and the format remains the same

It’s been a week since my last out-patient appointment.  A week since I had what amounts to a nervous breakdown.  A week since circumstance forced me to relive the trauma of the past.  I’m sure some would claim I’m merely being over sensitive.  But such people haven’t had to live with what I’ve had to live with.  And until I’m able to do something to address the fundamentals I don’t think I’ll ever truly be over it.  Rather I’ll be destined to endure relapse after relapse until I the day comes where I’ll totally flip.  Harming myself or harming others.  Either way the prognosis does not look good.

I suspect I’m over the worst, this time.  A couple of days locked in my empty room screaming at the walls until I could face the world without weeping.  Followed by hesitant attempts to step outside.  Culminating in my running away to a location where I can at least pretend I don’t have to go back.  Not that I really believe such pretense could ever work.  But my demons are not as quick to rise-up in an unfamiliar place.  And perhaps by the time I return those that do rise-up will be softer.

You pause for a moment to consider what you know.  The recent past.  Which bits of when happened before which bits of what.  For two weeks you’ve wandered around with a knife in your bag.  Other than an ongoing concern as to why it needs to be there you’ve not thought about it.  The voices which have spoken of it tell you not to worry.  That all will become clear.

Over and over you tell yourself you don’t want it to be like this.  Yet inside there is that cold heart of fury which will not see things different.  There are  mechanisms to deal with these problems, you argue.  Such mechanisms have yet to work, it replies.  You’ve given them their chances, it continues, now it’s time to take the law into your own hands.

It was an strange day.  I was in oddly good spirits.  Not that I was looking forward to the appointment with my Psychiatrist.  Rather that I was keyed up.  Twenty-minutes every three to four months leaves a awful lot unsaid.  So in part I’d begun wondering about what the important things were.  For a while I even began to consider why I bother.  Psychiatrists only hand out pills I don’t need.  They don’t have sufficient training to fix my mind.

Partially, I suppose, it’s because they are the legally mandated guardians of mental health.  One signature and your rights go bye-bye.  Right or wrong you can’t ignore them.  But at the back of my mind there is another reason.  I’ve encountered others who are unable to see within themselves what’s painfully apparent to others.  Others who lack insight into their condition to the extent that they harm those around them.  I’m not planning to fall into the trap of being close-minded.  And a psychiatrist is currently the only option on offer.

You step off the bus and in part your earlier good mood begins to evaporate.  It’s an anxiety response, you tell yourself.  These people have the power to take your life away.  A fact that’s not especially conducive to a therapeutic relationship.  Maintain your open and honest approach, you tell yourself.  Don’t allow your fears to push your concerns out of the room.  So you calm yourself with a simple breathing exercise and you carry on.

As you walk you see three figures in the distance.  For a moment you see ghosts walking towards you.  Faces from a different time.  Those you shared this place with.  Others like your self.  In the distance you see the walls behind which you were imprisoned.  Remembering the garden you helped landscape.  It was, after all, the only occupational therapy you and the other patients could conjure.  With an ironic smile you remember too how it is that after years of not smoking this is the place you truly learned to chain-smoke.

The figures from the distance move closer and begin to resolve.  The ghosts of the past evaporate.  Other than vague similarities in dress they are strangers.  Yet a vaguely feral look in their eyes suggests their world is not entirely unknown to you.  As they pass you begin to sense a vague feeling of ennui.  A memory of your past, you wonder, or a sense of their present.  Then you begin to consider if it comes from within, from the now.

Looking back I begin see how I slipped, then, into a mildly dissociative state.  A prescient heads-up, maybe, leading me into what came next.  Something not quite right, perhaps, in the way things were to unfold.  A little demon began suggesting it wouldn’t be that bad if I turned around.  Better, in fact.  But my feet were on the path.  I wasn’t going to turn around now without a good, externally offered, reason.

As ever passing the Genesis Prevention Centre amused.  An inane juxtaposition of thoughts regarding the first book of the christian bible perhaps.  Or was it perhaps something to with having a psychiatrist called Khan.  Then the voices started.  The ones which flood my mind with pain.  Not the ones I regard as benign.  But again I pushed through.  My standard approach of slowly and cautiously confronting what triggers the negative was not an option.

By the time I found myself walking across the car-park my mind had begun to fragment.  Part of me had begun to remember the traumas of past.  Remember the fury and the anger at the casually offhand and dehumanizing way I’d been treated here.  It was as if a piece of me had been dragged though time.  A sub-block of personality from the past was trying to find release.  A sense of another self straining to take over.  The little piece of me who wanted nothing more than to run away.  To find a place to hide, never to return.

But I’d already made up my mind.  So I reached within and found my inner strength.  Shaking like a leaf I found my way to the door and entered the Outpatient Department.

The first thing you find yourself thinking is that they’ve deliberately changed the time of your appointment to arrange this.  Because behind the receptionist is the very man who caused this.  You’d convinced yourself you would never have to confront this individual again.  Something you did to allow your psyche to survive the bad times.  Yet here he is.  Just as arrogant and uncaring as ever, a voice tells you.  And you nod because you agree.  Then you realize your vision cannot be considered impartial.  You’ve surely lost the ability to judge this fairly.  The voice concedes the point and your mind falls quiet.

