Remembering a Restraint

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It’s been fourteen and a half years since the moment that first set me on my path to becoming an activist – a moment that overwhelmed me, cowed me even, but did not, in the end, destroy me.

I still remember it well. I doubt that will ever change.

I was fourteen years old, and I was in the hospital. I didn’t want to be there. My objections were clear. They were loud. They were impolite. But they were verbal.

I had been signed in by my mother against my will. I was not entitled to disagree. My parent’s signature was, under the law, my consent. To make matters worse, I had been admitted as a result of a lie. My mother, feeling I needed treatment, made up a story that ensured I would get it.

I was furious. I wanted a hearing. I wanted to challenge the accusation. I wanted due process. But I was a child.

I was admitted and discharged several times. Each time I came home, I’d challenge my mother to tell the truth. Each time, she – furious I had the audacity to call her on her actions – would take me back to the hospital. Each time, they would re-admit me. I didn’t even get all the way home in the car, most of those times, before I was returned and readmitted so my mother didn’t have to bear the brunt of the guilt trip I laid on her each time they let me out.

My mother recanted her story, but they had already decided I needed treatment – and that I would still get it whether I wanted it or not. I had, after all, just been readmitted four times.

One time, on the unit, during all of this, I demanded to see an attorney. I demanded to file a petition for writ of habeas corpus. I was told they would get back to me. A few days later, when I followed up, I was told I wasn’t entitled to request such a thing. I was a voluntary patient, after all. The words “habeas corpus” did not overcome my mother’s consent to treatment on my behalf. I thought that was wrong. I could have cared less about the law allowing it. Some matters of right and wrong transcend legalism.

So, I decided to make a point, after that. One of the times I was re-admitted, I waited until the doors clicked shut behind me with that thick, rapid thunk of a relay clicking into place and a magnet sealing the path between myself and the world. The sort of sound that mocks an unwilling soul behind impassable walls.

I wanted them to understand they had me. There was no issue of safety, no risk of escape. I let the doors close, so my action could not be misconstrued.

Once I was, again, a prisoner, I made my point so it could not be missed. I refused to take another step.

I told them that, if they felt I was a voluntary patient, they should understand what their use of power really was. I wanted there to be no question of meaning, no sideways threat or verbal coercion. Such things, though often the essence of oppression, are rarely recognised as such; I wanted utter clarity.

“You’ll have to drag me, if you want me in this place, because I will not go willingly.” It seemed the only stronger way to say what the words “habeas corpus” had failed to. I was loud, but I made no physical move, no threat.

I don’t know what I was expecting. I didn’t imagine they wouldn’t take me back to the unit by force. Force seemed to be what these people were all about. That was sort of the point I was trying to make.

But I didn’t expect what happened next.

I was grabbed, handled by two men, and dragged back to the seclusion room along some fifty to a hundred feet of corridor from the front of the hospital’s locking doors to the adolescent acute unit. There, I told them that they had made their point, and they could let me go.

They had other ideas. I was thrown onto a bare mattress in the seclusion room and two became five. They had me by my hands and feet, one person to a limb, and one of them was on top of me with his knee on my back, the pressure of his weight constricting my chest.

I could barely breathe. I thought I might suffocate right then and there.

I panicked. I didn’t realize that, instead of meeting me with exactly the force I suggested – all that was needed to make the point – they would escalate. It never occurred to me that a standard procedure take down would flow into a prone restraint, following what to me was a simple act of civil disobedience.

I had naively believed they’d drag me to the unit and call it a day, my point about how they were using violence made.

I fought back, already pinned and helpless, and the force became all the stronger. With my breathing restricted, instinct took over. I verbalized this, and begged them to stop.

“I can’t breathe.”

“Go limp, and we can stop this,” they said. Of course, my fight-or-flight instincts had taken my being. I was being pinned by men whose authority was absolute, whose use of force would never be questioned, whose directives could never be appealed. And it felt like I could barely breathe.

