Helping friends in psychiatric inpatient
This is a truly great question and my answer is one word: abide. My pastor demonstrated this word to me. It means “to endure without yielding; to bear patiently.” Even if there’s nothing you can do for your friend, be there. Don’t walk away.
Send your friend cards letting her know you are thinking of her. Telephone her, even if it’s really difficult to get your call through. Listen to her. GO VISIT. Don’t be afraid to walk through the locked doors. Take food (pizza is good) or flowers (but not in a glass vase—they’ll confiscate that). The more visitors a psychiatric inpatient has, the better the patient will be treated. If the staff knows that somebody is watching, then they treat the patient better. If the patient has no visitors, then gradually the staff begins to ride roughshod over their human rights.
You don’t have to “do” therapy or any other thing. Your friend has got therapists, doctors, nurses, social workers and case managers up the wazoo. What your friend needs is you. What did you do or share outside the hospital? Continue to share the same things, to the best of your ability. Whatever you do, do not ever, ever, ever agree with the staff. Your friend is surrounded by them 24/7, and forced to accept their control over her life. She needs you to stand with her. That might be as an advocate, but is more likely to be just as a friend. She’s got nobody to whom she can vent about the staff problems; as her friend, you be the somebody.
Don’t be afraid of the locked doors. You have a right to visit. My friend came to visit me after church, bringing her two young children with her. The aide who unlocked the door told her the kids couldn’t come in because it was unsafe. That was a total lie, born of an arrogant young man having been given the power of the key: he could lock or unlock the door. Unfortunately for him, he didn’t know who he was messing with. My visitor was a physician assistant and sister-in-law of the hospital’s director.
It is physically safe to take children to visit on inpatient psychiatry, however, it can be disconcerting because they may witness some bizarre behavior that is hard to explain. For this reason, inpatient psychiatric units will arrange for children to visit in a small room off the dayroom, or in the patient’s bedroom. Privacy is given to protect the very young.
My friend’s daughter was in second grade and had just lost a front tooth. In solidarity with her, I whipped out my dentures, showing her that I didn’t have any front teeth either. She was absolutely dumbstruck; apparently she didn’t know anything about false teeth. At the end of our visit, I told her that we should keep my dentures a secret between her and me. She replied, “My mommy says it’s not nice to keep secrets.” Thanks a bunch, mommy.
Don’t be afraid of the staff and don’t let them bully. Go, sit and abide with your friend. Ask her what she wants. She may have lost her mind, but not her right to choose. If in doubt of your welcome, ask her if she would like you to leave. Give her the chance to say yes. She is in a physically and emotionally strange place. Have the strength and courage to go there with her; don’t let her go alone.
When to fire your psychiatrist
At the end of your first visit. But seriously, folks . . . there is no good formula for when to fire a psychiatrist because psychiatrists are tricky bastards. First of all, they’re very smart, which means they can create lots of justifications for their non-therapeutic acts. Second of all, there is no fixed pattern of weirdness. You get your hair cut, walk into your shrink’s office, and he says, “I like my women with long hair.” Run like hell away from this guy.
In another example, in the third session I asked a psychiatrist a question and she snapped, “You know what I’m talking about.” That’s an answer you give to the husband you’re mad at, not the patient you’re treating. Ninety-eight percent of all psychiatrists are squirrely. I knew one who stabbed his wife and claimed it was self-defense. Okay, I can buy that—but then why did he hide the knife in the attic?
The best advice I can give you is: TRUST YOURSELF. You know you best. You have lived with you longest. How much time has your psychiatrist spent with you? Does he know enough about you to treat you wisely? He may try to guilt you out, saying that you’re running from your problems, or that you’re refusing to face the truth. Don’t believe it. You’re being manipulated.
Here’s the God’s honest truth: healing doesn’t have to hurt. If you’re feeling better, then keep working with him. If you’re not, dump him. I know that he’s got an enormous amount of power and prestige—he’s a doctor, for Pete’s sake—but that doesn’t mean he’s right. He lives in an enclave of wealthy people, vacations on South Seas islands, and doesn’t empty his own trash. He has no idea what your reality is. How many life-points do you and he have in common?
If you’re asking yourself when to fire your psychiatrist, then it’s past time to do it.
A therapist who works in a hospital calls healing “The F-O Day,”—that’s the day when you develop enough confidence in yourself to tell your doctor to fuck off. Try it; you’ll like it.
How long can a person be legally maintained in a locked psychiatric intensive care area?
Forever, as far as I know. There are specific and copious rules and regulations about how a person can be treated while locked in “intensive care”—also known as solitary confinement. First among these is that you cannot be left alone; there has to be a staff person within earshot. At St.Joe’s, they do not use nurses or therapy aides for this constant accompaniment; they use security guards, which should tell you just how therapeutic they consider the experience to be. It’s prison without all the fuss of a trial. It is all perfectly legal under NYS Mental Hygiene Law.