Training to be a psychoanalyst has made me realise how well the NHS cares for the mentally illby Anna Blundy / June 22, 2011 / Leave a comment
When I tell people that, as part of my psychoanalytic training, I have the privilege of observing ward rounds on a secure psychiatric ward in a big London hospital, they shudder. “I wouldn’t dare go in. They might not let me out!” one friend said. So many of us are in some kind of therapy that the idea of tipping over the edge into real psychosis, of being sectioned and treated forcibly on a ward full of maniacs, is a nightmarish fantasy we prefer not to contemplate.
The reality is that, for many patients on the ward, being sectioned turns out to be a solace. It is the only way out of a state of mind that has become unbearable: the last resort. Here, someone else will take responsibility. As the psychiatrist I am assigned to observe puts it: “This is a place where people can allow themselves to disintegrate and we help them put themselves back together again.” This is usually achieved by administering a large and ongoing dose of anti-psychotic medicine.
When I started observing ward rounds I was shocked by the extremity of suffering—and that the recommended treatment was powerful drugs. I had thought that drugging people up to the eyeballs, especially against their will, was the antithesis of psychoanalysis. (Not to mention that when a 6ft 4in body builder, restrained by a posse of policemen, doesn’t want to be injected, he really doesn’t want to be injected.) But I had never seen seriously mentally ill patients close up. When the extent of someone’s contact with reality is that they don’t bump into the furniture (much) and they routinely pour bleach into their eyes to cleanse the demons, talking to them about their early life is patently absurd. The psychiatrist I observe says psychosis is as dangerous as cancer and must be treated as assertively—with the right medicine.
There was a broken and silent 20 year old who seemed almost catatonic following a suicide attempt. He mumbled something about his mother who was, it turned out, waiting outside the room. She came in, a disturbing and chaotic alcoholic, pleading and desolate. As the nightmare was played out right there, it was easy to see how her son had reached a state of such desperation. The psychiatrist said; “I think we’d better increase his dose.” I was still sceptical.
Yet within a month he had made an astonishing…