, maybe even most people, sex is one of the greater pleasures in life, at least sometimes. It certainly promotes better intimate relationships for most people and lets face it, people like it. So what is one to think of a drug that “treats” depression by inducing reduced sex drive, and problems having and enjoying sex. Is the reduction of pleasure in sex without importance? Or is the doctor saying, well, you can give up sex and sexual pleasure, what does it matter?

The thing is, reducing any pleasure, especially in a person who has trouble feeling pleasure at all, is not, in my considered opinion good treatment. Who has the right to tell a patient that if she or he takes an AD that they will have include reduced sex drive, and problems having and enjoying sex but that this isn’t important in the general picture. Of course it is important. Think of all the men who are devastated by “simple” impotence. To clinically induce impotence or the female equivalent, to clinically, biochemically reduce the ability to enjoy sex or to enjoy pretty much anything, is not just bad treatment it seems to me nearly criminal. How many people who have taken ADs and found themselves experiencing reduced sex drive, and problems having and enjoying sex actually got better? Well, okay, if perhaps you are not told and so do not understand that the drug itself causes this effect you might just say, “Ah well, I dunno why but sex is not important, I don’t really give a damn about it anymore..”. In short, you might “forget” — having no sex drive tends to do this — that sex was pleasurable and attribute it to your natural state. But in that sense you simply are denying that what you “don’t know” or feel any longer was ever important or a source of pleasure because you do not feel it now. Instead, you might accept that it is and always was a trivial concern.

But no one has told the millions of users of ADs that while they might feel some increase in pleasure elsewhere in their lives, their intimate lives will be fraught with reduced sex drive, and problems having and enjoying sex. How many people now feel utterly depressed because of their unexplainable reduced sex drive, and problems having and enjoying sex? Do they even understand that is is not “they themselves” not some inner deficiency, but a side effect of the drug that is/was supposed to make them “feel better.” If I were more paranoid than I am at the moment, I would say it sounds like some sort of ugly conspiracy by doctors and drug companies to avoid even informing patients of these serious consequences lest they refuse the drugs in the first place…So I ask you, how many of you, or how many people in general, would voluntarily, not to mention eagerly take a pill the effects of which include reduced sex drive, and problems having and enjoying sex?

Argh, it is getting very late and this has been a long treatise, impassioned in a curious way for someone who has never, drugged or undrugged, cared about sex…I so wanted to get to the APs and the dangers of adding them willy nilly to an AD “cocktail.” If reduced sex drive weren’t bad enough, is anyone telling these people who are being prescribed an AP either off-label or unnecessarily that it will almost certainly cause some weight gain, with all the usual concomitant consequences, and may even induce diabetes? Is anyone telling them about how it feels to suffer from akathisia, a very common effect of APs?  Drug companies may discount it as mere “restlessness” but akathisia does not mean that you simply want to take a walk every afternoon…it is completely agonizing, those of us who have experienced it will with alacrity tell you. No one simply accepts akathisia – restlessness, hah! – and ignoresit. You cannot ignore it and it is devastating to all feelings of pleasure and all sources of enjoyment, should you, after losing your sex drive, have any left.

But as I wrote above, it is getting too late at night for me to write more, and perhaps I have said enough. You might accuse me of having “done enough damage” too, I dunno. But I believe these things and I think they need to be said, whether or not anyone takes them seriously.

Hey everyone, I just found out that the original Wagblog at schhizophrenia.com is available. I started that blog in 2003 and in 2008 there was a server accident in which it seemed that my entire blog had been lost. I just happened a minute ago to try looking for it, and lo and behold it seems to be back. If you are interested in all my posts, from the original site, go below.

Good luck. I think this link will get you there. (I am writing this on my ipad so all of this is new to me. I hope that the program works here as well  as on a computer.) I think it will work now, but if not, try putting the address in manually until I get to a computer to do it properly.

http://www.schizophrenia.com/pam/

I plan for this to be part of BLACKLIGHT, my second memoir.

She brings in the tray: white bread with two slices of bologna and a slice of cheese tossed on top, a packet of mayonnaise, a small green salad in a separate bowl, with a plastic slip of French dressing, and a packaged Hostess brownie for dessert. I didn’t eat lunch, though they brought it in, so even this impoverished repast looks good to me and I eat everything, despite not having taking the hated medication. I curse myself for it, of course, and do some surreptitious leg lifts and crunches for exercise afterwards. Ever since I’ve been refusing the drug, I have been losing weight. Now I am down to 155 lbs from 180 the last time I weighed myself and I intend to get much thinner, since I started at 95 before medications over the years slowly put weight on me.

