“You Are Completely Screwed” – A Firsthand Experience with Psychoeducation

Around me in the room I could see the different faces lit up by the big whiteboard raised above us. “There are these symptoms...” The psychiatrist would talk for long periods of time, while the nurses would sit quiet, nodding. I became skeptical and thought: “You are trying to talk me into something.”

Robert Whitaker has encouraged me to share my personal story after my talk at DISPUKs conference on psychiatry in Copenhagen, March 2019. Here is a small part of it.

I suffered a bad anxiety attack in late spring of 2017. I have suffered mentally for years. It all relates to my childhood. I was forced to live with two psychopaths for twenty years. That is how I regard my parents. My father would scream, “Shut up you crazy bitch” and kick my mom out of the car, leaving her somewhere off the freeway. In the back of the car my sisters and I would cry.

At an early age I got very mad at times. I would knock over tables and chairs crying and screaming. My mother’s response was to ignore me. She would sit, legs crossed, with a cup of coffee in her hand turning newspaper pages like I didn’t exist.

I ended up surviving it all by suppressing my feelings. I crawled up in a children’s tower at a playground and I used all my strength to make a hard shell around my feelings. I spent days crying and struggling and, in the end, I came down as a new person.

After my panic attack I went to a psychiatric assessment with a doctor called Søren.

When I visited him there was an endless stream of questions:

• “Have you ever had the experience that there are signs specifically aimed at you when you watch TV?”
• “Have you ever had contact with extraterrestrials?”
• “Are you religious?”

Søren was writing on a notepad during all these questions. The fourth and last time I visited him, he suddenly raised his head, looked at me and said: “I am absolutely convinced that you have a bipolar affective disorder.”

Then he stood up, walked to his computer and typed for a while. Then the printer started making noises and a piece of paper appeared. It was a pill plan. Søren explained to me how to increase doses, and the specific times I should take my medicine.

A few days later my nurse called. She asked how I felt. “I feel okay. Maybe I am a bit down,” I said. “Do you sleep at night?” she asked. “I have a hard time falling asleep,” I answered. There was quiet on the phone for a while, but then she started talking again: “I can see on your pill plan that you have to take Seroquel in the evening. How does that work out for you?” “I only take Seroquel when I have a lot of anxiety,” I said. She responded, “I can see that they are in your plan, and it says that you have to take them each night. They make you sleepy. Take one of those tonight and let’s see if that helps.”

She then started talking about a program called psychoeducation. “We have really good experiences with these programs. I strongly advise you to participate.” It was important that I participated.

The Psychoeducation Program ran for two months with a meeting every other week. We were eight participants of varying ages and genders. Then there was a male nurse. He was recently employed and was there to learn about the program. I often sat next to him. My nurse was also there and a female psychiatrist. We all sat by a long desk and there was a computer and some different graphs projected on a whiteboard. On the wall there was a painting of some figure raised above some other figures with the text: “Minority defender.”

First, we had to learn about the illness: How frequent it was and how it presented itself. They would show us a lot of graphs with curves going up and down. “You can get into rapid cycling where your mood changes fast. Here you are depressed and impulsive at the same time, which is very dangerous,” we were told. Thirteen percent commit suicide, they said. And so, psychoeducation started to take form.

Around me in the room I could see the different faces lit up by the big whiteboard raised above us. “There are these symptoms…” The psychiatrist would talk for long periods of time, while the nurses would sit quiet, arms crossed, nodding willingly.

I know that if you scratch the surface of any subject, you’ll always find people who disagree. So, I quickly became skeptical and thought to myself: “You are trying to talk me into something.” “This guy won the Noble prize,” the psychiatrist would say, smiling, like a used car salesman says that “this car has spare tires with it.”

One day, “mania” was on the schedule. “Some of you have asked for us to talk less. So today you are the ones that will talk,” the nurse smiled as she handed out papers to all participants.

I looked at the paper. “Mania – Symptoms and Action Plan,” it said. Then there was a diagram with two rows and two cells. We had to fill out symptoms on the one side and then state what we would do about it in the next. The nurse started talking: “Who wants to go first?” The male nurse had written “Symptoms” and “Action Plan” on the whiteboard. “Why don’t you go first,” the nurse said while smiling at a woman in her late 50s. “How do you first recognize that you are getting manic?”

“I have a lot of energy,” the woman replied. “But what happens before that? We are looking for the signs of the signs. And it must be something concrete,” the nurse said. The woman was quiet for a while. “I take my motorcycle for a ride,” the woman said. The nurse looked at the male nurse and he started writing on the whiteboard: “I ride my motorcycle.” “And what are you going to do?” the nurse then asked. The room was quiet again. I could hear the cleaning assistant in the hallway scraping the mop across the floor.

I was thinking to myself what I would say when it was my turn. I have noticed that there is a way of exercising power in psychiatry. If you don’t answer their questions it seems that the whole institution slows down or even stops. And then everyone is waiting for you to talk, so that things will get normal and run again. But you have to say the right things.

You often hear about people getting forced into the mental hospital and then having electricity forced through their brain. Forced electroshock treatment is still legal in Denmark in some instances. But there is also this kind of everyday use of power that is subtler and quieter.

