YO psyche ward!

These are quotes heard from my 40 hours a week working in mental health... some of these are quotes from me some from other staff and some from patients.
No names are used to protect peoples rights. I will not... tell you if it was a patient or a staff member I am quoting...
it's the old saying you can't tell the difference between the staff and the patients.

Monday, January 25, 2010

Found recently in Modus Operandi Magazine.

Working in a psyche ward allows you access to the more disturbing things in life. Often times its just a mild accent of the oddity that is life as we currently know it, sometimes it's a disturbing magnification of those aspects of life that we all really cant easily wrap our heads around.
Being a Scorpio sex and death always seem to stick out like a sore thumb... its something we just seem to take notice of a bit more. It is also something that is most frequently a sore spot for those locked up in an involuntary treatment facility. Sex in a psyche ward... sigh... Just the subject is taboo, you can't let people even talk about it. You have to snap at folks "Keep it appropriate, or your going to take a time out in your room.", if the subject comes up. It's too sensitive of a subject,maybe the libido is the base force behind neurosis I don't know...
People tend to respond to stress with masturbation, I have noticed... more then once. It's pretty common. Just remember if your stressed out whip it out in front of every one and just go for it. In those situations its pretty hard to confront the person. It's not a situation that we often have to confront. When have you said to any one "Hey will you stop masturbating we are trying to eat here!", once again you have to be abrupt and abrasive and tell them, "Hey go to your room, there are other people present!" There is rarely an argument, people generally speaking will act a bit shocked that you confronted them and just walk to their room and continue.
You have to do room checks every 15 minutes. Every ones rooms have a window in the door, and only the staff gets to look into them. Which always seems awkward when you have to tell a patient to respect the privacy of the other patients and not look into their room. It always seems a bit hypocritical. But really we are just saving them further trauma. You see things that can curl your toenails. I could see how the nudity of the opposite sex could be totally turned into a trauma for veterans of this field. PTSD being triggered nearly every time you see a nude woman. Involuntary nudity is much different then voluntary nudity, it's kinda disturbing but you can never put your finger on why. Maybe it the highly confused motivations that drive the nudity in the first place, it's hard to say. But regardless psychosis does not always lead to nudity, but it is fairly frequent that it does. Perhaps it goes with the liberation of to being fully "there". You look into a patients room and you see things... sometimes terrible people naked doing strange things.
One evening a patient who needed to be observed 24/7 was not, due to a co-workers negligence. The patient ended up in the bathroom innocent enough as that may seem to most of us, there are those that should never be left to their own devices in the bano. I rushed to monitor the man to find he was not responding to my calls at the door, I opened the door to the extremely rare and unpleasant aroma of roll on deodorant mixed with blood and feces. You know the sent when it hits you, truly a rare sent to be found in ones day to day adventures. What ensued was a wrestling match between the man who had just shoved a deodorant bottle up his ass, and the staff, myself included.
There are moment where logic fails you, there are also moments when the most logical and necessary action you must take is not the most logical. You react first with out much thought at all honestly, and you begrudge yourself for it after words. Wrestling a man covered in blood and feces to the ground is one of those moments you just cannot forgive yourself for but it seemed the right thing to do at the time. The thoughts that went through your mind that led to such a choice must be looked at very closely after words and with much scrutiny. "If he still has the blood/shit/deodorant covered bottle then he will contaminate everything with it!" Thoughts like that for example. "Get it!" someone yelled...and so you do< and your sorry for doing so, and you always will be.
After we got it away from him I had to know why it happened in the first place."Why did you put that bottle of deodorant up your ass man?!""Because when your covered in shit every one leaves you alone."Once again there are moments when logic fails and is replaced by the logic of madness that can not be refuted, for there is truth present. Yet I am not sure to this day that that was his real motive, and even if it was, and even though it does make perfect sense, it did not work out that way... unforgettably as that was for all involved.
People like to hook up in psyche wards. Especially people who are stabilized, it kinda takes that to hook up anyway, at least a little bit. There would seem to be no issue with that, but these are not always consenting adults. Sometimes people get to that same point we can all relate to waking up the next morning to a patron of the same bar we frequented the night before laying next to us. "What the fuck did I DO?" So when boundaries are not in place some one has to step in for you. Like in bar situations this is called cock blocking. Depending on how far gone or how stable the patients are in the cock blocking situation you find that the results are often times the same as if you where doing so in a bar. Wrath. I am not sure if this is just hard wired in the human nervous system or not, perhaps its a evolutionary mechanism to make sure we get to pass on our DNA, but cock blocking will in most living things create a fight or flight response. Ultimately in humans though it is always resented and unlike in the bar situation, you are not going to get anything for your trouble. Perhaps the satisfaction that you prevented someone from making a bad mistake but mostly the outcome always seems to go poorly and that satisfaction is usually far from being felt... ever. Occasionally though lasting relationships form and people stabilize and it is a beautiful thing. I recall seeing to of my past patients running hand in hand with each other down the street wearing matching cloths and matching backpacks. It was cute... surreal and cute. I felt really sad when I saw the man in the bar alone talking to himself after she killed her self. But for a while they where happy, and that's the way of it seems.
