Category Archives: In

Stories, information, checklists and anything else related to being ‘in’ – i.e. an inpatient of a psychiatric ward (especially relating to private psychiatric wards/clinics in Australia)

Abandoned again: psychological irresponsibility

I really had hoped I’d seen the last of “psychological irresponsibility” in my life, but it seems I attract mental healthcare professionals who like to end our professional relationships with cruel abandon. Thankfully, I have the rest of my far more reliable care team backing me up – though the shock of D’s departure was enough to increase my depression to the point where hospital was required. (Yes, I’m back in hospital. No, I don’t want to talk about it.)

Am I angry? You betcha.

This time, the news was broken in a phone call. His tone was chipper: “I told the hospital last week that I’m leaving to focus on my private practice.” I accessed his services through my hospital’s outpatient outreach program, which is designed to help people stay well and prevent admissions – yet here I find myself again; ironic much?

He didn’t even suggest we have a final wrap-up session. I asked for one, and we made a time, but I was certainly left with the impression that this was something of an imposition. Would you believe he sent me a text asking to reschedule that session because he had a lunch to attend? Mate, sometimes it’s best to give a little less information: I don’t want to know that finishing up our work together is less important to you than a social outing.

I called his supervisor the day after the news. (The psychologist in question wasn’t available, or I would have had a conversation with him.) I reminded him that, about a year ago, he’d asked me to “give [this psychologist] a go” after an administrative reshuffle meant the excellent worker who had had my case was re-assigned. I reminded him that I’d had reservations about welcoming a man into my home, that it had taken a great leap of trust on my behalf to make that OK. I also let him know – since he seemed unaware of the fact – that my mental health had been deteriorating over prior three weeks. He asked that I give the next worker assigned to my case “a go”. I put down the phone with a shiver: those words no longer inspire confidence.

Having left the supervisor in no doubt as to my displeasure, I tried to put the matter out of my mind; but, as I was driving to the post office nine days ago, I suddenly remembered the original phone call with awful clarity. I remembered how cheerful the psychologist has sounded, how he delivered the news as though he were commenting on the pleasing results of a sports match.

If you’re new to this blog, you won’t know my history with abandonment and health care professionals. I had a close professional relationship with my first psychiatrist who treated me for almost five years, then stopped with five days’ notice. The rupture of that therapy came at a time when I was vulnerable on many fronts, and eventually resulted in a complete breakdown. This psychologist knew of that history. I’d made sure of it, and included it in the PowerPoint presentation I made summarizing my medical history when we started work together.

Anyway, I was driving to the post office, and I heard his voice on the phone again in memory’s ear. My reaction was immediate and physical. I felt numb. I walked into the post office and stood at the counter with my parcels. The clerk said something to me from across the shop, but the words didn’t penetrate the fog which had wrapped itself round me, filling my ears and eyes with thick whiteness. I mailed the parcels, walked back to the car, and started the engine. I was only as I approached the corner that I realized the clerk had asked if I was all right. I’d completely ignored her! I drove around the block and walked back inside.

“I’m so sorry about before,” I said, and felt tears on my cheeks. “I think you were talking to me, but I didn’t hear what you said. I probably seemed rude.”

“That’s all right,” she replied, looking at me carefully. “Perhaps you need to go home now?”

“Yes, I think I do.”

“Should you be driving?”

“No, probably not; but I don’t have far to go.”

“OK. Take care of yourself.”

I turned and walked back to the car as though I’d received a full-body beating.

It seems as though my trauma, like my preferred name, is something this psychologist “can’t be expected to remember”. Yes, sadly, that’s a direct quote when I reminded him I prefer to be called “Catie” rather than “Catharine” … three months into treatment.

So: here I am in hospital again. Is it wholly because of the rupturing of that professional relationship? No; my mental health had been deteriorating before that. On the other hand, would I be here if he had handled things differently? No, almost certainly not. This trauma, re-opening the door to that historical hurt, is what precipitated the events which landed me here.

