September 27, 2008

When did you last see your lawyer?

One evening when I was in the unit, we were allowed to watch a video: somebody, either a patient with a good sense of humour or a member of staff with a poor one, chose Terminator II. Or perhaps they had just forgotten, as I had until it started, that part of the movie is set in a psychiatric hospital in which Sarah Conner is incarcerated.

Having stuck to her story about a robotic killing-machine sent backwards through time to assassinate her, she finds herself locked up and thereby facing a dilemma. Does she continue to tell the truth, which has caused her to be considered mad - or does she lie instead, in the hope that if she does, they will believe her? Eventually, seeing that while she continues to insist on the truth of her story, they will keep her inside indefinitely, she tells them that she's changed her mind. She now understands that it was all nonsense, no such thing ever happened, she had imagined it: but she's all right now, so could they let her go? It is of no use: as she admits she suffers from delusions, they decline to release her. There is no way out. Enraged, she attacks the psychiatrist.

I thought this was pretty funny even at the time. I didn't laugh a lot during the fortnight I was locked away, but it was far too close to my own situation to do anything else. The doctors believed that I intended to take my own life, which I did not. So they decided that the reason I wanted to be let out was so that I could kill myself: anything I said other than "I agree that I am suicidal" was therefore a front, a scheme to induce them to release me so that I would be free to kill myself if I could. If I told the truth, they would assume it was a lie, and I would continue to be locked up: if, however, I decided to play along and tell them they were right, they would consider me suicidal, and I would continue to be locked up.

I had read Kakfa, but I had never lived inside it until then. If it was funny, it was perhaps because there was no other way to make sense of it than to consider it absurd. If you tell the truth, you will be disbelieved. The only way to be believed would be to lie. That is funny: the world turned upside down. The absurd is funny, what's funny is what's absurd. It's funny to recount it: it was even funny, very briefly, at the time. But it's less funny to recall it, to recall the fear that it involved.

If to be mad is to refuse to accept reality, then this was madness: to live within it was to live in the power, the genuine and frightening power, of the mad. They can keep you there: they can do things to you when you're there. They can do these things not on the basis of anything they've proved, but only on the basis of what they've decided. They are not people who like to admit that they might be wrong.

How does one approach such a situation? Wait it out? What if you had to wait forever? Or wait for one's chance? I don't know if I ever would have run, though I thought about it often: it was a contingency rather than a contingency plan. Everybody who is sectioned is entitled to appeal to a tribunal: I was told this on the afternoon of my incarceration, and made the appeal that same day. If the appeal failed, I decided, then I would have to try and run. I say decided: I decided only in the way that you "decide" anything that you don't believe you will ever have to do. That is the thing about madness, you never really believe that it is happening. You can never quite accept it. You cannot never quite decide that you have no choice, that you must act on the basis of having no choice, because this is mad. How can you believe what is mad? How can you proceed on the basis of madness?

The need to take that decision was postponed by the existence of the Tribunal which, by law, should have taken place within seven working days of the day of my incarceration. This should have been no later than Friday the 22nd of September: having some sense of habeas corpus, I assumed that if it was not arranged by that time, I would, of necessity, be free to go.

But I assumed, at the same time, that I would not: just as one had to try and cope with the apparent fact that truth would be treated as falsehood and falsehood as truth, so one had to believe two opposite things at the same time, in the absence of any information to discount either one of them. Plainly, if the law said that a patient was entitled to a Tribunal within a certain period of time, and that period expired, they must perforce be released. Otherwise the provision of the law was without meaning and rendered that law an ass. But equally plainly, the Friday came, and I had no notification that any Tribunal was arranged: the Friday passed, and nobody came to tell me that I was free to go.

Nobody came, in fact, to tell me anything. Except, eventually, late on Friday, I was told that somebody from the relevant department had phoned the unit, in the afternoon, and said that no Tribunal had been arranged. They did not even ask to speak to me. I did not even possess that right, the right to be told, directly, that my legal rights were without meaning. I insisted on phoning them back, of course, once I had been told, and told them what I thought about it. But it changed nothing: I was still locked up, and the rights that were supposedly mine in law did not apply. Did not apply and did not matter.

