I’ve been on the ward just over a week.. It’s been enlightening. From the oddities of other inpatients, the monotonous structure of each day, crisis and interesting team dynamics.
The first day came and went quietly for me but there was one quite unwell woman that did a lot of shouting, banging and attempting to intimidate younger woman on the ward.. By day 2, I was sat in the garden vaping with this woman pissing directly behind the bench I was sitting on, producing a stream of steaming hot piss coursing its way to my shoeless feet… this was a mere taste of the madness to come. She started throwing things at the window in a bid to frighten me, would come up behind me and smash a chair down. The thing is, I work with people with forensic histories as long as your arm, with people known to carry weapons and recently witnessed one of my clients doing flying kicks across the day area of a PICU and didn’t bat an eyelid. She was going to have to do something pretty spectacular to grab my attention…
And so she did. In the middle of Tipping Point, this woman pulled down her crusty trousers that looked like she’d worn for over a week and proceeded to shit on the floor of the day area. Evidently roughage had not been a priority for her. She then went about smearing her deposit about the floor, like a putrid Nutella. That grabbed my gag reflex’s attention at least and I swiftly exited. There was another incident the following day when again I was sat outside in the garden and she came up behind me and left a steaming hot turd. Then things got violent.
She’d been carrying a pub quiz game around with her since I got there; never putting it down, not even to shit – there was no wiping so she didn’t need to. Another patient made the mistake of asking about this game as was promptly twatted around the back of the head with it. There were then 4 assaults on staff in under 10 minutes and I’d had enough of her by this point and felt like giving her a slap myself. Another assault on staff was made, furniture was thrown and I’d had enough of a) her and her behaviour although I appreciate her being acutely unwell; when you’re feeling pretty mental yourself it’s not ideal to be around and b) the staff’s inability to contain her. This resulted in me grabbing old of one of the nurses and screaming “WHY THE FUCK ISN’T SHE ON A PICU!??” This isn’t like me, I sympathise with staff whole heartedly, I know how hard their job is but I was incensed by what this woman was doing, how it was making me feel and the impact it was having on the voices.
The voices told me I too should hurt staff, that I should smash stuff up and try to get off the ward while they were distracted. I battled them and they called me gutless, pathetic and weak. I did not want to become what they wanted me to and my burning desire for people to like me and to be good was the only thing keeping me going. For once my maladaptive schemas and lifetime of shit came to be useful. Never have I been so happy to have BPD.
She was moved to PICU half an hour later and I like to think that was thanks to me telling them how to do their job; the reality probably is a bed had only just become available.
The ward went quiet and sleepy – for a little while at least. A girl with BPD who’s been here for 9 months tried to abscond. I find the staff’s approach to her really strange. It’s not malevolent, cold and boundaried like you’d often expect, instead heir method for majority of staff is placation, infantilising and being overly tactile. You can see that this causes real discomfort for a few members of the team who do tend to use a firmer hand, but neither way is appropriate.
In Laura Hamilton’s Boundary Seesaw model, she suggests that a fixed but flexible approach to working is best, where negotiation is key. Being too placating or over involved is considered abusing as is being controlling and punishing. The idea is in order to stay safe and caring within the boundaries, you opt for the middle of both, being flexible enough to tilt slightly each way when the situation needs it but never becoming polar opposites; anything beyond fixed and flexible in the centre of the seesaw, you’re abusing both your own boundaries and the boundaries of others. At times I’ve noticed this has caused real tension between team members where particular staff have told her to stop whining as they’ve dragged her away from the door and others have stood their hugging her. I experienced these odd boundaries first hand a few days ago.
There’s been a guy on the ward that was manic and obnoxious. He made a number of racial remarks against a member of staff and I ripped him apart for them. The irony was he’d use his Bluetooth speaker to blast out Northern Soul records… This was fine for a little while but it quickly got on my tits. I asked him to turn it down several times and he either ignored me or would purposely annoy me by singing and dancing about. It got to the point I’d just retreat to my room and then he began sitting outside the door to the female dorms playing it.
