What I Learned In A Psychiatric Unit And Why You Need To Know It

The summer I spent five weeks in a psychiatric unit I ate mint choc chip ice cream for dessert every day. I sat at the same table, in the same seat, with the same people. But inside everything was changing forever.

On the cold buffet table one day I drew attention to a small card placed in front of a bowl of rice salad. Lifting it and showing it to my crazy friends we marvelled at its unintended irony. “May contain nuts”. We laughed. We often laughed.

You wouldn’t think of a psychiatric unit as a place of humour, and sometimes it wasn’t, especially the afternoon when a young girl attacked herself with some scissors during an art class. But I learned that there’s something powerful about shared experience and feeling the freedom to be yourself, however temporarily “broken”. But it’s an opportunity we don’t always take.

John would always sit next to me in group sessions. Sometimes I felt like his mouthpiece, coaxing him to open up,  mostly without success. Given paper and crayons to draw emotion was hard and felt awkward, but liberating too. Filling my paper with swathes of colour, light and dark lines scratched in wide arcs I found a picture which made perfect sense to me and none to anyone else. I glanced to my right where John was motionless, his paper blank.

I learned in a psychiatric unit that we don’t change because we are too busy holding tight to our misery.

This week I was working with a married client stuck in a long term affair. He is unhappy in each relationship but refuses to move away from either, let alone both. He feels increasingly bad about himself for his deceit to his wife and his dwindling value to his mistress. This diminishing sense of self worth is what got him into this mess, and it is what is keeping him there.

Our friend Rich is in rehab for the twenty third time (literally). We get a phone call from him seven days through his twenty eight day treatment. He’s in the pub and slurring his speech, waiting for a train to bring him back to the shit he isn’t sufficiently engaged in escaping from.

I learned in a psychiatric unit that we seem somehow more comfortable in misery.

Our self image is precious in its familiarity, no matter how disastrous. When we have come to see ourselves as anxious, depressed, worthless, bad, broken, “fucked up”, it isn’t easy to let go. “If I am not really this, who the hell am I?”  Better to be crazy than non-existent, right?

We stay in addiction and self destruction because we do not believe that we are worth more, or we believe that the journey out is too perilous and without the certainty we already have, however dissatisfying.

In a psychiatric unit I learned that changing the way we see ourselves is the only route to recovery.

The greatest tragedy of all is the myth that recovery is dependent on the way that world see us, rather than the way that we see ourselves. Waiting for validation and affirmation that we are allowed to feel different doesn’t ever come, and mostly it was unhelpful and dysfunctional projections from other people which helped us paint the dreadful picture we have of ourselves in the first place. Change happens from the inside out. This is always the truth no matter how hard it is to accept.

Also this week a client in what has been a hugely distressing relationship with an alcoholic, is describing her hard fought success in getting him into rehab for the first time. I tell her that she probably saved his life. It is he, though, who must take responsibility for continued breathing. I think of Rich and muse on how hard the act of breathing seems to be for so many of us.

We change the parts we want to change and we only need permission from ourselves. Often that’s hard but it can be done. I know this because the most valuable lesson I learned in a psychiatric unit was about the power of hope. I still love mint choc chip ice cream, but everything else is different.