A Year on the Inside by Donna Holder

Donna Holder worked as a Chartered Psychologist for approximately twenty years. In 2019-20 she had a breakdown for which she was sectioned and placed on locked psychiatric wards for four months. This is an extract taken from her forthcoming personal memoir. 

It’s late in the evening but people are still up and about. In an offhand way I’m shown a room. It’s about ten foot by five foot and it has a huge lock on the door. There’s a sink in the corner where the water runs for a set amount of time then switches off and a window that opens about an inch wide with the cheapest blue curtains I have ever seen.  I tug at the curtain and satisfyingly one of them comes down. The furniture is all fixed to the floor. Iincludes a shelving unit where you can fold your clothes. But I don’t have any clothes. I don’t have any night clothes. I don’t have toiletries or a toothbrush. I don’t have a computer. I am physically and mentally bereft and I’m angry. 

When I saw the bed I thought it was some kind of joke. There must have been a mistake or a plot hatched. It isn’t a bed. It’s like a children’s sleepover mattress. It’s made of bright blue plastic and comes in one piece with no separate mattress and base, so it’s low to the floor. Blazoned across the bed, written in huge letters, is the word, ‘Clinell.’ I’m standing in a daze and am sharply told to follow a nurse, at least I presume it’s a nurse, to a linen cupboard.  She talks to herself in short spiked tones. At least I assume she isn’t talking to me. Then she passes out some blue sheets made of thin cotton and says, ‘here are your blankets.’ She gives me two or three, but I’d need about six or seven to keep warm. When I try and tell the nurses that the material is thin cotton they hotly deny it, and keep referring to the offending articles as blankets. Nobody offers me a toothbrush or toothpaste and no one seems to care that I’m in soiled clothes. In fright and fear I’d urinated on my trousers, but this has passed everyone by.  

I am truly on my own. I lay down on the bed and no one comes to explain anything. No one even comes to say goodnight. But thankfully I manage to go to sleep.   However, about fifteen minutes later, I’m woken up by the ’nurses’ doing their rounds on night shift. They come with powerful torches to rooms that are already open and shine them into your face every fifteen minutes. This is part of suicide watch. The less vigilant nurses allow you to leave your door open and look in, or shine their torches, every hour. But no one ever asks you if youre ok, or if you’d like to talk.  

I get up the next day and I’m still confused, angry and bewildered. I’m wearing the same urine stained clothes with a ripped trouser leg. I wander down the hallway and realise, without being told, that the room at the end is a dining room. There’s cereal or toast and a woman behind the counter. She’s the friendliest person I encounter. She asks, ‘are you a flora girl or a butter girl?’ I take the butter and sit down in an easy backed plastic chair. However, I’m quickly rebuked and told to sit at the table and chairs. I do so slowly, not as an act of sullenness but because the other patients make me feel ill and put me off my food.  

There’s an Italian nurse sitting at a table and he’s slicing a banana into his hot porridge and the thought of the texture of it in my mouth makes me feel ill. Like slime. I push the toast away and grab some orange juice from a trolley that’s only available at breakfast time. Later, the second time I’m admitted, when he accompanies me on a walk around the grounds because no one can go out due to COVID, I ask him about Italy. He turns to me and says, ‘If you’ve got a place in Italy what on earth are you doing in a shithole like this?’ It was the most helpful thing anyone said to me during my time on the ward. But I wasn’t aware of this then 

I go to the toilet and push the toilet rolls out of the window as an act of rebellion. Then I stand outside the nurse’s station and chant and shout and run up and down the corridor because there is nothing else to do. I do this for several days running. People tell me to be quiet and a boy nurse tells me, ‘be quiet Donna or I’ll have you forced down and medicated.’ I didn’t know then that what he said was not only breaking the spirit of the Mental Health Act, but it was breaking the law. But it happened: in a fit of seeming temper, and in the words of punishment, I was flung onto that Clinell bed and injected against my wish. 

I rant and chant about many things, but my words are largely lucid and relevant. I ask the nurses about the Laingian view of psychiatry or to update me on the Dopamine hypothesis. All I’d learnt about schizophrenia from my days at GoldsmithCollege came back to me. I collectively ask, as I chant out the theories, and individually ask each nurse that exits the nursing station. Not one of them takes me seriously and not one of them answers my questions. 

Laing spearheaded the anti-psychiatry movement in the seventies. He argued that schizophrenia could be seen as the result of peculiar kinds of enmeshed relationships and environments, where language becomes dysfunctional and unclear. I remember reading his book of poetry about the dynamics of Jack and Jill, his literary protagonists, and the confusion that exists in their relating to each other. Laing ran therapeutic communities outside of hospital settings.  

In all my confusion about what was happening to me I just wanted to know what model the staff held to. Despite the lowering of my voicethe cessation of the chants and a direct gaze, not one person could answer. I asked if we can have the dopamine hypothesis explained to us. The dopamine hypothesis states that schizophrenia is due to an excess of the neurotransmitter dopamine and that balance neurotransmitters being out of kilter.  It’s been around for a long time and is still the cornerstone of the medical model. I ask nurse after nurse about it, but their faces blanch as they push by and ignore me. 

I stand there for six or seven days, sleeping night and day in the same urinesoaked trousers with the ripped leg, chanting and asking.  No one cared at all I recall reading a blog where someone made distinction between psychiatric abuse and psychiatric neglect. They argued that psychiatric abuse in modern times has become psychiatric neglect. 

In my frustration I snap off the lid to the kettle in the male sitting room. I rip the baize on the pool table and I pull the leaves off plants. I tear the pages of the few books that are left lying around and tip the milk down the sink. Petty and mindless acts that ultimately make no difference, but nobody notices, and no one really cares anyway. 

Apart from the one server behind the dining room hatch, the nurses and other staff all have airs and graces. If they speak to you, you should feel privileged because they are busy. They speak to each other and they huddle together in the nurse’s station with the door locked, resentful of any interruption. Not one nurse asked me how I was in the four months I was there. 

It was seven days before anyone listened to me about being in the same urinesoaked clothes night and day. It was meant to be a hospital but instead it felt like a hellhole where people are dumped. Neglect becomes abuse not vice versa. But I didn’t hear anyone else complain. Voices are lost. Rights are abrogated. I watched as some of the people around me slowly became sicker. 

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 This is a sample article from Asylum 28.1 [Spring 2021]. Subscribe to Asylum Magazine.