More Than “Three Hots and a Cot”

Three hots and a cot. A casual phrase, but one that provokes an immediate, visceral reaction for me. The first time I ever heard anyone use the phrase was when I taught freshman composition at a local community college. I had assigned my students  an article to read about prison reform or unjust sentencing, and the class was discussing the author’s ideas. One young man defended the existing state of prisons and concluded by saying something along these lines, “Look, they get three hots and a cot, TV, and a workout room. In lots of ways, life in prison is better than where those people come from.”

The River of Uncertainty

Those people. The very anonymity of the description renders imprisoned people faceless shells of who they actually are. And for the past three years, I’ve volunteered in a local prison and gotten to know a lot of “those people.” Getting to know several of the men and women who are incarcerated in our state prisons has erased any stereotypes I previously held of who they might be. And the food and living conditions in our prisons are far from being better than where anyone came from, at least in my experience.

So when I heard a new friend use the phrase “three hots and a cot” in relation to patients in a psychiatric hospital, I was shocked into silence. To be fair, this woman, a physician’s assistant, was talking about the need for in-patient psych facilities run by the state as opposed to our current situation that leaves many people wandering the streets or being imprisoned. But again, the phrase was casually tossed into the conversation where she advocated for “three hots and a cot, a safe place to regroup, counseling, and meds for two to three weeks to help people get back on their feet.”

My reaction was instinctive, but I was mute. I listened and pondered what I could say. “Better than putting those people in prison, which is what we do now,” one woman said. And while I agree that we have a need for more care for people who suffer from trauma-induced emotional distress (I refuse use the term depression because of what it connotes), I know that the solution is not as simple as providing in-patient facilities for emergency care. And I wondered if any of the women in my circle had ever been psychiatric patients themselves. Like I had been. Like my mother had been. But I was silent.

I didn’t want to get emotional–passionate, really–with my response. This is what I wanted to say:

No, we can’t just medicate people, hospitalize them for a week or so (if you are very, very lucky) and then discharge them without addressing the environment that they will be returning to.  Have any of you ever read about what psych drugs can do to people over the long-term? Do you know about the dangers and difficulties  of discontinuing psych drugs once you start? Do you know there is no scientific proof that a lack of serotonin or an excess of dopamine causes depression, schizophrenia, or bipolar disorder? Do you know that sometimes taking  antidepressants can actually cause bipolar disorder?

And how about this admission (excerpted from “More on the Chemical Imbalance Theory” on the Mad in America website) from Dr. Ronald Pies, a highly-regarded psychiatrist?

The “little white lie” is, of course, a reference to the 2014 article by the very eminent and influential psychiatrist Ronald Pies, MD.  In that article, Dr. Pies characterizes the chemical imbalance theory as “…this little white lie…”

Dr. Pies has also insisted – arguably delusionally – that psychiatry never promoted the chemical imbalance theory of mental illness.  In a 2011 article he  wrote:

“In truth, the ‘chemical imbalance’ notion was always a kind of urban legend – never a theory seriously propounded by well-informed psychiatrists.”

But Dr. Pies’ words haven’t filtered down into mainstream knowledge. Part of the reason I didn’t speak up is because I meet so much resistance when I present the information about lack of evidence for the chemical imbalance theory  and the harm that can come from psychiatric drugs. But I am convinced, based all the books and articles that I’ve read over the past five or more years. And I’m convinced by my own life-experiences and the experiences of other people that I know.

Because I know that there is a desperate need for compassionate, community-based care,  I’ll be posting a blog on what would I advocate for in the next few weeks. In the meantime, here is a poem of mine, recently published on the Mad in America website, about my experience visiting a friend in a local psychiatric hospital and recalling my own experience.

A Therapeutic Environment

I bring a small basket of flowers
for my friend in the psych unit,
the nurse buzzes me in.
She silently yanks
the plastic card-holder,
then chides me,
It has a pointy end.
My friend tells me later,
“No one gets flowers here.”

My friend wears
blue paper pajamas—the only thing that will fit over her cast—
until I bring new sweatpants
“No drawstrings,” she tells me. “The nurses will take them out.”
Other patients wander
as if in an endless maze
blankets over their heads,
eyes trained on the ground.

