When I go to Marks and Spencers I usually have a list and I have to stick to the list or I’ll just go wild and buy stuff that I don’t need. As you can imagine, in M&S it’s virtually impossible to obey the written command of a shopping list and whilst I may have entered the shop aiming for a pizza, four frozen baked potatoes and a bag of fancy apples, I usually come out with those items plus a box of biscuits, a bag of Percy Pigs and a chocolate lolly for my niece.
In Waterstones I will go in with around five books on my list and I give myself permission to buy them because they last longer than a bag of Percy Pigs. But more often than not I come out empty handed because I’ll look at the books and for some reason I might not like the cover, or I might not like the first five words on the front page; so I put the books back on the shelf because none of them have met my expectations and there’s no point buying a book if it doesn’t tick all the boxes that it needs to.
Now this is where psychiatric life gets interesting. When your mental illness starts to act beyond the realms of a GP’s capability a good GP will down tools and say…
“This ain’t my bag; I’m sending you to a psychiatrist!”
…and after you’ve waited between four to six months for your appointment this is where the fun starts!
Nineteen years ago the only psychiatrist I’d ever heard of was Freud – and let’s be honest he doesn’t have the greatest reputation, I mean I was at university reading Dracula and they were throwing the Oedipus Complex about like it was a football covered in cream. In case you don’t know what the Oedipus Complex is, it’s something Freud came up with where a guy has a complex relationship with his mother and this is because he fancies her and it results in all sorts of chaos in his life and relationships (something to that effect). It got dragged into every book I read while I was doing my degree and I now have to make a conscious effort not to give off any impression that the characters in my own stories fancy their parents because it’s a crazy idea and I will not be tainted with the same literary ridiculous brush that the likes of Bram Stoker and the Bronte sisters have been tainted with, no thank you!
Aside from Freud I didn’t know a great deal about what a psychiatrist was about. I knew they were doctors and I knew they looked after brains but that was it. When I got my appointment to meet my very first psychiatrist all I could think was that he was going to fix my brain and make me normal.
When you have a physical ailment and you go to the doctor or a specialist, they can look at the problem and they can see it because whatever it is is usually staring them in the face. My bowel problem was a physical problem and whoever looked at my situation knew that there was a real problem and they tried to fix it. When it comes to your brain all a psychiatrist has to go on are the words that come out of your mouth.
You can’t lie about constipation. You can’t hide a lump that shouldn’t be there and if you’re in pain, or discomfort and you can barely move there’s no disguising that because it’s real; a doctor can see it. But if it’s your brain that’s in pain, if it’s unhappy or it’s got a million things going on in there that it shouldn’t have, voices, despair, moving inanimate objects and a crazed idea about saving the world with the help of the singers on a playlist on your iPod; then those are the things you have to tell the person the system has placed in front of you and hope to God that they believe you and they want to fix you!
In 2002 I was a first timer in a psychiatrist’s office. In the waiting room I sat and looked all the people who were there with their social workers and nurses. Some had no teeth, some had yellow fingernails from too much smoking and some just stared into space. I remember looking at all of them and thinking…
“Is this my life? Is this who I am now?”
No one tells you what to expect when you go to a psychiatry appointment. A few months ago I had a CT scan and I got a leaflet in the post to tell me how it would work. In the summer my mum had an Endoscopy and she got a booklet to tell her the exact steps her feet would take. When I walked into the Rivington Unit at the Royal Bolton Hospital in 2002 and sat with all the psychiatric patients, no one told me how it would work, no one told me the steps my feet would take. No one told me that it doesn’t matter if you have good days and bad days or if the only reason you managed to get dressed today is because you’ve just had three bad days and this one is a little lighter. It doesn’t matter. It doesn’t matter because it’s not about yesterday or last week or ten years ago. It’s about…
…how you present on the day…
You have to be willing to work in that room. You can’t be shy or secretive. You can’t hold back and you have to be the strongest version of yourself even when you have no fight left in you, you have to find some because if you put forward a wavering claim of insanity and a psychiatrist doesn’t see it to be a convincing representation of how you truly feel, then you will walk out of that door with absolutely nothing. No diagnosis, no meds, no referral to therapy…absolutely no help whatsoever. And believe me, when you’ve jumped through the hoops to get to the top dog, you don’t want to leave with nothing, because you have to remember, these guys are pros. They could probably pay off my entire mortgage in a couple of pay checks. They take no prisoners, they haven’t got time to be messing about so the least you can do is get your facts straight.