Some years later, I found myself in an office of a legal firm, through whose window I could see, a few yards away, the wall of the house in which my late great-aunt had lived for fifty years. I was there because I had recently read about some people in a similar position to the one that I had once been in: denied a hearing by the time the law demanded, they had gone to court over the matter and - no small amount of time later - been awarded compensation.

Only small sums, a few hundred pounds apiece, but something, at least, for being treated as a person without the protection of the law. Holiday money, not disproportionate, something at any rate. I could see no obvious difference between their cases and mine, so I consulted a solicitor to see if a precedent had been set from which I could gain some small benefit.

It had - and it had not. A precedent had been set - and an important one - but it was not one that could benefit me. The lawyer explained why. The action had been taken under the Human Rights Act, which, although passed in 1998, had not come into effect until the start of October 2000. October 2000. And I had been inside in September.

I laughed again. One would wish for other things to laugh about than ironies. But even if that is all there is, one laughs at them nonetheless. Of course, of course, it would have to be that way. What other way could it have been?

It was futile to shout down the phone at a functionary just because they couldn't even be bothered to tell me I had no tribunal. But I did it anyway, and I was right to do it: when you can do nothing, you have to do the little you can do. I stopped eating, too, after the Friday afternoon: that was a contingency plan I did put into action. And it was futile too. But you have to do the little you can do. If you are deprived of the protection of the law, you have to do the little you can do.

I was not, however, deprived of the protection of a lawyer. When they informed me, on the first afternoon, of my right to appeal to a tribunal, they also provided a list of legal practices which specialised in the field. I chose one, for no reason that I can remember, and a solicitor came to see me. Over the following fortnight she did a lot of things for me. The most important was that she believed me.

I can remember her saying so, not straight away, but later. Perhaps even afterwards. She hadn't just represented me, she had believed me. It's a strange thing for a lawyer to tell their client. A strange thing for a lawyer to have to tell their client: a lawyer who said they didn't believe their client would be obliged to terminate their relationship. It goes unsaid. You assume that your lawyer is prepared to believe your story and act on that assumption. If they had to assure you they believed you, it would as likely mean they didn't, as they did. The spoken assurance is no stronger than the unspoken assumption. It merely raises the same doubts it aims to assuage.

But the rules are different, inside the unit. Normality is that you are not believed: the assumption is that what you are saying cannot be accepted. People lie: but normally we assume that they are telling the truth, if only probably, if only as a provisional position. In the unit, the provisional position and the normal one is that you are not to be believed. You are not normal: you are lower than normal. You feel it, you feel it. You feel less than human, because you are not free to move: because you are not trusted to move. You are deprived of the normal assumptions about your intentions and your integrity, the assumptions which comprise everyday human dignity. And you feel less than human because where other people are believed, you are not to be believed. As much as anything, it is absence of worth. And, this being so, when you are believed, it is transformative. Where belief is restored, the same is true of self-belief.

We did have a tribunal in the end and when we had it, I was sure that I would win. You always are. Even though you know, from practice, that you are not believed, it is impossible to accept it. What is true, is true, no matter how many times it is not believed. Where you know what is real, you cannot believe what is unreal, not unless you want to. There are always four fingers, never five: never five unless it suits you to believe that. And you can believe the truth indefinitely, provided only that one other person believes it too.

Once people have taken the decision to lock you, up, they cannot take the decision to let you go, unless something has changed. Not lightly. They have a stake in it: they cannot change their minds, or cannot open them, cannot accept that they might have got it wrong. For all the protestations that people do not do this lightly, for all the claims of professional integrity, once they have done it, it is not like that any more. After that, there is ego involved, there is face to be lost. It is human, perhaps, to wish to avoid to loss of face. But it is human, too, to feel anger, anger that has barely abated eight years on, when somebody keeps you locked up, and humiliated, rather than accept a loss of face.

Dear Christ - there is much that it is hard to remember, but it is so easy to remember how angry I was. They told me that I had a problem with anger: maybe I did. But maybe I was so angry because I was angry at them for what they had done. And that, they could not see. With their all-seeing eyes, that could look into my head and tell them what I was thinking, that could tell them what my plans and intentions were - that, they could not see.