With evident bravado you give your name to the receptionist.  Laughing inside because you know this is not your true name.  You’ll never see the real me, you want to shout.  You want to fill the air with derision.  To do what ever you can to deflate an ego which thinks it has the right to impose its will directly on others regardless of the wishes of Law.

Suddenly you remember another patient telling how ECT had been imposed by this man without being NICE about it.  And you truly know then how it’s not just you who has suffered, is suffering, at the hands of this monster.  Only today is not the day.  Now is not the moment.  There are better ways.  You’re here to see someone else.  So you rise above it.  Place it out of your mind and take take the best seat in the waiting room conducive to ignoring his presence.

But you can still hear his mind.  Feel the force of his delusion.  You’ve been around enough people who are mentally ill to recognize the feeling.  He’s dangerously insane.  The irony brings a smile to your face.  You too are insane.  Yet you’ve accepted it.  You’ve even developed insight into the nature of your condition.  It may contribute to you leading a dysfunctional life, but mostly you can compensate.  Mostly.  And for certain you know you’ve done no harm.

So you place your mind outside the box.  Think of other ways and other days.  For a moment it works.  The battle raging within subsides.

I don’t like waiting rooms.  It’s not the waiting.  Patience is, after all, one of my virtues.  It’s the empathy.  Sensing the other minds in the room.  Sensing too how they wish to occlude their pain.  To stop the waters of their mind flowing out into a world of which they understand little.  A world which manifests out of fear and uncertainty.  I can see too how they are disturbed by my knowing.  Yet I can avoid it as easily as a tree can stay dry whilst it is raining rain.  So I throw my mind onto other things.

I look within and try to understand the past couple of weeks.  Begin to wonder why, within that most private of inner senses, I can truly sense others.  Written on my face.  On the inside.  So I passively watch the others come and go.  And in the pattern I sense the time and place my mind needs to go.  Then I discover why it is I have a knife in my bag.  For deep within I discover a fragment of personality.  That piece of displaced self who suffered at the hands of the man who is now siting no more than a stone’s throw away.  It’s not so much that it was done, says its voice, as the way it was done.

How it can be that I saw this moment, I wonder.  Sensed this piece of me beginning to rise all those weeks ago.  Knew enough to place a knife in my bag.  Knew enough too to write the prelude to the story of this knife.

Consensus interdicts my urge to fight or flee, it replies, then offers a door to a third way.  Yet the door to the third way is blocked by this monster and his kind.  A viscous cycle designed to frustrate me into violence because I am truly different.  And then, as our enemy steppes out of the office, it asks me for the knife.  The knife is plastic, I say, I only wanted to catch you in the open, to understand your pain and your reasons.  Now you understand, it smiles, don’t let my death be in vain.

And with that the Tiger in my mind slips out and pads silently down the corridor.  An avatar of thought designed to destroy our common enemy.  Cats versus Dogs it smiles, it’s only natural.  The picture it paints is not pleasant.  And then the door closes and the monster is gone.  Once again I’m alone in a public place trying to pick-up the pieces of my past lives.

PTSD says another voice.  Very possibly, says another, you’re right.

You loose yourself, then, in the unanswered conundrum of time left in your mind.  You have the answers, you realize, you just don’t have the ability to resolve the dissonance.  Yet.  And this, you also realize, is not the place.  Then the person you’ve come to see disturbs your introspection.  Your wait is over.

Uncommunicative and sullen.  You’re sitting in an office.  Yet your mind is still sitting in the waiting room.  How do you raise concerns, you ask yourself, when the mechanisms which support you are tied to the area of concern.  When what concerns you stands behind the person before you.  And they simply cannot see behind them.  When the words you speak as metaphor are understood as literal.  When attempts to raise valid concerns are treated as symptomatology.  When your attempts to explore symptomatology are frustrated by miscommunication.

You listen to what you’re saying.  Aphasia perhaps, because you’re making little sense.  Distress so severe your personality is breaking-down and fragmenting.  But you knew this moment was coming.  So you slide around.  Until the psychiatrist can provoke enough upset for you to expose part of it.  You tried trusting, more than once, and so often in this place that trust has been abused.

So you hit him between the eyes with your ire.  Explain how it makes sense your way.  There’s a hint of aggression in your voice you find alien.  It’s directed outside the room.  Yet still it has no place here.

Then you hear yourself agree once again to cautiously consider the case for medication.  You still have a psychological addiction to the Lorazepam you were force fed on the ward, you realize.  It’s been two years and still you find you’re still at a place where you’d almost, but not quite, sell your soul for a handful of tiny blue pills.  And with that you fall into the matrix.  Because now you remember dreaming of blue pills a week before they were ever handed to you.  Penn & Teller, the Men in Black.  An impossible reality that happens to be true.  What do chemicals, you wonder, have to do with any of this.

Then it’s over.  And you’re out.  And for a whole day you don’t think about any of it.