When it was my turn I was prepared: “I have more motoric agitation in my fingers. I pick up a pencil or a lighter and spin it with my fingers.” Accepted. The male nurse started writing on the whiteboard. “Then what do you do?” the male nurse asked, pencil ready in the next column. “I call my wife, Ida,” I said. “Is there anyone else you can call?” the psychiatrist asked. “My friend Allan,” I replied. The psychiatrist’s body language interrupted, and the male nurse froze. “What about calling your nurse?” the psychiatrist asked. A moment later the male nurse had written “Call nurse” in my diagram.

Weeks later we were talking about mindfulness. I attended a mindfulness course through the municipality because I was on welfare benefits. We were having a discussion and I said that I thought that mindfulness was silly. When I close my eyes, it gets dark. “That’s all that happens,” I said, and continued: “All these smart solutions, which are supposed to solve all your problems, like mindfulness, drugs, cognitive therapy and so on are silly. It’s obvious to me that I am in trouble and suffering right now because my parents were complete psychopaths.” I explained that to survive my childhood I had to suppress all my emotions, but now I was starting to feel better because I had been practicing and getting better at feeling sad again. Sometimes I even get so far that a tear appears. It really helps. I had been escaping my feelings and emotions by going into wild projects or letting the anger take over, instead of letting go and feeling the sadness and relief it later brings. “I am not bipolar — I’m sad,” I explained.

Suddenly the psychiatrist interrupted me, loudly bursting: “You were completely screwed back then, and you’re completely screwed right now.”

“What? Am I screwed right now?” I thought to myself, looking down at my fingers, making a routine psychiatric assessment of myself as I have learned during my career as a psychiatric patient. Am I having a body attitude that reveals something? Do I have too much motoric agitation? I concluded that I was fine. But the way the psychiatrist reacted made me think of my father screaming at my mother.

I know that I am biology in many ways. My heart pumps blood cells around in my veins. But I am also something else. And I know that my problems are not biological. It is obvious to me. When my stream of consciousness starts racing I now know how to get back in contact with my emotions and it helps. So, it is a social problem.

Psychoeducation was like being part of an absurd roadshow from the 50s. In many ways it was hilarious. But at the same time, it was so damn sad. I had to be a good patient because I was completely dependent on psychiatry and my diagnosis to get peace from the social workers employed in the municipality. I knew that I needed care and calmness, and it felt claustrophobic that I couldn’t get it. This whole thing just made my recovery take much longer. If I hadn’t left psychiatry, I would never have recovered.

In many ways all the social workers, nurses and psychiatrists I have met are good people. Some are horny for power, but there are also some that want to help you. But they are still complete amateurs when it comes to relating to other people. They are just too filled up with all the psychiatric ideology and mayhem to see what is going on right in front of them.

After one session I was going to catch a bus to my friend’s place. When I arrived at the bus stop, the psychiatrist from psychoeducation was there. I could see by her face expression that she wanted to talk. Then she started talking. I’m not sure of what she said, but this is what I got from it: Every day when the psychiatrist is on her way home she goes to the baker and buys a bun. Then she eats it on her way to the bus. When she has eaten the bun, she saves the bag that came with it. There is an abandoned house close to the psychiatric center. It is worn down and the garden is now wild nature. There are often a couple of vineyard snails in that garden. The psychiatrist then picks the snails up, puts them in the bag and then releases them in the woods close to her apartment when she gets off the bus.

I didn’t really know what to say to her, because I really didn’t understand what she was talking about. I guessed that she was completely screwed so I made a friendly and understanding face.

The last time I went to psychoeducation, the psychiatrist said that some people would never accept the illness. I raised my hand and then the psychiatrist asked me: “Are you signing up for that group?” “I guess. Because I am not convinced by any of this,” I replied. Then she started ranting about trials with twins that demonstrated this or that. “It is biological,” she said loudly. The nurse nodded and nodded, and they got more and more aroused, until they lost their grounding. By then, it was impossible to reach them.

“Damn, she is psychotic. What should I do?” I thought to myself, looking around at the other members of the group. When I was younger I thought that psychosis was something that happens in the brain, but now I know that it happens in relationships between people that really get wound up.

While the psychiatrist was losing grounding, the male nurse looked at me and said quietly: “We don’t really know anything about these things.”

During my time in psychiatry I was advised many times not to study social work because I would not be able to work with human beings with my disorder. I also got different documents about my condition and how “professionals” saw me and forecasted my life.

In one of the documents the following was written:

Niels has exhibited symptoms of bipolar affective disorder for ten years. It’s a chronic disorder which will create problems for him in the form of rapid exhaustion, focus and concentration difficulties, comprehension shortfalls, low threshold for stress, short-term memory.

Niels has trouble relating to his current disorder which he must learn to live with both privately and in his work-life.

It is difficult to estimate his future levels of functioning because he does not wish to take mood stabilizing medication.

I know that all of this is not true. I have been teaching windsurfing for years, and I can easily relate to other people and handle stressful situations. Last year I started studying pedagogics and social work, and I am doing fine in this field. I know that I was in distress because I was sad and still searching for meaning in my life. I have found meaning in this field. As a professional I am convinced that people that are having a mental breakdown often need to do something new. If something doesn’t work out, it’s time to try something else. Get a fresh breath of air, you can say.

Therefore, I have decided to introduce the following initiative that addresses people that are in great distress:

“WINDSURFING FOR DISTRESSED PSYCHIATRIC DOCTORS AND NURSES.”

The primary goal of the program is to enhance the well-being of doctors and nurses.

3000 Danish kroner per participant.