I was quite explicit to staff that if they did not confiscate that fucking speaker I’d have to smash his face in. Staff tried to retrieve the speaker with little success and then I saw my moment. At dinner, when he’d gone to the hatch to retrieve whatever culinary abomination on offer that evening, I swiped it with stealth like prowess, made it out into the garden and threw it as far as I could over the fence. While I was doing this a nurse was repeatedly asking me to give it to her but I was too far gone. Enraged and full of noise I couldn’t hear anything else. I went back in and sat down to eat my dinner and the voices praised me for the first time. After dinner, I passed my tray back through the hatch the nurse came up to me and said “when I ask you to give something to me, Hollie, you need to give it to me” I apologised… and then she hugged me. Rewarded me for damaging someone else’s belongings. Mental.
When I first came in my dorm was full. A woman that was mute, a woman that didn’t shut up and in the bed next to me a woman in her early 20s with BPD who is lovely. The talky woman was only in for a few days of my stay thankfully. She’d repeatedly say the same thing and then suddenly be tearful, then laugh then say the same thing again. It was exhausting and you could never get a bloody word in. Mute woman was mute, despite me asking her every day if she was okay. And then on the morning she left she asked me and the other girl in our dorm if we were alright… she did this in the most chilling way; a harsh whisper. I’m guessing that was down to her vocal chords rarely being used.
After talky woman left another came in who was dressed as though she’d been out on the razz for a week. She was clearly rattling and judging from her teeth she was either a crack or heroin smoker. She was nice, pleasant although obviously troubled and was battling with psychosis. She’d outwardly respond and become agitated quickly. On Tuesday afternoon around 13:25 she tried to take her own life by setting herself on fire in the bathroom. She had no knowledge of this until we were evacuated.
I was in bed, half asleep thanks to the flupenthixol. The alarm sounded but I assumed it was someone kicking off and someone had triggered their personal alarm. Then there was another alarm and the sound of one of the nurses screaming “SHIT… SHIT… FIRE!!! FUCKING FIRE, GET OUT!!!” It took a few seconds to register and then I could smell it; the stench of burning plastic and what smelt like hair but turned out to be a blanket and a shower curtain. I opened the door to the dorm and could see nothing but black smoke, as someone with fucked lungs I immediately struggled for breath and started coughing so hard I thought I’d cough up the only working one. The fire was to my immediate left in the bathroom and I had to walk past it to get out. I exited just as the nurse was shutting the door on it after she’d checked no one was in there. Amid the black I saw the flickers of orange, red and yellow and felt heat like someone had opened an oven. The nurse grabbed me and flung me towards the exit.
I don’t remember getting off the ward. I remember being half way down the corridor when I grabbed hold of someone trying to abscond and remember the relief of seeing my dorm mate who I knew wasn’t in the dorm because I’d checked but had no idea of where she’d gone. And then in the pandemonium I heard a voice say “I think it was me, was it me? I don’t know. I think it was, I had the lighter” I turned to see the woman I shared the dorm, with noticeably shaken and I held her hand. I knew that if it had been her things weren’t going to end well. I felt for her and at the time I thought it was just fire setting it wasn’t until much later she was able to remember what had happened.
We were herded like cattle to an OT room, then to a CAMHS clinic where I got everyone water from the machine and went into full peer worker mode. I sat with the woman who believed she’d started the fire and she made her confession. My heart broke for her. She sobbed and sobbed and I hugged her. That doesn’t come easily for me but she needed something and I couldn’t tell her it was going to be alright. I knew a spell in forensics was coming. She apologised profusely for doing what she’d done, how she could have killed me and the other girls in our dorm, that she just wanted it to be over. She went on to tell me that the voices had been really bad and she wanted a moment of quiet so she went to the bathroom for a cigarette with a lighter she’d smuggled in. In the bathroom, it felt like the voices were coming through the vents and echoing off the walls, telling her to set fire to herself. She wrapped a blanket around her head because her hair was still damp from her shower and set fire to the blanket. From what she described it sounded like she’d dissociated and when she’d realised what she’d done, threw the blanket in the shower, her arm singeing. She ran.
