Saturday, 30 August 2014

Independent Mutha

We have been waiting for the article to come out for the last couple of months. I kept telling myself it would come out at the right time. 

It did.

It came out when I needed strength the most. I was back at the scene of the crime last week. I was back on the Children's ward where The Thing took hold. I was back in the corridors where my mind unraveled. I was re-walking the path of hell.

I was at the hospital for routine check-ups for the little man, who was yet again proving to be a complete source of bravery and joy, whilst having several different canulas inserted in various areas of his chubby anatomy. We were waiting for his dose of radioactive fluid to work its way through his body for a kidney scan and we found ourselves with an hour to kill.

Right, well...we'd better go and get a copy of the paper we're in. Obviously by a copy, I mean five. I've been wanting to go and thank the nurses on the Buxton Ward for some time, but have resisted because of not knowing what to do or say and being unsure how revisiting that place would affect me. Somehow I felt a box of Green & Blacks didn't convey the deepest gratitude a human heart can bestow on the compassion and unflinching kindness of strangers. I also wasn't sure what to say: "Hi, remember me? I was the one that screamed in your face while I was sitting in a bath covered in wet towels". I felt that taking a copy of the article would be an easier way to reintroduce myself. Introduce Me. The Me they had never met.

I sensed my breath deepening, my heart becoming more like a restless animal in a cage, it wanted to escape out of my chest. I stalked the corridor leading up to the children's ward with a strange sense of familiarity and fear, I felt I had never been there and yet I had. My body remembered.  My muscles started becoming twitchy underneath my clothes; they knew I had been in danger here. The adrenalin was pumping, supplying my limbs with fuel to run. I prepare to walk through the double doors. I don't know what or who I will recognise, I don't know who will recognise me.

The biggest shock that smacks me straight away is how small and safe the ward looks. It chokes me and sends a shockwave all the way through my body. Psychosis had created a labyrinth, where I now saw a corridor. The Thing had made the walls terrifyingly big and the layout fitfully confusing. I was so lost here. I was so scared. Now I saw its simplicity, the playful cartoon characters that line the walls, the friendly faces, the fish tank.

Then I see it. 
My cell. My prison. My torture site. My hotel room. My holiday stay. My interrogation room.

Now I see it for what it is. A small hospital room. A light, safe room, with fish stickers decorating the windows. Were there windows!? That room was transformed by my mind on an hourly basis. I swung from being prisoner to captor repeatedly. 

Going back there was cathartic and heart-breaking. No-one was working there that knew me that day. I left a paper for those that would remember. My psychosis stutter threatened to surface, but I breathed through it and mastered my recent panic. I was reminded in that moment how far I had come and that recovery was still an ongoing process. 

The response to the article has been wonderful. So many people are saying that the illness needs more visibility. It does. That we need to talk about mental illness more. We do. And that we need people to share their stories of Postpartum psychosis. I will. But right now what I want to say is Thank You. This time, it's not to everyone that helped me, which is a vast and powerful list of incredible people, but this time I want to say Thank You to my psychosis.

Thank You that you picked me, so that I can speak out and share my experiences.

Thank You for showing me the depth of strength I have as a woman and as a Mother.

Thank You for everything I have learnt about gratitude, presence, connection, honesty, talking and accepting help.

Thank You for giving me my family back in a very real way.

Thank you for that time you made me feel like the Buddha. That was awesome.

Love and big bellies,
Mutha Courage X

Saturday, 23 August 2014

The Puzzle

Several large pieces of the jigsaw of my life.
If found please return.
Many Thanks.

Each week I think about what to talk about next. I've been very lucky that each week I've had something to write about other than this. This may be what still haunts me the most. The lost month. Nothing would please me more than to move onto the subjects of leave, recovery, and the beauty that can emerge from horror, but in order for me to do that I feel the need to address the psychotic elephant in the room. It's not what is there that hurts the most. It's what isn't.

There is a chunk of my existence that is lost. Lost to me at least. It's like I've been given the puzzle, but the picture on the box has been severely scratched and no matter how hard I try to put the pieces all together there are huge patches that can't be filled. No matter where I look I can't find the missing bits. Fragments remain. My memories pad around in slippers and dressing gown through the stark corridors of my mind.

I was mad.

Maybe it's better that there are only suggestions, emotional shadows and strange imprints on my mind. Maybe my brain is helping to keep me safe. Maybe I would be even more horrified if I remembered that time clearly. Maybe all this is what I tell myself to help the healing process.

