Philosophical Ramblings

Recent conversations have prompted me to consider how my experience of my mental illness has impacted the course of my life and how it has catalysed formations in character, conscience, my world view and my relationships with others.

Prior to my diagnosis of obsessive compulsive disorder (OCD) in early 2005, my life seemed to follow a predictable pattern of consistency, almost totally undisturbed and undisrupted by outside forces. Unexpected surprises occurred rarely. I had control, or at least a sense of it, and in that way I felt highly powerful. I felt that I possessed the power to control the direction and course of my life in the manner I so intended. However, I was deluding myself if I thought that change would not come and that things would remain in enduring stasis.

In the early months of 2005, disorder erupted from a place I least expected – my mind. Numerous uncontrolled and uncontrollable thoughts circulating my psyche. I could not control these thoughts, and they distressed me for two precise reasons; their content was obscene and contradictory to my most cherished beliefs, and I could not control the direction of my own thinking. The notion that I could not control my thoughts completely disrupted my sense of control and sent me down a spiral of anxiety. I tried immensely, and yet in vain, to exercise control over the content and direction of my thoughts. I tried incredibly, and yet in vain, to control and organise the content of my mind. The fact that I could not order my psyche and command my thoughts caused me great grief, distress and anxiety. In order to establish order in my disordered mind, to reverse or redress the distressing thoughts and to gain some sense of control over my life I engaged in compulsive behaviour.

My compulsive behaviour was exceedingly exhausting – it drained and depleted my energy and resources, and was exceptionally time-consuming. Sometimes I would wash my hands for more than the usual amount of time that other people would do so, though this compulsion was only occasional. While studying I would tear a myriad of papers from my note-book, even after only having written a single word on each one. I would walk forward, then having experienced a distressing and uncontrollable thought, walk back to the point where I started and tread the same path again. I would walk in and out of rooms repeatedly, compulsively moving backwards and forwards. My muscles became tense. At one point I almost fainted for having tensed so much as to have stopped breathing for a short period. My speech became interrupted as I would frequently stop mid-sentence and then repeat the sentence from the beginning again. Sometimes I would simply scream or groan. My screams were either of no particular lingual comprehension, or I would declare that these thoughts were not my own. Unless others reaffirmed this declaration, my anxiety would only continue to heighten. All such measures were taken in order to exact some sense of control over the uncontrollable.

My behaviour became highly prominent and noticeable, that inexorably my family became deeply concerned over my yet unnamed and worsening condition. After one particular episode after which I was reduced to tears, I was offended at my father’s suggestion that I should seek clinical assistance. My pride seemed hindered at that moment as much as my already diminishing sense of control. Eventually, my family convinced me to consult with our physician. She was reluctant to definitively diagnose me, as psychiatry was not her specialty, but she believed that the condition governing my anxious state was obsessive compulsive disorder.

Having being well-acquainted with my family, our physician sought to find me the best available psychiatric treatment, which apparently happened to be in Colingwood. In clinical consultation with psychiatrist there, my diagnosis was determined to be OCD. I was placed on two sets of medication, which I was very reluctant to accept. I was skeptical as to the side-effects of the medication and in particular to the effect it would have on my cerebral chemistry. Despite these concerns, I still consumed the drugs, one of which was to help me to sleep, since at that time my anxiety disrupted my sleep cycle and I was exhausted.

I must thank my father at this point. Colingwood is a far distance from where we live, and every two weeks when my appointment was scheduled my father, who suffers from a spinal condition, would drive me to the consulting rooms. Despite his own medical condition and the significant pain that it caused him, my father devoted his energy and time to assuring that his son obtained treatment. It was a labour of love. It is not, however, the magnitude of the action that seemed important to me, but rather the simple intention, love and passion that he placed into it. Thanks Dad.

Despite having received psychoactive drugs and consulting with a psychiatrist who was apparently one of Melbourne’s finest, my condition continued to deteriorate. The anxiety intensified to such a point that I was unable to dress myself or even tie my own shoe-laces. The impact on my study became noticeable as my grades declined and my abscenes from school increased. At this point, as I spiraled further into anxiety, my family and particularly my father, believed that hospitalisation was necessary. I feared that suggestion for two reasons; one was that I was not very sociably at the time and I was aware that hospitals were social environments, another reason was my perception of what an institutionalized environment was like – white walls and sterility. This discomforted me further, as did the feeling that being hospitalized would indicate further the status of my lack of control over my life.