I understand that I don’t know all the details surrounding this incident. I acknowledge that there may be factors beyond anyone’s control which contributed to D’s sudden departure. However, what I do know is this:

  • D had been given the knowledge that an event like this would be extremely triggering to me
  • D had told the hospital a week before he told me that he would be leaving (which implies that he had been planning the move for longer)
  • the therapeutic relationship we’d had was terminated abruptly, and without closure
  • I am now in hospital.

My issue is not that D stopped treating me, nor even that he stopped treating me suddenly. My issue that that he had been given the information that this would be a destructive event in my life, and yet did nothing to mitigate the damage it may cause.

Here endeth the rant.

Have you ever been the subject of psychological irresponsibility? How did you recover?

Therapy ruptured

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Black Psych Ward Humour: TV Shows

Just back from visiting a friend in hospital, where we entertained ourselves coming up with psych-ward-flavoured TV show names. I’ve had some time on the way home to enlarge the list. Enjoy! And please feel free to add your own shows in the comments section below:

  • Desperate Inpatients
  • Crazy Housewives
  • Perfect Zap
  • My Ward Rules
  • The Biggest Crazy
  • Home is Away
  • Neighbours Roommates
  • Who Wants To Be An Outpatient?
  • Wheel of Medications
  • The Good Nurse
  • CSI: Kitchenette
  • Law and Order: ICU
  • A Current Affair
  • Scooby Dopamine
  • Happy Days 
  • Doctor Where-are-you
  • Star Trek: Introspection 
  • Two and a Half Xanax
  • CHarmed
  • Sedation Street
  • Med Key Hunters

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Revisiting the Psych Ward

Don’t worry, I haven’t been re-admitted! That wouldn’t be the end of the world – after all, I’d only be re-admitted if I needed it – but, thankfully, I don’t need it right now. However, I have been back to the psych ward I spent so much time living in last year.

In 2013, due to extreme depression and anxiety, there were four months when I spent as much time in hospital as I did at home. Thankfully my wonderfully plastic mind has redacted most of those months out of my memory banks, but I remember the good bits: laughing hysterically with some of the patients who’d become friends, the nurses’ names, the times hospital felt like a haven rather than a prison.

I’ve attended the same building as an outpatient quite a few times since then: my medications bloke is housed in the same building, as well as some other services, but I hadn’t been back on the ward until a few days ago.

One of my very good friends is “in” right now having a course of ECT. Obviously, I’ve been going to visit and support her.

In 2010 I also had a lengthy hospitalization, in the city I used to live in. I also went back to visit, this time to help out a friend who only had accompanied leave (i.e. she wasn’t allowed to leave the hospital without a responsible adult). She needed cigarettes, and so called me up to come walk her to the shops. When I turned up at the hospital, one of the nurses laughed and said to her, “So this is your ‘responsible adult’?” Way to make someone feel good, lady.

Going to visit my friend these last few days has been a completely different experience. The staff were friendly and welcoming. for a start. I even saw one of the clinical coordinators who’d helped me out last year and clapped him on the shoulder. “I haven’t forgotten I owe you one,” I said jovially. “Only one?” he replied. Apparently favours accrue interest!

Even being in the place felt good. I wasn’t overwhelmed with gut-wrenching fear. I didn’t feel panicky. My friend just happens to be sleeping in my old best (weird!) and even going into that space felt OK.

I’m pretty chuffed that I could go back to a place in which I had suffered a fair bit last year, and feel good about being there. The place is a good place. My friend is in good hands. And should I ever have to be re-admitted, I know I’ll be OK, too.

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Medication Queue Blues

A little-known terror of the psychiatric inpatient system is the medication queue.

Imagine a group of mentally unwell people arriving at an inadequate row of plastic chairs in no particular order to wait for their personal medications to be dispensed through one of three glass windows, as the patients step up to a window, in order of arrival. Can anyone else see a problem with this?