The pressure on my back was reduced, but now I heard them discuss giving me a shot of Ativan to calm me down. I was terrified. I knew things would only be worse when I woke up.

“Please don’t inject me,” I whimpered.

“If you don’t want that, then go limp,” was their reply.

I knew, deep within my being, things would be worse when I woke up if I continued fighting. I had never wanted that fight in the first place. I honestly thought they’d just drop me off, having demonstrated their power. Issues of rights and politics and civil disobedience fall away when you’re more worried about breathing.

I didn’t want to stop, though. And I did anyways. I had wanted them to understand their power over me was based on violence. Instead, I had learned the very lesson I wanted to teach them.

Their position was superior and I was overpowered. To them it was just another takedown and restraint. To me, it was something all the darker.

I realized they owned me. Completely. I understood there was nothing I could do to resist them. I felt my very powerlessness as they prepared the shot. Any moment, they would be inserting a needle into my body and ending the demonstration themselves by putting chemicals into my body I didn’t want.

Somehow – I still don’t know how – I reached out. I took control of my body from my panicked, oxygen craving backbrain. I halted fight and flight and movement and fear. I commanded my being to go limp, and it complied.

After some time – it felt like an eternity but the entire escapade, from the front doors to the restraint, had only lasted minutes – they let go. I hadn’t been injected. I had been calmed, in their estimation. I had surrendered.

Something changed inside me, in that moment, though. Something that never had before. I’d always been one to resist – to make my discontent known – even if only symbolically. It’s probably how Oppositional Defiant Disorder was added to the list of my diagnoses.

This time, I wasn’t resisting. I had completely surrendered. I understood what I had been telling them, but instead of them realizing they were wrong, I understood their power.

It’s a terrible thing, overriding yourself in such a way. It changes you deeply.

It has been as many years since that day as I had been alive before it, and I still think about it. It was the day they broke me. It was the day I learned that power overcomes everything – if the people who have that power want it to.

It took many years for me to overcome what happened that day and reclaim my voice. It took years for me to be able to speak of that day.

It was the day I was physically broken because I had tried to assert what I felt was an absolute right to some meaningful hearing on my detention.

It was the day I learned about torture.

It was the day I became an activist.

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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12 COMMENTS

  1. The same thing happened to me. The first few times I was hospitalized against my will, I fought back, and as a result was taken down on multiple occasions. Like you, my fight-or-flight response kicked in. I remember thrashing and squirming as four or five male orderlies tried to hold me down to give me an injection. I remember kicking a nurse into a corner of a room, my fight-or-flight made me so strong. I remember once having 4 police officers hold me down so someone could give me a blood test against my will!

    Eventually I learned that the only way to avoid more violence on their part is to not fight, to completely surrender. One time, I was led onto a ward at night and given a pile of pills to swallow. I swallowed them like a good patient, hoping they would not escalate, now knowing how things work. But because I wandered around the ward a bit after I’d taken the pills, the nurses took me and led me down the hall for an injection anyways. I remember how terrified I was. They brought me into a dark room and bent me over a bed. I knew it would be worse if I fought. So I said, “Be gentle” as they pulled my pants down. Like, “Please rape/stab me carefully.”

    Once the system did break me by confining and drugging me up enough, making me scared of their power to destroy me even more, it took years to undo the brainwashing. Now, I understand how institutions of social control function in society, and that to stay safe from psychiatric coercion, you have to avoid getting caught up in the net of authoritarian attention and behavioural sanctions. Like you, I was naive before, thinking they would be more rational than they were. It was quite an awakening. A horrible one – to realize how brutal these institutions and the people in it can be.

    That same brutalizing, authoritarian tendency probably underlies Western genocide, too. And people think it’s gone from our society because of, say, the amount of Holocaust awareness we have. But it’s alive and well… as many psych survivors know from personal experience.

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  2. Aubrey,

    Thank you very much for posting this; I say that with all sincerity — even as part of me wishes that I hadn’t read it this morning.

