Nineteen seventy one was drawing to a close and I was entering my sixth month as a student nurse. The months since July had begun to shape and mature me. I recall clearly and fondly my maturing but in many respects my adolescence still predominated. The arrival of the next student nurse intake, fresh and breathless from school and full of wonder provided me with the perfect opportunity to show how wise I was in the best schoolboy tradition. It was time to show the new boys the ropes.
As students we were witness to and participated in a form of abuse that was widespread and had it’s roots in an earlier time. I know that many readers will recognise the phenomena instantly. I call it “performing”. The “performance” is an interaction where patients are encouraged to maintain bizarre behaviour, often triggered by key phrases passed on from one staff member to another. Records of this practice go all the way back to Bedlam in the thirteenth century and beyond where performing was rewarded by food and non-compliance with starvation. Our form of “performing” was subtler. It was an elaborate ritual played out without obvious gain or loss.
In 1971, a star “performer” was a man called Geordie. He lived in a medium secure “locked” villa and was only allowed out in a squad of other patients. Geordie’s “party piece” was to “break free” from the squad and chase unsuspecting students, usually women, always under the watchful eye of the qualified staff who primed and pointed him. Geordie cut a terrifying figure as he screamed towards his victims but we all knew Geordie was a clown and harmless. This assumption was the beginning of my first lesson in the consequences of institutional abuse.
I had latched on to a new student called Marti Brown. Marti was a bright youth who was entering nursing from previous employment. I had offered him “the grand tour”. Our journey took us into a therapy area known as Lagan Basement where patients did various dirty jobs. The main work was stripping down old telephone cable into its component metal parts and filling trays with the various metals. Geordie worked in Lagan Basement. When we arrived, he was having a smoke. I had worked several times in his villa, we had seen each other but I didn’t really know him. I suppose I didn’t think knowing him was that important as I saw him only as a clown, “a star performer”. I called him over and he came reluctantly, looking puzzled and a little hostile. I remember thinking “Good, Geordie is going to give Marti a fright – this should be fun!” He stood squarely in front of me without talking. I made some banal patronising remark to him. I imagined a secret understanding based on some myth that, because I was a nurse he would immediately know that I wanted him to perform. In defiance of the myth, Geordie caught me squarely and firmly between the eyes with his forehead releasing tears of pain and humiliation as he knocked my arrogance and my credibility into touch in one go. “Don’t you ever fuckin’ talk to me like that again son”. He said in a low, menacing voice.
It was over before anyone else had noticed. Geordie was back talking and smoking in the corner and I left quickly as fear and anger fought for position inside me.
I have often thought of this incident over the intervening years although it took a little more maturing before I rejected performing as the human rights violation it obviously is. Geordie started me on this path. He did me a bigger favour than I ever returned. We encountered each other often since that incident but it was never mentioned again. I never really got to know him.
It would be too easy to assume that “performing” was a simple behavioural consequence of classical or operant reinforcement. A more likely explanation is that it is a survival or coping behaviour in institutional life motivated by Victorian values and the need to “know your place”. A ritual engendered of apathy, performed in dissociation or submission as a shield to protect internal dignity in a crazy and oppressive regime. For us, – for me at the time there was no conflict between my high ideals and treating people this way. It was one of the first and most frequent lessons for the new student nurse. A “normal” occurrence in an abnormal place.
There are other, current examples of abuse, many reported daily in the media but the media itself perpetrates many abuses in the guise of reporting the news. Society clamours for justice as each new abuse is revealed. We are overloaded with horror beyond imagination and as each new horror is brought into the light, the previous horror fades a little. Soon it becomes difficult to tell violent fact from violent fiction.
Newsmen apportion justification or blame in the name of “news worthiness” acting more as judges than newsmen. The media plays patronising propaganda games with us using words like “Yob” and “Thug” routinely to ascribe all violence as mindless, grouping people as “loony lefties”, “fascist boot boys” and “Schizo Killers”.
In THE SUN, Saturday September 16, 2000, a front-page leader, described as a “Showbiz Exclusive” revealed the “MENTAL WARD HELL OF CORONATION STREET’S TRACY SHAW”. The paper looked at the star’s fight against anorexia in 1994 and about her foundation to help other anorexics. The story captured the reader’s attention with the use of two-inch banner headlines. (Right) The lead into the main story described how “Tracy 27, was locked up with crazed patients” and how “Whenever you walked into a room, people would be rocking backwards and forwards. Some even had straitjackets on” Before entering the main story, the paper supplies other anecdotes of screaming and slashing and of a schizophrenic girl who got two dinners so that she could take one back for the “other one”. The point is that the media cannot resist the chance to exploit negative myths and stereotypes. The story would have stood up on it’s own merits. THE SUN in it’s frenzy of gratuity pays little heed to the fact that many of it’s readers are likely to be sufferers of mental health problems who may be put off seeking help with scare tactics such as this. It is as guilty of abuse as those it reports. Doubly so in that it refuses to be specific about the institution concerned and because it does not seek to put things right.
The most open minded and intelligent of us are bound to uncover personal prejudices as even the “serious papers” sacrifice facts for seller headlines in a mounting cynical campaign that preys on fears and feelings. We are missiles on a ride through the media empire’s pinball machine of violent anecdotes.
No one ever asks WHY and no one seems to care except those who are the victims of the violence or victims of those who “report” it. As “schizo” rates with “yob” and “royal rat”, who wants to listen to the schizophrenic’s side of the story? If this sounds like a sweeping attack on the media, it is how I intend it to sound. I want to grab your attention and focus it on a less popular story, as emotive and just as important, the abuse that exists within the psychiatric service. These are little abuses compared to Cambodia but on aggregate, world wide, adding history to the contemporary and counting subtle and unintentional abuse alongside the more obvious, there is a major human rights issue that deserves a place in the ranking with Cambodia. Not least because like Pohl Pot, it has survived without real comment or concern but unlike Pohl Pot, its consequences are still largely unreported.
There is much coverage of one side of the story and the tabloid dogs love to pack together and rip apart the human rights and dignity of the overwhelming majority of harmless sufferers by holding up a few as an example of the rest. The vast number of psychiatric patients are more likely to be abused than to be abusers. All violence is consequential and rarely gratuitous.
My story ended in violence and while I could have lived without the “Glasgow kiss”, I can understand why Geordie behaved that way. He recognised a small fish to whom his survival owed nothing and he treated me as he felt I deserved. Considering the abuse he tolerated, I feel that he let me off lightly.
If there is a process by which secret understandings can pass telepathically between psychiatric nurses and patients, I hope Geordie, who by this time has probably reached the “Ultimate Asylum”, recognises my acknowledgement as rapidly as he did my arrogance twenty-nine years ago.
Abuse can be unintentional but is nevertheless abuse. We are all guilty of it, or have been at some time and however good you think you are, complacency is the prerequisite to abuse.