I am going to tell you about the trials and tribulations of trying to get from mental illness to mental health.
I recall my first interview with a (child) psychiatrist, when I was a disruptive child according to my mother. I now see that as my having a disruptive mother with a child. I remember being told what an awful child I was, my mother told me. I had a lot of problems, however it never seemed to occur to my mother that the fact that I was born in South Africa, taken to Israel to live on a kibbutz for two years, brought to London, then to Canada and finally settling in London, might have some influence on this. These moves were something I had no control over, however, I go on about this point as later on in this piece of writing you will see that I had many moves within the psychiatric system and many a psychodynamic psychotherapist has liked to put forward the psychodynamic perspectives of it all. I have no definitive views, other than the omnipotence of my mother throughout my life, in particular my childhood and adolescence. I remember not going back to the child psychiatrist as my mother decided it wasn't necessary. I was referred to child guidance and continued seeing a child psychotherapist (clinical psychologist) until I was fifteen years old. I then approached my GP who referred me to another child psychiatrist. I felt that I wanted some of the autonomy in having psychiatric treatment.
I went to see this psychiatrist who was very sympathetic however told me that soon I would be sixteen years old and would have to be referred to an adult psychiatrist! However, I managed to stay with him for a year, until his head of department told him to tell me that sixteen was the oldest a child psychiatrist was allowed to see an adolescent for. So, I got referred to a new psychiatrist who was actually very nice. She was a psychiatrist who practised psychotherapy at some stage. I continued to see her, and finally I got allocated a therapist. He and I fought the whole time, although on reflection he helped me to develop my ideas about reality and fantasy. I was upset when my psychiatrist went on maternity leave during my therapy and I in fact left my therapist as I felt that I was getting nowhere and had no-one to talk to about it. I contacted my previous child psychiatrist and asked him for advice. It transpired that the private medical insurance that I had would cover psychiatric treatment so he suggested I get referred to a private psychiatrist. I did this and broke down and told the new psychiatrist my whole life story all over again!
I remember going to see this psychiatrist at this hospital, that looked more like a stately home than a hospital. When I arrived, he saw me sitting in the waiting room, and immediately rushed over and introduced himself. I was overwhelmed by the plush surroundings and the gentleness of all the staff who I had already had contact with. After spending the best part of an afternoon, it seemed, talking to him, and answering the million questions he proposed that I be admitted to hospital as I was very ill. I remember going home and discussing this with my parents. They wanted to see the place, so one Saturday we arranged to go and meet with the psychiatrist one more time. We were shown around by him and he introduced me to staff and patients. It had a very good feeling, I decided that I wanted to stay. My mother a bit saddened by this agreed to take me home and bring me back with all my things that I needed. I spent four months in there. I learnt a lot too. I met patients who were lovely people but mentally seemed so fragile and it was comforting to see the staff respond accordingly, that seemed the best part of it all. I remember the in-patient stay and think I was educated a lot there. Medication was used but therapy was considered paramount. I remember a recovering alcoholic begging for his medication however he was told that because he missed his therapy session he would have to wait for the therapist who was coming to see him first. I recall that as being hard but humane. I was discharged to the psychotherapy day hospital. I remember the long journey to get to Roehampton everyday, as I was living in a bedsit in Golders Green then. In the day hospital, there were four groups a day and it was expected you attended all of them. This usually lasted until 12 then there would be a group therapy session for one hour. In the afternoon we did various things like art and drama, or would go out into Central London to an art exhibition or something. I left after six months as I was fed up and no better, apart from the fact I had now been diagnosed as having bulimia nervosa and an obsessive compulsive disorder.
I went into my next private psychiatrist's office. He was horrible, but had a name for himself in eating disorders. He said that he was going to take me off all my medication. I came off gradually, and felt ill again, then I tried to kill myself. Unfortunately the medical insurance company would not fund my next hospital admission.
I was referred to my district general hospital. The psychiatrist was horrible. The first thing that came to mind was the sheer contrast compared with the private sector. The omnipotence of the NHS psychiatrist was paramount and little was thought into what I felt. I was admitted into hospital. The ward was pleasant. The staff horrid. They never responded to needing to talk. Seven months I spent in there. I befriended an occupational therapist called Jackie. She used to talk about asylums, she told me about Goffman. I was penalised for befriending her. I was told that she was busy, yet she was the Head Occupational Therapist! I asked my consultant whom I was supposed to talk to he told me that I talked too much and needed to shut up to get better! Jackie and I continued to talk.
I was discharged with four hours notice. My consultant said that I could go home, because I disobeyed his orders as he said that I wasn't allowed diet Coke, and he saw me drinking a can! I left and was refused any follow up.
I went to see my old consultant psychotherapist/ psychiatrist and cried in her office for a whole two hours. She took me back, reluctantly. I begged her for more therapy, she said that I needed time to heal the wounds and to let the anger settle from my recent experience. I remember her refusing to let me have therapy, so I went to an organisation called Open Door. That was interesting, my therapist there just sat in silence the whole time. Never said a word. I never finished the year she agreed to see me for. I went back to the psychiatrist/psychotherapist, after three years she agreed to let me have a therapist.
My year of good psychodynamic psychotherapy started. It was so good. He was a brilliant therapist, however as she had said, I needed someone very good. After a year, I was refused more. I applied to the Tavistock, but was told I was too mentally ill to engage in any form of therapy.
My own health district didn't think I needed any help at all except the minimal support of a community psychiatric nurse once a month. I went to my GP, we finally won the support of the director of public health who agreed to fund treatment in any NHS hospital that would take me. It took my GP three months, however I eventually found help and support at a psychotherapy day unit, where I have been offered long term support and the consultant isn't too overwhelmed by omnipotent tendencies. This has all been difficult, however my message is that despite the shaky ground for almost ten years, I have finally (I think) found a treatment unit that is appropriate.
Fenella Lemonsky