A Personal Experience of a Therapeutic Community

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This is a brief (EVEN THO ITS LONG) explanation of what I lived with prior and whilst I was an inpatient at the Crisis Recovery Unit which is a Therapeutic Community based at The Maudsley Hospital in London ENGLAND. Any questions feel free to ask them and I will answer them. Lea Howard xxx

I guess that I am fortunate. When I was 18 my life was in chaos. To be honest, I was living a very dull and pathetic existence. Nothing entertained me, nothing gave me a purpose, the things I once loved I found myself lacking in enthusiasm for, I was merely existing. Predominately, I guess, my life was in crisis. I was surviving minute by minute, but at times those minutes were too long and frightening, so I began to exist seconds by seconds. Any money I had, which wasn’t much, was being spent on Razor blades, tablets, taxi fares to the hospital and back home, first aid equipment and not much else.

It was January 2001. I was in a private mental health ward, and somehow - and I can’t fully remember how - I found out about The Crisis Recovery Unit, which is part of the Maudsley Hospital in London. I saw it as very much my last chance of help, last chance of understanding; I guess, last chance of everything. I managed to persuade my pdoc to write a letter of referral. I was desperate for something to help me, as I knew I couldn’t carry on in the ways I was because sooner or later my self-injury would leave me dead.

I got the letter for an assessment. That was April 24th, 2001. I didn’t sleep the night before: just laid awake, glaring at my ceiling, ideas of what I might be asked racing like cars in the grand prix rebounding around my head.

The morning of April 24th came, and I left home early, at just after 5am. It was to take 6 hours to get down to Beckenham. I can remember being half way on the journey and begging my Dad to turn around and come back home, as I didn’t think I could go through with the assessment. What if they saw me as the pathetic waste I saw myself? What if they decided I wasn’t worthy of their help? So many “what’s” and “what ifs” in my head.

Anyway, I entered the building and realised I was the youngest there by about 20 years, which was kinda freaky. I was made a hot drink and then entered the room. I felt my body slowly slump into the chair which I was told to sit in. There was a lady and a guy doing my assessment. I later found out she was the ward manager, and he was a care worker.

The assessment was long and incredibly emotionally gruelling. At several points during it I was ready to say ‘enough is enough, and I will walk’; but I knew deep down that this was my last chance of help, so I had to stick it out. They said I could take breaks during the questions, but every time I felt that I needed a break I couldn’t find the voice to ask for it, so I just plodded on with the questions. The assessment was incredibly thorough: It covered everything and anything. Things which I had previously never told a soul. I kept reminding myself that it should be ok, and that I am strong, and I can get through it.

The assessment finally finished, and G-d I was relieved; but I knew that was the easy part out of the way. The staff said to allow up to three weeks for their decision as to if they were going to offer me a place at the unit. Those three weeks were the longest three weeks of my life. Every day seemed as if it was taking a year. It was crazy: Every day, as soon as I heard the postman ruffle the letter box I would be downstairs so fast checking if they had sent me anything, and then return to my bedroom with disappointment. I was just so eager to hear. I was probably hell to live with for those three weeks, but never mind!

Soon the postman brought me what I had wanted and craved for so long - the magic letter from which my future was about to begin. Except what was that I read? - ‘Provisos for admission’. No one had mentioned these at the assessment, so they took me by a little surprise. Nevertheless - I mean, they weren’t going to be that ‘hard’ were they? WRONG! I wish now, with hindsight, I had prepared myself more and taken longer before saying I had them under control. They would have made the 24 weeks easier to live with. All the same I phoned the co-ordinator up and said ‘I’m ready’. She said they would phone me again nearer to the time when they had a space available for me to start to spend the next 24 weeks with them.

I remember well the morning on which I got the phone call from D, who was in charge of admissions. It was Friday, 20th July, and she woke me up, asking if I would like to start my admission on Tuesday, 24th July. As I counted up to ‘24’ on my fingers I realised SHIT that is only 1- 2 - 3 - 4 days’ time! Four days to say my temporary goodbyes to the city I had grown up in, Four days to say goodbye to acquaintances I had made. Above all, four days to start to find a healthier and more productive way to live my life.