It’s actually quite amazing that the ‘system’, such as it is, works so well. In all my hospitalizations, I’ve only ever seen or heard two blow-ups at medication time related to the queue system.

I’d better define some terms first. I’m talking about adult wards in private psychiatric clinics in Australia. All admissions are voluntary, and patients with more extreme problems are either in an intensive care unit or at a different type of hospital which can cater to their needs.

Some people take the medications queue in their stride, but I once brought it up in group therapy, and there was a general agreement that it’s a fairly stressful situation (all bar one extroverted and highly confident patient who couldn’t see what we were going on about). Because people arrive in dribs and drabs, there’s no order to the queue – so somehow you must remember who was there before you. I do it by counting heads. The problem with my method is that it doesn’t identify who’s still waiting, so if, say, the person immediately ahead of you in the queue forgets their place, there’s this awkward holdup while everyone says: “Were you next?” “Not me, I think it was you.” “Who, me?” [Yes, you. Just go to the window and get your fucking meds so the rest of us can move along.]

During the group therapy session in which I raised the topic, one brave soul suggested numbering the seats from left to right, and having people sit down in order and move along. A few problems were identified:

a) people are always being admitted to and discharged from the ward, so the new-though-sensible rules would need to be continually explained

b) some people bring knitting or other craft projects to keep them occupied while they wait, and won’t want to move seats

c) for some reason, no matter which hospital it is, there never seem to be sufficient seats

d) come on, we’re talking psych patients here! Are they really going to follow the rules?

Look, perhaps it’s just my anxiety talking, but it seems a minor miracle that the medication queue works at all. As a psychiatrist said to me once, with all these unwell people living in close quarters, it’s amazing we don’t have more disruptions.

Do you have a psych hospital bugbear? A story of systems which somehow hang together?

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Bleak

Regulars will know it’s been a difficult few days. I think I’m ready to tell you why.

On the advice of my doctor, I am making an income insurance claim going back to 2010 when I stopped working full-time. As a general rule, I don’t trust insurance companies, so I am approaching this exercise with a great deal of trepidation: no matter how strong the moral claim I may be able to lay, I  know they will do anything in their power to avoid paying up. Still, my doctor thinks I have a strong case, and he says he has helped other people with such claims in the past.

I needed to get accurate data about my admissions to hospital during that time. The private hospital I had no problems with, because by the time I was transferred there I had recovered some function, and can remember when I went in and when I was discharged. The public emergency admission which preceded that has always been a bit fuzzy in my memory, though, so I made a FOI (Freedom of Information) application for copies of my hospital records. (At least the records show another reason why my memory of that time is hazy: it looks like they doped me with lorazepam whenever I opened my mouth.)

They sent me everything from notes of the initial phone call my psychiatrist made telling them I was on my way, to nurses’ observations, to the evaluations of various psychologists and psychiatrists. It made for pretty horrific reading.

Yesterday I took my journal of that time and read the corresponding pages to my therapist. I have not looked at those pages except briefly, last week, to try to verify admission/discharge dates. The pain and self-loathing seemed to fill the room, even as I stumbled over the frequently illegible words. The belief that I should somehow be punished for being so ill as to have to go into a hospital; the now-poignant letters of apology to my loved ones (never sent); the bleak certainty that my life was over … the sense that there was no hope, that I deserved no hope, and that no hope would be forthcoming.

I’m not in hospital now, but I feel a similar sense of hopelessness, and I struggle not to feel the same levels of self-loathing. I was so stupid to think I could read that material and it not affect me deeply.

I don’t want to write much more now. I feel, overall, a strong absence of hope. I’m deeply connected to that part of me which despairs; I need to go and reconnect with my positive self, my beloved self, the observing self which sees but does not identify with this suffering.

I feel obliged to end on a more positive note, so here goes: this, too, will pass.

Bleak; but this, too, will pass

Bleak; but this, too, will pass

 

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