Consulting with my psychiatrist, two psychiatric nurses a mental health worker named Craig over the telephone, it was determined that the best course of action was clinical inpatient care. At approximately the middle of the year 2005, I was admitted into the Royal Children’s Hospital Banksia Unit on Mavis Street, Footscray.

My first day at Banksia was actually rather short. I arrived for admission only to discover that there were no available beds at the time. Instead, I was given a tour of the unit by one of the regular nurses, a Macedonian lady. My original perception of what a psychiatric unit is like was shattered. It was not the stereotype I expected. No white walls or sterile environment. It was a colourful, warm, cosy, modern, almost homely environment. There were two wings, the North and the South. I would later find that I was to be situated in the South wing. Where each wing met was the nurses station and the lounge, with couches and a television set. The kitchen was also not far from there and looked out onto the rolling grass outside. Outside, there was a basketball court and a pond in which there apparently lived a turtle, thought I never saw it. I went home that day only to return a few days after. Admittedly, I felt relieved to be going home.

On the day I was admitted, before I left home, I recall my grandmother weeping. The entire situation saddened her, and probably added to her worries. At that time she would remark how very few members of our family were in good health. My grandfather was ill, suffering from gout and cardiac problems. My father suffered from his spinal condition, and my grandmother herself was not ideal in health. Her grandson being hospitalised only further compounded her concerns. However, I must thank my dear baka. She comforted me in my most agonizing and tumultuous moments. Even though she could not fully understand the notion of a mental illness, her support remained unwavering and her voice was soft and gentle and her message of compassion came from the heart.

My grandfather, severely ill himself and frequently hospitalised, also did not understand fully, yet he could understand what it was like to be hospitalised and reflected that it was not a pleasant indication of one’s health. He empathized with me. During the night, neither of us could sleep. He could not sleep because of the excruciating pain of his condition; I because of the tumult in my mind. I must thank my dida for his support, which like my grandmother’s, was unwavering. Despite whether or not my grandmother and grandfather could understand the concepts that mental illness entailed, they could understand suffering, and so they could still emphasize and support me regardless of whatever insight into psychological disorders they lacked.

On the day I was actually admitted into the Banksia Unit as an inpatient, I was first placed in the High Dependency Unit (HDU), though I do not know why. While watching Harry Potter and the Prisoner of Azkaban, one of the clinical psychologists spoke to me, though there were many awkward silences. I had spoken to a psychiatrist before, but this was the first time I had spoken to a psychologist. It seemed different, and I was uncomfortable with the situation. After she left, I was alone for some time, that was until a head peered through the door. His name was Peter. He was slightly shorter than me, his head shaven and a supporter of the Western Bulldogs in Australian Rules Football. He came in and sat with me in HDU and we watched the Potter film together. A year younger than me, he was the first patient that I had conversed extensively with and befriended.

Conversing with Peter and the many others I would meet in Banksia helped me to break through a social barrier of isolation. In vainly attempting to control my thoughts and organise my mind I had focused inwardly into the realm of psyche, and in doing so had isolated myself from the outside world. One of the psychologist’s at the unit observed this and remarked that I was not really connected with my sensory experience of the world, and was instead too inwardly focused into the mind and thought. I feared conversation and interaction with others. Slowly, however, through my many conversations with the people in Banksia, this isolationism began to crumble and so began the process of reconnecting my mind to my sensory experience.

While in the inpatient unit, my medication quantity was increased, and I was allocated to a particular psychologist. Her name was Lorraine. On our first consultation, we conversed extensively for well over the prescribed hour. Our successive consultations were within the prescribed time limits. During one particular session, a fire safety drill had occurred. We were unaware and so did not leave the consulting room. Despite the fact that the door of that room clearly indicated that people were inside, no one came to advise us to leave the room during the fire drill. If it were not a drill, Lorraine and I would have been left in our session while the fire consumed the unit. Lorraine was a wonderful psychologist. During our sessions, I gained profound insight into the nature of my condition. Insight, which another psychologist later remarked, was fundamental in my recovery.

There was a running program in the unit, much like a time-table, where an activity was allocated for each day to keep the inpatients socially, physically and emotionally active and contemplative. Included in the program was pilates, an art class, general class, several group sessions declaring with issues, and an outdoor excursion that occurred weekly. In the time that I was there, those excursions were to Williamstown for gelati and the aquarium where one of the nurses had mistaken an unknown man for me, much to her own embarrassment. I recall on that excursion to the aquarium, we participated in a wild simulator ride. Several of the people I had befriended screamed. I simply shut my eyes, rather than risk feeling physically ill at the swift hurling motions of the ride.