I got lucky. My first psychiatrist was a human being. I was in that room an hour. I was nervous, my hands were sweaty and when I followed him into the room the first thing I said was…
“Where’s the couch?”
When he gave me my diagnosis I cried. Not because I was sad – I mean I was, obviously, Bipolar Disorder is not something to celebrate – but because I finally had answers for the behaviour I couldn’t explain. I left with meds and a weight off my shoulders because just when I thought no one could help me, I’d found someone who could.
What’s the worst thing that a good psychiatrist can do? The answer is simple…
…get a new job and leave.
You never know who’s going to take their place, it could be any old fool. You know that saying people use when you’ve just split with someone and they’re trying to make you feel better…
“You have to kiss a lot of frogs to find your prince.”
Well for me, it was a bit like that. My first psychiatrist, let’s call him Dr Jackson, he was amazing, but he wanted to move on and who was I to hold him back? But he left a train wreck in his wake. Anyone who took his post didn’t stay for long and in most cases that was a good thing.
I met so many frogs. Really ugly, dirty, smelly frogs. Frogs who made me cry, they made my mum cry…
“You’re putting words in her mouth”
“You’re too intelligent to be a psychiatric patient”
“You’re not Bipolar”
“I don’t think you need psychiatric medication, let’s take you off it”
Maybe this is why I had so many hospital admissions, because these buffoons were confusing the situation. Being an outpatient and having so many different psychiatrists – and I’m talking double figures, not just a couple – I was passed from the consultant to their junior. When you see a junior doctor doing their psychiatry training you really get to see how the cogs turn. All the questions the consultant has casually asked you over the years that you interpreted as general conversation, turns out, it’s a trick.
Everything they ask you is a tick box exercise and the juniors haven’t quite mastered the art of the general conversation tone. They have a shopping list. A list I like to call the Shrink’s Shopping List…
- What medication do you take?
- How much of it?
- What benefits do you claim?
- Who do you live with?
- What is your current mood?
- Do you want to hurt yourself?
- When was the last time you wanted to hurt yourself?
- Do you want to kill yourself?
- When was the last time you wanted to kill yourself?
They literally tick the boxes on the paper in front of them. I don’t know if they realised that the doorstep of a folder with my name on the front of it lying on their desk already had the answers to 90% of those questions. But they don’t look at you; they just tick, and after that they tally up your responses and send you on your merry way.
I hit my head against the goal post so many times. I was in that room less than ten minutes and ten minutes when you have to wait months for your next appointment to get another nit wit who doesn’t know how to think outside of the tick box is excruciatingly painful, physically and emotionally.
In nineteen years of being in the system I have four psychiatrists who I owe my life to. Just like the doctors have a tick box list, I have a tick box list of my own.
Dr Jackson put me on the right track numerous times. Dr Ogden did the same. I once saw him shopping in Sainsburys and he had a twenty-minute conversation with me and my mum standing next to the fish counter. When he wasn’t my doctor and he discovered I was on one of the wards he paid me a visit and sat down with me and asked what went wrong? He was a saint and if I ever get to see him again, I owe him a fish.