That morning my parents were both at work. My mum was due home at lunchtime, which seemed like an eternity away. I got on the Internet, waited impatiently for the self-injury message board which was my life-line to load up, and typed out to let everyone know what was going on. I then disconnected the Net and picked up the phone. I first phoned my Grandpa, as I knew he would be excited but nervous for me. After that I phoned both my parents. I can still remember my Mum saying ‘calm down and breathe, you have four days to get sorted, then the hard work will begin!’ I phoned up friends and told them of what was going to be, then I walked back into my bedroom, collapsed on the bed, and began to cry. This is what had been keeping me going, giving me a reason to get out of bed each day for the last few months; and suddenly I wasn’t sure if it was what I wanted after all. Doubt begun to creep into my mind; but the overpowering voice of ‘wanting to get better’ shouted it down each time it began to creep in. I laid on my bed; was restless; got up; picked up the cd with ‘Last Resort’ by Papa Roach on it; screamed out the lyrics as I knew the Maudsley was my last chance to get a grasp upon my life. The rest of that day and the next four days are a blur, as I scampered about ensuring I had everything packed - cd’s, clothes, teddy bears, paper, pens, phone charger et al.

The morning of July 24th quickly came. I barely slept the night before: My head was alive, questions, ideas, everything rotating about, not sure what I was about to in the morning let myself in for. All I knew was, I was afraid to carry on living in the ways I had, and I knew I had to try and reclaim my life before it took control and then destroyed me even more.

Impressions of new – July 2001

Walking in the crowded room, It’s as if egg shells have been stamped upon and scattered on the floor, Individuals watching where they stand.

Attempting to gain a balance on the see saw of self protection and that of trust

Sitting around the table, Analysing who drank, ate or said what.

Music blaring, Difference tasting, Fuses burning.

Verbally attacking one and then another, Trying to live with the pretence that you’re cool, calm and in control when they speak to you.

Out for walks, You hear them express their concern about your current lack of self awareness. Strange they umbrella term us as ‘self injurers’ Yet we all differ so damn much.

We long to unite with the unity of acceptance and understanding, Shut away beyond closed doors, Laid on your bed, dwelling and pondering your reasoning as to why, Attempting to figure out what you may have said, and why Fred Bloggs aint talking

Walk back into the room, Is it a crime to ask for honesty with yourself and each other?

The first day of being at the CRU was too much for me: Too many things to take on board, too many new rules and boundaries to attempt to adhere to, too many faces to remember a name to, too many questions of everything, everything being analysed. It all got too much for me, so I went for a walk, found myself at a supermarket, found myself purchasing razor blades. I got back to the unit, locked myself in my room, and found myself self-injuring. Yes, I should have ‘safety planned’ prior, but I didn’t know what that was, let alone how to ask for it; so I dealt with my overpowering emotions in the only way I knew, which was to harm. I soon found myself having to fill out a ‘blue form’; told to grab a book, as the wait would be long; and told to go outside and wait for the taxi. That night I experienced hell for the first time – well, it was Bromley A+E, but I soon realised why my fellow residents regarded it as hell.

The place was crazy, the worst A+E department I had ever experienced. The place was dirty, the staff clearly had never worked as a team, I was left to wait, the clock was ticking, experience told me that stitches had to be given within 6 hours of a injury in order to prevent infection, it was now nearly 3am. A brief line from my journal back then: ‘I just want to curl up and bleed to death, but no I have to sit on this chair which is more uncomfortable than anything iv ever sat on before, the staff walk past and talk out loud about me, they pick up my card then don’t call my name, they just call the next patient and the next, now I know why this place is subbed hell on earth.’ I eventually received the stitches, which I had to have without anaesthetic as the doctor decided that as I had done the harm to myself I didn’t deserve anaesthetic. I rang the unit once he had stitched me up, and waited for the cab to arrive. Got back to the unit, and went to sleep.

As the first week came and went I found the groups hard and the 1-2-1’s even tougher; but some how plodded through. Found myself going for walks around the grounds to clear my head, and on returning found out the staff were deeply concerned about my personal safety, as apparently it was clear I had no sense of personal danger.

