Psychosis: A Quest For A New Tomorrow
By Neil Caton
It was a summer’s evening in 2016. My brother, uncle and dad had been taking turns to stay at my flat with me out of concern for my state of mind at the time. I had upped and left my parents’ house when they were out at a concert, suddenly deciding that my life was under threat living at their house. I believed that I would be safer in the flat I was still renting and had been living in the same time the previous year. Suddenly mid-afternoon, two psychiatrists and an AMHP were let into my flat saying that they had to assess me. They asked me a series of questions about my beliefs of grandiosity and paranoia. At the time, believing I was the next Einstein, and far more problematically, that there were dark forces operating around me I was deeply unsure who I could trust, or more precisely who the CIA (whom I saw as the enemy) had got to. I was hostile to all the questions they asked, believing it surely could not be the plan of MI6 (whom I saw as my allies) to send me back to the place that had deeply traumatised me when I’d willingly admitted myself the previous year. I had felt persecuted by the staff and patients and left the ward in a far worse state than when I entered.
When the team assessed me, I ridiculed one of the psychiatrists’ speech impediment as I thought he was ridiculing me by speaking with it. As far as I was concerned, I was learning to navigate this world I had found myself part of in the same way I had struggled previously having failed my social work MA a few years before. I had not really been able to find my feet ever since. I certainly had no plans to end my life or harm others at that time, suicide not crossing my mind as it had when I was focusing on my struggles with daily living; although I concede, self-harm could have been an option in the coming weeks and months. From where I sit now, it’s not a surprise that when the AMHP came back into my flat the news was that I would be detained under section three of the Mental Health Act, but I was taken by surprise at the time. I flew into a rage initially but soon after when the police were called, I broke down and began sobbing, convinced my life was over. I saw the game was up and eventually put my shoes on and left my flat voluntarily getting into the back of the police van that was waiting to take me to hospital.
I do understand the perspectives of the professionals who sectioned me that day when to my surprise they took away my freedom to live as I wished at that time. I even question whether in their shoes, I would have done anything different. However, I see many systemic failings that had led to this outcome, which are perhaps easy for professionals to overlook. I had been under the crisis team for months before being detained and had found the care I received to be problematic. Most of the clinicians I saw talked to me in a matter of fact way, lacking validation and concern, trying to keep a professional distance. This just meant to me that they were far more likely to be influenced by the dark forces that were conspiring against me. I was also unsettled when it was someone different each time I had an appointment with the team meaning no one ever stuck around long enough for me to start to trust them. Worst of all though, they would continuously express disbelief at my belief system. I wanted them to be creative and help me find a way to trust those around me without challenging the overarching narrative, prior to which I had been rendered suicidal due to my felt lack of importance in the world. They did try to put me with a nurse who would just sit and actively listen to my problems, which was an improvement, but I needed someone to get in there with me and find tangible ways to trust primarily my parents.
The role of the AMHP to advocate for me was one that couldn’t be fulfilled in the remit of a single meeting to decide, at that time, whether I should be detained or not. They needed to be involved in advocating for me much sooner from when I started to express concerns about how I was being treated by the crisis team, whilst maintaining their independence from the team. It would not be an easy job getting me to articulate at that time what I wanted to be different and that would have involved a degree of interpretation, but it could have prevented a subsequent detention and renewed hope for me to be cared for in the community.
My admission to hospital was markedly better than the previous one, layers of feelings of hopelessness had melted away from the tears I had shed after being detained and I could see more clearly. I immediately trusted some of the staff as I could see they were compassionate in the way they spoke to me. I still felt I could not trust some of the staff and spent time being aggressive and challenging towards them. On one occasion, I was marching up and down outside the ward office where a psychiatrist was working repeating ‘quack quack’ as I walked past. Eventually he came out with a big smile on his facing me clearly trying to make light of my behaviour. I consequently grabbed his face in an attempt to stop him smiling. When I eventually let go a couple of nurses approached me with some medication to calm me down. I could see the compassion in their eyes and that they were genuinely concerned. I took the medication and threw the cup it was in to the floor and they simply picked it up and threw it away. This was the final straw in my dance to see whether I could have enough trust in the staff for me to believe they had good intentions towards me. Shortly afterwards all my beliefs about being the next Einstein, MI6 and the CIA all subsided and I was discharged. I’ve never been referred to the crisis team or impatient facilities ever since.
It is worth noting that I do feel that medication played a part in bringing me out of this state and has certainly provided a buffer in preventing me from going back into such a state of mind. It also allowed me to sleep at night. However, the first time I experienced psychosis I was brought out of the state by my parents’ attentive concern and compassion, demonstrating that it is possible for this to happen for me, even though they had little understanding of what I was experiencing at the time. I also experience great relief from going into these states as I express emotion in a way I would not otherwise that has brought me relief for many years after I experienced these states, making big breakthroughs in my recovery in my last two admissions. However painful it is to go through these states, maybe part of me does not want to interrupt them. However difficult it maybe, when I challenge those around me, if I’m shown compassion and understanding, in a way that doesn’t challenge the over arching narrative, I can make progress processing what difficulties I have in the rich metaphors that come out of what can be called psychosis. It is also worth noting that I have struggled to make progress in my recovery when not in these states. Whilst I absolutely need to learn to do this, I think these processes being interrupted stifled my recovery. I am not saying there are any easy answers to these difficulties, and I would want medication to be an option when I am in these states. It does strike me however that what the mental health system sees as my biggest problem has also been my biggest ally. In the years before and after I experienced psychosis I just seemed to languish making little noticeable progress in my recovery. It has only been when I have experienced these states that I have made noticeable steps forward in how I felt and perceived the world. Whilst I acknowledge the need the handle my difficulties on a day-to-day basis rather than plunging into crisis periodically, for so much of my life it has seemed that these crises have been the only way to move forward in my life.
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