    My day was going rather well, to begin, I felt — until now, my mind is on the verge of being overtaken by unpleasant memories.

    It’s a beautiful, early Summer’s day (just in from taking my dog for a morning walk… mocking birds singing); suddenly, I’m troubled by thoughts of my own distant past.

    [Note: Maybe if your post had some sort of “trigger warning” attached, I might, at least, have braced myself, first, so that my method of reading it could have been more methodical/objective? (I think it’s ‘unprotected’ way that I read it, which brought upon me, memories of my own having being ‘restrained’ and forcibly ‘medicated’.)]

    Though it’s been now more than 25 years, since the last time I was “hospitalized” (i.e., captivated and drugged by a psychiatrist), such recollections are still rather easily triggered, by an unexpected encounter and/or reading of others’ stories of similar experiences.

    [One more note — to be fair to the memory of my mother: I feel it’s necessary for me to point out, that, while your post triggers similar recollections, what you describe of your mother’s behaviors is *not* something familiar to me.]

    Your experiences with “hospital” staff do resonate, with an all too familiar feel…

    And, IMO, what must be emphasized here, at last, is this:

    Though my experiences of such psychiatric abuse were a quarter century ago, and yours began roughly a decade and half ago, these abuses are, in fact, still happening — all over the world — countless times, daily… including here, in the U.S..

    Unfortunately, there is *much* denial, amongst psychiatrists and others, that any such abuse is happening.

    See, e.g., the now one-year-old article, “Myths and Truths: The Locked Inpatient Psychiatry Unit” by By Arjune Rama, MD.

    It can be found at this link: http://hummagazine.com/?p=3044

    And, the even more recent ScientificAmerican(dot)com article, by Dr. Jeffrey A. Lieberman, newly installed President of the American Psychiatric Association (APA).

    As you emphasize that this post reflects the experiences which set you on the path to becoming an activist, hopefully, it is not inappropriate — and MIA readers won’t mind — my providing the following few paragraphs, an excerpt of that article, by Dr. Lieberman:

    I do understand how anti-psychiatry ideas first developed and why they have been so difficult to combat. There is historical fear of mental illness, stemming from when these diseases were viewed first as demonic possessions and later as character or moral defects, before we had any scientific understanding for the biological basis of, say, schizophrenia, bipolar disorder, autism or Alzheimer’s disease. The brain is a complex organ, slow to reveal its secrets, and the effort to understand its myriad functions goes to the core of each individual’s self-identity. Patients are challenged by the intimate aspects of their relationship with any doctor—a caregiver for whom you have to disrobe, and who pokes and pries. But in psychiatric treatment you “disrobe” in an even more profound way, revealing yourself psychologically.

    And I do not overlook the checkered history of psychiatry itself. It’s a relatively new discipline which branched from neurology in the 19th century, whose early practitioners were alienists and analysts, superintendents of asylums and Freudian therapists. But, at the time, asylums were little more than humane warehouses, and Freudian theory turned out to be a brilliant fiction about personality and behavior. When psychiatry did make its first forays into medical treatment, it used crude instruments like strait jackets, cold packs, fever induction, insulin shock therapy and psycho-surgery. The underlying theories for the causes of these illnesses at the time were also wrong; it was largely about blaming the parents.

    However, that was then and now is now. The scientific foundation of psychiatric medicine has grown by leaps and bounds in the last fifty years. The emergence of psychopharmacology, neuroimaging, molecular genetics and biology, and the disciplines of neuroscience and cognitive psychology have launched our field into the mainstream of medicine and on a course for future growth and success. Though not everyone, including ourselves, is satisfied with the rate of our field’s progress, no one can argue with one simple fact; if you or a loved one suffers from a mental illness, your ability to receive effective treatment, recover and lead a productive life is better now than ever in human history. Moreover, we have every reason to believe that there will continue to be unprecedented scientific progress, which will enhance our clinical capacity and benefit our patients.