My medical notes go some way to filling in what happened, but they are not my reality. They are an outside impression. They are cultural judgements and medicalisation and clinical observations. They are not "truth". In some ways I think that what is so disturbing about being psychotic is that you have access to true reality. What I mean by that is, you realise that it doesn't actually exist. All there is is THIS reality versus THAT reality. Some of you will say, "Well, I think we could agree that you were mad, and that was the reality." But was I mad? What and who is anyone to say what 'mad' is? In some cultures I would have been revered as a wise and holy medicine woman that has access to other worlds. Someone that can offer huge healing and understanding to her tribe and community. Here, I was contained, drugged and left feeling utterly ashamed. I may have missed my true calling! 

Don't get me wrong. I'm delighted I was drugged. I'm very happy I was contained, and the shame has helped me speak out about my experience, but when you have a reality altering experience like that, it makes you question everything you thought you knew about the world and the people in it. 

I'm beginning to realise now that I have in front of me the pieces from many puzzles. There is so much in life we don't understand; perhaps we never will. There are so many pieces that I realise that trying to make sense of it all is futile. 

There is a peace in that. 

Having it all worked out and finishing the puzzle is not really the best bit. Trying to put the pieces together is why we keep doing jigsaws. Our search is never finished. Our quest to understand is never complete, but still we try to put the pieces together, knowing we never will.

Love and shaman blessings,
Mutha Courage X

Saturday, 16 August 2014

See You Next Tuesday

Being a resident of the "Hackney Holiday Home" was a massive privilege for me. I will never forget the overwhelming sensation of safety and peace I felt when I arrived there in the early hours of the morning on February 15th. It was a balm to my sore soul and gave me hope during that terribly frightening episode in my life.

I remember the sheer joy I felt at seeing an A4 sheet of paper attached to the back of my door with a timetable of activities that were on offer during the week. Yoga, baby massage, cookery, weaving, dance & movement therapy, relaxation and art classes. I seriously thought I'd won the psychosis lottery. Who knew there were this many perks? This wasn't a psychiatric ward, this was a holistic commune! Not only because of all of these brilliant workshops that would give me a reason to get up in the morning, but because I was NOT in Chelmsford. Phew.

To begin with I was utterly bewildered by life in the Mother & Baby unit. I had no idea how things worked and was intensely upset and distressed about the seeming complexity of its daily rhythms. Time there was divided into two main categories: medical and psychiatric, and the more holistic, alternative therapies. For some reason completely unknown to me, I was very suspicious and resistant to the medical treatment, but was much more happy to comply with talking, drawing and movement therapy. Having been a self-help junkie for over a decade I was completely into all of the classes. I can't think of many more things I'd like to do of an afternoon than being held in a giant blue cloth and given permission to be completely in touch with my feelings. For people walking in on a class like that it would probably look like I was in the throws of yet another manic episode, but let's be's a thin line, people.

It took a while for me to even have the foggiest clue what was going on in my new clinically enhanced home. I had so much to learn. There were so many timings to remember and rules to follow. All of my cups and plates had my name on them. Believe me when I say that giving me a labelling machine when I was psychotic was a brave decision on the part of the nurses. You had to order your food at certain times; eat at certain times and in certain places. Visitors were not allowed in the kitchen, which sucked big style because no-one could ever make me a cup of tea AND I had to wash up! I was told recently that I used to insist visitors brought me tea from Costa when they came, so I didn't have to clean up after anyone, including myself. I wish I could be as demanding in normal life. Babies weren't allowed in the Kitchen or Milk Kitchen either, which made carrying your child in a sling pretty tricky. It becomes a real palaver if you realise you've forgotten to butter your toast or milk your bran flakes, which is easier than you might think when you're on a massive cocktail of anti-psychotics and mood stabilisers. You only hope that you don't come out of the kitchen one day with a baby covered in butter and a sling full of bran flakes.

At one point I had so many alarms on my phone I no longer had a clue what they were reminding me of. Wake up, meds, food, class, visiting times, baby feed, meds, food, medical observation, baby feed, class, meeting with psychiatrist, meds, food, visitor leaving time, meds. This was my new reality, my new life.

Part of this new life was a weekly visit to "Ward Round". This happened every week, in my case, every Tuesday. It was one of strangest, most surreal and intimidating experience I may ever have. During that first ward round I was heavily medicated, still extremely ill, paranoid, emotionally volatile and couldn't retain or process information. I think we can all agree, not the best set-up for a meeting about the intricacies of your own mental health.

