Editor’s Note: This article originally appeared on our affiliate site, Mad in Finland. In it, a mental health worker and former long-term patient describes the aspects of treatment and life experiences that helped with recovery, as well as which aspects hindered recovery.
I have spent several years of my life in various psychiatric institutions and have come to be seen as a chronic patient whose chances of recovery have not been considered very high. However, the predictions made at that time have turned out to be wrong. In this article, I will concretely list the things that have supported my recovery and those that have made it difficult.
Psychoeducation—did not help
According to Wikipedia, psychoeducation is “an evidence-based therapeutic intervention for patients and their loved ones that provides information and support to better understand and cope with illness.” The importance of psychoeducation is emphasized today in all current treatment recommendations and treatment paths related to mental health. In practice, this fancy term means that a person is told about the disease he is seen to have, its symptoms, prognosis, and good treatment.
“You now have this disease, which you have to live with and make sure that you take these medicines and live a regular life, and yes, over the years you will learn to live with these symptoms.” Somehow the most important features of this psychoeducation belonged to me. And in my mind I thought: “Bullshit. I know myself better. I’m not sick, I don’t need medicine, I can get through this, at some point this will become easier.” Of course, you couldn’t say these thoughts out loud; that would have been insensitivity to the disease and the basis for ever more psychoeducation.
It was that dark moment when I believed this psychoeducation, when it really seemed that “I will never survive this” that death was close.
Dealing with trauma—helped
I would never have recovered if I hadn’t been able to talk through my childhood experiences in a safe caregiving relationship. It wasn’t trauma psychotherapy and it didn’t last for years. The most important thing was to be able to tell what had happened and at the same time free myself from the thought that the events were my own fault. If someone had given “psychoeducation” in advance, telling me that such difficult childhood experiences actually cause permanent damage, that processing them requires several years of intensive psychotherapy, and that one way or another the symptoms have to last for the rest of my life, I certainly wouldn’t have been able to recover. I would have surely believed that it is so, and given up.
Medication—did not help
I was prescribed several different medications. They were started, changed, added, subtracted, and given by force. The neuroleptics caused excruciating fatigue that was completely impossible to fight against. Of course, anxiety is not felt and the patient in the ward is easy to treat if he sleeps 20 hours a day, but is that also real life or being treated? And after all the time spent on medication, the feelings have been down there the whole time, waiting and rising to be confronted.
I’ve never been on ADHD medication, which many people today find helpful. I can’t help but remember how similar it was about 10 years ago, when sales of SSRIs really started to rise. In the same chilling way, the newspapers were filled with stories about how “help and understanding had finally been found after the depression diagnosis and medication.” A big bubble has started to burst around SSRIs. I think we’re going to experience something similar in a few years with ADHD drugs: the longer we get follow-ups, the smaller the benefits start to look, the bigger the harms, the bigger the profits for the drug companies.
Diagnosis—did not help
I found no self-understanding or experience of relief from the psychiatric diagnoses I received over the years. It was certainly not that the diagnoses were wrong, but that all of them were and are equally empty. They were strange: some “symptoms” from each list fit and some didn’t. You could find a description of your own experience in one of the expressions, but not in another. In any case, I had already found many better and more appropriate words for my own experiences in poems and novels and had written them myself. When defining the diagnoses, no one seemed to care about the causes of the experiences or told of how the symptoms could be cured.
“I feel so bad that I can’t take it anymore.” That was the thing and the problem and the experience, and there is no such diagnosis.
Diagnoses bundle different things considered as symptoms in different combinations together and create different names for these combinations. What explanation could they give? For the “merits” of the psychosis diagnosis, of course, I received various benefits and admission to ward treatment, I became, as it were, a real patient in the psychiatric system. If a person’s own experience were listened to and understood as such, there would be no need for such instrumental values attached to diagnoses.
In recovery, it was necessary to let go of these diagnoses and the definitions they gave. I think I washed them off. I refused to think of myself, my experiences or my feelings as “sick,” such terms were not allowed to be associated with me anymore. It was a big step.
Connection with others—helped
In some moments, I found a connection with some people in the care system. Rarely did I hear psychoeducation or advice about my life. Never when I got an instinct of the other party’s disgust, boredom, and cynicism towards myself and my “difficult symptoms.” But there were indeed some good moments when I could experience acceptance, understanding, safety, and presence. Those moments and experiences were really valuable in my mind. However, I think that in these situations the other person never understood how important those moments were for me, what meaning they had for me. I had come to look for them in the psychiatric care system, and you would imagine that you could get them wholesale, but they were very rare.
In the end, however, what opened up a new kind of life the most was finding contact with people outside the care system. At last I qualified, at last I could be equal with others, at last I had a place among some others.
Threats, blackmail, subjugation—did not help
“Now you take this medicine or it will be forcibly injected!” “Now you’re going to isolation if you don’t stop that!” “Your care ends there if you cut yourself, and I don’t care where you go from here!” “Yes, I can get those men from the department to pick you up, and then think!” “You could go home and continue that game!” Those are what the staff representative said—it didn’t help.
Guts, questioning, own goals—helped
In the psychiatric treatment system, one often had to believe oneself and one’s own feelings more than what kind of definitions, predictions, or interpretations one could hear about one’s self. For example, I knew and decided that I would survive high school, even though I heard “you probably won’t be allowed to go to that high school.” I also decided by myself and in my right mind which members of the nursing staff I would talk to about my innermost feelings and issues and who I wouldn’t. I knew and understood and saw that some of the nurses treated some patients with disdain, indifference, and provocation, and this was not “distorted thinking caused by the disease,” although, of course, it was interpreted as such.
I decided that one day I would still recover and live a normal life, even though I had become seen as a long-term patient, for whom there would not be much trouble in the future.
In addition to the diagnoses, it was also necessary to give up the psychiatric treatment system, and the idea that I need something from that system, that I belong there.
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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