One particular group session, which I believe was called ‘Issues’, took my interest. Lorraine coordinated that group. I do not recall exactly what we were discussing, but one of the inpatients said something that engaged my curiosity. Perhaps we were talking about what meaning there is in life, and the girl’s response to it was along the lines of ’sex, drugs and rock and roll’, and getting pissed and smashed (ie: binge drinking). Though I did not say anything, I did not understand where such an answer could come from. It seemed very blunt to declare that the purpose of life was self-gratification. It even seemed to drain life of any meaning or purpose beyond the self. To this day I cannot understand that girl’s response, but I do not judge her for it, merely wonder why it is she thought thus.

While in Banksia, my family and I had at least two productive family therapy sessions, during which we discussed how my early family life and childhood had impacted upon my current state. My mother felt immense guilt after those sessions. During my early childhood, my mother was encouraged to ‘push’ me, so to speak, academically, since my grades were poor and I seemed to retain little of the content of the curriculum. That ‘pushing’ often resulting in evenings of frustration and tears, with my mother yelling and me suppressing my voice and my feelings deeply – bottling them up, confining them into some deep part of my psyche. I wanted to express anger, yet I did not. I suppressed my anger deep inside, thinking that perhaps it would go away. I forgave my mother, yet I still felt that she believed herself to be guilty. I understand that her intentions were pure still, and that she still does, even as she did then, want the best for her sons. Her support, along with my fathers, has been important in helping me to find the right treatment and to proceed in seeking recovery.

In Banksia, I met many wonderful people, many of whom I befriended. On my first day, I was less than socially inclined to engage a conversation. However, I was forced to defy my inhibitions when confronted by the warm welcome given to me by the in-patients with whom I sat at the kitchen table for lunch. Vittoria, whom was known as Vitty, was the first to speak to me, with a warm and welcoming tone. Her friend next to her, Ashleigh then joined the conversation, as did Elaine, and Peter whom I had previously met. Quite frankly, I did not expect to be received so kindly by strangers, but I was welcomed convivially and Vitty, Sami, Ashleigh and myself fast became friends. During our many conversations, I felt quite at ease to be with people who could perhaps understand my own condition because of their own experiences.

I had particularly developed a very close bond with Ashleigh. She was two years my senior, completing Year 11 and possessed a vibrant smile, gleaming eyes and dazzling red hair. We developed a fondness for each-other, one that was surely noticeably to both nurses and patients alike given that one of the nurses questioned whether Ashleigh and I would remain in contact after our discharge, and Amy’s comment that the rules declare that there are to be no romances in Banksia. Of course, the rule prescribed no romances in Banksia; it did not mention anything of romance beyond Banksia. I recall Robert, one of the most eccentric persons I had met, remarking that the sun would come out to shine when Ashleigh smiled. It did indeed feel that way to me.

Ashleigh would lay in my lap on the couch as we watched television together. We frequently played ‘Around the World’ on the basketball court outside, during which Ashleigh demonstrated her profound netball skills. She was able throw the ball through the hoop while standing with her back towards the ring. Our rooms were next to each other and so we would often knock the wall to each other during the evening. One evening, however, I heard soft cries coming from Ashleigh’s room. She was in tears. I came out to the hallway, not certain if it were here weeping that I could hear, but in those cries I could discern pain.

Another person whom I met in Banksia was Sarah. Sarah was short and thin and her skin was pale. She had a tube in her nose, whose function I did not know for some time. She was often silent and did not speak. If she did speak, it was never too loudly, but in a mild tone. At the beginning, I wondered, though I did not inquire, why Sarah was in Banksia. One evening I was to find out. We were sitting at the table, conversing convivially over dinner as Sarah sat in silence staring at her meal. She began to cry, and the conversation dissipated into a terrifying silence where naught could be heard but Sarah’s weeping. It was in this moment that I finally understood. Sarah suffered from anorexia. I was also soon to learn that Sarah had spent the longest time as an in-patient in the ward – some two years or longer. Since discharge from the unit, however, I have still maintained some contact with Sarah and was pleased to hear of her discharge from the unit also. Sarah had gone on to attain a professional qualification, in aged-care, and carried on with her treatment.

