It is quite common that people who have experienced mental problems, especially those who end up in psychiatric hospital care, feel that they are misunderstood and mistreated by the psychiatric system. How can that be? Why do they seem to believe that psychiatrists and mental health staff don’t have their best interests at heart? Is it that they just lack insight into their condition? Is it paranoia?
For the psychotic patient’s family and friends it can be very frustrating that their loved one is opposing the care they are receiving. Who should be believed and trusted, the psychotic person, or the doctor? It’s quite understandable that it’s easier to lean towards the doctor.
During my first hospital admissions, I was positive about the care. Gradually that changed. I was on a closed ward, which meant that the doors were locked, and we had to ask permission to go outside. Phones were taken away and could only be used in a specific telephone room. When it was time to take the medication, you did not have the right to refuse it. If you did, it was administered to you by force.
It is easy to understand why the ward started to feel like a prison. It felt as if a lot of the staff saw us patients as unruly children who had to be kept in check.
All went well, as long as I agreed to the care, and did what the doctors and nurses told me. But when I voiced some criticism towards the care and challenged the doctors’ and nurses’ views, it didn’t go well anymore. In their eyes I became a noncompliant patient who lacked insight into her condition.
In a psychosis, it is common that you feel that something groundbreaking is happening, something fundamentally important. This can actually be true, the psyche might go through a huge upheaval and transformation, which could ultimately be healing and positive. However, the hospital is an environment where this is not recognized and supported. Patients are told that what they experience doesn’t have any value. And they are obliged to take drugs that aims to stop the process they are going through.
I believe that deep down, people know something is happening within them that could lead to healing. It is painful when this process is hampered, and the psychotic experiences are not seen as meaningful, but as an illness that has to be eradicated. It is seen as a part of the treatment to get the patient to adapt this view, which can be in stark contrast to what they are feeling inside. It is easy to see why it starts to feel like the staff don’t understand you and are in fact against you.
In involuntary care, your rights are stripped away, and you are at the mercy of the doctors and nurses. This can feel very humiliating. Most staff members are empathetic and caring, but there are those who have entered this profession for the wrong reasons. Some intimidate and bully the patients. Some staff members seem to think that to keep order on a ward, they have to exercise power over the patients. It becomes a weird kind of subculture, prison culture. The other patients that you have bonded with become your allies. The psychiatric hospital starts to feel like a prison that is trying to crush you.
It’s clear that this is not the ideal environment for healing. But it is hard to see a solution. That would require a huge paradigm shift within psychiatry, but old beliefs die hard.
It is my hope though, that it would one day happen.