My Beautiful Mind: Personal experience of an in-patient unit for emotionally and behaviourally disturbed adolescents

by Sarah Williams

[This piece was written for the King’s Experience Award’s A Beautiful Mind: Art, Science and Mental Health’ module.]

My Beautiful Mind – narrative reflections on a mental continuum: Personal experience of an in-patient unit for emotionally and behaviourally disturbed adolescents

“To the adolescent with a behaviour disorder, medication implies that he is ill, and cannot be held responsible for his behaviour; it also feeds his panic that his inability to manage his tumultuous feelings is, after all, crazy.”    (Wells, 1986)

BEFORE

I was about ten years old the first time I remember wanting to die. I didn’t want to kill myself, although I did consider taking an overdose of my mother’s pills, but was too scared of the wrath if my attempt was unsuccessful. Instead I settled for scrawling ‘I want to die’ on a mirror in my bedroom, (using blood-red lipstick for dramatic effect), and hoping that I wouldn’t wake up in the morning.

My actual suicide attempt occurred at the age of 14. Twenty paracetamol and a charcoal stomach wash later, (hideously more painful that it sounds), I found myself in front of a psychiatrist, being drilled on why death might be preferable to the pathetic existence that was my life.

“The Young People’s Unit deals with teenagers with behavioural problems. It’s not a mental institution but it does provide therapy to help these youngsters understand why they behave the way they do.”

It’s not a mental institution, but it’s linked with the enormous asylum next door. It’s not a mental institution but the kids have therapy and it’s staffed by psychiatrists, psychiatric nurses and art and drama therapists. It’s not a mental institution but all the kids who go there have self-harmed.

“OK,” I thought “If you want me to pretend I’m not insane so you can get me into the madhouse, I can go along with that.” I could smoke whilst there, and be away from my mother for five nights a week, what was there not to like?

In a 1978 review of the Y.P.U. the authors rejected the approach of “therapeutic milieu to the maturational tasks of adolescence.” The needs of an emotionally disturbed adolescents were “establishing a sense of identity and responsibility.” (Jones et al, 1978)

All we (non) nutters needed was to learn how to grow up and behave – why it was so hard was irrelevant.

DURING

I should make a disclaimer here: At no point, prior to admission, had I revealed the main reason for my suicide attempt. I did nothing to relieve anyone of the belief that I was simply angry with my mother for not allowing me to smoke and insisting I be home before 9pm every night, (not to mention a childhood framed by severe domestic violence).

“The most frequently stated main problems were school refusal, depression, aggression towards people, sexual behaviour problems and stealing; with lying, inability to relate to others and temper tantrums as the highest rated subsidiary problems…These features of the youngsters may not differ substantially from those of “approved school” youngsters.” (Jones et al, 1978)

I didn’t really think through the consequences of being painted with the delinquent label. The sympathy went to those whose behaviour was a result of being abused; the rest of us were just naughty little monsters who needed to learn some respect for our elders and stop acting out. So, whilst maintaining the façade of the angry youth who was never going to conform, inside I felt un-liked, unloved, lonely and in pain; an immense agony that no painkillers could touch.

Each of us made a ‘contract’ with the unit. The contract was essentially a list of the behaviours that we were working on changing or stopping. I think my contract included going to school and not being aggressive towards my mum. To be honest, I was more interested in the contract of a girl who needed to be less promiscuous, she had been sexually abused for years by her father, who continued to ‘care’ for her every weekend. If I could get promiscuity added to my contract, without admitting to anyone what had happened to me, then perhaps I might get the same therapy, (and sympathy),

…… I quickly changed my mind when, having given up my secret, I was encouraged to ‘speak’ to the perpetrators of this anguish, during a group therapy session for sexual abuse survivors.

“Seriously, you want me to act this out in front of everyone?” Thoughts, not words. Somehow, I was supposed to articulate the destruction of me, finding non-profanities to express my anger and punching a pillow if it all got a bit too much.

“The policy of not admitting youngsters if they are mad, i.e, psychotic, is made explicit.” (Jones et al, 1978)

How I longed to be sent to the loony bin, to be left in a corner to rock my emotions to sleep (as I had witnessed one girl do after unavoidably being sent to an adult mental ward for the weekend). This view was at complete odds with most of the other Y.P.U. residents. Any hint we were ‘mental’ was scorned; going home at weekends meant having to explain a weekday absence.

