The Psychiatric Hospital Part 3 - Seclusion
/My seclusion room story requires a bit of set up: after voluntarily committing myself to Ridgeview in 2011, I was given a brief tour to get comfortable with my new little world. Part of that world was a seclusion room consisting of four walls with a solid, rubber mattress on the floor. Why solid rubber? So that someone could not strangle themselves with sewn fibers.
Brilliant white light radiated from a fixture mounted flush with the ceiling. Why flush? So that someone could not hang themselves from it. A substantial, but easily opened door with a large window separated this little psych ward from the big psych ward. Why the window? So staff could keep an eye on the patient. The door was strategically located directly across from the nurse’s station for even easier tracking.
I distinctly remember thinking: “I’ll never be in one of those.”
Life, I learned, loves irony.
Bedlam from 'A Rake's Progress' 1733, By William Hogarth - “Bedlam” was the byname of Bethlem Royal Hospital due to the noise. Visitors were welcome! For a shilling or two, you could walk through the hospital and gawk at the crazy people.
After a hospitalization for extreme panic attacks in the fall of 2016 I entered an Intensive Outpatient Program, or IOP for several weeks. Basically, you go to the hospital every morning, stay till three, and get to sleep in your own bed at night. This program gradually gets a person into a more regular routine, and they can more easily transition into the life they choose to live.
My panic attacks were a side effect of a new medication I was cycled onto by my psychiatrist. Wellbutrin is a fantastic anti-depressant as it falls into a class called “activators”. Depressives get a jolt of energy once they titrate up to the 300mg theraputic dose. However, if you have an underlying anxiety disorder, medications in the activator class act like NOS to a turbo-charged drag racer.
I have never experienced such terror. I write this because it explains why I needed the seclusion room on that crisp Friday afternoon in late November.
“They’re looking at me.”
“They’re spying on me.”
“They’re judging me.”
Such are the thoughts of a paranoid mind in the early stages of a panic attack. Truth be told, the nursing students on their psych rotation had no idea who I was, and they certainly had no evil intentions toward me. But, my mind was unaccustomed to seeing them. The unexpected and unwanted presence of several new faces in my safe hospital ward triggered a massive panic attack.
Almost entirely paralyzed by fear, I somehow got a nurse’s attention and communicated with him by grunting and shaking my head “yes” or “no” to his questions. He gave me a high strength, anti-anxiety medication, which was nice, but at that point, it was about as effective as putting a single sandbag in the path of a massive flood. Using our meager method of communication, we agreed that I wanted to go into the seclusion room to feel safe and ride out the worst of the panic attack, but I could not move.
Four nurses picked me up in my chair and placed me in the room. They lifted me out of the chair, removed my clothes and put a paper gown on me. Why paper? Because it’s unlikely a patient could hurt themselves or others with pieces of paper. A nurse asked if she would be safe sitting in the room with me. I grunted, “yes,” but my mind was on fire, and after a few minutes I told her: “I need you to get out of this room and lock the door.”
She did, and I lost it.
You already know that seclusion rooms are designed to prevent someone from significantly hurting themselves. I knew this too. So I used the room to cause pain that I could control.
I punched the walls. I chained combinations together until my knuckles bled. I screamed. I paced. I raged. When I could no longer lift my hands, I slammed my head against the wall.
I did not feel agony. I WAS agony.
I unleashed all of my panicked energy while the nurses and doctors pleaded that I stop. Protocol dictated that they stay outside the room. Sure, it would have been nice to have someone restrain me, but the safer course is to let a person burn themselves out until they are no longer a threat.
Eventually, everything slowed down. I collapsed onto the mattress and the door opened up. Several large men secured my limbs and put me on a gurney, to which my wrists and ankles were temporarily strapped.
A nurse injected me with Haldol, an antipsychotic drug that “decreases excitement of the brain.” It’s the human equivalent of horse tranquilizer — you get real chill, real quick. Then she gave me another injection to counteract the side effects of Haldol. I woke up two days later with a pounding headache and swollen knuckles, and all I could think of was how wrong I was so many years before.
Seclusion rooms serve a purpose. They’re the final tool when a patient is out of control and needs protection. While I thought I’d never go into one, I’m certainly glad it was available when I needed it.