It took a while for the fire to be put out but it was relatively well contained in the bathroom with only smoke damage to the corridor and my dorm. The police came and interviewed the girl from my dorm and took her off to PICU. She’ll be charged for arson and endangering life and taken to forensics, most likely in the trust I work for soon enough. Hearing staff drag her away down to PICU was terrible, the screams and cries of a woman so terrified were unbearable. After she’d gone we were waiting for clearance from the Fire Brigade. That’s when my head started getting noisy; the adrenaline of everything had happened had left me and I was left with crippling anxiety and voices telling me I should do the same thing.
We were taken to a tribunal room and then back to the OT room where it was roasting. They brought us drinks and ice cream to cool us down but the heat, the claustrophobia of 20 odd people being in a small room and voices telling me to smash windows and burn the fucking place down became so overwhelming all I wanted to do was cut. My friend was on the phone to me for a little while, distracting me but it was short lived. I asked to go to the toilet and found a loose piece of plaster board in the wall – seemingly where someone had punched it. It wasn’t massively sharp but I knew if I ran it across my skin enough times It’d cut it. Now I have 4 of these horrible scabby scratches a few centimetres wide and a couple of inches long on the inside of my left wrist. I hate them because they aren’t as neat as a cut with a blade. I hate them because I had to do it in a toilet with some fucking plaster board. I hate them because as I was doing it the voices told me what a weak cunt I was and they were right. I hate them.
When we were finally let back on the ward I begged for my PRN. I have never done that. I might occasionally knock on the door and ask for some lorazepam but I have never physically begged someone to give me it before the way I did that day. When they said they hadn’t got clearance to access the clinic or see if any of the drugs had been damaged by the smoke I cried. I have never been so desperate for relief. It got so bad, they went to the neighbouring PICU and got some for me. I trapped myself in a quiet room away from everyone else told to stay in the day area and stared at the ceiling. I wanted to die. Again.
That night I struggled to sleep and kept hearing the sound of the alarm. The smell of burning was still clinging to the building and to me. House fires and burning alive is genuinely one of my biggest fears and I was worried this would start some sort of arson chain reaction. I asked for some more lorazepam and zopiclone and was quickly in a sedative stupor. Sleeping is now incredibly difficult without any pharmaceutical offering but no one has set any more fires as yet…
The ward is full of other characters. One in particular who is convinced my name is Laura and steals my vape every chance she gets. She is so high energy and seems to have some sort of comorbidity with schizophrenia and psychic ability. She knows things about my life she would have no way of knowing or ever overhearing. The 2nd day on the ward she came up to me and said “you saw Alex’s mum die didn’t you, she left him 100 grand” Alex is my brother and all of this is 100% accurate. I don’t know how she would ever know this. And the following day said “you hate her, don’t you – you hate Ella” Ella is my dad’s new wife, who despite never meeting I do despise. She freaks me out but at the same time I think she is wonderful.
On my first day on the ward a girl stole the crackers for my cheese and biscuits. I asked her why she’d done this and asked for them back, she ignored me and proceeded to unwrap them. Pissed off I asked her “does being this obnoxious always work for you” and she then put them down on the plate and walked off. This woman then spent the next few days glaring at me until she came into my dorm and asked if I’d like to hang out and could I play her some music on my phone… hanging out consisted of me watching her draw a picture, which was actually quite good in fairness; she signed it and gave it to me. It seemed strange to just sit there watching someone draw but was weirdly fascinating. She doesn’t barge past me anymore but then she doesn’t really talk to me either.