But I got out. The minute that it was not their decision, I got out. On the 27th of September 2000, I got out. Nobody ever said a word of sorry and nobody ever paid a penny by way of compensation. But I got out. We had to wait a short time while they filled in the paperwork - and what an outrage that felt like, having to wait for the freedom that had already been restored to you - but I got out. I never lied and I never told them what they wanted to hear from me. And I got out. And in the struggle to get out, in the anger at my incarceration, in the sense of outrage that it set off inside me, in the restored sense of self-belief that it gave me when I was believed, I found myself alive again, I began to believe in myself once again. I beat them, I beat them! I was hopeless, in a cell, pinned down and assaulted, deprived of privacy, deprived of liberty, threatened with forcible medication, and I beat them! I got out, I got out! There is, there is a light that never goes out, even when you cannot see it, even when your eyes close in the cell and you believe you want to die. There is a light that never goes out.

There were friends who sustained me while I was in the unit, and there have been friends who have sustained me since. Friends I stayed with, friends I met, friends who I will never meet. The love of cats, the love of chess, and the experience, finally, of finding my second life. There is a light that never goes out.

All these people and all these things. There was a nurse, too, just one of them, who spoke to me, and began to believe me, and told the tribunal that she did not believe I should be there. But I remember that my lawyer got me out, and drove me, from the place that was no place, to the station, from which I took the train that took me away from there and to a place where I could rest. She told me she believed me, and she believed me. And I remember that. Often, I remember that.

But I cannot remember her name. I had her card in my wallet for years, but eventually, in one of my many clearouts, in one of my many moves, it was mislaid. I cannot remember her name. I remember the date. I remember all the dates. Eight years ago today, she got me out and drove me to the station. I am crying here, as I write this and I remember, in front of my computer, in a small shop, in a small town and very far from England, and every two or three minutes I have to go to the sink, and wash my face, and dry it with a towel. I remember. It was eight years ago today. And today, I am moving house, and going to the village. Today, I am moving house, and in May I shall be married. In May I shall be married. But if she had not believed me, I would not be here.

But I cannot remember her name. I would like to remember it. I would like to send her a card. To say thank you. To say thank you for believing me. To say all the thank yous in the world.

September 13, 2008

When did you last see your mother?

On the 13th of September 2000 I was taken by the police, against my will, to a secure unit in Bedfordshire, and confined there for a period of two weeks, until an appeal tribunal decided that I should be released. Nobody involved has ever offered any word of apology.

I say, now, nothing more specific than Bedfordshire: I know exactly where it was that I was taken, the name of the unit both then and now, its address, its exact location, and perhaps one day I will go and look at the place from the outside. But at the time, I had no idea where I was: even when I knew the name and address, I had no idea. A place exists only in relation to the other places that adjoin it: a place without that context is no place at all.

Where I was, I knew only from the inside, as one knows a prison, and in the occasional moments when I tried to work out how I might escape, the absence of any knowledge of the world immediately outside was as much an obstacle as the doors, and walls, and staff. I could run, if the opportunity arose: I could climb, if I absolutely had to. But after that, where would I go?

They came while I was at my mother's house. I have not seen it since, though I have passed over it in an aeroplane, more confined, when I think about it, than I was in the unit, though rather more free. I had been half-expecting something like that to happen: I had been afraid of it, I had told people I was afraid of it, but although I had half-expected it, it was only half - the half which defers to the other half, the half which sees what is real but assumes that its perception is nothing more than pessimism. The half that knows, but never quite believes. The insufficient half.

I had thought that I should run - that if they came I should run as fast as I could, for as long as I was able, and only then stop to think what I should do next. But when they did come, because I had not really believed it, I wasn't ready. Not ready to see them, not ready to run. So I stayed where I was - until they hauled me out and took me to wherever it was that they took me. And I stayed there, still not really believing it, for those two weeks, all the time wondering where I should go if I should run.

I had a room. I thought of it as a cell, and although I told myself that this was anger speaking, it was a cell, or closer to a cell than to a room. I could prevent nobody entering that wanted to, and though I was free, most of the time, to leave the room itself, there was not much further I could go. Nor could I stay there whenever I wanted to. It offered only the sanctuary that they let me have, which was no sanctuary from them, which was no sanctuary at all. It was a cell.

I remember standing in that cell, for the first time, on my first afternoon. It was the only time in my life I have ever genuinely wished that I was dead. I was not afraid of dying: I was afraid of declining, of spending months and years locked away, an open-ended sentence, medicated, only half-remembering who I was or how I came to be there, trying to fix my mind upon a point before I forgot what point it was that I had chosen.

