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.


At September 15, 2008 1:50 pm, Anonymous Anonymous said...

Brilliant post, sir.


At September 18, 2008 12:35 am, Anonymous WorldbyStorm said...

I agree Ian.

In a limited context all power shifts to others and they can exercise it - even if by their lights they are well-meaning - tyrannically. Problem is our society is filled with these limited contexts.

At September 20, 2008 9:14 pm, Anonymous James Grieves said...

I don't really know what I can say that isn't horribly inadequate.

This post made me remember a friend of mine who is by now either dead or in the American equivalent of an institution you describe in this post. I am now struggling to decide which would be the worse fate for her.


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