Having sexual advances placed on you is a tough one. You feel embarrassed for them and for you depending on the situation. But it is never appropriate in that sort of relationship ever. It's easier though to set boundaries for a co-worker then for your self when its happening. Sometimes you need that, a co-worker on the floor to watch your back if that happens, to cock block the patient. But its always better if you do it yourself. The patient has to know that its not appropriate and that it makes it hard to establish a therapeutic relationship if that dynamic continues. I don't jest as much here because it's a serious thing, well this all is. But the line between serious and humorous fade the longer you work in the units. I once made a patient cry because it was the only way to get through his delusion that all the female staff wanted him. You couldn't accomplish anything until that delusion was broke. It was a sad moment for both of us. Some times its easier to just let the delusions continue and the sickness run free, but never in the long run, it always comes back to bite you in the ass. When it's happening to you though, and a client is hitting on you its hard to know what to do. Once a male patient was having seriously bad recall of childhood molestations. He was a married man who had always kept his homosexual tendencies at bay, but now it was all flooding out. Being propositioned when it is unwelcome is always awkward, but having your patient ask you if he can suck you off or that he would like to kiss you, well if presents that difficult moment of shock where your just not sure if that just happened and how you should deal with it. Especially when it comes out of left field during a card game with other staff present who are even more shocked and unable to set the appropriate boundary. You have to be cautious, this is part of some ones healing moment deep rooted shit is coming out and you can tell that. "That would not be possible," you say in a calm cool manner regaining your composer, " For one I am straight and though I respect your feelings, if you continue to have those sorts of feelings for me I will not be able to help you as your counselor."
As I said its messy, sex and lust on a psyche ward is always a messy subject. It's tricky, allegations can fly and the next thing you know wham your fired for just being in a room alone with a patient helping them with something... doors must always be open, always tell someone what your doing. Never let any one hug or touch you. " No touching!" Its a rule... they love rules in a psyche ward.
Developmentally disabled patients are tough. Adults with little impulse control, or ability to process complex emotions. Adult bodies, adult drives, adult hormones, with the mind of a child. The patient had been swallowing foreign objects to kill her self. It was a power play with her care providers so that she could get a video game. It got out of control, and so there she was on the ward. She swallowed a pen capon my watch. I was kinda excited to leave the ward it had been a rough day watching her, and honestly I was hoping that at the ER they would let me stay and watch as they did the endoscopy. They did it was great I got to the see the insides of a fellow human and watch as they played a real life video game that object was to remove a pen cap, a golf pencil and red crayon. Amazing. The part that sucked for me however was having to watch her in the ER out side of the ward with little aid from the nurses. She kept taking down her top and exposing her self to me asking me if I would have sex with her. Deformed, retarded and hideous in all honesty. I couldn't take it I was in the corner, there was no way out... I had to gnaw off my own legs to escape! I couldn't take it though, in the ward the female staff would have taken over at that point, and the male staff would have separated from the patient. Not an option though, so it kept happening all night, and I kept asking the nurses to come in and put her top up and to tighten the restrains.
There are so many moments where the experience itself of being there at the ward causes you the counselor total trauma. Mental illness I swear is contagious. The smell of an obese womans vaginal yeast infection during a take down where body parts are every where cloths ripped genitals exposed. You block the words the sounds, the sights, the feelings, and smells from your mind only to find like the smell of the yeast that will not come off your sleeve all night something lingers. A memory, an image in the minds eye, of something awful. You tell your self you have to be mature about these things, you have to distance your self, take a step back, be the observer and like Buddha just let it float by like a storm cloud. Then something else comes to top it. An old man shitting in your hands as you have to wipe his ass a woman throwing her urine in your face, but that's just the 9-5 thats life working in a psyche ward.
Not to long ago a patient kicked me in the nuts. I had to stop for a moment and take a look at things real hard. I am getting paid to get kicked in the nuts? Aint life a trip... I quit the job, moved on, left the ward and went on to more challenging work if you can believe it. I left because my best friend who I worked with couldn't take it any more and shot himself in the head twice. His coping mechanism was women, several at one time, without the others knowing. It all crashed down on him. He used his lust to combat what he saw in the psyche ward. It wasn't enough to hold back the gates though. The gates fell and what was released was absolutely horrible to behold and he removed those thoughts that his lust for life could not fight back and he ate two 9mm rounds in a park a day before his sons birthday. Lust and women was his escape from the horror he saw and fought to process, cope and just deal with. But he needed to much from that one. Lets say that it was not a sustainable plan.
Me... well I drink...

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