The doctor paused, and I lit another cigarette, and went on answering questions. I seemed to have answered a lot of the same questions today, and felt so thoroughly mentally and physically dissected that it was a wonder that I had anything left to say at all. There had been five doctors so far, whose names and faces and roles blended into one medical mass of notes and scribbles and half-recalled irrelevancies. Weight, height, name, next-of-kin, payment method, madness in the family, regularity of bowel movements, eating habits, delusions, hallucinations and grandmother's maiden name, all earnestly recorded and then repeated again to the next white coat in line.
It was a strange feeling, making myself into a case history, turning nine months of complex hell into tidy psychobabble, becoming a name, a number and a series of classified disorders. In a way, it was reassuring to have a label and a signpost; it made the warped and lonely sensation of a mind removed and a character utterly altered into something as safe and homely as just another diagnosis - perhaps, I thought hopefully, a broken mind would be cured as easily as a broken leg.
Just at this moment, however, most of me did not want to be here. Here was a loony bin, a psychiatric hospital, a hotel full of badly doped axe-murderers. They called it a clinic, issued neat, euphemistic brochures, offering Jacuzzis and hairdressers by appointment, proudly showing off the pastel decor and the room service perks for the crazies with health insurance. I had looked at the pretty brochures, convinced myself I would be going on the mental equivalent of an Outward Bound course, told friends I was just going away for a bit, and confidently, in a responsible adult fashion, booked myself in. Only now they told me that some guests were staying without their consent.
The path that had led me here was a long and rambling one, but by the time I arrived I was an interesting confection of Nineties diseases, from anorexia through depression to panic attacks. All of them were symptoms, and I knew - I thought I knew - how to deal with them individually, but not how to drag out their roots. I was born without brakes, it seemed - whatever I touched turned to excess, any hint of moderation lobotomised at birth. By now, my various habits were winding further and tighter round my neck to the point where I was being strangled just by daily life and I was faced with two remarkably simple options: sort myself out or stop the whole lot with a packet of pills.
In December, I had weighed six-and-a-half stone, my brain was shrieking for nourishment or oblivion and I tortured my family and friends with the habits of a dictator and the control of a robot. At the lowest point, I lost my sense of humour, any interest in anything but methods of silencing my mind and all notion of the way my behaviour affected those around me. Just by giving my brain a little food, most of these things had returned, and brutish
animal instinct had got me through a winter and spring of jerky improvements and lurching regressions, patched up by an assortment of doctors, therapists and self-knowledge. By late spring my splintered mind was returning, albeit in a different shape, and I stopped wanting to bolt every time I saw an acquaintance.
Though the physical evidence of anorexia had gone, the panics and habits of it had remained, rigid and unyielding, despite the persuasion of a thousand logical facts and all the emotional bribery I could muster. I had blundered down endless blind alleys, picked myself up again and then purposefully set off for another mental cul-de-sac, but the depression had persisted, black and unexplained, bringing with it insomnia and immobility. I was getting tired of a nightly wrestle with the Grim Reaper.
Only my own bloody-minded pride, I knew, had kept me from hospitalisation long before, but as the sound of doors closing had continued unabated and the obsessions didn't disappear, just took on different forms, I thought I'd better give up pride as well. So here I was, staring at the four walls and checking the locks of an upmarket loony bin. I felt profoundly sorry for myself, and also blackly aware that, if I was honest, all I had done in the past few months to run away had only led me inexorably here, and that I could change the surroundings as many times as I liked, but the mental furniture didn't budge an inch.
For the first couple of days, I was too disorientated to function, terrified to ask someone to pass the pepper in case the medication had worn off and they thumped me, seeking solace in distractions which didn't work in the evenings and grateful for the discipline of the different therapy programmes in the morning. It was normal, they told me later, to get worse immediately after admission; caught between one form of reality and another, taken away from all the blocks and obstacles to truth, and unprepared for the 'I'm just fine' defences being met, for once, by disbelief. Most of the rules of life just didn't work in here, I soon discovered. The first
question from one's fellow patients was always 'What are you in for?', to which it was no good replying that you were just here for the rest-cure, and the inane query 'how are you?' at breakfast was a journey into someone else's mental inferno. It was a hinterland, a surreal cross between a smart hotel and One Flew Over the Cuckoo's Nest, where one partook of breakfast in bed and listened for the twice-daily creak of the medication trolley, made a choice perhaps between a spot of yoga or a little ECT, a massage or a short trip on Temazepam.
Guests could make their multi-million calls to dealers in the morning and be recounting their latest suicide attempt at lunch; they left the car keys to the BMWs at reception, and reception decided whether they were sane enough to have them back. You could get closer to someone's naked soul than a friend you'd known for years and still not know their surname, find out every gruesome detail of someone's childhood and not know what they did for a living, know more than their wife did about their drinking habits and never know that they'd been married.
Mealtimes were strangest and funniest. Should one sit with the depressives, who all felt suicidal again today, or the anorexics, as they poured boiling water on their cornflakes and sent back the porridge 14 times, or the detoxers, as they grimaced through their grapefruit juice? Patients ate in a neat, smart canteen, with waitress service and the most discriminating tasters in the world on the Eating Disorders table, where visitors brought their children to check on Dad's delusions, and the sounds of the city outside were as far away as in a grand country hotel.
My fellow patients were, I found, bizarrely normal, semi-animate proof of the classlessness and agelessness of malfunctioning minds. Most were those, like me, who preferred to consider themselves sane most of the time and who had just reached a horrible crunch-point in their lives. The rest were generally the long-term mentally ill, such as the manic depressives or the schizophrenics who would be coming back and back to institutions like this for the rest of their lives but who made perfect sense if you only spent a couple of
minutes with them. Only a very few were irrecuperably bonkers.
