“A Choice, of Sorts”


This morning’s Facebook has brought a paper by Dr. Rachel Bingham about “voluntary” psychiatric hospital.  She references Dr. Peter Breggin and what she calls the “Breggin gap” referring to the coercion that keeps a supposedly voluntary patient locked up.  Good doctors may talk to each other about this.  Let me show you what it looks like from the patient’s point of view.

You are the patient.  You decide that you are in so much emotional pain that you just can’t stand it anymore and you want help.  Hospitals are supposed to make you feel better, so you go to a hospital’s Emergency Room, where you tell your story and agree to voluntary hospitalization on an inpatient psychiatric unit.  They put you in a wheelchair.  It starts right there:  you are physically healthy but in order to “get help” for your troubled soul, you have to act as if you are physically ill.  Then you are pushed down hallways and up elevators, and arrive at the door to the unit.

You sit and wait until somebody comes to unlock the door and let you in.

Once you go behind a locked door, nothing else that happens to you is voluntary.  As long as you know that you are not free to leave, you have no freedom to do anything.  Nothing is voluntary.

Behind the locked door there are many, many staff members, all of whom are committed to telling you what you must do “for your own good.”  This all arises from the false premise that somebody else knows what’s good for you better than you know yourself.  A 19-year-old female high school dropout now has authority over a 59-year-old male chemistry professor.  He knows that she has neither the education nor the life experience to bring greater wisdom into his life but she does have the one thing that makes him have to listen to her:  she has the key to the door.

As long as you know that you are not free to leave, you are in a state of coercion.  How does that play out?

Let’s say that it is something innocuous:  the dietary department hasn’t gotten the message that you are there, so they don’t send you a supper tray.  You’re really hungry, which is making you irritable, and you know that your mood will improve if you have something to eat, so you say you want to go down to the cafeteria for supper.  Your request is refused and you are told to wait.  And wait.  And wait.  When somebody controls your access to food, you begin to get the message that you’re no longer in charge of your life.  Being “voluntary” means you don’t eat according to your needs.

You are used to taking care of yourself, but your basic needs are now under the control of strangers who—it quickly becomes apparent—care more about how their system works than about how you feel.  You are offered a pill, instead of food.  Or, as a nurse said to me one day, “You seem angry.  Can I get you an Ativan?”  They will not deal with the legitimate source of your anger; they will drug you into giving the appearance of calm.  And if you don’t accept the pill, what then?

Then you will be forcibly drugged.  If you’ve been hospitalized before then you have seen it.  Why only the day before yesterday, three staff members piled on another patient, dragged him to the floor, pinned him down and injected him with a sedative.  His psychiatrist stood nearby watching quietly while this aggression took place.  His psychiatrist is the same one who is treating you.

The staff members assure you that this never would happen to you, but the fact is that you have some very angry, aggressive feelings buried inside you, and you’re pretty sure that if the staff knew then they wouldn’t hesitate to forcibly drug you, too.  For the patients who get angry and “act out,” there is an alternative to being drugged—they can just tie you down.

The staff members call it “four-point” and it means being tied hand and foot to a bed.  Tied down on a bed.  That’s what they do in the name of “mental health.”  Outside the locked door, if someone tied you down to a bed, you could reasonably expect that you’re about to be raped.  And this “tied-down” thing is not done by the “nice” staff members who serve you your pills instead of food:  it’s done by the staff from the Security Dept.

The unit door—to which you do not have a key—opens and admits a couple men wearing uniforms and carrying radios and guns.  These are the guys who invite you to lie down on the bed and let them tie you up.  Are you unwilling to do so?  Do you want to fight for your freedom?  Do you really?  Coercion occurs when there is no balance of power. 

What you also know from experience is that if the staff gets fed up with you, then you can be transferred to a state hospital.  That transfer out does not involve being pushed in a wheelchair.  It is done by two state troopers—more men with guns—and you are put in handcuffs.  You have seen it done to other people.

There is also the issue of electroconvulsive treatment—shock treatment.  If your doctor decides—in his opinion—that it would be good for you then he can go to court and get an order to do it.  You will be strapped to a gurney, drugged, and semi-electrocuted.  Yesterday your roommate went—“voluntarily”—to have shock treatment and came back so disorganized and disoriented that he didn’t know where he was or what he was doing.  By any functional definition, he no longer was a human being.  They can do that to you.

The fact is that once the door is locked and you can’t run, nothing else that happens is voluntary.  You go “willingly” because you have seen what they will do to you if you resist.  You will be drugged, tied down, zapped, put in handcuffs and made to disappear.  Your only safety lies in “voluntarily” submitting so that you maintain some small semblance of control.

It is a choice, of sorts.

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About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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6 Responses to “A Choice, of Sorts”

  1. Erna says:

    Thank you for writing this and a wonderful description of what happens in a mental health ward
    No wonder volunteer and/or in-p volunteer patients get PTSD in these Hospitals. My husband was strapped in a wheelchair without his glasses he only can see one foot from his face and no drugs help him they just make it worse. He was put in this wheel chair because he was in the faces of other patients.
    How do we stop these problems as mentally ill labels are ground in the minds of people as much as a danger as the war on terror? And usually it is the drugs that make people not respond appropriately, you go in for help and you actually get worse and now have to cope with a label and your emotional pain from treatment and what brought you in a place like this in the first place….

    • annecwoodlen says:

      You are absolutely right. I buried all the pain I felt from the so-called “treatment” for depression until this year when it all started pouring out. I have been blessed with some good friends to help me through all this coming out. The damage done by psychiatric treatment far exceeds the damage done by mental illness. In April, at the Empathic Therapy Conference, Dick Gottlieb, MSW, and I will be doing a workshop entitled “Treating the Maltreated”–how to identify and treat people who have been damaged by psychiatric treatment.

  2. Olli Mustonen says:

    Thanks for the truth Anne.

  3. Judith M.L. Day says:

    I have recently published my book “Judging Judi” which is my personal account of the experience that I had behind the walls of psychiatry for almost six weeks. This book contains actual clinical, medical and nursing notes of the human torture that resulted, and notes from the journal that I had written while I was locked up there with a normal mental status, except I lacked their insight into a diagnosis that was formualated in error. What a terrifying experience!

  4. Alicia says:

    Way to go!!!!!!!!!! Keep writing.

  5. Anne knocks the breath out of me every time she writes. Powerful.

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