I was afraid. I was afraid of being taken for walks with people who I needed to be told were friends or relatives, afraid of the conversations that would take place beyond my hearing or beyond my comprehension, in which everybody would agree how sad it was and express an unfelt optimism that things might get better in the future: afraid of the shaking heads, the signatures. I wanted to die rather than have that happen, really wanted to, really desired the ability to close my eyes and command them never to reopen. At very least, I wanted to will that to happen while I still possessed the quality of will, before it was taken away from me for fear of what I would do with it. Most of all, I wanted to live.

It is impossible, I think, to communicate the distress a human being feels during the experience of confinement. Frustration, anger, fear: foreboding, resentment, hope and the absence of hope. These are words, collections of letters, collections of letters that have a certain shape. If you pulled and squeezed them, out of shape, they would become unrecognisable, apparently useless: but left as they are, they represent nothing that is not as orthodox as their habitual shape. Confinement deprives you of your shape. It imposes other shapes on you, shapes that you cannot understand. It demands of you, imposes on you a state of permanent incomprehension: you cannot, absurdly, do what you would normally do without question and without any thought. The words, the letters, make no sense. It makes no sense.

The door in the wall is closed and will not open. What then is the purpose of the door? You want to walk outside, but can't. Why not? Why are they doing this? How can that purposeless restriction possibly be understood? And just as one cannot walk beyond the wall, just as one's progress is unnaturally impeded, so is the expression of one's feelings. They do not make sense: they cannot apply themselves to an experience that makes no sense. They are cornered, just as you are cornered: you feel yourself not only powerless but in the presence of malign power. Your feelings are forced out of shape. Anguish at the incomprehensible expresses itself as an incomprehensible anguish. If they can do this, when they should not, what else, what further, might they do? You cry: you cry out. And because you cry out, they conclude that you are sick, and because you are sick, it means you need to be confined.

You are always afraid. Afraid of what might happen, afraid of decisions beyond your control, afraid of not being believed. You are afraid of the staff. You are afraid of the staff, and they are afraid of you, and the tension that this mutual fear creates results in incidents, assaults, the need to leave one another alone and yet the inability to do so. Because there are tensions, there are sides. Because there are sides, both sides are jumpy. But only one side has the power. Only one side has the capacity to act together, only one side has impunity, only one side possesses the impunity that derives from the knowledge that you, and not the other side, will be believed.

I witnessed several assaults, of patients, by the staff, in my two weeks inside the unit. I remember two in particular, in one of which I was the victim: though none of these assaults would have been seen as assaults by the law. Still less, much less, by the people who committed them. But they were. In almost every case they were committed without prior threats or violence, from the patient, and almost always the need to restrain, even if it existed, had been created because the staff had provoked a reaction. When they could, had they so wished, have left the patient well alone.

On afternoon, we were allowed out for a short time, within the grounds, to get some air. I went out, for a short time only, and then went back to my room, preferring my own company to that of the other patients and the staff. Almost immediately a member of staff came into the room: he wanted "the stone". The stone. Some sort of stone, he was looking for a stone, some stone, whatever it was he was talking about. What was he talking about? What was he talking about? I asked, he raised his voice, and I raised mine, and in they came, the staff, pinning my arm behind my back, throwing me face down in the way that kills several people in police vans and stations every year, rendering me immobile, stuffing my face onto my bed, going through my pockets, seeing what was there. There was no stone there.

The member of staff, I later learned, had decided that I had picked up a stone from outside and put it in my pocket. He hadn't seen me pick one up: what he'd seen, and all he'd seen, was me spinning a coin, a coin I'd found earlier, and putting it back in my pocket. He didn't know exactly what had happened, nor did he bother to find out. He could have asked me "excuse me, do you have something in your pocket?" and brought in his backup only if he didn't get a co-operative response. Instead he rushed in with a demand the patient had no chance of understanding, and inevitably, the patient ended up with arms behind his back and face against a pillow. Inevitably. Because that was the way they went about their work. And usually, nobody was hurt, or only temporarily, not enough to matter even if what the patient thought or felt had mattered. But it didn't need to happen, it was made to happen. And because it was inevitable, and because there was nothing you could do, you hated them. And you were afraid of them.