    For this reason, I am especially shocked when other clinicians—psychologists, social workers, even, in some cases, primary care docs who would rather just dispense psychiatric meds themselves—side with anti-psychiatry forces without realizing these people are “against” them, too. These strange anti-mental health bedfellows include a series of contemporary psychiatrists and psychologists who have fashioned platforms for self-promotion from their critical positions on psychiatry and DSM-5.

    See that full article here: http://blogs.scientificamerican.com/mind-guest-blog/2013/05/20/dsm-5-caught-between-mental-illness-stigma-and-anti-psychiatry-prejudice/

    Those who are on Twitter can, perhaps, offer Dr. Lieberman their honest opinion of his views, via an occasional tweet… @drjlieberman.

    Likewise, the above-mentioned Dr. Rama can be tweeted (@arjunerama).

    Respectfully,

    ~Jonah

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    • Uh…………I just got through reading the article by Rama that you posted the link to. What fantasy land is this guy living in? What he described certainly doesn’t fit with what I experience each and every day where I work. This guy is swimming in the longest river of the world, the River of Denial! How can people write this kind of stuff with a straight face and still look themselves in the eye when they look in the mirror every morning? This was unbelievable!

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      • Stephen,

        Yes, I agree, …quite unbelievable (to say the least).

        Dr. Rama’s article (“Myths and Truths: The Locked Inpatient Psychiatry Unit”) reflects his true-believer’s — Utopian — vision, of what it means to be a resident psychiatrist, working with “inpatients” of psychiatry.

        Note prominently, he’s describing life, as he sees it, in a “hospital” run by Yale University (I presume it is on the Yale campus).

        Meanwhile, I think (from my reading your comments) you work in a State “hospital”.

        So, is it possible that his experience/observation of the “inpatient” unit, as described in his essay, is not a fabulous fiction?

        Or, do rose-colored glasses blind him to the actual realities, which are presented, in the environment, where he works?

        (Really, that question is somewhat rhetorical, as I think I know the answer…)

        Last July, via Twitter, Dr. Rama sent tweets to me and to a number of other psychiatric survivors — recommending that link, to his article, asking would we, perhaps, comment on it.

        Here’s a bit of my tweeted reply, to him:

        4/9 @arjunerama u paint ‘poetic’ view of life, in Yale’s locked “hospital” wards ( http://hummagazine.com/?p=3044 ) …i find your view purely absurd.

        5/9 @arjunerama u say, “the right medication or psychological therapy falls into place, the heart and soul of inpatient psychiatry emerge.”

        6/9 @arjunerama This expression, “inpatient psychiatry,” is terribly misleading; these “patients” are on a *locked* ward; they’re prisoners;

        7/9 @arjunerama u’ve worked briefly, yet u say they, “on balance, do well”; tweet me longitudinal studies. (Or, have u blind faith in Yale?)

        8/9 @arjunerama Also, u hope, “average inpatient stay will increase” ! So, they, “on balance, do well, *&* u hope to imprison them longer?!?

        In my last tweet to him, I offered my response to his having written this line, “I wish I could say there weren’t situations in which patients need to be forcibly restrained.”

        I did so by tweeting the the following tweet (which, as you can see, includes my directions to “SEE” a page in my blog),

        9/9 @arjunerama RE “I wish I could say there weren’t situations in which patients need to be forcibly restrained.” SEE→ http://beyondlabeling.posterous.com/on-the-trauma-of-being-forcibly-kidnapped-and

        That was nearly a year ago; as it happens, now, the link which I tweeted is no longer working. (Posterous.com shut down their blog platform a bit over a month ago.)

