Psychosis: Chapter 1
by Doug Dean
Was I going to something, or going away from something?
That’s what a psychiatrist asked when I requested an Against Medical Approval (AMA) release. Little did I know this document was unnecessary for those, like me, who were here voluntarily admitted under the assumption that no sane person would freely be confined to a mental institution.
I had been at the notorious Illinois Psychiatric State Institute (8E-ISPI) for three months without knowing this – or much of anything. My stayed at ‘ISPI’ was provided by the taxpayers of Illinois State, represented by the first two letters of ISPI (pronounced ‘is-pee’). Psychiatric Institute was the ‘pee.’ I stayed on the east wing of the eighth floor, which explains the 8E.
I learned a few things about “institutional living,” a paradigmatic oxymoron if there ever was one. One is official authorities mischaracterize truth for their own benefit by not revealing my choices. A second is deceit doesn’t necessarily mean it isn’t meant for the good of the other. But as they say, ‘the road to hell is paved with good intentions.’
With his best “this is in your best interest” attitude the shrink attempted to get an answer to the question again, “Are you pursuing something or running away from something?”
Attempting to imagine what it’s like to be psychotic doesn’t hold the true mortification of being psychotic. Unlike nightmares, which readily dissipate upon awaking, psychosis sticks around. Part and parcel of being mentally ill is the humiliation of being crazy. Or is it the fact that too much self-humiliation is what mental illness is?
I heard others speaking to me but nothing they said made sense. They weren’t speaking another language. I understood every word being said. Comprehension was what I lacked, although lacking that I didn’t comprehend this. People seemed to be playing some part, a role, in a staged masquerade without filling me in about what was going on. Was there a plot?
Staying inside one’s own head for too long is considered catatonic. Whether it was the intentional overdose of prescription drugs I took, or the natural outcome of my sad life colliding with bad LSD, I was being rolled into a mental institution half conscious. “Who’s the president?” I was asked. I was lost in my own mind and really couldn’t understand why someone would want to know who the president was when I had just tried to check out. No need for me to put energy in answering this question. I don’t understand why it’s being asked of me anyway.
Depression had filled me to the point where I couldn’t be with others without remaining mute or bringing them down. I chose the former. Social suicide precedes bodily suicide whether completed for the sake of mercy or vengeance. For both fear and anger can be overwhelmingly painful and functioning under such conditions hardens one. I trusted no one but my dad, and he had been dead for seven years now. He’s not coming back.
More questions, more not comprehending, more no answering, and I had a bed in the notorious ISPI of Chicago located in one of Chicago’s toughest neighborhoods. I was free to walk out at any time, something I tested the first night. The night guard quickly glanced at me with a, “It’s dangerous out there.” Ninety seconds later, without looking up this time, I heard, “I thought so,” while I quickly heading back to a relatively safer mental institution.
That night my antipsychotic medication, Thorazine, was increased to therapeutic levels.
The new dose of Thorazine kept me knocked out for months. Daytime blurred into nighttime and then back again. Even walking became a chore I avoided at all cost. Some called it the Thorazine shuffle; dazing straight ahead while shuffling the feet without lifting them fully off the flood. Drooling accompanied those new patients, like me, as well as those ‘needing’ a form of physical restraints. Time was passing by without me.
I was lucky at first. I had no roommate in my cold twelve by ten foot room painted the same pale green of the hallways. Willy Brown was a veteran patient who seemed to know the ropes of the hospital, having been an ISPI patient multiple times. Willy was black, tall, thin and sported a scruffy beard. Every ten minutes Willy walked by my door pacing one side of the hall, or the other, of ISPI’s 8th floor days at a time.
Willy’s footfalls could be heard echoing off the end of the hall that held approximately fifteen rooms. My room was the second room from the nursing station which separated the female wing from the male wing. It amounted to one long hall with a nursing station in the middle that served to keep different gender parts apart.
Each footstep slowly bounced sound off one side of the wall to the other keeping the silence punctuated with the rhythm of echoes, which Willy seemed to play on. Up and down that hall Willy walked, turning around one room passed my mine at the nurses’ station. The Doppler Effect made the sound seem electrified when he walked by. It got to the point to where I could accurately guess which side of the hall I would see Willy pass merely from the subtleties of sound vibrations. This, I found later, foiled the point of Willies wall-walking activity.
One day the sound of his pacing abruptly stop short of his well worn path and in front of my open door. “Hey man, meds,” slipped smoothly out of Willy’s lips and echoed into my stark living space. Each room was bare except for two or three metal beds, each with a three inch rolled up mattress, and two or three institutional type metal drawers to place cloths in. Door had to be open during the day.
The floors that carried the sounds of Willy’s walking were cold and hard throughout the entire hall. I looked up with the same Thorazine empty stare I wore on my face for the last four months. “You gotta start cheeking, man,” Willy whispered.
Learning to Cheek
Staying by oneself all day seems natural when the medication they served in little paper cups held my mind still without thought or feeling. Four times a day we stood in front of that nursing station, some shaking, others in stupors, all waiting to be handed a little cup of pills. Mine had two large tan colored pills along with an extra pink one at night. Then I saw what Willy was talking about, as he walked by me in line he tipped his hand just enough for me to spot a handful of saliva drenched pills as he whispered, “Cheeking.”
With the pills in my mouth I found my tongue to be quite talented in pushing those tiny bits of chemicals to various crevices of my cheeks. Eventually I could open my mouth with the un-swallowed pills remaining unseen. When the nurses worn rubber gloves for probing those crevices it was time to learn how to regurgitate half swallowed pills. It’s amazing how far humans will go not to be under someone else’s control even when they’re not in control of themselves.
It was the first thing that made sense to me since being institutionalized. The medication didn’t so much end any symptoms of thought or passion as they simply dulled my mind to the point of not recognizing my symptoms as disturbing. I do realize that much of civilization goes to great lengths to reach such a state of similar inebriation most weekends. The difference with Thorazine is its dysphoria, which is the direct opposite of euphoria. It just makes one feel shitty.
That’s why head-doctors once combined Thorazine with other drugs meant to reduce a condition called Tardive dyskinesia, a nasty side-effect of tics and spasms from taking psychotropics. But the drugs for reducing side effects also functioned as “feel good” pills in combating dysphoria, which keeps many patients from not taking their medications.
Willy wanted more of these feel good pills and less of the Thorazine. Everyone does what seems to make sense to them and cheeking was what I understood would wake my brain up – up to what I didn’t know. Nothing else was making sense at the time so that seemed the first step to doing something.
Soon Willy had a steady source of feel good pills from me while my stash of unwanted Thorazine grew larger. The trick, I found out too late, was to trim oneself off Thorazine gradually to the point where the staff doesn’t notice the change. Changing from a Thorazine zombie to an alert, yet crazy, person in a week will alert doctors to prescribe Thorazine injections, which are hard to cheek – so to speak.
By tapering off of Thorazine over a four to six week period nothing will be said by the staff except, “Oh good, you’re adapting to your medication”. Staff’s suspicious looks gave one notice to put on a little more fake shuffle for a while longer. As my mind slowly cleared of the energy draining medication I found other patients my age also living institutionally, each with their own unwanted pile of Thorazine.