I Voluntarily Signed Myself Into A Psych Unit

My little book that I’ve been working on for the last few months, My Heart Is An Autumn Garage, came out last week. It’s a short memoir about the breakdown I had in 2003 and my subsequent hospitalization. I am still kind of overwhelmed with Feelings about this, so I’m not sure what else to say. Below is a short excerpt that’ll hopefully explain the book better than I can right now. It takes place shortly after I agreed to sign myself in voluntarily to the psychiatric unit.

Almost as soon as I passed the papers back to the nurse, a hospital commissionaire came to escort me to the psychiatric short stay unit. It was a long walk, to a separate part of the hospital called the Abbie J. Lane building. The name seemed like a funny combination of Abbey Road and Penny Lane and I suddenly wished that I had someone other than the commissionaire to tell this to. No one knew where I was, though – not my friends, not my roommate, not even the mother of the boy I babysat. Oh, I’d called her to tell her that I wouldn’t be able to work that day, of course, but I’d given the flu as an excuse. My voice, rough and shaky from hours of crying, was enough to back me up, and she’d accepted my lie without question.

Once we reached the short stay unit, the commissionaire had to call to get someone to buzz me in. I heard the lock gently snick as the door closed behind me and the sound sent me into a full-on panic. I’d been crying ever since we left the emergency room, but now I started to sob even harder. The commissionaire, an older man with white hair and laugh lines around his eyes, just patted my hand and told me that I would be fine. Then he turned around and the door closed behind him and he was gone, slowly ambling back into the world of people who weren’t locked in psychiatric wards. I turned around and found a nurse standing behind me; I told her, gasping and more than a little inarticulate, that I wanted to leave. I told her that the emergency room nurse had said that I could leave whenever I wanted, and I damn well wanted to leave this second.

She said that I couldn’t leave, though, not until I’d spoken to the psychiatrist on call. So I told her to call the psychiatrist. She just sighed and rolled her eyes.

The nurse went into a glass-walled room and sat behind a desk; I watched her pick up the phone and mutter something into it; I could tell that she was muttering by the way she pressed her mouth to the receiver and barely moved her lips. She paused for a moment, nodding in agreement with whatever the psychiatrist was saying, then muttered something else. She hung up the phone, came over to where I was waiting and, a fake smile plastered on her face, suggested that I let her show me around while we waited for the psychiatrist to come.

The glass-walled room was, she explained, the nurse’s station, where I could always find the nurse on duty. There was also a small closed-in room with a long wooden table where the staff held meetings and took breaks. After that, she showed me around the rest of the ward; most of it was a big, open space sort of set up like an open-concept house. There was formica-topped, institutional-looking table in the middle of the room, surrounded by half a dozen aluminum-and-vinyl chairs. In one corner there two ratty old couches and an ancient television, and in the opposite corner there was a dingy white-tiled bathroom, complete with bathtub and shower. All along one wall were our “rooms”, which were really just small alcoves containing a hospital bed and a bedside table. These so-called rooms didn’t even have doors on them, just heavy hospital curtains that could be drawn if the patient wanted privacy. Each room came equipped toothbrush, toothpaste, and a child-size paper cup full of viscous blue liquid that was both shampoo and body wash.

“You can leave your coat and bag here,” the nurse said brusquely.

There didn’t seem to be much point to that since I would be leaving as soon as I met with the psychiatrist, but I did it just to humour her.

After that I tried to call Denise, figuring that at least someone should know where I was, but she’d already left the office for the day. So I sat and read my book until the nurse announced that it was time to eat and ushered all of us patients towards the formica table. Supper was some sort of grisly meat in a pool of gravy with a side of instant mashed potatoes and green beans from a can, but I tucked into it eagerly. My financial situation had by then deteriorated to the point where I was eating No Name brand macaroni and cheese every night, so I was pathetically excited to find meat and vegetables on my plate. I only had the chance to eat a bite or two, though, before the nurse came over and told me that the psychiatrist was ready to see me.

They took me into the little meeting room where the psychiatrist waiting to talk to me. She had brittle, curly blond hair and spoke in a cold, clipped Eastern European accent. Without any preamble, she asked me why I felt that leaving the hospital was a good idea, and began taking copious amounts of notes as soon as I started talking. Meanwhile, I was struggling to pull myself together enough to properly explain why I wanted to go home. I began by telling her I didn’t feel safe or comfortable spending the night there, and she nodded without looking up, indicating that I should keep going. Having already made what I thought was my strongest and most obvious point, I thought fast to think of something else – unfortunately, the best that I could come up with was that I had a lot of laundry to do and it was my turn to wash the dishes and also I’d promised to call my mother that night. The doctor looked up then, frowning in a way that I knew meant that she didn’t think I was very bright, and said that none of those were good reasons for leaving the hospital. I realized, then, that I should have just kept elaborating on my first point, rather than trying to come up with more.