        So, here, as follows (because this is pertinent to this fine blog post by Aubrey), I’m posting what had appeared on that page, in my blog. (If Dr. Rama ever read it, I don’t know.):

        About anyone who’s been forcibly treated by psychiatry, the foremost question in my mind is not, ‘Was that treatment traumatic?’ but: ‘How traumatic was that treatment?’ After all, there are greater versus lesser degrees of trauma; and, from experience and observation, I know: Any forced ‘medical treatment’ of a perceived ‘psychosis’ or other supposed ‘mental disorder’ is going to have traumatic effects. Note: “force” here refers not to crime prevention – but to impositions aimed at ‘medically’ subduing the would be, otherwise, free expressions and behaviors of one viewed ‘mentally ill’; his/her reportedly “extreme emotional state” and/or “poor mental health” is said to ‘warrant’ such treatment. But, does it, really? I always question that supposition – as I critique not ‘law enforcement’ – but enforcement of mental and emotional ‘norms’.

        Now, you may reasonably ask: “But, aren’t people treated by psychiatry against their will for presenting a danger to others and/or themselves?” In fact, generally speaking, they must be accused of that and of some theoretically causative “mental disorder”; but, such accusations are seldom adjudicated by a court of law. Therefore, one is easily accused based on false information. (This happens frequently.) And, once ‘medical’ force is applied ‘effectively’ (i.e., according to standard protocols), s/he will become noticeably subdued – thus appearing to most as though ‘benefiting’ from the procedure; but, these ‘benefits’ are superficially perceived; and, they do not take into account long-term effects.

        “Yet, mightn’t there be substantial positive long-term effects?” (You may wonder.) … All long-term effects must be, at first, matters of speculation – based upon observing similar treatments, previously applied, to others; and, yes, many who are forcibly subdued by psychiatry do come to accept ongoing psychiatric treatment as supposedly ‘necessary’ for themselves; therefore, more than a few such individuals look back upon having been treated against their will with some expressed sense of ‘thanks’; but, I see such individuals as having been, indeed, forcibly ‘kidnapped’ and indoctrinated by psychiatry; subsequently, they convey gratitude to their kidnappers – a phenomena oft dubbed “Stockholm Syndrome” (based upon events of August, 1973, wherein a group of Swedish bank robbery victims became demonstrably sympathetic to their outlaw captors). //

        I received no reply whatsoever from Dr. Rama — until, just a couple of months ago, in a tweet, he asked for feedback on yet another article of his.

        As he’d never commented on that blog post, of mine (above), which I’d recommended, nor did he even offer a tweet about it, and as his second article was, IMO, hardly better than his first, I didn’t reply to his tweet.

        (I guess one could say I ‘ignored’ it; and, yet, I did read the second article he’d offered.)

        In the past year or so, I’ve realized, this: I simply haven’t the stomach — nor the energy — for attempting to educate individual psychiatrists…

        And, generally speaking, I think they should be paying many of their “patients” for the education they might receive if they only listened to them.
        (I am aware that Dr. Rama is now writing about listening more to his “patients”.) I’ll not be spending a lot of time now, educating psychiatrists for free; for, it really takes a *lot* of energy, I find… because they tend to be very ‘thick-headed’ — according to their training and (I believe) according to their need to avoid recognizing *most* of the harms that they’re doing, in their work, professionally.

        Respectfully,

        ~Jonah

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        • Yes, I attempt to work in a state hospital as a peer worker. What I’ve come to finally accept is that the only reason that they hired me was to say that they had a peer worker and that they support “recovery.” As a peer worker you can’t do what you were trained to do when it comes to dealing with organizations in the system. Now I know why most peer workers work in situations outside the system so that they can function properly. It’s pretty disheartening but, like the French Resistance and the French Underground, I stay so that I can work my alternative viewpoint in here and there whenever I get the chance.

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  3. Seclusion and physical and chemical restraints are nothing more than punishments, often used at the whim of the charge nurse on the unit to show the patient who is really in charge. There is absolutely nothing theraputic in being thrown or wrestled to the floor and being tied down to a bed. There is no way that the system can call this theraputic.

