The Difficulty Of Talking About Anything Other Than Mental Health When You Are An Inpatient In A Psychiatric Ward

I have an amazing family and, since being in hospital, my mum has visited me nearly every day. During visits there are a variety of activities we try to do to distract me from my current situation, sometimes we watch TV programs mum has downloaded to her tablet, we have been known to dabble in a little scrabble and once a week my mum will help me edit these blog posts that you love so much, to let me know if there are any glaring grammatical errors (that’s right. If you ever see a grammatical error on this blog feel free to blame my mother…only kidding…thanks for the help mum). When it comes to conversation however, there is little to no variety in topic and usually, if not every visit, we will end up talking about something mental health related which understandably can get rather tiresome.
It is therefore no wonder that the other afternoon my mum asked if we could possibly “talk about anything else” and lord knows I can see where she is coming from. Anyone would get fed up talking about depressing brain nonsense all the time and I do not blame her at all for asking for a different topic once in a while but at the same time I don’t think people realise how difficult it is to talk about things other than mental health problems when you have mental health problems, even if you are trying really really hard.

I hate admitting that because it makes me sound incredibly boring and self obsessed to say that I am frequently caught up in conversations regarding my head demons but the thing is, when your head demons are in your head 24/7, it is practically impossible to think about the “anything else” that other people wish to be discussing. Which part of your brain is supposed to be free to think about this supposed “anything else”?
When you are lost in your mental health problems, asking such a question is pretty much the same as asking someone who is being repeatedly smacked on the head with a wooden pumpkin to say anything other than “Oww”, “please stop hitting me with that”, “that hurts” or, if the person is a particularly articulate fellow “My frontal lobes are in a state of great pain so please desist with your actions and then tell me where on earth you were able to find a root vegetable carved out of the finest mahogany”.

I think this is especially the case when someone is in hospital because not only are your mental health problems all you can think about but they are all around you and you are in a location in which forgetting them is impossible, like trying to forget the smell of fresh bread in a bakery. I know people are always telling me that I am “more than” my mental illness and that it isn’t my entire identity which should mean I do have other things to talk about, but I think when in hospital you are often treated as an illness rather than an individual, and psychiatric units, though helpful, can make you start to feel like you are not a person at all.

It is like the problem I am currently facing being on 1:1 Observations.
Now, considering I write a blog on the internet all about how I am a flipping lunatic (or “Marbleless Marvel of mysterious Marblelessness when being addressed formally), you could say that I am perhaps not the world’s most private person. I talk about my mental health problems publicly every week and whenever I go into hospital for treatment I no longer ask friends to make up excuses to explain my disappearance in day to day life (my favourite of which was when I was 16 and to cover up my detainment in a psychiatric unit a rumour was spread at school that I was working on voicing a rat in the Disney Pixar sequel to “Ratatouille”, a rumour that was regrettably untrue in that I have never voiced a rat for Disney, nor has a sequel to Ratatouille ever materialised). However, as open and honest as I am, like any regular person, I still do like a reasonable amount of privacy in my life and unfortunately, for the past few months, privacy is something that I have been severely lacking due to the nightmare that is 1:1 and 2:1 observations.

The terms 1:1/2:1 observations in hospital are probably self explanatory and in explaining it I apologise for offending your intelligence, but basically it means that wherever you go, there will be at least one member of staff staring at you (aka 1 or two staff to your 1 patient ratio). It doesn’t matter whether you are going to the toilet, having a shower or having a snooze, the staff member will be with you (possibly within arm’s reach if that is stated in your care plan), and they will be watching every move, almost like a real life version of that song “Every breath you take” by The Police with those creepy lyrics (seriously if you haven’t heard that song look it up. It is weird and is a perfect summary of the 1:1 inpatient experience.) That song and indeed that experience has been my life for the past two months and to be blunt, it is incredibly humiliating. More than humiliating though, it is dehumanising and that is one of the things that takes me back to the question as to how you can talk about anything else other than mental health problems when you are being treated as a new species of disorder that is able to walk and talk. You are not a person, you are a thing that needs to be watched and observed. I am constantly hearing staff in the corridor ask each other “who is watching Katie?” or “who is with Katie for the next hour?” as if I am a ticking time bomb that people are just waiting to go off.

I suppose in fairness everyone loses a certain level of privacy when they are admitted anywhere. Even if you aren’t on 1:1 obs in hospital, you will be on some kind of observations, just as I was initially on 10 minute observations meaning that every ten minutes a staff member would appear at my door to see what I was up to. Therefore staff knew what I was doing all of the time but still in that ten minutes of unobserved time there was an element of privacy that I am sorely missing today, and I think that having just that ten minutes again would make me feel more human and less like a living issue in need of being managed. In those ten minutes I could hum a jolly ditty if I wanted and nobody would know, but now I can’t even convert oxygen to carbon dioxide without a beady eye watching to make sure I do it appropriately.