Still, I said, they’d told me that since I was signing myself in voluntarily, I could leave whenever I wanted. And I wanted to leave.

The psychiatrist ignored that, and told me that if I wanted to call my mother, I could call her from the hospital.

No, I said quickly – too quickly – that was fine. I could call her the next day. It wasn’t urgent.

But, the psychiatrist said, sensing that she’d found a sore spot, I’d listed that as one of the reasons why I wanted to go home. Didn’t that mean that it was important?

The thing was, I explained, hesitantly, the thing was that my mother didn’t exactly know that I was in the hospital. And I didn’t want to tell her, because I thought that it would just worry her needlessly.

The psychiatrist smiled like a cat with a fat, wriggling little mouse pinned under its paw.

That settled it, she told me. If I’d agreed to call my mother, she might have let me go home, but since I hadn’t, she wouldn’t.

Unable to keep the note of triumph out of her voice, the psychiatrist went on to explain that this type of behaviour was known as fragmentation. Fragmentation is the fancy, technical term for only telling one or two pieces of the story to each person, but you never explain the whole of what’s happening to any one individual.

It was a sign, the psychiatrist said, of a deeply disordered personality.

The worst of it was that she was right: I definitely did have a tendency to share only parts of the story and never the whole. At the time, when the psychiatrist first said this to me, I felt panicked, disoriented. Fragmenting, or whatever you wanted to call it, was something that I’d consciously done as a means of protecting myself and the people around me from my sickness; I’d never imagined that I might be making myself sicker. It was as if I’d been climbing and climbing a long flight of stairs, hoping that I’d find the exit soon, and then suddenly realizing that I was instead taking myself deeper and deeper into the labyrinth. And maybe there was no exit. And maybe all paths lead only to the heart of the maze.

Here I’d thought that doling out my life in bits and pieces was a smart self-preservation technique, a way of taking everything on myself so that I would never have to lean too hard on any one person or another. I had this idea that I would somehow figure out what information my various friends and family could handle, and then I could divide up my confessions accordingly. My reasoning went something along the lines of, If I don’t ever tell anyone anything that bores or upsets them, then it’ll be easier for them to love me.

The fact that I was difficult and frustrating to love was, I assumed, just a given.

These days, I’m less convinced of my unworthiness of love, and that fact alone almost certainly means that I’m much more mentally healthy than I was ten years ago. I try much harder to be honest about the parts of myself that I find shameful or embarrassing, and although that kind of vulnerability has been tough, it’s a gamble that has more or less paid off. Having stripped myself down, often publicly, and having bared some of my darker aspects, I feel much stronger and happier. I’m glad that I don’t compartmentalize my life to the extent that I used to.

That being said, I still don’t entirely agree with the idea that “fragmentation” is the sign of a personality disorder. I may no longer convinced that it’s the smartest, healthiest thing to do, but I also feel that it’s a perfectly natural coping mechanism. When you get to a point where you just hate yourself so goddamn much, it makes total sense to think that other people would, if they knew the whole truth about you, feel the same revulsion that you do. It makes sense to want to hide what you think are the terrible, deal-breaker parts of yourself. It makes a whole fucking lot of sad, desperate sense. And, I mean, sure, in an ideal world everyone should have someone, or even better, multiple someones, with whom they feel comfortable sharing all of themselves. In an ideal world no one would ever feel shame or guilt for things that they can’t help, things like sadness or fear or loneliness. In an ideal world we wouldn’t have so much trouble loving ourselves.

But we don’t live in an ideal world, do we?

After the psychiatrist accused me of fragmentation, I began frantically scrambling to explain that no, it wasn’t like that, really. I tried to tell her that everything that I’d said had come out exactly wrong. I wasn’t whatever she thought I was.

It was too late, though. Ignoring my babbling, she stood up, walked across the room and pulled a piece of paper out of a filing cabinet.

“I didn’t want to do this, but you leave me no choice,” she said.

Of course, her tone and facial expression indicated that she didn’t really give a shit one way or another over whether she did this, whatever this was, or not.

“What are you doing?” I asked, my voice cracking with fear.

“I’m certifying you.”

What does that mean?

I felt like I might throw up.

“It means that I’m signing this so that you can no longer leave of your own free will,” she said very calmly.

“No,” I yelled, losing what few shreds of dignity I might have had left. “No, you can’t. You can’t sign that. They told me that I was here voluntarily. I’m allowed to leave. They said that. The nurse and the doctor, they told me that. You don’t understand. This is my life you’re fucking with. You can’t just do this.”

But it was too late, she’d already made up her mind. TC mark

If you enjoyed this excerpt, get Anne’s book here.

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  • http://bripolarlife.wordpress.com bripolar

    Reblogged this on bripolarlife and commented:
    Inspiring and courageous. Thank you for sharing.

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