Multiple Sensors

“It’s like having a heating system. If the temperature sensor for the thermostat is in a spot that’s become drafty, the heat will never turn off even though the room is scalding. If you add a few more sensors located around the room, you can get the system back under control.” - Elizabeth Young (quoted by Andrew Solomon in The Noonday Demon)

I am in a residential treatment center. I gag on those words because, to paraphrase the venerable George Carlin: society has sanitized and lobotomized the words we use to describe unpleasantness. As if we all can’t read between the lines.

I am here because my system (read: brain) has some inoperative sensors. The residence in which I stay provides a whole buffet of sensor options, but, unlike a traditional buffet, all options are mandatory, and I must eat my fill.

A psychiatrist writes prescriptions. A counselor works on DBT. Social workers lead groups. Nurses drive the shuttle bus and administer medications. All are involved as a part of my treatment team, and all are on the lookout for behaviors or statements that might precipitate a serious dip in my mental health.

I’ve noticed that I’m much less angry at myself here than at psychiatric hospitals. Here at least, the food is good and there are no locked doors. I’m still upset that I’m here, and still acknowledge my need to be here. That is DBT lesson number one: two opposing forces may be simultaneously true.

The task before me: learn how to operate between those forces.

Life in a Psychiatric Hospital - Part 4

Group is a regular part of every day in a psych ward. The type of groups may differ between facilities, but they are invaluable to the patients and to the caretakers.

Facilities have different rules on expected behavior. Ridgeview required me to attend all groups in order to get the privilege of dining in the mess hall. Those that avoided group, got their food delivered to the ward in a styrofoam box. At St. Joseph, food was delivered to the unit so there was no real penalty if you did not attend group, but, since group is a primary method for determining a person’s readiness to leave, attendance is a good idea if you want to get past the locked door at the front of the building.

Most of us went to group begrudgingly. If nothing else, it passed the time. Also, the staff turned off the television during group time.

Looking back, I would say that Ridgeview’s groups were focused on everyday life skills, and St. Joseph’s groups were focused on communication and interpersonal skills.

Behold! My awesome hot plate!

Behold! My awesome hot plate!

I definitely enjoyed group more at St. Josephs, because they were more fun.

Reminiscent of a kindergarten class. Feel like coloring? Go color! Want to play with blocks? We have all the blocks! I even learned to grout and made my own hot plate over a three day period.

At this point, some readers may be wondering, “Really? Coloring books? This is supposed to make you better?” No. Group does not make a person better. It facilitates recovery because human beings are social creatures.

Isolation can destroy a person. Ask any prisoner who has spent time in solitary. Or, just watch this video about Harry Harlow’s Pit of Despair experiments with rhesus monkeys:

Now, I am an introvert’s introvert. I find nothing more enjoyable than reading a book on a lazy Sunday afternoon, and never saying a word to anyone for the entire day. That said, I am human, and I do not do well with extended periods of isolation. No one does.

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Group, in the context of psychiatric care, establishes a place where someone with a frayed mind can get their bearings under controlled circumstances. The depressed person who cannot speak can, at least, listen.

The person coming down from a manic episode can ease out of it with people who won’t judge. The addict who just got through the worsts of withdrawal can talk about their experiences.

The hospital is not real life, and group allows for an approximation of life. As such, it gives insight into a person’s state of mind around other people that is objectively measurable by those providing care.

For instance, for the two days that I avoided group entirely and stayed in my bed, I was not ready to leave the hospital. Because I likely would have gone home, got into bed, and avoided my life. But, oh how a nurse’s face lights up when you walk out of your room and sit down in group! Even if you do not say anything, your presence shows a willingness to engage with others.

Group is a means to an end. It gives patients the opportunity to experience time with people in a controlled setting. Combined with daily therapy, consistent medication, a good diet, and sleep, the whole treatment becomes greater than the sum of it’s parts. It is a staggeringly simple idea, but that is why it works. Put a human being in varied, yet safe, social situations and give them time to learn how to exist with others.