In 2011 I met Dr Murphy. Now this guy is my favourite. I owe this one my life five times over. He is the one I quote in my presentations because he put me on the path to what the pros call…
He put me in my place. He gave me a nurse I didn’t want but it was the best thing he could have done. He told me there is always something else to try when it comes to medication. He did what he said he was going to do and he gave me…
“The life I wanted and the life I deserved”
If there is one person on this earth who I want to see me strut my stuff on a stage, it would be Dr Murphy. Because of him, I put Bernard in his place and now I’m in the driver’s seat.
In December I had my four monthly check up appointment with my current psychiatrist, we’ll call him Dr Smith (inventive, I know). Last time I spoke to him I was in the middle of an episode and I wasn’t sleeping or eating. While he was on leave I had no one so when I had my appointment with him months later I told him all about losing my job, redundancy, finding a new job, starting a new job and he said…
“…and you did all of that while you were ill?”
“I am proud you’ve been able to do that.”
No psychiatrist has ever said they were proud of me and his words warmed my heart. When you’re a psychiatric patient quite often you’re labelled as being at the bottom of the barrel, some professionals see you as a no hoper, there’s not much they can do with you and you have two options…
Crumble and die
Prove them wrong.
I went for the second option. Option one was never really an option. I don’t admit defeat easily.
On the first day of my new job I was shown around the offices. Bearing in mind I haven’t been an inpatient for ten years it took me a second to realise the finance office used to be the reception of the locked ward I once spent two months of my life on and from the window while I wait for the girls in the office to count out my petty cash I can see the room I used to sleep in. I can’t describe the feeling.
Every time I look across at my old room I see a version of myself that was lost and had no idea what the future would look like. I never imagined I would get a grip on Bernard. When Dr Murphy would challenge my grandiose ideas I would challenge his questions and my family and friends would look at me and wonder if I was ever coming back.
In March last year, eighteen years after first meeting him, I saw Dr Jackson. I sat in his office and told him there was alien being in my brain with superpowers and I was waiting for it to give me the instructions on how we were going to save the world (this is just before Corona wreaked havoc in the UK). He found the problem and he set the wheels in motion to fix it and once I felt better I thought…
“…one day I will show him who I have become.”
On Wednesday I walked across the hospital to take a document to my senior administrator. I knew he worked just down the corridor and every time I make this journey I walk past his office and I think to myself…
“…one day he’ll open the door and he will see me.”
The senior admin knows my past, she knows Dr Jackson has been my psychiatrist and in passing she mentioned my name and he passed on his best. There is nothing nicer than being remembered but when you’re a psychiatric patient you never know if you’re remembered for the right reasons. When I took the document over I phoned my mum for a chat on the short walk I said the words…
“I’d love to see Dr Jackson when I’m doing something like this.”
In the office I was looking at a spread sheet when the senior admin tapped my hand and nodded towards the door. Fate works in mysterious ways and sometimes you really do get what you wish for.
Every time I come out of an episode I am embarrassed. I am ashamed of my behaviour, my words, just Bernard in general and it can take months, years, forever, for that embarrassment to fade but when you’re stood in an office with the secretaries for all the Psychiatric Consultants in the hospital and you look up from that tapped hand and one of your most treasured psychiatrists is standing in the middle of the room and he waves and asks you if you’re okay? There’s no other feeling like it.
I was having a tough day on Wednesday and seeing Dr Jackson gave me a lift I didn’t think was possible. It must be nice for a consultant to see a patient go from the bottom of the barrel to having a job in the very area where they’re still a patient, but let me tell you now, it is the best feeling when you realise all your hard work has paid off and you really have proven all the terrible consultants wrong and no matter how small your achievement is, it’s still an achievement.
In that moment I felt like a success story, for me and for him. It’s a sign that he did a good job with me and I did my best with the tools that all of my favourite psychiatrists have given me.
The shrink’s shopping list may be an abundance of difficult questions and there is no right or wrong answer, but sometimes it’s not what’s on the shopping list that matters…
…it’s how you do your shopping.
Dedicated to the four psychiatrists who saved me and still do to this day.