ECT Takes place on Monday, Wednesday and Friday each week and though I vomit many times upon waking up, that is the least of it. What I dread most is the anesthesia, how I plunge into the dark pit of hell from perfect alertness and feel like I wake a second later, confused. I grow more and more afraid until, at the end of one series, 8 sessions, I refuse to go on to a second, though my symptoms are still severe and I need Caledonia more often than not. Dr Barbour tries to persuade me, but I am adamant until she threatens to have the next series court-ordered. Along with my taking the drug I so hate. I explode.

“What! You can’t do that! I’m a free citizen, I’m not a danger to myself or others! I haven’t done anything to deserve it!”

“In fact, I can do it, and I am going to do it, whether you like it or not. You need more ECT and unfortunately you refuse the only drug that is effective for you. Pam, look, how can you say you’re not a danger to yourself? Look at your forehead! The mark of Cain, you say? I say it’s self-disfigurement. Look at where you carved that mark into your hand when we weren’t watching you carefully enough. Isn’t that danger enough?

“But I’m NOT going to kill myself. I don’t want to die. I just want to be disfigured so no one will want to be around me and they’ll stay safe and uncontaminated.”

Dr Barbour’s eyes suddenly glitter and she has to blink a couple of times. “Well, I’m not going to let you do what you want. Period.”

She was standing at the foot of my bed, one foot on a lower rung, casually clasping a clipboard. But she moves to stand in front of me, on one side, the clipboard clasped business-like across her chest. Gazing intently at me, she shakes her head in what appears to be sadness.  I’m not sad, I know what I have to do. I don’t understand why she feels this is so terrible, but I know enough to remain quiet. Finally, she turns and quietly slips out of the room.

This alarms me; it shocks me. I know she means what she says. Dr Barbour never lies. Worst of all, Dr Haas, my outpatient psychiatrist, has signed off on it too, agreeing that it is the only thing left to do, that already I’ve been in the hospital two months and little has changed, that the situation is desperate. The problem is that to get a court order I have to have a conservator agree to it. They want to appoint my twin sister and they discuss with her whether or not she’ll agree to forcing more ECT on me, as well as the hated drug. Despite fearing that I’ll hate her, she too is convinced there are no other options.

So Dr Barbour wins and I endure eight more ECT sessions. Finally I’m discharged, much improved, a month later, solemnly promising, as a condition of my release, that I’ll continue to take the drug that is so abhorrent to me. I’m supposed to return once every two weeks for maintenance ECT treatments and am threatened with a police escort if I don’t comply. But this time I thumb my nose at Dr Barbour. So, she’s going to get both the Hartford and the South Haven police involved just to force me to ECT, something they themselves probably consider barbaric? J’en doute fort. I doubt that!

Five month later I pour lighter fluid over my left leg and set it on fire.

Although it is only 10:30pm, I seem to be falling into dreamtalk as I write this…I must be sleepier than I know, and half asleep or falling asleep every so often as  I write. I say this because I came to a couple of times already, only to find a paragraph of weird gobbledygook on my post. If this happens again, and I do not recognize it until tomorrow, forgive me for sleeping and writing this with the consciousness of a bad dream only. I plan to proofread this entire thing tomorrow, just to vet what I did write.

The subject of this post says it all. I have been exposing myself to “the problem” ruthlessly for months now, and to no avail. I still suffer from the same symptoms of what would be PTSD (had not the good doctors redefined the word “trauma”) and I cannot in truth say that they are any better. Yes, I do remember a little bit of what happened, more than I did before (for those who do not understand the reference, see my Oct 7, 2011 post titled “Psychiatry and Authority: Restraints Update”). At least it can be recalled to me by other means and I can assent to it with some sense of Yes, I do remember that happening…But as to the tears and trembling and heart racing etc I see no improvement, and if no- improvement after these many months of self-treatment is less than to be expected, then I would say that not only has exposure therapy not helped me, it has made things worse. Rather than being literally therapy, it has only added “insult to injury” or as I put it, laid salt on the wound.