It is just so humiliating to be watched all of the time, even in the “private moments” that people take for themselves just to respect their own decency. Take urinating for example. Sure I have learnt over time to manage it and can now pee with staff even if I don’t have music playing on my phone (although in the early days such an activity was practically impossible and it is safe to say that I have publicly urinated to every song in the current top 40 charts…have fun getting that image out of your head when you next listen to Ed Sheeran on the radio), but it is still something that I want to do on my own. Worst of all though is showers and I think that is where my main issue lies with this whole 1:1 thing.

Imagine absolutely hating your body, despising every ounce and seeing it as nothing but a source of shame and then having to parade it around naked in front of a different stranger every day whilst you wash yourself. Surely that would be a challenge for even the most body confident person out there but for the person whose body is a constant source of torment and torture? How can anyone feel human or respected then? How can you feel anything other than dehumanised, humiliated and not respected as a proper person with their right to their own privacy whilst they have a good lather? How can you see yourself as, let alone discuss, “anything else” other than mental health problems?

I suppose I know on paper that if I were to print this blog post out and give it to any of the members of staff looking after me right now they would say that they do 1:1 Observations to look after people and keep them safe rather than humiliate but it is a lot harder to believe that when you are the one standing naked in front of a complete stranger whilst you frantically look for a pair of pants (hypothetically of course…this has never actually happened to me… Trust me, when you are on 1:1 you always have your clean pants prepared for after a shower!)

So, when you have mental health problems how easy is it to talk about “anything else”? Well, not very, when you don’t have the brain space or power to think about these “anything else’s”. Sometimes though, the biggest challenge isn’t thinking about anything else, but, when you are on 1:1 observations and have no say in your treatment, it is about trying to see yourself as anything other than a dehumanised circus freak in a constant humiliating parade.
Take care everyone x

TalkAnythingElse

 

Why Familiar Surroundings Are Important When You Suffer With OCD

The original title of the blog I was planning to write today was “Tips on staying away from home when you have mental health problems”. You see, my parents were jetting off to Malaysia and seeing as I am not well enough to manage by myself at the moment, the plan was for me to go and stay with their friends in this lovely little house out in the countryside.
We have been planning it for months, I had visited the house and felt OK about it seeing how nice my bedroom, personal office AND personal bathroom were going to be. There was even a cat called Pingu. A cat. Named after my favourite childhood penguin. Ideal right?

Well I thought so, but was still worried about managing my mental health with new carers who do not know me as well as my parents, so I came up with a list of coping strategies and ways to manage it. Consequently I decided to write a blog sharing my oh so helpful tips incase anyone else out there was in a similar situation, but then…well…I went to the house where I was due to stay for two weeks, lasted approximately four hours and then was driven home in hysterics at midnight with my parents due to fly the next day despite having still not packed so much as a flip flop, because we have been spending weeks packing for me to go away (if you want to imagine how many things and bags it was, think of the average stuffed car that people often drive off to uni in, double it and chuck a penguin on top for good measure. Oh and a Christmas elf. One must never travel without one’s cuddly Christmas elf. Oh there we go! I did give a travel tip! YAY ME.)

Clearly then, I am in no place to be giving tips about staying away from home right now BUT over the course of this traumatic experience, I have been reminded of a valuable lesson about mental health problems, so I thought I would share that with you today instead.

Having been mentally ill and having been in therapy for over a decade, I would say I understand my conditions and myself rather well, which is why I felt that I could make a plan about an approaching situation in advance without running into any unforeseen issues.
Trying to do my same rituals in a different place however, really reminded me of something a lot of people might not realise: that being that sometimes with OCD, it is not just about carrying out a specific behaviour like a shower routine, it is about carrying out a very specific shower routine in a very specific shower.

I always knew that because of OCD and anorexia, I have a LOT of routines, rituals and specific ways of doing things. I eat out of certain bowls with a certain spoon, I drink tea out of a certain mug at certain times of the day and I wash my hands, shower and get dressed in very specific ways. As rigid as these and a number of different actions in my day are, logically you could assume that I could carry them out in a different place so long as I had the correct equipment. There was a shower where I was going to stay so of course I could do my shower routine, there was a sink so of course I could wash my hands and I was taking all of my cutlery/crockery so obviously I would be able to eat all in my usual ways.

Even I can admit that years ago, though still having OCD, I was able to do these fixed ritual things in other places with other sinks and showers. I have been on holiday since my diagnoses, have stayed in a hospital and went to university (kind of…), always carrying out the same actions just in different locations. Therefore I tried to do that this time going to a strange house but, with things how they are at the moment, as hard as I tried and as good as my intentions were at the time I attempted it, it isn’t possible (at least to a manageable realistic degree that doesn’t involve hysterics 24/7 for a fortnight which is less “a good challenge” and more cruel torture. I am all for accepting challenges and trying things out of my comfort zone but sometimes you need to eat a few mini muffins before you are up to demolishing an entire five tier wedding cake by yourself).