After three weeks and a day I had my first monthly care meeting, where the staff discussed how my stay was going. The fact that I was finding it hard to attend groups was brought up, as was the fact that I was finding it increasingly hard to work within the strict and rigid boundaries which I found imprisoned upon myself. It was also discussed if the unit was right for me, if I was to be allowed to remain for the next 20 weeks or if I was to be chucked out. That hurt - to think that the one thing I had put all my hopes of survival and getting better and stuff on might be taken from me just as fast as it was given to me. I made the decision there and then that I was going to work my socks off for the next 20 weeks, as I knew deep down that I wanted to; and not push aside the help and support which was being offered to me. I said and explained to the staff ‘how am I meant to know and manage to stick to the boundaries if the yard stick was being moved almost daily?’ I promised that day that I would attempt to allow myself to trust the staff, as I knew within that if I didn’t trust I would get nowhere. I faced up to the fact, perhaps for the first time, that I had had my childhood stolen by the monster which is self-injury, and I had lost my inner child. I knew she was somewhere, but where was anyone’s guess. She was lost, and I knew in order for me to reclaim my life my first job was to find her and let her know that it’s ok and she don’t have to hide no longer. I also took the opportunity at this meeting to thank the staff for being the first group of people who didn’t give up on me, which was a nice and pleasant change. I also thanked the staff from the bottom of my heart for giving me back the freedom of choices. The chance to have the choice was nice - a little frightening initially, but something I realised was missing from my life till that point. To conclude, my first month I promised to ‘work my socks off’; a metaphor the staff found hilarious, as I rarely wore socks and when I did you could guarantee that they wouldn’t match!

A few days later - I remember it so clearly -, I bravely found the courage to hand in to the staff my stash of blades and tablets, as I knew that in order to ‘get well’ I had to ensure no weapons of what I called and have often referred to as ‘weapons of mass deception’ were left in my possession. It was damn hard to hand over my tools, but from that fear I gained so much more. I found inner strength that day, and for the first time in living memory I admitted to the outer world that I was strong and that I wanted to try and recover. I realised that whilst blades and tablets were still in my possession I was looking at life through a distorted spider’s web, which was encapsulating me further and further; so I made the brave decision to give up my safety, and made up my mind that I wasn’t going to harm for the remainder of my admission. I wrote in my journal that night ‘i really fear that I have blown it and lost my final chance to prove that I want to get better, but please G-d let them realise how hard it was for me to hand over my blades, for if they truly realise how hard that was for me then they will know how much I need them to give me a final chance’.

The next few months plodded on without too many glitches. Then, in October 2001 I found myself having surgery on my knee: Returned to the unit to find a fellow resident had let herself into my room, helped herself to my secret stash of vodka. Another resident had told the staff I gave her a paracetamol for a headache, and - the straw that broke the camel’s back - I was caught smoking a joint of dope. I was called into a 1-2-1 and asked to explain my actions. “Great.” I thought, “ Through my own stupidity I am about to be evicted from my safe haven and place of sanctuary.” But no, I was handed a phone and told to phone my parents, as I would be sent on a week’s enforced leave to think about my actions, and what would I do differently next time. So, crutches in my hands, under my arms, I got a taxi to East Croydon station, where I found that there was a problem, so no trains were going to Kings Cross – GREAT!!!!!!!! “SO I am meant to get there how?”, I thought! Thankfully there was a lovely guy who was also trying to get to Kings Cross, and said he was going to get a cab and I was more than welcome to join him. Yes, I know that I am the girl who was warned by the staff that I have no sense of personal danger; so I thanked him for his offer, and said I would get a bus or something. He then brought out a card, an i.d. card for Orpington Hospital, and reassured me that he was a safe person, and that I would be safe travelling with him; so I reluctantly got in the taxi. I offered money towards the journey, to which I was told ‘that’s what expenses are for’! Anyways, I made it back to Leeds, found my way to my Dad’s office, and got a ride home. The atmosphere at home was dreadful. I felt like such a failure; but I told my parents that I was home cos the staff thought it would be a chance for me to rest my knee which I had had surgery on. I am not sure if my parents believed me or not, but they didn’t question it. I spent the next week online more or less solid, working at updating my website, as a lot of it was out of date.

The next month or so of my re-admission is a bit of a blur. I know that I did a lot of talking, and dealt with a lot of difficult and buried issues. Found it hard to put into words some fears, but managed to get through it with the support of the other residents and the staff. Managed to stay self-injury clean as well, which was incredible, considering how hard the issues I was talking about were.