I do not know what to do about this. I find myself irritable, even irascible, especially with family members who I believe did not care enough to rescue me from the clutches of malignancy when they knew it was going on. Indeed, they in fact did not either care or do so. But that is the same old story and I can beat myself over the head with their inadequacies as family members, or I can simply wave them away as inadequate in such matters and go on…Ah, but how to go on? How do I continue to live despite these horrendous feelings and constant on-the-verge tears? Even Dr C seems at a loss, though I am not sure why. Surely she must have dealt with trauma — or “trauma-like situations” (since this wasn’t Katrina or the tsunami, so by definition it wasn’t trauma…) before now. Surely she ought to know what to do about this situation. Why then does she seem so helplessly unable to tell me what to do or to help me get over this? Why won’t she give me any advice or help? I can barely go on some days and yet she never offers anything but a mirror to myself, to what I might think or feel. I tell you, I can hear the professional technique in her voice sometimes, even as I fall for it.

Yet I really like her and I don’t know why. Is it because she does NOT order me around the way Dr O did? Is it because she is NOT authoritarian and directive the way Mary was? I dunno I just know that she listens to me and takes me seriously, does not consign every idea I have to the dustbin of delusion as Dr O (Mary) did.

Nevertheless, I still do not know what to do or how to get over this problem, and even though the OPA has decided in my favor and is sending my case on to the the Dept of Public Health for further action, even that doesn’t relieve me or help my anxiety and anguish abate. Why should it? What is done is done, and the consequences are as they are. My problem is how to go on, how to survive, how to deal with the result and get on with life. But so far I have not figured out how. Despite my talk of forgiveness and acceptance, I have not reached that state yet, not perfectly, not even adequately. If I had I would not be so torn apart. I believe in forgiveness as the healer of all, but when push comes to shove, I cannot seem to take my own advice any more than most other people can.

Yet I see that I resent so very much and it does not all have to do with the restraints issue. Some of it is much larger and concerns a general anger or resentment towards how certain people and family members have treated me  over these past decades, issues that have not even yet been resolved. This — my anger — doesn’t endear me to anyone, and it solves nothing to go there, to decide and then rage against whoever did “this” to me.

I do go there, of course, or I wouldn’t be complaining of how they tortured me. I torture myself with these things. And I get irate and start sobbing and write angry emails that likely no one understands the genesis of, though I make the assumptions that they will be obvious to the person on the receiving end. Yet the grievances are real. It is just that it is useless to bring them up, not so much with others as for me. What good does it do to cry over what happened twenty or thirty years ago, even if it continues to happen now with the same person? I ought to have learned something over those intervening years and that is that the person is not going to change and that their injurious nature, their manner of hurting me is going to continue no matter what I do or say to them. Either they do not care or they simply have no idea or understanding of the impact of what they do or say (or do not do or say) has on me. But in the end it is I who must continue, must soldier on, and I should have learned to do so without their support or confidence.

I have, I have. It is just that a little improvement in things fooled me yet again into expecting real change, a real difference, a genuine affection and positive behavior towards me. Instead, in both cases, I get the same old,  same old, just dressed up in affability and pretend benevolence until I cross them. In one case, it is egregious, and the reaction is fury, the greater the truth I point out, the more massive the indignation and rage. In the other case, the sheer oblivion to the hurt caused is cause for massive hurt itself. And both people continue to pang me today, either on purpose or because they cannot help it. In the one case, I believe it is in fact deliberate. In the other, perhaps not so, but from personal weakness. I can try to forgive the latter, but the former is just too galling and it behooves me to stay the hell away from that person…as that is the best I seem to be able to do to protect myself at this point.

Well, without respect to the above discussion, which was vague in the extreme because I do not believe I have real privacy here and you never know who might linger around to read, despite all that, I want to show you a new piece of art I did over the last two days. As art it is nothing, though it is the first time I have attempted a scene with multiple “characters” actively engaged in physical activity, so in that sense it was st least personally challenging. But the scene itself may be instructive, if horrifying to some people.

 
I am only going to post the initial sketch and the final version, plus some details from the drawing as it is good to get a closer look at parts of it that a monitor-size photo cannot give you. The original is at least 24″ by 17″ so it is reasonably large and has room for more details than my usual 11″ by 14″ drawings.