I remember how afraid I was. I remember what was said, and how terrifying it was. There was another patient, a woman. She was upset. I never found out what had upset her, whether it was anything in particular, or whether it was just the being there that had, for a short while and in undramatic fashion, become too much for her. But all she wanted was to be left alone. She said so: she just went to a corner, by herself, and asked them all to leave her alone. And they would not. They pestered her, and she asked them to leave her alone. They asked her what was wrong, and she asked them to leave her alone. They kept on at her, and eventually, as she was bound to, as they knew, most certainly they knew she would, she lashed out. And in they went, nearly all of them, and pushed her down, and twisted her arms, until she started screaming from the pain. Everybody could hear her. I was afraid that they were going to hurt her, more than temporarily, more than trivially. At that stage I was afraid only for her.

The most senior of the nurses was a violent, vicious man. He is the only member of staff whose name - Jim Chalmers - I have not forgotten. Everybody was afraid of him. I am sure his colleagues, too, were afraid of him. It is hard, to tell the truth, to think of him as a nurse, since he was so willing to use violent methods against patients, so little concerned to see those patients as anything other than a threat to be combatted and attacked. He saw the other patients, now, watching their friend suffering pain under the weight of this assault, and he ordered them to leave. I wouldn't go. I was afraid for the safety of the patient, and I said so. He ordered me again. I said that I would not. I said - and loudly, so that everyone could hear, so that there was less chance that later, everything would be denied - that I was not approaching the incident, and I would not, but nor would I step away until I was sure that the patient had suffered no harm. I looked at Chalmers as I said it. He looked at me, and then he said:
That man needs medicating.
He kept looking at me. It was probably this, in truth, that kept his threat from being carried out, because had he given the instruction to anyone in particular, I am sure they would have followed it. But nobody did. Perhaps nobody could believe - even there, even in the unit - that a nurse had ordered a patient medicated for nothing more than witnessing a incident. Perhaps they were afraid that there would be consequences if they followed his instruction. But I am sure that they were more afraid of him. I am sure that had he given the instruction directly, they would have followed it. But they did not.

She was medicated, in the end, and taken off to the isolation cell, or whatever they called it, the rubber room, the place where you were put to cool off, a place I only once saw from the inside, as patients were placed there routinely on arrival. And I remained unmedicated. On this occasion, unassaulted. I wrote a complaint about it, afterwards. The hospital investigated by asking Chalmers if he had made the threat. He told them he had not.

I say they have impunity. In a legal sense, of course, they do not, and in a theoretical sense, were enough violence done and were enough witnesses prepared to speak, then it is possible to imagine a prosecution against a member of staff in a special unit. But this would rarely happen: and even if it did, such a prosecution would nearly always fail, as the staff would always be able to claim, as the police do, that they felt threatened and acted to protect themselves. In practice, in everyday practice, they have impunity. Because they will always be believed.

Why not? Who is going to be believed? A psychiatric patient? Even this, this account written eight years later, is only one side of a story, the side of somebody who was confined in a special unit, whose mind must therefore have been disturbed. The side of somebody who therefore cannot be believed. And that is what it's like. That is the real state of madness, that is what is so incomprehensible, that is what causes you anguish. Nobody will believe you.

Nobody. Nobody. Whatever happens, whatever you may say, whatever you may see, whatever is the truth, nobody will believe you. Your word is nothing. And where your word is nothing, so your worth is nothing. You are nothing. That, if you can grasp at it, is what it's like.

Sometimes I find it hard to believe that these things happened, when I try to remember, when I try to remember what it was really like. What it must have been like, what it must have been like to be me, nothing, worth nothing, helpless in the face of disbelief, taken and locked up in a place that was no place at all. It is hard to remember, harder still to believe it, impossible to understand. Now, I think and pray, at this distance, eight years away, a thousand miles, there is some sort of peace, some rebirth, some perspective. But it happened. It always will have happened. That man needs medicating. It was madness, and the madness was not mine.

On the NHS it is, essentially, impossible to get assistance for mental health problems unless you have tried to kill yourself. It is hard enough even then: there are no resources available. Yet there are thousands of people, expensively imprisoned, in units like the one I knew. Most of them should not be there. I was sent there myself, on the 13th of September 2000, eight years ago. I could, had things gone differently, be there, still, today.