Before I realised it, it was almost Christmas. I can clearly remember the staff running about the unit like headlesschickens whilst us residents just did what we had started a month or so before, which was to ‘do a staff!’ - which consisted of playing them at their own games. They analyse everything that we say and do, so we will analyse everything they say and do. Anyways, one evening we started to play ‘blackjack’. We then, for some reason, decided we were going to play through the night. So we did. The staff who were on ‘early shift’ arrived and asked us to get dressed as they had a rule of no pj’s in groups; but we decided to ignore them, and proceeded to enter the group room in our pj’s. I wrote a poem for the Christmas Newsletter, and it was

Hum CRU I Guess

I arrived here in July, Without knowing a soul, Except for him and her, As they assessed me back when twas nearly may.

In the car that morning, My heart was racing, Head was bashed, A ping pong game erupting.

I walked slow, unsteadily in, To this my home for the next 24 weeks, Sense burning, Stomach churning.

You were all sat at lunch, I felt like the new kid at school, Yet I knew I had lessons to learn here as I did there.

Slowly I relaxed, Took some time at first to find, I think I am still 4 ½ months on, Searching for the middle ground.

Someone took me around, Informed me of the when, where, who, what and why, I knew the how was down to me.

How to open up, How to seek assistance, How to change what was my way for o so long, How to reach out, handle rejection, I guess how, I could go on.

Within hours I was getting to know the other hell, Some say ‘you’re sent to Coventry’ yet you prefer Bromley. Left to take responsibility in the taxi, To ask and to wait, And then to be treated like SHIT!

Time evolved, And people came and went Staff as well as us residents,

As the time progressed, And evenings drew in, Games and activities were played, Won drawn and lost Each and every moment, You remained nurturing the good, And helping me to learn I think that I have come to comprehend, Its ok to be sad, Mad, happy or glad.

I am a person and thanks to you I now believe my life is worthwhile

Now my time here, As this poem is coming to an end.

I guess all that is left for me to say is thanks, You haven’t given up on me, you have enabled me to slowly realise I am worthy of a space on this earth.

I am still learning, And thanks to you forgiving me the chance to show I can, Begin to change, I may be discharged in January but I know you and the care, love and mutual respect you have given me will last eternity.

Things here are not easy, And being here is a strain, But hang in and hang on and the doors will be unlocked and the world will wait till you’re ready to be someone you’re proud of again

Before I conclude with what I have gained from my time at the CRU I am going to share briefly just a few of the fun things I will always remember about my admission.

There was a white board outside the staff office which had residents’ names, and also the name of who our allocated worker would be for that shift. But one night we (the residents) decided to change our names to those of the fish in the tropical fish tank, and gave each fish a ‘primary team’. A member of the staff working that shift came out the office shouting at us and telling us that she was going to report us to the morning staff, so we dared her; we were simply trying to have fun, and were slightly annoyed that we clearly couldn’t!

Another time we noticed one of the fish in the tropical fish tank was eating the baby fish, so we filled out a blue form and filled out the overdose side of it, as in our eyes we decided that the fish had taken an overdose. Again, the staff came out the office and said they were going to report us to the morning staff, as clearly we were trying to communicate something!! Erm, yes! “We are bored!!”

Anyways, to conclude I will let you know just a few things that I gained from my time at the CRU, as to write everything would take a lot - and I mean a lot - of paper!!

The main thing which I learnt was that it’s ok to show how I am feeling, no matter what the emotion is, and that acknowledging all emotions - even the more ‘negative’ - is ok; e.g., it’s ok to be in a bad mood, providing that you know why you are in a bad mood, as long as you can say why you’re in a bad mood!

I also learnt that I have a lot of inner strength, and that my past is not what I am, nor is my past me. It is a factor that has enabled me to grow into a brave and courageous person.

I learnt trust, and to realise not all health workers are going to leave me and abandon me, or do a ‘disappearing act’.

If I could say just two words to the staff, then they would be THANK YOU.

Lea adds:

I think - well in fact I know - CRU saved my life, as without it my life would probably still be in the chaos I was encapsulated deep within. I struggle for money still, but I'd struggle more if I was still buying blades, tablets, dressings, cab fares (I lived a fair distance from the hospital A+E department), etc. I used to literally spend all my money on them - close to a minamum of £100.00, if not more...

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