Just had to erase a paragraph of complete “dreamtalk” here, and fearing that I may descend to such incomprehensible language again, I will hereby cease and desist in the verbal production department and just upload the two photos. First the sketch and then the final colored pencil product. Both are very closely connected with the trauma that I wrote of at the outset and the drawing was part of my next attempt to “expose” it out of me. Whether it did or did not, I will find out on Jan 6 -9, 2012, when i go back to Wisdom House to write for the weekend. If I cannot do more than continue in this vein, then I will have an idea of how little I managed to help myself. But I am hopeful that this will finally prove to be a working solution — to draw what happened on paper but then to write about dealing with my anger and resentment and other feelings, which is really what is important at this point, not with the “mere” facts of what happened. If it is, I will be very proud of resolving at least part of the problem on my own.

First of all, I’ll post the sketch, as it will print out above the text as follows.

Who is Smiling at this Image of Torture?

A picture in graphite and later in colored pencil depicting with absolutely accuracy the sort of thing that a “take-down” by a hospital goon squad can entail before they force a person into four-point restraints. The nearly naked person in this depiction is, of course, me at a certain hospital…I am afraid that as I look at this version (correctable) the smile has turned into a grimace on the face of the white woman in the foreground. THat needs to be tweaked a bit…I also note that there are NO SHADOWS… But this is almost more of an illustration than a real drawing, so I will forgive that lapse. Next to come I hope will be a painting.

Here are some photos of details:

I realize that it looks like “I” am lying both on my back and on my stomach, but that is an illusion of the photo. In reality those are the backs of the legs, not the front.

Enough for now. I need to wake up  and then I want to discuss the book, ANATOMY OF AN EPIDEMIC. Perhaps in my next post.

REFLECTIONS ON ROOM 101* IN  WARD D

Collage, available as is or finished with bound edges

$1800.00/$2000.00

I started this collage at Natchaug Hospital in Willimantic, using scraps torn from magazines and glued onto a large sheet of brown paper. This was my effort to deal with the emotional trauma associated with other hospitals where I had been far too frequently shackled in four-point restraints. Although I have tried to depict a seclusion room realistically, I have also taken some artistic license: in a real such situation, the restraint bed would be facing the door, so that an aide or nurse monitoring the patient would be able to see his or her face clearly. And here, of course, the window is neither heavily grated nor closed. Instead, it has been opened (how? by whom?) and we see a winding path that leads far away…

*In George Orwell’s book 1984, Room 101 in the Ministry of Love is where recalcitrant prisoners are tortured, the instrument being whatever it is they are most afraid of.

mirror view into a seclusion room with a restraints bed.

You  really need to stand back from it to get the full effect, but this wasn’t possible, despite my wall being on a T intersection of hallways as someone had planted a bright torchiere lamp down the perpendicular hall. This was helpful for other displays but unfortunatley caught the light in such a way as to cause my collage to reflect it, leading to glare and poor visibility of necessary features. Ah well, live and learn, live and learn. Had I known this would happen, I would not have used a gloss finish on the mirror section, even though I wanted to in order to make it look “mirrory” compared to the non-mirrored “flat” or matte parts…

I have a few other things to say about my experience at the OpenStudio show and sale today — I was quite uncomfortable despite appearances. Or at least I think I presented a comfortable and at ease appearance. But in point of fact there were three or four women in my hallway who were talking about me and who did not want me there. I think the woman who was almost directly across from me, except for the space where the T opened up to the other perpendicular hall, was particularly upset with me and trying to marshall support from others against me. I don’t know what I did to bother her, but she clearly had conceived an antipathy to me. She was the one I believe who won the award at the group show. I thought her paintings, decent, glowing and colorful, and skilled to a nice degree, though not all that creative to my eye. Highly colored oil paintings, likeable but somehow a bit lifeless I cannot quite say why because everyone else seemed very impressed.

Be that as it may, I do not trust her and frankly I believe she is likely bad-mouthing me as I write this. I had the distinct impression that she was enlisting support from those others to get rid of me at the exhibit, and even harm me in some fashion. Every time I left for one reason or another, or walked down that hall to get to the stairs, I felt watched and heard them whispering. Damn her and damn them. I could have had a reasonably okay time, had they not taken to tormenting me…though in point of fact, had not a few visitors talked to me a bit, I would have sat in silence all day long, except for when my family came. No other neighboring artist spoke to me all the day and no one even so much as introduced themselves. If anyone did anything — conversed with me, introduced themselves, started a conversation, it was I who had to do it, and then it seemed as if they responded only reluctantly.

