A to Z challenge and the letter Y
A few days ago I wrote a whimsical post about the fun side of living on the edge of reality. As I wrote that post, I made a promise to myself and to the ghosts of past clients, that I would tell their stories of courage, resilience, and survival. I knew just where to put it. I was working on the April 2018 A to Z Challenge and I worked on the story while waiting for the letter “Y” because Y is for The You Inside and I haven’t forgotten. Because these are the stories of real people, I wanted to take time and be true to them. I will post each story as a different part this week. I also decided to hold the post a few days because, since 1949, May has been Mental Health Awareness Month. This year Mental Health Awareness Week is May 14-20, 2018.
Case Manager Vs. Life Coach
In a previous life, I was hired by the Department of Mental Health to join an army of professionals and para-professionals. We were tasked with providing community services for persons with recurring and persistent mental illness as the push for deinstitutionalization continued from the previous decade. New medications were addressing the symptoms of their illness and we were going to help them return to their communities to find a “life worth living”. I was a Case Manager. Actually, I considered myself more of a Life Coach; I was ahead of my time. I can fill my days simply writing the stories of the men and women I’ve met. Instead, I will tell you of the snapshots that jump from my memory when I see the news or hear the debate about affordable healthcare.
For some reason, she wanted to die.
Time and again, I remember the day one of “the new girls” ran to our apartment crying and looking for my mother. They needed help because their mother had just eaten some rat poison. For some reason, she wanted to die. Days later, I accompanied my mother to visit the neighbor in the psychiatric ward. I didn’t remember seeing her before that day; she looked like death warmed over. We caught a glimpse of others on the ward; they looked the same, pale gray figures, walking in circles. It was scary. I was a just beginning my teens, it was the late 1960s.
Anne
I met Anne when she was in her late thirties. She had been a clerk for IRS when she had her first major “break down”. She had become angry and the police took her away. She was a tall, woman with a large build. Her short blonde hair was starting to turn gray and she glared at me with powder blue eyes. She explained that she had been angry because no one believed her story that the Mayor had raped her when she was a child playing with his daughter. We worked together for several years after that meeting and I learned her perpetual glare was more a sign of fear than defiance. She lived in fear, never knowing when “the cops would show up and haul her away for no reason.”
It was the mid-1980s. She had a long history of psychiatric hospitalizations precipitated by psychotic thinking and consequent irrational, uncontrollable anger; this was common jargon in hospital records back then. Her mother couldn’t confirm her rape story. No one bothered to corroborate it because it was considered a symptom of her illness. She carried the diagnosis of Paranoid Schizophrenia. She told me she had stopped her meds often because she didn’t like how they made her feel; she felt no need to elaborate. Anne had been discharged on an injectable medication to assure compliance. She agreed to move into a group home to increase her independent living skills. It was my job to get her an apartment in the community and provide support to get her out of the revolving door that kept her in and out of hospitals. Needless to say that it all sounded so much better on paper.
In our society, social drinking of alcohol is quite acceptable. Some people say it takes the edge off and they can relax. They feel more social. Unfortunately, we all know folks who are better off when they don’t drink at all. One particular year, things were going well for Anne. She had her own apartment in a nice part of town and had made friends with some neighbors who were not associated with her life as an ex-patient. Sometimes, they would all go out to listen to a band and have a good time.
Y is for the true You inside
Anne and I would talk about how to stay safe in the city and about the risks associated with mixing alcohol and meds especially an injectable medication. Part of my job, of course, was to point out all she had achieved while on the prescribed medication. I don’t remember the exact conversation or the words I used but I do remember something I said caused her to stand up and stared down at me with her powder blue eyes, holding back her tears “you don’t understand do you? You never will. Those medications take away my YOU. THAT’s who I really am. Who I’ve been from the day I was born. It’s my dreams, who I want to be. It’s MY reality. The one on the medications, that’s not me. The one everyone says is doing soo well”, she added with a touch of sarcasm, “She is a product of the meds.”
Irrational thinking starting to sound rational
She went on to ask questions like who determines what’s irrational. Who determines what right and wrong, what is true or not? And then she started telling me that no one knows that Bill Clinton comes to visit her and loves her. She explained that they had to let Hillary stand next to Bill in her place in the news because she looks better for the TV cameras. A part of me could rationally understand what she was saying about her dreams and her meds. I can’t begin to explain, however, what it feels like to watch someone lose their grasp on reality, know where it’s heading and feel powerless to stop it. It was her right to drink socially as it was her right to refuse medication and treatment. I’ll try to touch on the laws surrounding this in one of my other posts.
It was months before she ended up in the hospital again. Yes, the police were involved.
It was another few months before she was ready to go home again. Fortunately, we were able to save her apartment and she didn’t have to start at the beginning again, even so, it wasn’t easy to return to that place. Eventually, we found another apartment and she found another group of friends. I don’t know if she ever made peace with her You and her medications, but she certainly gave me an education that I could never repay.
Resources
You can find many more stories, resources to find services or general information for consumers and their families at the following sites:
SAMSHA (Substance Abuse and Mental Health Service Administration) at https://www.samhsa.gov/
NAMI (National Alliance on Mental Illness (a grassroots organization run by families and consumers) https://www.nami.org/About-NAMI
Please look out for my other posts related to this topic.