There was a particular episode though that highlighted for me a failure of either cultural understanding or the mental health system or both. Since discharge, Sarah had relapsed and was in a terrible situation in which she was contemplating suicide. I think she overdosed on some substance, though I am not sure of the details. Sarah bravely summoned the inner courage to seek emergency help, which she obtained. However, once hospitalised, she was told by a police officer that was ‘wasting’ a bed. I contemplated what would have been said or thought if Sarah had not sought help and died. No doubt that some would have inquired why, oh why, did she not seek help. Yet Sarah did seek help, only to receive it grudgingly with a comment that seems to suggest that she is unworthy or undeserving of help. I applaud and admire Sarah for her courage to continue her quest for recovery, despite comments such as those which seem to highlight a lack of cultural understanding towards those who suffer from mental afflictions.

A person suffering from any affliction, whether physical or mental, simply requires a person to reach out to them, to connect with and communicate with them, and to touch their lives. Sarah needed someone to open a window of understanding, to connect with her on a personally level and to communicate with genuine compassion. She did not need nor did she deserve to have the suggestion that she was wasting space. Any such a suggestion could perhaps exacerbate one’s feelings of worthlessness.

After two weeks of in-patient care, I had gained insight and the coping strategies and mechanisms to combat my condition. What I had learned is that often we engage in destructive behaviour simply to cope. Not all drug abusers are addicts because they simply love the drug. Some engage in destructive exercises and other extreme measures simply to cope and gain a sense of control. To improve health status in such a situation, one must be empowered with more efficient, non-destructive, coping strategies. I believe that a good mental health system must seek to empower individuals by providing insight and such coping mechanisms. Leaving Banksia, I was equipped with both of these, thanks to the numerous nurses, psychologists, psychiatrists and the people I met there. It was in meeting these people that I was empowered, inspired and re-invigorated. To these people that I had met in Banksia I owe a great debt of gratitude and thanks, not only for the insight I had gained in discussions with them, but also for their understanding, their compassion, and their friendship.

I resumed out-patient care at a Royal Children’s Hospital (RCH) outpatient clinic in Sunshine where I was treated mainly by a psychiatrist named Stephen. There was a period while I was being treated by him that I was considered for re-admission into Banksia, despite my undeclared objections. This did not eventuate and treatment at the outpatient clinic persisted until the time where my age prohibited me from continuing treatment at the RCH. I was discharged and arranged an interview with Orygen Youth Health, an organisation that could have taken me as a patient. In my consultation it was determined that my condition had improved significantly, and so my application was declined since Orygen had limited spaces for clients. I then resumed treatment with a psychiatrist in Sydenham who maintained my medication levels at a constant norm.

There seemed to be at this point a period of normality and order. I was able to engage my studies, to share relationships with other people and to enjoy my youth. However, this was not to last. First, my friends noticed, and then my family. I had relapsed into old habits and the spiral of anxiety reintensified to a noticeable degree. To me, it seemed as if the medication was beginning to have the opposite effect, or at least, I felt its side-effects impact my daily living. I was frequently fatigued and could not concentrate or adequately focus, which further compounded my frustration. At the recommendation of my family and friends, I saw another psychologist. This time locally.

Perfectionistic tendencies became apparent at this point. I began to view my worth, success and happiness as intimately and intrinsically linked to my performance and productivity, and thus I allocated copious portions of energy into self, at the expense of my relationships with others. I consistently evaluated, assessed and compared myself to others. A perpetual report card. Perfectionism, I realised, is ultimately destructive of one-self as it involves immense devotion of energy and resources into the self and ego, rather than in giving, to relationships and to reaching out and connecting with others. It can lead to self-absorption and valuing only the superficialities of status and notoriety, rather than considering a person’s innermost heart. I still struggle to overcome perfectionism.

Friendship with Ashleigh and my other friends has empowered me in many respects to attempt to overcome my OCD and my perfectionism. Ashleigh has always presented me with her unwavering support, even in times when my frustration lashed our ferociously against her. It is to my family and my friends that I owe my recovery, for their support, their understanding and their love. Thank-you all. In my times of despair and anxiety, you were there, you reached out to me, you connected with me on a personal level and gave me hope.

To all people who suffer from a mental affliction, there is hope. There is always hope. Sometimes we just need someone to show us that. A support network to sustain us in our times of despondency. Friends to lift us up when we are down. A fellow human being simply to reach out and touch one’s life. These the things that can help someone with a mental illness tread that worthwhile path of recovery. These are the things which give one hope in abundance.