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Channel: Steve Colori, Author at The Good Men Project
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Power Dynamics in Psychiatric Care

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I remember having a conversation with someone who mentioned how only fifty years ago people were still performing lobotomies and other experiments and how that was considered psychology. This person knows I have schizophrenia but he still felt compelled to talk about his fascination with psychology’s past which is a dark and painful history that led to many deaths and still goes on today. Being someone who works in a good hospital and provides good care, I can still see how distressing it is for others to come into the hospital. I haven’t had an in-patient stay in ten years and I don’t think I’ll ever have another one but I sometimes wonder how things would be if I was in-patient again.

Working in mental health, I often hear horror stories of people’s psychiatry experiences before coming into my hospital. The mistreatment, the mismanagement of medication, the way people weren’t improving or becoming any healthier. The way people were restrained simply because they didn’t get along with abusive staff members and they were afraid of them.

I think it’s pretty fair to say if someone is abusive and you are locked on a unit with them, consisting of a number of bedrooms and only three hallways, it’s a normal reaction to be afraid of them, never mind when you’re also in an altered state. It’s been terrifying to think that if my mental health declined I could potentially be put in one of these hospitals and be subjected to the same trauma I’m helping others work through and recover from.

I hear a lot of stories about abusive mental health staff, people being restrained for hours, people being forced to take medications they don’t want, medications that don’t work for them, and medications that they never asked for. There’s a bartering that goes on when you’re a patient; you basically have to take these medications. Otherwise, you’re not leaving the hospital, and if you stay at the hospital for too long you’ll be going to the state hospital.

The idea of the state hospital always terrifies me. It makes me think of Danvers State hospital which I researched a few years back. Every day on my drive home, I see the monolith still standing against the horizon, a beacon and reminder of the hellacious conditions that psychology is hopefully moving away from, but that still exist in many places that are not too far away from my home.

In Danvers State Hospital’s worst year, over three hundred people died. It’s a staggering and terrifying number to imagine, just at one place, never mind however many hundreds of places it’s been happening all over the world. And this was a place where people were supposed to be receiving care. Instead of making it into a memorial, they made it into condos. Even during the holocaust, the nazis murdered over 275,000 people who had mental health diagnoses. Having a diagnosis of schizophrenia was a death sentence. It makes me wonder why there isn’t a museum or memorial to honor all the people who have been subjected to terrible psychiatric care. For every other type of oppression in the world there have been memorials, services, remembrances, days to mourn for those who have been victimized by these awful conditions.

Why has this not been created for modern-day survivors and past victims of mental health torture and murder? Millions of lives have been ruined due to being subjected to psychiatry—which is premised on helping people through the worst times in their lives. Part of me likes to think it’s an oversight, but that’s a naïve answer. Although I do believe that justice demands such a memorial, I recognize that there’s a problem with the idea: how can we have a memorial when the thing we’re commemorating is still happening and hasn’t been addressed in a remotely appropriate manner, never mind fixed or corrected?

Thinking of these things is terrifying. Thinking of the number of different ways people are mistreated makes working in mental health incredibly difficult at times.

Of course, there’s been some movement in better directions and I like to think there aren’t too many hospitals like Danvers State anymore, but this was and still is recent history. Danvers State hospital was only closed June 24, 1992. The thing that comes to mind for me is how much further psychology needs to move away from this dark age, and how much psychology is still in this dark age, judging from the stories people tell me of their hospitalizations at other places.

There are times when I have heard about how patients have been treated like inmates or criminals at other hospitals and there’s an otherness and less-than mentality that has been directed towards them. Many times when people are afraid they create hierarchies and put themselves at the top. One of the many motivations for power is fear and mastery of fear. If you have power over the thing you’re afraid of, then you control it, and you have safety from it. The problem is, when the thing you’re afraid of is people who are already in a helpless power dynamic, it amplifies their stress and fear and puts them into a far worse state of being.

People sometimes describe being in-patient as being incarcerated. The similarity is that they’re on the unit against their will without a way out. The difference is they haven’t committed any crimes. In fact, many of the people on the units have had crimes committed against them that are still affecting their mental health in a negative way and those crimes are the reason they still need psychiatric care.

I guess for a while I was trying to push away all of this. I kept reminding myself that I work on two in-patient units on a weekly basis to help people get better, to help them recover, to help them have a full life again. They talk to me and hear about how I fully recovered and I’m living a full life and it gives them motivation, courage, and hope. I work with them on their darkest memories, experiences, and most painful moments to help alleviate their burden.

Psychiatric care is not where it needs to be. Therapy does take courage, but in our most vulnerable moments, we shouldn’t be afraid of being abused, restrained, overmedicated, and having our lives taken away by people we’ve never met.

 

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