The nurses stare into computer screens
behind thick walls of safety glass
—barricaded against what danger?
Perhaps mindful that one day they too
might be lost
like the wandering “others”
in the blue paper pajamas.

My friend is hospitalized
because she tried
to hang herself. She had stopped eating.
Has your appetite returned? I ask.
“We had fish sticks for lunch.
They were so hard I couldn’t chew them.”

She recites the meds in her psych-cocktail—
Lexapro, Topomax, Prozac, and Zanax.
She shrugs and whispers
“I don’t feel any better,
and the weekend doctor
wants me to add Ritalin.”

We move into the dayroom
and I step across a stream of time
to the same place I left in 1997.
The same tattered furniture,
the same dull green walls,
punctuated by a lone picture hanging
crooked and uncentered.

Board games thrown on the shelves—
lids with no bottoms,
scattered pieces from the “Game of Life.”
“No one bothers
to start a puzzle—
we can’t find all the pieces,”
my friend tells me.
A bin of crayons
sits on the shelf,
but there’s no paper.

When I see the flip chart,
I flash back 18 years and remember
the goals’ group twice a day,
but still no art classes.
No dance, no movement
except the aimless wandering
of the blanket people.
No way to shape the confusion
churning inside.
No play dough.
No glue.

Two nursing assistants
fill chairs on the perimeter of the room.
They poke their heads up quickly,
like prairie dogs scanning for predators,
then return to the games
on their mobile phones.

References for further reading:

See The Hidden Epidemicby Robert Whitakerfor more information on the history of developing psychiatric drugs, long-and-short-term effects, trends in rates of mental illness and disability, and alternative treatments.

See Psychiatry Under the Influenceby Robert Whitaker & Lisa Cosgrove for an exploration of the mutually-beneficial relationship between the pharmaceutical industry and the psychiatric community, including medical schools and professional development.

See Prozac Backlashby Joseph Glenmullenfor research on the clinical trials related to antidepressants and the numerous side-effects that patients experience. The book also includes a section on alternative treatments for emotional distress (depression).

 

 

How Poetry Heals: A Personal Story

How can poetry help depression?  Aren’t medication and therapy the best ways to treat the illness? My story may surprise you.

When I suffered from depression in the early 1990s, Prozac was the new “miracle drug.” Along with this so-called “miracle drug came a physical explanation of causation: that depression is caused by a chemical imbalance in the brain. This thesis is still widely promulgated, though much research is coming to light that disputes and even negates this biomedical explanation for the darkness that is so prevalent in our modern world. More information on the research side can be found at the website Mad in America, curated by science reporter Robert Whitaker. As part of Whitaker’s work to educate the public, he invites doctors, psychologists, counselors, and patients from all over the world to share research, essays, and personal experiences on the issues of depression and its treatment.

Ancient doorway in Rome
The other door to healing

Even in the 1990s when I  struggled to climb out of depression and tried numerous medications for several years with no results, the idea that the chemicals in my brain were out of whack did not provide a solid answer. Instead, I pursued a more metaphysical explanation for the questions that haunted me:  “Why am I depressed?” and “What longings are unfulfilled?”

And that’s what led me to poetry. One of the most valuable resources I found to aid in making sense of the gifts of depression was poet David Whyte’s 1992 CD entitled The Poetry of Self Compassion. Whyte’s recitation of Mary Oliver’s poem “The Journey” confirmed my feelings of being on a perilous but necessary quest through darkness and confusion. And I was deeply confused by the all-encompassing psychological pain that I was experiencing. But once I heard Whyte recite “The Journey,” I knew that someone understood a piece of what I was experiencing. And that the way I was feeling  had nothing to do with messed up brain chemistry. My depression had everything to do with self-discovery and taking charge of my life.

The Journey

One day you finally knew
what you had to do, and began,
though the voices around you
kept shouting
their bad advice–
though the whole house
began to tremble
and you felt the old tug
at your ankles.
“Mend my life!”
each voice cried.
But you didn’t stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do–
determined to save
the only life you could save.
~Mary Oliver

I remember listening to the poem over and over–as if rolling around a mysterious new food in my mouth, trying to figure out why it tasted familiar. What was it I was determined to do?  What else besides raise my children, serve my community, and be a good wife? I just knew there was more. And Mary Oliver’s words gave me the courage to make the journey that would save my life.

