Posts Tagged 'therapeutic community'

First Person Narratives 4: ‘One Good Year’ Part 2

The remainder of Jackie Hopson’s account, One Good Year: Being an in-patient in the Charles Hood Unit, Bethlem Royal Hospital, 1974 -1975 follows (to read part one, click here):

Something new for me, after the long, inactive days in county asylums, was occupational therapy, of which there were four sessions each week, one of them being entitled, “Social Skills”.  I particularly remember the well-equipped pottery workshop (I still have a dish I made at Bethlem by my bedside, 35 years later).  There were two gruelling but productive afternoon sessions on Wednesdays and Thursdays: these were Psychodrama (role-play, improvisation, reading dramatic texts and dance), led by the inspirational Miriam Plummer, and Art Therapy.  On Fridays, there was a large meeting of all patients and staff (medical, OT and social work) together in the big room.  We who were patients were involved in decision-making.  On one evening each week, one or two patients would collaborate to cook an evening meal for all patients and those staff who could come, which often included the consultant psychiatrist.  All of this was very different from the “them and us” set-up of the county asylums, where the staff members were, on the whole, more like prison wardens, who most certainly didn’t fraternise with patients or relate to us in any way that wasn’t disciplinary.

Because we lived in a hostel, slightly apart from the main hospital, I didn’t feel like an in-patient.  We went out to the supermarket, the pub (sometimes meeting escapee alcoholics from another Bethlem ward) and to the shops in Croydon.  Friends visited us in the hostel, sometimes staying overnight (though I never discovered the official policy on guests, if indeed there was one.)  All of this normality within our hospital experience made the transition to post-discharge life outside much easier.  We were in charge of much of our own lives, within the safe and tolerant setting of the hospital.

I remember several noteworthy events, some terrifying and others positively joyful.  The freedom and lack of hierarchy could be scary.  After one of us being permanently thrown out of the unit for violent behaviour, the rest of us, alone in the big room, smashed the entire supply of dinner plates against a brick wall.  This was both liberating and very frightening: the nurses left us alone in the ward.  We felt both powerful and scarily uncontained.  Another, more positive, day saw the whole group of eight patients (no staff!) setting off to London to celebrate the 21st birthday of one of our number.  We went to a great restaurant in Greek Street and had enormous fun on the way home, encouraging everyone on the tube train to sing, “Smile, though your heart is breaking.”  (Not many passengers joined in – they clearly thought we were bonkers!)  We were high on normal life and it was wonderful.

Sometimes we behaved like unruly children.  One day in the pottery workshop, the OT potter having left briefly, we had fun throwing lumps of clay at each other and the ceiling.  The OT leader returned to shout, “It’s bloody bedlam in here!” which, of course, increased the hilarity.

I am aware that we were a very privileged group, specially selected and given a most unusual opportunity to receive a rather experimental form of treatment.  My overwhelming memory is that we were considered as human beings with futures that we might realise, rather than psychiatric dregs to be confined, drugged and, at all costs, to be kept away from the “healthy” population outside.  The Charles Hood Unit at Bethlem set me off on a path to believing it might be possible to live.  When I left (I discharged myself, having become impatient with my life being on hold), I felt I was leaving a safe home, better able to cope in the outside world.

First Person Narratives 3: ‘One Good Year’ Part 1

Following on from two recent pieces on first person narratives (here and here), we are extremely grateful to the author of Through the Wasteland, Jackie Hopson, who has written us an account of her experiences at Bethlem’s Charles Hood Unit, entitled One Good Year: Being an in-patient in the Charles Hood Unit, Bethlem Royal Hospital, 1974 -1975, to be posted in two parts. She writes:

Winning a place in the Charles Hood Unit at Bethlem Hospital in 1974 was harder than getting into university and felt to me like a greater achievement.  There were two long and demanding interviews, each time with a roomful of doctors, nurses and social workers.  After the first interview, they sent me away with what seemed an insuperable task: to finish university, get a job and survive for a few months.  I sat down on the platform at King’s Cross Station and cried.  Some months and the second interview later, I was given a place.

Bethlem was very different from the county asylums where I had earlier spent many months.  I felt safe and settled at Bethlem: in other psychiatric hospitals I had felt punished, a prisoner, alert for possibilities of escape, fearful of ever-worsening, harsh, physical treatment and drugged into stupor.  Our time-table at the Charles Hood Unit was demanding but, with a small, supportive group of patients and a very informal, non-hierarchical atmosphere (all staff and patients were known by their first names), life was pleasant and felt pretty normal.  Some eight or so patients lived in a “hostel”, a large, comfortable house called “Winchelsea”, which was, I believe, the former Hospital Governor’s residence.*  We were all roughly between 20 and 35 years old and, almost without exception, well-educated, though some members had dropped out of higher education because of illness.  Every morning, we walked across the field to the Charles Hood Unit, where most of our activities (it didn’t feel like treatment) took place in a huge, light, high, wood-ceilinged room, comfortably furnished and with an adjoining kitchen.  We had lunch provided here by the hospital; breakfast and supper we made for ourselves at the hostel from an in-patient stipend of £4 per week.  This meant we had to shop in the local area and cook, together or individually.  We did our own cleaning and laundry in the house – and had to deal with the tensions that arose among the “tenants”.  We were given no psychotropic medication whatsoever.

As members of this therapeutic community, we had a full, five-day timetable, which ran from 0915 to 1600, except for Fridays, when we finished at 1400.  Many patients then went away for the weekend to friends or family.   Three times each week we sat on the floor in a circle in a small room for a ninety-minute group therapy session which was tape-recorded.  Normally a registrar and a senior nurse were present with the patients, sometimes two nurses; and these staff members might interject personal material, as well as helping us along with frequently very painful issues.  In addition, there were two one-hour hostel group meetings each week to deal with domestic problems, again with staff present: the small group of patients was together pretty much round the clock, so there were difficulties sometimes.  Each of us then had a 45-minute session of individual psychotherapy every week.

*Actually the former residence of the Hospital Steward



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