However, I should cease and desist at this for now as I left out my “business” cards, and so I guess any artist there could have, though I doubt it, picked one up and could now be “listening in.”

In any event, I am doing a little drawing at the moment, small cards, “trading card-size” drawings. Dunno if I will give those away, trade them, or not. But it is fun to work on such a small scale nonetheless.

The only thing I would give away free this time for sure, though I have given and donated a lot previously, is Christabel, the portrait collage. If the real Christabel came along and introduced herself (with proof that she is who she is, because my amnesia for that hospital stay is such that despite my remembering her kindness I do not actually remember her face or anything else about her) if she came to see the show and saw her portrait finished, I would happily give her the collage wall-hanging for free. So Christabel, that is my offer. (I won’t know you, but if you remember me and come to the show, find me and find your portrait.)

Enough for now. Just wanted to let my readers see the final “product” in case it sells. Fat chance of that though. It looks as if I will be going home with literally everything I brung with me…Well, it is a learning experience. And it has been that to the max.

This is the sketch I did of the collage, largely because I was fearful that I could not accomplish my vision for it without one.

And this is the collage as it is now, and nearly finished. I see now that I also need to add back the second set of restraints, and a top molding for the window, as well as the sill molding and certain shadows. Also clearly the mirror needs to be fixed and other things, but you can see what it will be like when done. If,  however, I do not finish it completely in the crunch to Friday, well I will exhibit it as a work in progress!

Title is tentative, still undecided. Reflection on Room in Ward 101. A reference to book "1984" where the Ministry of Love was where lies were taught: Love is Hate, Peace is War etc

Reflection of Seclusion and Restraint : There is hope and freedom somewhere.

I want to post today some photos from the progress I have made on my large collage of the restraint room (seclusion room) in a psychiatric unit. I must say that it gives me the shakes whenever I work on it, or at least whenever I look at it afterwards, and certainly when I photograph it. But I think that the fear and heart-racing palpitations are slightly diminished compared to this time a month ago. Possibly. That is what I am hoping for at any rate. The process of doing this is my attempt at “exposure therapy” I suppose, because I cannot live with what feels like PTSD any longer. (I know, I know, according to the New Rules, you cannot, by definition, have PTSD unless your life was mortally threatened; unless you experienced a tsunami or earthquake, mass murderer, or Hurricane Katrina, it does not count as “real trauma,” so say the doctors, and they should know, right? After all, they are the ones who defined the illness, and keep redefining it, and who made it up! Well, since they have the initials MD after their names, standing for Missed Diagnoses, I dunno if we can trust them on anything as important as deciding for us what it is that counts as traumatic. It seems to me that WE ought to be the ones telling THEM, no?) Be that as it may, let me change paragraphs and resume the discussion I left off so abruptly above.

Whatever the case, I do suffer with heart-racing fear and sweats and tremors that make it difficult even to take a clear photo of the collage after working on it but whether it is PTSD, I care not.  All I care about is 1) communicating the experience, or at least what the rooms look like, and 2) purging myself of the residual fear.

I don’t want to go on any further with that. It truly does cause me great anxiety. And I prefer to work on the collage and on forgiving the specific people who did those things to me. It is likely that they had grown to hate me, forgetting that I was a troubled and profoundly ill person because I was also loud and frustrating and violent…(treated with violence didn’t make me any more docile, I might add). So  things only escalated and escalated, when from the start their goal was to have a quiet unit that ran smoothly and had everyone get discharged in a matter of days, no questions asked. They did this by helping no one, by talking to no one, and by questioning no one. All they cared about was making sure that everyone stayed “safe” for as long as they were in their clutches. And that they would say so until they left. BUT I said I was working on forgiving them, and trying to see them as tired human beings, flawed but human. It does me no good to get all riled up again.

so I will leave it here, with the photos of the art. I will add only that I plan to redo the curtains, since as it is the blue competes with the sky. Also there will be a curtain rod, and such…But as you can see, it is still a work in progress!

You see the mirror now, and the bed with the restraints? The garden below the window?

No those are not "banjos" on the bed...Look closer. This is a psychiatric unit...

But so is everything it sees and reflects...

Behind the mirror, beyond the window, an open garden gate...