In some ways I'd love to be able to tell you what happened in my first ward round. I can't. My mind was not functioning in any linear or rational way. nothing was being processed how I would normally. I was in utter chaos. It wouldn't be until my 6th or 7th ward round that I would begin to understand what had happened to me, was happening to me and what would happen to me. What I do have are several very powerful sense memories, of how I felt and what it was like from where I was standing.

The door shuts behind me. Bang. Silence. Eyes looking at me. Not one pair, not two, 3, 4, 5, 6, 7, 8. All these people staring at me. I take a seat. I am at the head of this table. I am off my head at the top of this table. The formality. Why are they speaking to me like this? They introduce themselves and their role. Why? I know who they are...Dr M, Ed the Head, Helen of Troy, Mother Mary...I don't understand the words that are being said. I don't know the names of these drugs. Write them down, write them all down, I must write them or all will be lost. Everything will be lost. You haven't been responding to...change of It. Means. You. Will. No. Longer. Be. Able. To. Breastfeed your son. 

I cry for 11 seconds. Fully. Powerfully. Then turned to my husband and said "Maybe it is. Maybe it isn't"

To give that phrase some context. My husband and I use this mantra in our life whenever anything happens that we could see as "good" or "bad". When something we perceive as "bad" happens we say "maybe it is, maybe it isn't". This allows you to remove the judgement from it. We never know what will come of what we experience. We can't foresee how we will use what happens to us in our lives. It helped me so much to remove resistance and judgement from what was happening to me, not by forcing it out or blocking it, but by allowing it to be what it was. Whenever I resisted my situation I felt deep pain and sadness, whenever I allowed it to be what it was it gave me a sense of calm. We just don't know where life will lead us, but even in my darkest times I remembered "maybe it is, maybe it isn't".

After you have discussed your prognosis, medication, thoughts, feelings and recovery with these professionals, made up of consultant psychiatrists, psychiatric doctors, psychiatric nurses, nursery nurses, psychologists, student nurses and social workers, it was time to return to the ward and resume your day. But not before I had left with the last word. From that very first, massively scary and hugely intimidating ward round, to the penultimate one before I was discharged I would always take in each person around that table, just before I left the room and say with a cheeky smile "See You Next Tuesday"

Love and buttered babies,
Mutha Courage X

Friday, 8 August 2014

Mirror Mirror

One of the strangest things about being on a psychiatric ward and gradually recovering is that as the mist begins to disperse you start to understand where you are and what's happening. It's at that time you wonder if you might actually rather continue living in crazy ignorance. I remember the first time I realised that staff were observing other patients and that, therefore, staff were observing me. I felt uncomfortable and agitated by the idea, like I was in a strange surveillance prison where everything I said and did was being charted and recorded. It didn't feel like it was to help me at that time: it felt like it was to catch me out and get me into trouble.

I dreaded to think how long I would have to live here. Whenever there was talk of timescales I would panic and become distressed. My resistance made my experience so much more painful. I knew I needed to surrender and concentrate on getting better for my family and for me. I would work hard every day to confront this illness head on and I would not give in. The not knowing was terrifyingly troubling, but I calmed myself with the thought that all any of us have is now. We can't predict what is coming or what will be. All that we know is it will be. What it will be.

Whenever I felt my speech becoming more pressured, my thoughts racing, or my Tourettes bursting out I would lean into that discomfort. I would know that my illness hated me getting better and would attack me more when it saw that I was.

During my psychosis I had to write down every single person's name I came into contact with. Missing one was not an option. Neither was not remembering who someone was. To make this process easier I gave everyone code names. There was Helen of Troy, Happy Hat, Shadow, Star, Ed the Head and Mirror to name just a few. There is a story behind each person's nickname and why it was chosen for them, but the one that had a massive impact on me was Mirror. She gave me the biggest problem of all and consequently helped me the most.

Having been a self-help junkie for years, I was no stranger to the idea that what we dislike or find problematic in other people is often what we struggle with or fear in ourselves. For some reason, as soon as I met Mirror there was a clash. All of my symptoms got worse when I was in her presence. We had big arguments. Well, I would shout at her and she would tell me it was unacceptable.

She was clear. I was unraveled.
She was calm. I was frenetic.
She was precise. I was a mess.

She pissed me right off. I knew I needed to spend as much time as I could with her. She was vital to my recovery.

I told her that she was the mirror in which I saw myself reflected. What made me angry in her company was the fact that she had the qualities I had loved in my old self but feared I had completely lost. I knew The Thing didn't want me to make progress, so it took my disorder up a level whenever she was near.