The answer was slow in coming, but I gradually began to  realize that my struggles with depression and a migraine headache exacerbated my ex-husband’s verbal abuse to the point where I could finally see his behavior for what it was. Depression and chronic pain became my crucible for change and my pathway to a new life. My body and my mind were finally aligned. Poetry became my way to unlock the profound secrets that illness led me to discover. Poetry helped me to have compassion for my journey and for all the mistakes I had made along the way.

Whyte ends on a note of great compassion in the poem “The Faces at Braga” as he compares surrendering to the fire of depression and embracing your flaws in this way: “If only we could give ourselves to the blows of the carver’s hands, the lines in our faces would be the trace lines of rivers feeding the sea” and we would “gather all our flaws in celebration, to merge with them perfectly…”  What a compelling call–to celebrate one’s flaws. What a gift of healing.

How Poetry Heals: A Personal Story

How can poetry help depression?  Aren’t medication and therapy the best ways to treat the illness? My story may surprise you.

When I suffered from depression in the early 1990s, Prozac was the new “miracle drug.” Along with this so-called “miracle drug came a physical explanation of causation: that depression is caused by a chemical imbalance in the brain. This thesis is still widely promulgated, though much research is coming to light that disputes and even negates this biomedical explanation for the darkness that is so prevalent in our modern world. More information on the research side can be found at the website Mad in America, curated by science reporter Robert Whitaker. As part of Whitaker’s work to educate the public, he invites doctors, psychologists, counselors, and patients from all over the world to share research, essays, and personal experiences on the issues of depression and its treatment.

Ancient doorway in Rome
The other door to healing

Even in the 1990s when I  struggled to climb out of depression and tried numerous medications for several years with no results, the idea that the chemicals in my brain were out of whack did not provide a solid answer. Instead, I pursued a more metaphysical explanation for the questions that haunted me:  “Why am I depressed?” and “What longings are unfulfilled?”

And that’s what led me to poetry. One of the most valuable resources I found to aid in making sense of the gifts of depression was poet David Whyte’s 1992 CD entitled The Poetry of Self Compassion. Whyte’s recitation of Mary Oliver’s poem “The Journey” confirmed my feelings of being on a perilous but necessary quest through darkness and confusion. And I was deeply confused by the all-encompassing psychological pain that I was experiencing. But once I heard Whyte recite “The Journey,” I knew that someone understood a piece of what I was experiencing. And that the way I was feeling  had nothing to do with messed up brain chemistry. My depression had everything to do with self-discovery and taking charge of my life.

The Journey

One day you finally knew
what you had to do, and began,
though the voices around you
kept shouting
their bad advice–
though the whole house
began to tremble
and you felt the old tug
at your ankles.
“Mend my life!”
each voice cried.
But you didn’t stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do–
determined to save
the only life you could save.
~Mary Oliver

I remember listening to the poem over and over–as if rolling around a mysterious new food in my mouth, trying to figure out why it tasted familiar. What was it I was determined to do?  What else besides raise my children, serve my community, and be a good wife? I just knew there was more. And Mary Oliver’s words gave me the courage to make the journey that would save my life.

The answer was slow in coming, but I gradually began to  realize that my struggles with depression and a migraine headache exacerbated my ex-husband’s verbal abuse to the point where I could finally see his behavior for what it was. Depression and chronic pain became my crucible for change and my pathway to a new life. My body and my mind were finally aligned. Poetry became my way to unlock the profound secrets that illness led me to discover. Poetry helped me to have compassion for my journey and for all the mistakes I had made along the way.

Whyte ends on a note of great compassion in the poem “The Faces at Braga” as he compares surrendering to the fire of depression and embracing your flaws in this way: “If only we could give ourselves to the blows of the carver’s hands, the lines in our faces would be the trace lines of rivers feeding the sea” and we would “gather all our flaws in celebration, to merge with them perfectly…”  What a compelling call–to celebrate one’s flaws. What a gift of healing.