I was truly shocked as I sort of hadn’t realised how bad things have got again.
The descent has been a gradual process, little slips that in the end add up to a sky diver height of a fall. It is like what they say about if you put a frog in boiling hot water it will hop out but if you put it in warm water and gradually turn the heat up it will boil to death before it realises (that is what they say isn’t it? Who are these people? Please dear readers, do not go putting frogs in boiling water. If you really want to see some green bubbling in a pan just whack in a bag of frozen peas, far more humane AND one of your five a day).

When we pulled up at the house I fully intended on staying for the next two weeks (obviously I did, I had my penguin and my cuddly Christmas elf, I was committed to this trip). Even though I was anxious, by using multiple packets of anti bacterial wipes and with support from my parents, I got through the unpacking and after two hours my room, bathroom and office all looked really nice, filled with familiar things, a comfortable home from home.

It was when I tried to shower that things went so horribly wrong. First there was the issue that the shower was a stand in shower cubicle with a door. At my house our shower head is hanging above the bath, so when I am getting all lathered I can stand out of the flow of water to reach the required bubbliness (I know that this is not the most environmentally friendly way to live my life and that I could just turn the shower off but just know that I am unable to do that at the moment and to be honest when you are focusing on just keeping yourself alive your carbon footprint is not a top priority. At least I am not flying across the globe in an aeroplane to Malaysia like SOME people…).
With this stand in shower however, I was unable to reach the desired bubbliness needed to get through all of my thought routines because before I had time to count to the required numbers the suds had all been washed away.
Then there was a problem that I had to put my soaps in a basket so my lemon shower gel for feet was too close to my banana shower gel for body and far too close to a wall that I couldn’t touch, and the way you turned on the shower made my usual vitally important life saving way impossible.

I took so long to shower that all the hot water ran out and after a while of forcing myself to stand under the cold ice like hail pelting me in the face, I got out though I still didn’t feel clean. I was in a bit of a state but I didn’t want to give up so I persevered and tried to get on regardless but it was one thing after another. I couldn’t wash my hands in the sink because the tap distance to the back of the sink meant holding my arm at 135 degrees rather than 90, I couldn’t step off the towel I had laid on the floor because my bare feet couldn’t touch the tiles and I couldn’t put on the socks that I had brought into the bathroom with me without direct access to trousers and slippers. “You should have taken slippers in and trousers too” I hear you cry but I had thought of that already and couldn’t because there was nowhere safe in the bathroom to put those things at an acceptable distance away from each other. I found myself standing stranded on this towel shivering and blue with cold, so I naturally did what any other person would do in that situation. I cried uncontrollably and screamed in terror for my mother.

Luckily my parents were still there because the unpacking had taken such a long time that they had ended up staying for dinner whilst I showered.
Seafood rice was cooked and eaten and a homemade rhubarb crumble was just being served when the screaming happened and mum came running. She tried to help by offering solutions, one being the ideal “I can go and get the trousers and not let them touch anything”, but I didn’t want to do that. Yes it would have been safe, but I wanted to solve the problem by myself somehow with support.
Mum could have easily gotten my trousers and I could have left the bathroom but what the hell would I do the next day when she was on a beach somewhere in Malaysia? Around this point my “in a bit of a state” descended into full on “out of control don’t know what I am doing dangerous risky chaotic hysterics and panic” and from there things are a bit of a blur. All I know is that I cried for several hours (I tried to talk too but was at that hiccuping crying point so “I don’t know how to manage I want to disappear” came out more like “Hic gasp gulp hic scream”), and my parents and friends frantically tried to decide what to do.
When I was able to talk and sob at the same time I made it clear that I felt it was a challenge too many and that rather than tackling the “parents away and totally different location for all rituals for two weeks” I wanted to attempt the “parents aka usual carers away, in a familiar place” challenge. Losing both was like losing both of my homes, a tortoise rudely ripped from his semi detached terrace house and his shell in the same day leaving a cold naked slug unable to survive in its place.

There were then more hours of discussion before we realised that this really was not a feasible option and then after two hours of packing all of my things back into the bags we had unpacked them from (we didn’t have to pack my elf. He went and got himself back in the car the second he heard the first bout of screaming. He knows me well), we were back in the car driving home in the dark, leaving the abandoned now cold homemade crumble on the dining table. It is a big shame. My parents love rhubarb crumble.

So it was that I ended up back home after my much shorter than planned and somewhat failed “stay away from home with mental health problems”. On the plus side I did manage to get to the house and unpack…I just left two weeks too early.

Clearly then, I think I have proved my point and raised awareness to all the people who might not understand OCD, that when it comes to OCD and other mental health problems with ritualistic behaviours, it isn’t just the rituals that are important to a sufferer but the specific location and circumstances under which those rituals are carried out.

Take care everyone x

Bubbly