No matter how hard it was, or how exhausted I was after our interactions, I knew that I would only see myself again if I kept looking in the Mirror. When there was psycho backlash I knew I was on the right path. I knew that the more I looked at myself, and the harder I gazed into the reflection of who I had become, the weaker The Thing became and the closer I came to recognising my own reflection again.

Love and (hopefully not) 7 years bad luck,
Mutha Courage X

Friday, 1 August 2014

The Observed

16 Feb 2014, 00.53

Patient "J" arrived on the unit at around 07:00 as an informal patient, escorted by the Crisis Team. She is 10 days postpartum. I approached her to introduce myself with another member of staff. She presented as very labile in her mood, at times becoming irritable and tearful. Despite various attempts to discuss her care and inform her of her informal rights, staff were unable to interrupt her conversation due to the extent of her pressured speech and her refusal to allow staff to speak. She repetitively stated that staff were not listening to her, when staff had been reduced to silence. She became increasingly distressed when staff attempted to answer her questions, making it impossible to have any meaningful conversations with her. She would at times say she was in her "safe place" and that she "loved staff", but this would change quickly when again staff made attempts to engage with her.

Patient J was seen by Duty Drs. During this time she became increasingly hostile and aggressively asked them to leave the ward. She followed the Drs. out of the room and appeared to make an attempt to grab them, but staff intervened and were able to prevent this happening without the use of any form of restraint techniques. She then became tearful stating that the Drs. had spoken about medication and the need to sleep while they were both sat on her bed. She felt they were preventing her from sleep and she felt as though they were trying to enforce medication on her. I remained with Patient J for 3 hours following this and made various attempts to disengage due to the repetitiveness of the conversation and the continued unwillingness to listen to me or other staff when attempting to speak with her. She then went on to say she had not been given food as promised and hadn't been offered a shower/bath. I attempted to explain that I had made various attempts to go and get her food/fluid and towels to have a bath, but that she would not allow me to leave the room to complete these tasks. She repetitively spoke about a "spasm" that we would cause her if she was interrupted and if we left the room without her "permission", which was granted in the form of a finger being placed on our mouths. I stated that I had to leave the room to speak with another service user as there were both staff nurses within her bedroom and I needed to complete other tasks. She became increasing hostile and aggressive towards myself, stating our "trust" had gone and that she did not wish to speak with me again today, subsequently slamming her bedroom door.

Attempts made to engage with her husband independently to inform him of the importance of medication and the possibility of being placed on a Section if she continued to refuse her oral medication. Patient J became distressed when she was not with her husband, making it impossible to have a 1-1 with him.

T/C (Telephone Call) with Dr. around 15:00. He was informed of Patient J's refusal of her medication and her unwillingness to consider medication.

T/C from Dr. at 18:15. Informed of continual refusal of medication and chaotic presentation. She has agreed to place Patient J on a Section 5(2) and has completed a capacity and consent to treatment form, highlighting that she is unable to retain information, unable to understand information and unable to weigh information as part of the decision process.

16 Feb 2014, 01:08

New Admission.

Entered room, patient is operating a system of sign language and is very particular about "her safe place", people speaking when permitted and listening to her. She uses the sign language she has come up with to show this.

She was using her husband to speak for her, as she could only whisper.

Feels she has postpartum psychosis. Doesn't know how long she has been in, but feels scared, smelly and degraded. Embarrassed. Stated she was initially happy to take advice and try "whatever medications as you are the experts."

Vey labile in mood, tearful, aggressive and very irritable at times, calm at others, pleasant, joking. First became irritable when we suggested she should "calm down" then later if we could discuss medication. "I don't want any medication from you"

"I am a lioness protecting my husband and cubs"

Would not let us leave the room without her permission, kept on wanting to tell us the rules but never got round to them.  
"If you don't calm me down I will have a spasm in 10 seconds"
"All I need is sleep and food, no one has bought me food. You must be thick if you think I need medication before these things"

Suggested medication could help her sleep "Shut the f-up"

Appearance and behaviour: casually dressed, tired looking, calm at times, joking, then irritable and both verbally and physically aggressive. Overfamiliar. Overstaring wide eye contact, made physical contact and squeezed both Drs. hands when upset. Wanted full control of the interview.

Mood: Subj: "exhausted, tired, scared, degraded" Obj: irritable, labile.

Speech: Pressured, formal thought disorder, flight of ideas. Whispering at first, then shouting when irritated.

Thought: Not able to assess as wouldn't let us talk.

Perception: Not able to assess as wouldn't let us talk.

Imp - postpartum psychosis, manic episode.

16 Feb 2014, 15:27

To be put on 1:1 observation today