On Traumatizing “Care”

In 1996, at the age of 24, I had my first episode of what doctors in Belgium would later define as ‘psychosis’. I want to start off by saying that I really don’t like the term ‘psychosis’. I consider what I experienced to be extreme states of consciousness or emotional-spiritual crises, not manifestations of some kind of disease. I don’t deny needing help when I was going through these states. What I did not need was the kind of help I got here.

In any case, the trigger for my first crisis was working too hard: I temporarily combined two full-time jobs as a teacher. I know: that’s crazy. But I was young, and I thought I could handle it for a few weeks. After that period, I thought I would get offered a permanent job as a teacher in that very nice school. Things turned out very differently…

My first crisis was extremely frightening. I had no clue as to what was happening to me, and my family and friends around me reacted with a lot of apprehension and fear. That increased my own fear, frustration and anger. The treatment I got in psychiatry did nothing to help: patronizing staff, forced drugging with injections, isolation, restraints… It was all deeply traumatic. Some parts of the ‘treatment’ felt extremely inhumane to me and rather typical of the Middle Ages.

I remember needing a long time to recover afterwards. I was depressed, numb, had nothing to say, even though I had always been a very talkative person. I felt like a bird with its wings clipped off. This lasted for about a year. Then I found a new job, not as a teacher this time, because I associated teaching too much with being in crisis.  I was rather lucky because I was treated by a psychiatrist who believed in lowering and stopping my antipsychotic medication fairly soon. The next nine years I did fine, without taking any psychotropic medication.

In 2006, I gave birth to my daughter Lisa. Three months later I had an episode again. History repeated itself. I was treated identically in another Belgian psychiatric hospital. This meant I was force-medicated, secluded and restrained all over again. That experience was hell.

My altered state had hellish parts, too. Yet there were aspects of it that were quite heavenly: I saw beautiful visions and experienced an indescribable sense of all-knowingness. I also saw how the world would end (by some kind of nuclear explosion) and received the key and unbearable responsibility to stop this from happening. I somehow believed I had only five minutes left to do the job. Luckily Albert Einstein appeared and told me that everything, including time, is relative. A very friendly man, by the way.

My third and last episode took place at the end of 2008. By and large it felt like a repetition of the episode in 2006: the same vision of the apocalypse and a feeling of omniscience.  The same harsh treatment in psychiatry.

In my altered state, I had suddenly understood the mystery of life and the universe, and it all seemed incredibly simple and logical. Unfortunately I could not retain this knowledge in my normal state of consciousness: it evaporated like a dream you can’t remember. After this third episode, doctors gave me the diagnosis ‘bipolar’.

What does all this say about Belgium, the European country I live in, which borders France and has a population of around 10 million? In 1996, 2006 and 2008, I was treated in three different psychiatric hospitals, in three different cities in this country, but each time I felt the treatment I got when in crisis was inadequate. At times it was inhumane. I discovered soon enough that I was not an exception, that people in crisis were treated this way all the time, that it was how the psychiatric care ‘system’ functioned in Belgium, in Europe, in large parts of the world at that.

I decided I wanted to do something about this. I wanted to make some kind of difference so 10 years ago I joined UilenSpiegel, a small non-profit organisation representing the interests of (ex-)users and survivors of mental health services in Dutch-speaking Belgium. I also started two blogs (in Dutch) last year: one about the use of seclusion in psychiatry and its traumatic effects, and one about the link between “psychosis” and spirituality and the search for alternative responses to emotional-spiritual crises. I do not know whether the pebbles I am throwing in the river will change its course, but we are a lot of pebble-throwers, and Mad in America is one considerable pebble. So here I am.

11 COMMENTS

  1. Strange: i was treated for psychosis and schizophrenia in the same country, Belgium,( between England,France , the Netherlands and Germany )about ten years earlier ( 1987 ) …. I was never forced to take medication, although i took medication ,and that was a big failure .I was never restrained in isolation or otherwise.Maybe the way my problems manifested themselves had an influence on how i was treated ? Maybe they saw that i was willing to listen to their arguments, even when i was in a deep psychotic state? Maybe i was willing to agree with them and did not seek extremely to be right all the time ? And could admit i was wrong ? I am also a long time member of the same patients group UilenSpiegel .But i have different views on psychiatry .But they are allowed in that group, at least for now.That’s what i love about it ! Taking part in it’s activities greatly helped me to get better and to be a more self-reliant person.Thanks !

    • Kris, I’m wondering if I understand you correctly. You are suggesting that if a person gets treated badly in psychiatric hospital, this is because of how they behaved? In other words those who can admit they were wrong and don’t insist that they are ‘right’ can avoid getting locked up or being injected with medications? I don’t think it works that way… I have seen people locked up in isolation just because they said they believed they were psychic; not because they disagreed or were violent.
      So how does not admitting one is wrong or insisting one is right justify forced injections and solitary confiment?
      As far as I know a person needs to be ‘a danger to self or others’ to be locked up. It’s not allowed to take away a person’s freedom or basic rights, just because they disagree. There are laws that state that, I suppose it’s that way in Belgium too.

    • Dear Jessica,

      I am far from being an expert on adequate treatment, since I never received it while in crisis. But I have some ideas and intuitions about what might work better: the Open Dialogue and Soteria approaches, involving the patient in the decision making process, truly listening to the person in crisis, refraining from restraint and seclusion since that amounts to torture in my opinion, breaking the cycle of fear, educating nurses on conflict and violence management and on ‘psychotic communication’, applying ‘intensive care’ in the first critical days, involving friends and family if the person wants this, stopping the dehumanization of care; involving experts by experience (I’m not
      exactly sure how yet), … As you can read in my bio info, http://www.madinamerica.com/author/nmahjoub/), I think still have a lot to learn about what exactly happened during my crises and about what can be done to improve the approach to madness. In my blog posts on madinamerica.com I will write about my personal search for answers and about hopeful initiatives.

      Groetjes (‘cheers’ in Dutch)

      Nadia

  2. I work in psychiatry and it certainly has a way to go. I believe education of nurses is foremost. Alas we are not able to teach empathy or the ability to be humane. We can only hope that those who enter this field do so with a desire to help people through their crisis and arm them with coping skills and education on medication(when that is needed). It doesnt surprise me that there remains a secrecy and shame around mental health still when I read of peoples ghastly experiences.