If you put one fish in a fish bowl, that fish will probably be very happy, especially if you give that fish one of those little plastic castles that sit at the bottom of fish tanks in cartoons. Fish love castles. Nothing makes them feel more content than a nice turret.

If you then add another fish to this bowl, there is a chance that both fish will be happy and will be able to enjoy their plastic castle together, ruling over their water sphere of a home like aquamarine royalty. Add another fish to the bowl however, and the chance of problems will naturally arise as while all fish love castles, every individual fin flapper has their own specific tastes and preferences. Some fish may like a drawbridge on their castle, some may enjoy a moat, maybe there are even a rare few who, dare I say, like their castles without those lofty turrets.
The more fish you add into the fishbowl then, aka the more individuals you have trapped in a confined space, the harder it will be for those individuals to breathe/swim about without accidentally smacking a passer by with a wayward fin and in this sense, psychiatric units are very much like fish bowls (except with really mentally ill fish and no castles…God I wish I had a turret…some fish don’t realise how good they have it).
Like fish bowls, psychiatric units are small confined spaces where you can often find yourself trapped living amongst a group of people you have never met before and it is unlikely that you will get along with all of them, not because any of them are bad people, but because all people, like fish, are different. I think it is easy to think of going into hospital as a very private, individual experience between the patient and their inner struggles and in essence I suppose it is, but that doesn’t take away the community side to inpatient treatment and how difficult it can be living in close proximity to people who are, like you, working through their own personal hell.

No matter how much you go into hospital focusing on yourself, I think a lot of people forget or don’t know about the community side that is bound to be a part of any inpatient admission. Every inpatient setting and inpatient group will have a certain feel, an ambiance if you will that creates some kind of atmosphere, be that positive or negative, on the ward. Sometimes that atmosphere can be constructive and helpful in advancing recovery but as with the fish in the bowl, eventually there are going to be disagreements about whether you install a drawbridge or start knocking down all the turrets, and that can be really difficult and affect your personal treatment more than you would like to admit.

It is a side of treatment that is really difficult to manage and not often discussed, but over the years I think I have realised that there is only one way to manage the difficulties of life in a fish bowl with your fellow mental mackerel, that way being:

1. Be friends with everyone
2. Ignore everyone

On the surface, trying to do both of those things are the same time sounds like kind of conflicting advice to give, but then again a lot of great things in life involve components which at first appear to be conflicting.
Just think of the person who invented sweet and sour sauce or the hero that discovered salted caramel. People said they were crazy, that their ideas involved too much conflict between opposing opposites, and where are those legends now? Living the high life in their very own castles (with turrets). And as for the naysayers? Why, they are all cowering shamefully in their hollow lives devoid of delightfully sticky sauce accompaniments with their egg fried rice and of sweet milk chocolate coated toffees set off by the salty tang of the sea.

Personally, I really struggle with the communal living side to hospital admissions and every time I go into an inpatient unit I privately vow to speak to no-one, close my eyes and hope that because I can’t see anyone else, they can’t see me either…But like I said, this is unrealistic and at the end of the day, it doesn’t matter how social or unsocial you intend to be, you do have to live with these people and if you want to survive a shared space of communal compromise, you are going to have to get along to some degree.

I guess it is very much like any communal office or work place where a group of people are forced to spend long periods of time together, regardless of whether or not you have anything in common. Though I have never worked in an office like you see in the movies with all the rows of desks and dividers, I highly doubt that people who do work in those kinds of places would be willing to give all of their colleagues their last Rolo, but you couldn’t get through the day if you held grudges and took things too personally, and I am pretty sure people would be fired if they weren’t at least civil to each other and forced themselves to be a little extra on the polite side.