“I remember on one occasion having to intervene to prevent three or four young people attacking a schizophrenic patient…in an attempt to drive her and her mad behaviour out. She eventually had to be moved to an adult ward, for her own safety, where to everyone’s surprise she rapidly improved.” (Wells, 1986)

Why the surprise? Did these idiots not realise why they felt a need to beat out anyone with an overt mental illness? Was it not obvious why we ripped at our own bodies?

Immersed in the bizarre, disturbed but sane world of the Y.P.U. I committed fully to art therapy. I loved the art therapist, who would allow us free rein to produce masterpieces, (such as the clawed baby trying to rip its way out of my womb), while he smoked roll ups in the art room office.

“What does it represent?”

“That I’m fucking bonkers?”

But I wasn’t bonkers apparently, I’d just forgotten I was a delinquent with authority issues. Using my own nails to gauge holes in my arms was attention seeking, and running away to get drunk was a mere kick back at the imposition of rules.

I disappeared inside, seeking only those who spoke in similar tongues:

“A perverse nature can be stimulated by anything…even a great work of literature if the mind that so uses it is off-balance.” (A. Burgess, 1962)

I played silent witness to Alex and his droogs, abhorring his actions but hearing his inner rage. I held midnight vigil with Elizabeth Stein, avoiding the dark but knowing it’s humour. Her year rained at the same time as mine . And, as One Flew Over the Cuckoo’s Nest, Nurse Ratched ignored my screams while my crush on Randle blossomed into devastating grief.

 “…the majority of adolescent problems derive from family instability, and that it is counter-productive to return a youngster to an unchanged family setting.” (Jones et al, 1978).

My family setting had already changed beyond all recognition. My sisters had left home, my mother regularly left her own mind, and my step-father refused to leave. Every Saturday I packed pain deep inside my rucksack, keeping her hidden below petulance for the 36 hours I spent at home, before releasing her back into the safety of the unit on a Sunday evening.

On a Monday evening my mother would join me for Family Therapy. My eldest sister came along once, my middle sister never. She had disowned me a few years earlier, hissing “don’t tell anyone you are my sister” when I went to the same secondary school. I solved the problem by not going to school, and she solved it by not speaking to me for years.

The family therapist would try and introduce the fractured teen to their parent, hoping the family could piece together the adolescent’s missing identity. I was a sheep in wolf’s clothing – a costume so good that I remained anathema to my mother and myself.

I saw beauty in life but my desperation for love, approval, and simple physical contact, allowed misdemeanour to reign supreme. The purgatory between sanity and sin proved a futile location for my emotional state. I was insufficiently ill to warrant medication, and my behaviour fell far outside the realm of normal. My variable could not be dichotomised – I was untreatable.

I was formally discharged in January 1990. A failure on the unit’s statistics and no longer a welcome resident at my mother’s house – I was placed in a foster home in local authority care.

AFTER

The Y.P.U. did not try to medicalise delinquency. Pills were rarely dispensed (even paracetamol was kept under lock and key), and behavioural consequences, not psychological cause, remained the focus of all treatment. I’m not sure if this was good or bad – I rejected all psychiatric support for more than a decade following my discharge, believing myself the wicked antagonist of my bleak fate. It took me almost twenty years to finally realise that life is a continuum, mental health and illness are not isolated poles. Sometimes the asylum is a blessed relief – for a time, it was for me.

I take anti-depressants for anxiety, depression, breakdown, pre-menstrual tension. Take your pick. I have all of them, and officially none. I am highly resistant to labels, deliberately evading and inadvertently eluding them. Fortunately, I need not accept definition because I – unlike many others – don’t need insurance or benefit payments. Some days I find the business of living as troublesome as it was when I was ten. My body feels absent of skin, open to the elements and humming with frictional intensity.

But the rawness of this emotion connects me to the wonder of life. I find beauty in all the senses – a hug from one of my children, the scent of my husband, an ultrasound of a beating heart, words in any book, a line delivered, an image created, and the view from Monsal Head in the Peak District.

Mental health, neuroscience, art – it’s all just a beautiful mind.

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