    I was trained in a large psychiatric hospital in 1971-72. At that time they would strip people naked and tie them face down, spread eagled on a bare mattress. You’d be left alone like this for as long as the charge nurse wanted you there. The really gross thing is that staff and other patients were encouraged to go by and look at the naked person through the round window in the door. Everyone was encouraged to do this! It was perfectly okay for everyone to witness the person’s shame and nakedness who was in seclusion! One day it was two adolescent boys who were spread eagled like this in two different rooms. I went to the charge nurse, who happened to be a nun since this was a Roman Catholic psychiatric hospital and asked her how this shaming was theraputic and good treatment. All I got was a sour look and a bad attitude from then on out of this woman, who claimed to be a woman of God. It was an eye opening experience for me.

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  4. Two great articles here on Mad in America about torture on the international day dedicated to thinking about torture.

    I think the above is great and I think Faith’s other article is great. In the end I could only leave a proper comment on one of them about torture, here is the link to that comment please click here if you’d like to read it. Trigger Warning.

    https://www.madinamerica.com/2013/06/why-is-it-so-hard-to-think-about-torture/#comment-26648

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  5. In Solidarity. I often wonder about what became of all the other kids who were in places like the one I was in.

    I’m glad you’re out there…

    It feels good to think that the efforts to make us compliant sparked, instead, a raw awareness and active defiance that has the potential to destroy the systems that tried so hard to destroy it.

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    • “It feels good to think that the efforts to make us compliant sparked, instead, a raw awareness and active defiance that has the potential to destroy the systems that tried so hard to destroy it.”

      I couldn’t have said it better myself.

      In the end, I think that is what will define us – not as victims, or even survivors, but as people forged through terrible experiences into agents of change in the world in the direction of justice for all.

      In solidarity,
      Aubrey

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  6. I remember being left in a cell at 16 because I reserved my right to not identify to a police officer, for which he could have given me a ticket and a court date, and instead had me arrested costing my family thousands of dollars, and attempting to ruin all my potential in life. this is something he has probably fled the country for, who knows, when they think they are a majority? I think that the work of Michael Foucault and first wave feminist has been seminal as it is suppose to be, to be able to think in certain ways, when a basic psychiatry textbook points out in lists the correct and humane way to treat a human being, and primes people for an ethical life, pre med can take people into many professions, yet the cognitive dissonance of realizing that the whole system is based off oppression? the random labeling of animals as dangerous, when we speak their languages? one false move and their back tendon is slashed, for no purpose other than a creepy sport. or to know that humans are to be superior? if it is a white man’s country and they understand their inferiority, it becomes very easy to be inferior by studying taboo, processes of torture are exceedingly simple. John Bowlby, humans attach, allowing a child to have to attach to a human simply because it came from it’s womb? It is the second sex, there are very practical and common sense reasons for divorce, you have no idea how many men’s lives have been saved. When men make it a war on everything for their continued ruthlessness?

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  7. I am grateful and proud of you that you spoke about these incident. I am so sorry for what they have done to you. I had been physically restrained for more than 3 hours once. It was an extremely scary and painful experience and I experienced pain on my body after the incident. Basically I told the triage doctor I was feeling suicidal and depressed recently and I was expecting them to help me with a psychologist. But 30 minutes later few tall and big security guys pushed me on a bed, strapped my limbs with restraints without explaining anything. My fight or flight response kicked in and I screamed and shout and cried for rescue…I kept on begging them to release me, but the more I begged the more restraints they put on me. I cried, asking them when will they release me? They said only if I “obey”…

    From then on I am scared of going to the hospital. Few days ago I saw a psychiatric nurse in the hospital and she kept on asking me if “I had ever self harmed” and warned me I’d be locked up if I did…I was frightened and I lied to her I never did.

    This isn’t helping me, this is torture and oppression.

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  8. I survived a near-fatal beating by jail guards, then was transferred to a State prison, where I was TORTURED with DRUGS for 6 months. That was 1986 – 87. I could, should, and would be more fully recovered from that TRAUMA, but lesser versions of it were, and are still being inflicted on me.
    That’s OK.

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