Sometimes I truly begin to wonder if anyone cares.  If the sentiments expressed with big yellow posters in hospital waiting rooms really matter.  Are they just lip service to ideals that nobody really believes in.  It’s expressed as a principal so important the police have promised to get involved should the line be crossed.

Yet you’ve been on the receiving end of those who cross that line.  Those who will not stop hitting you until you hit back.  You try to object.  To stand up for yourself in a civilized manner.  Seemingly there’s none who want to acknowledge the problem.  And so they keep hitting you until you hit back.  And when you do they’ll tell your proving them right and hit you again.

You’re in denial, jokes the psychologist at the back of my mind.  No I’m not I reply.  See, laughs the voice, the frustration of a no-win scenario.

Regardless of how they appear are my perceptions of the world as I see it any more or less valid than yours.  Why then do none care to help me find a way out of this dark maze of inner conflict.  Why is it all I can see is a system closing ranks to defend itself from an outsider.  Regardless of right or wrong.  Or indeed the principals which the system itself was designed to uphold.

It’s not my fault, says a voice.  It was like that when I got here, says another.  Springfield psychology, grins Homer Simpson.  Prisoners dilemma, I sigh.  At worst selfish pride and inertia.  At best good old-fashioned wishful thinking.

For a moment you detach.  Look at the situation from an outer perspective.  Consider psychiatric services in the abstract.  An entity.  A person.  Then you apply what you know about mind.  And then you see how this one is suffering from a serious psychiatric condition.  A condition reinforced in the evident denial which has found its way into the minds of the mental health professionals.  Those that would support a system that has failed.  From MPs to Nurses.  Because they simply cannot admit their complicity.  Then a voice informs you how it’s seen as a better alternative.  Better to harm individual service users than harm the confidence of the masses.

Nobody believed Cassandra either, says a voice.

Still true, grins another.

The next day I convince myself there is no problem.  Until a meeting with my social worker triggers something dark.  The frustration is tangible.  And in my frustration I realize how loud I’ve become.  Everyone in Starbucks can probably hear me rabidly exposing the the low-points of my journey.

So you detach.  Step outside your life.  Begin discussing your views in the abstract.  Because what’s actual leads you to a place where you’d start screaming.  And no matter what you think of your social worker’s inability to understand, nobody deserves to experience that.

Your meeting ends.  And you step outside.  Still affecting a detached air.  You conclude the usual social pleasantries and walk to the bus stop.  The bus arrives and you step aboard.  You find a seat and the bus moves off.  Then you begin to feel the mask slip.  You’ve got another place to be.  Yet you realize this is not now possible.  So you scuttle back to your abode.

You’re running.  And you know it.  So you don’t feel so bad.  Calm almost.  As if your purpose, no matter how foolish it would appear, allows you to hold it together just that little bit longer.  Long enough, in fact, to get milk.  When you finally find yourself locked in a safe place you begin to relax.  You make a hot drink.  For a moment you begin to hope you were wrong.  That the meltdown you were anticipating has found a different way to manifest.  Or, perhaps, all you needed was a place of safety.

Fifteen minutes later you find yourself screaming at demons.

And you’re scared too.  Because what passes for your reality began anticipating this moment weeks before.  But that’s crazy talk.  And you know the world is not ready to hear that.  You’ve been down this road before.  Suicidal depression is a duvet away.  When you’re like this the only solution is to push.  So you walk the streets until you find a groups of friends.  And do your best to close your eyes.

I’ve been down this road before too.  I tell myself.  A pint turns into three.  A bad mood flips-up.  A crash-back is on the horizon.  So I find another place to hide.  Drinks are social.  Drink is not a solution.

A few illegal downloads with some others and you’re still melting down.  Even here you can feel the world hitting you.  The final episode you watch makes everyone feel creepy.

Two brothers feel the need to get into a psych ward.  They slay demons by trade.  A wraith is feeding on the patients.  One of the protagonists has started the apocalypse.  Letting Lucifer out of his box.  An invite is not hard to arrange.  A diagnosis of Schizophrenia is handed down.  One Flew Over the Cuckoo’s Nest.  My money is on the nurse.

This can’t be happening, you tell yourself.  It is, says another.

It’s not so much that the story triggers a flashback.  As it is a flashback.  Even the name of the nurse is the same.  Some of it’s informative.  One scene does a very good job.  A psychiatrist asserting his truth.  A patient asserting hers, aware of both.  The story of another.  A good example of assertive denial.  If only the Doctor could see.  How it is he’s displacing his fear onto his patient.

Time flips about.  The brothers are talking.  One asks himself why he’s always angry.  Time flips again.  He’s chasing the psychiatrist down a corridor with a knife.  And I’m at the moment my mind let loose.  Reliving my panic.

But it is Wendy after all.  Once she’s dispatched the brother’s escape.  More demons to slay next week, no doubt.

Synchronicity.  Coincidence.  Ideas of Reference.  Believe what you like, I see it all the time now.  Where once I did not.

That’s not normal, says a voice.

i know, i reply.