And then there was Cunty Cathy and I’ll name Cathy because she’s such a cunt. One morning at breakfast Cathy decided to sit next to me after ignoring me for 2 days since she’d been on the ward. She told me 15 times her daughter was a vet and that she lived in a lovely little village. Stuck-up, middle class, middle age, white bitch. Cathy then asked me to pull my sleeve down; not because the cuts bothered her but because it was such a shame for me. You know what’s a shame Cathy, how your children don’t like you enough to visit you, that’s a fucking shame. Then she went on to tell me about how she’s a runner and she’s only 53 – I thought she was in her 60s… so keep that up, love. She told me she was really put off by me at first and that it was because of my weight. Had I considered losing 2 stone because I COULD be really beautiful… This woman weighs herself every day and clearly has some sort of eating disorder and while I am more than aware I am the fattest of bastards, you know what Cathy? Eat a bowl of dick.
As you’d expect from an acute ward there’s lots of unrest and a lot of emotionally charged people. Most of which just want to be let out. It got to the point where their banging and screaming became so intense for me I asked to leave, to be met with “we’ll need to call a medic in to review you” I knew that was the case, I know how it worked but this made me so inexplicably angry. As an informal patient, I have been treated as though I am under a section 2. I’m only allowed out for an hour with my partner, my clothing is documented, the car’s registration is documented and I am grilled about my mental state before I am allowed off the ward.
I demanded to leave with immediate effect which they refused to facilitate. I rattled off a load of rights as an informal patient and they seemed very unmoved by this. I didn’t exactly kick and scream but I was close to. And then a nurse popped her head out of the office “I’ve spoken to the doctor on call. He advises that you reconsider your want for discharge as he may deem it necessary to hold you under section after the review” coercion at its fucking finest. Play nice or we’ll formally detain you. Through gritted teeth I spat out “fine” and stomped off back to bed.
In all honesty, I don’t think I did want to leave – on the whole I feel safe and contained here, far more so than I did at home and not being around Simon so much makes things a lot less stressful without 5 or 6 voices in unison telling me to strangle him. I do know I don’t want a long admission and that sooner or later I’m going to have to try home leave. That feels quite anxiety provoking.
Simon has visited me daily and still the voices are there, although no-where near as intense as they have been previously. My uncle, sister-in-law, brother and clinical supervisor from work have all been to visit me. The person I wanted most refused. About a year ago, when joking about me being mad with my best friend, he made me a promise that if I were to ever go back into hospital for whatever reason he would come and visit me. My friend lives about an hour and a half away from me, which isn’t a massive distance and I drove to see him a few weeks back. I was given an endless list of excuses about distance, time, back pain and that I’d be discharged soon anyway…
My life has been a long list of let downs, broken promises, disappointments and rejections but this one hurt me more than most. Once again, I’d been made to feel worthless and unimportant; like what I’m going through and how I’m feeling doesn’t matter to him. I cried and felt like a knob for crying. I scratched away at my arm with the sharp edge of a hand cream bottle and felt like a knob for doing that. I felt like a cunt for being his friend, for everything always being on his terms and what he wants, for never being enough and for him meaning more to me than I do to him.
He says he hates hurting me and that it hurts him but does it again, he says maybe we shouldn’t be in contact if it affects my mental health – this feels like more head fuckery. He knows what that would mean to me, he knows that I long for this to be a secure attachment to someone because of everything I’ve ever experienced and still it feels like he tries every now and again to push me away. It’s like BPD isn’t all one sided and although I am the only one of us with a diagnosis, so many classic BPD like behaviours get thrown my way with no acknowledgement to them.
I tell him how I feel and he makes me feel like I’m being unreasonable and then I end up apologising for getting arsey. It’s almost like gas lighting, at least that’s how it can feel. I hate that but he is so important to me and however pathetic and weak that makes me I never want to not be his friend. Because for all the times he is a cunt and he hurts me that’s outweighed by the times he goes out of his way to help me with things at work or university. He makes me laugh like no one else, he understands obscure references to things like no one else, he understands me like no one else. That’s partly because of the job he does but also because we’re alike and I guess that’s sometimes what makes our relationship so fractious.
I just wanted a hug.