Maybe you have an office neighbour called Janet who keeps stealing your stapler, puts empty cartons of milk back in the fridge after making a cup of tea and is well known for dropping those little white paper circles that fall out of hole punches all over your paperwork (if this is you then damn it Janet, pull yourself together and keep your little white paper circles to yourself for the love of God.)
If we all had a Janet and behaved as we wanted to (aka smacked her over the head with that stapler she clearly loves so much and changed all the passwords to “Empty milk cartons go in the bin Janet”), it is unlikely we would keep our jobs for very long and nobody would get anything done in life. To keep the country moving and employment rates up then, people tend to bite their tongue at work around their own personal Janets, to keep the peace. That is sort of what it is like in an inpatient setting. You will be in a close proximity to a variety of people for large portions of the day and basically if you want to survive, you have to treat others with all the kindness and respect that you can muster and get on, as good a group of friends as you can.

Sometimes it isn’t even hard to be friends with everyone in an inpatient setting and it is a thing that comes naturally with no extra effort required. After all you are all stuck in a very similar situation going through similar experiences that not everyone in the outside world can relate to. Whilst in hospital it is easy to feel disconnected and isolated from any friends or family members who come into visits talking about holidays abroad and new umbrella decorated cocktails they have tried, whilst the only trips you have been on have been to a walled garden and the only cocktails a brand new combination of anti-psychotics (little umbrella not included).
Fellow patients will be able to relate to that kind of thing and can certainly make you feel less alone. They can also be a great support system who you share a lot in common with and often the most helpful things you can find in treatment are people you can relate to, who maybe give tips as to what has helped them in the past. I have even had admissions where the whole group of patients have got on so well that it has actually been like one giant sleepover in a boarding school with friends and you build such strong relationships that you won’t know how you would have survived the inpatient experience without them. Dare I say it, on special occasions when the brain devils are not out to play, you may even have a few laughs and leave inpatient with a fondly remembered evening of choreographing dance routines to “Spice up your life” by the Spice girls, after a rebellious water fight to cool off in the summer in the wet room (not that I have any experiences of such things personally you understand).

That said, when inpatient it is also important to stick to the second “way” of surviving the experience, aka part two “Ignore everyone”. This is not to say that when a fellow patient greets you with “good morning”, you keep your eyes on the floor and pretend that they don’t exist (a nice smile and “morning” is a far nicer option for both parties involved), but you do need to keep yourself to yourself to a certain degree. As helpful as it is having people you can relate to, it can also be triggering in ways detrimental to your mental health and wellbeing.
When you are in the fish bowl, everything is intensified and feels more dramatic than it might do in the outside world. In the outside world for example, like in the workplace, there is one Janet out of a global population of several million billion thousand other humans (that is a rough estimate…I lost count). Thus your Janet/difficult person in life makes up a tiny 0.000004% of the population or something and so it is easy in a way to avoid that person, avoid conflict and take yourself out of a situation. Say however that when inpatient there is one person you don’t get on with and it is a 10 bed ward, that is ten percent of the population, so the actions of that person can feel a lot more dramatic.
It is therefore important not to get too caught up in other people’s business and let them affect you , rather it is safe to keep yourself to yourself with your blinkers on and focus on your recovery and goals for admission.
I know I really struggle with getting caught up in the inpatient bubble, very distracted and involved in the lives and worries of people in the other bedrooms along the corridor and it is only when you start to get things like leave that you realise there was a whole other world still outside of those walls and half of the things that were incredibly dramatic whilst on the ward are totally irrelevant back home. When you are in hospital, those people you see everyday are constantly on your mind because they are constantly in view, but when you are home with family and friends living your life and benefitting from all the hard work you did on the unit, you are unlikely to think of them at all (unless you keep photos of them on your bedside or something…don’t do that…that would be weird.)

As much as an inpatient stay is an individual experience then, there is a lesser discussed fish bowl style communal element and that is going to be difficult. There are however ways to deal with it, and for me, this blog post is how I get through and is the advice I would give to anyone else who is currently stuck in a mental hospital fish bowl or anyone looking to an admission in the near future. Never forget that any unit is really just a small glass orb on a coffee table and there is a flipping massive ocean to swim in when you get back out.

Now if you don’t mind, I am off to the nurses’ office to demand we get an immediate emergency supply of turrets on this ward. Fish get whole castles and damn it. I WANT A TURRET.

Take care everyone x