By the third day I was getting used to it, after it had occurred to me that seven years of boarding school made this place a comparative picnic. I was issued with a timetable, fed regularly and could even go out occasionally; a privilege given only to those that the clinic thought were not going to endanger its reputation by injuring themselves or murdering someone else. Daytimes took on a routine and a recognisable form, which I grabbed gratefully, knowing that there was nothing like the distraction of other people's lives to shut one's own wayward mind up.
Perhaps the most fascinating time was the group therapy, to which anyone could come, and which was led by a bonhomous middle-aged woman of considerable pragmatism, a sort of Betty Boothroyd of the Bin. In here, for an hour-and-a-half, one jumped on to the moving soap operas of a thousand lives gone wrong, listened while someone wept for the first time in 20 years or furiously compared salary bands and were promptly crushed by a teenager's put-down. Twenty years of boardroom brilliance and as much money as the bank could hold meant nothing if it was all done in emotional blindness. Letters to an ex-lover could mean more than a lifetime's social or artistic genius if what you had achieved meant nothing to you now. Small things became big in here, and big small.
In some ways, the groups were a featherbed of Personal Enlightenment, a mission in Learning to be Selfish and a testament to everything you ever heard about American psycho-speak, and dreaded. (I remember sourly reflecting in the first group-therapy session that anger, selfishness and getting in touch with one's feelings didn't have to be such an acquired skill for most of the patients.) In others, they were sometimes unbelievably moving, and the consolations of comparison, the similarities of experience from the most unlikely sources and the feisty 'I speak English, not Californian' attitude of most people rendered cynicism dead. Only a few took on the jargon of sharing and bonding, the rest, like me, wanted their emotion hard, raw and in comprehensible language.
In the first session, I sat there, limply sticking to a stiff-upper British objectivity for almost a whole 10 minutes until the honesty and the riveting misery and charcoal humour got me too, and I understood the language.
It was a peculiarly respectable arrangement, truths told without jargon, horror without sentiment, and mundaneness with irony. Gradually, characters began to emerge from the mist of faces and cases, some patients remaining in menacing quiet for session after session, others throwing themselves with corporate zeal into the mental fray.
Certain themes recurred; often people on the point of leaving got the horrors and had to be gently prodded outwards, terrified that when they left, none of the hard-learnt theory would be practicable, and that the language in here wasn't spoken outside. Others raged, impatient for instant results and furious that nobody gave fixed dates and times to heal a broken mind. Usually, these were the men, railing at such ephemeral notions as feelings and grappling for what used to be reality in a sliding, melting world.
I learnt rapidly that unless one said nothing, in which case the whole exercise was a waste of one's Bupa premiums, there was no hiding, and that one could be torn apart and then rebuilt by one's fellow loonies as easily as Lego. A lifetime spent learning how to lie and disguise outside could be torn off by another patient faster than paint-stripper. Sometimes, patients who had been there for weeks dissected with brutal honesty someone else's story. One day, a gravel-voiced manic depressive paused in the middle of his sixth suicide anecdote, waiting for a suitably impressed reaction. 'Don't you realise, John, that trying to kill yourself isn't cool?' said an ex-alcoholic merchant banker in here for a breakdown of unspecified origin, 'We've all done it, so shut up, stop using your disease as your excuse and fuck off.'
If group therapy made sense, took me out of my own boring, obsessive self-absorption for that precious hour and a half every day, the other groups in the daily timetable could sometimes be a careful exercise in rebuilding confidence and distance. On the general psychiatry programme, there was Stress Management, Loss and Change, Relationship Issues, Feelings Groups or Self Awareness on offer, most of which provided heavy mental snortings when I looked at the timetable, but all of which taught me something, even if it was only that they didn't teach me anything.
The Women's Group discussed relationships, which I thought was thoroughly sexist, until someone said that in time-honoured tradition, they had tried a Men's Group and nobody came. Tom, a doped-up teenager with deep, straight red scars on his arms that didn't need to be explained, told me early on in my stay that the Art Therapy was great; he'd spent an hour last week scribbling Jackson Pollock nonsense in crayons and was told after measured consideration that it meant he was confused. Great, I thought, and we pay for this?
There was also Psychodrama, where life was one long Steven Berkoff play, and in Cognitive Behavioural Therapy there were smart Venn diagrams of polysyllabic words for thinking your way logically out of depression. I went earnestly to the first couple of sessions and then gave up, on the grounds that I had usually cognited quite enough for that day, wasn't in here for my ability to think logically and could never understand maths anyway.
On the Eating Disorders floor, they watched you eat and made you write Feelings Diaries. To tempt me, they offered Assertion Training, Goals Groups and even Individual Time, but I refused, grateful for just a counsellor and my own occasional investigations. I thanked fate and the intake officer every day for putting me with the psychos - mealtimes with a table full of alter-egos was agony enough without the additional aversion therapy of being mentally spoon-fed or explaining that dodgy craving I always had for mozzarella cheese to a roomful of Kleenex and sympathy.
I was, after all, fully aware that I was an anorexic, even though I no longer weighed like one, but I also powerfully loathed the label and all that it brought with it. I also knew that if I regressed, I had the gun to my head of being put on a floor full of people just like me. Usually I pushed myself forward, propelling myself to look at mental puddings I didn't like to, knowing that avoidance in the end proved expensive and messy.
By mid-week, my brain felt like it had been blow-torched and I wondered when I went out on to the streets whether I wore a large sign with 'clinically insane' on it. I soon realised that if I did, no one was looking: everyone on the outside was as crazy as in there, they just didn't have Bupa. My wanderings round the streets gave me back my bearings, showed me that the world rolled on, oblivious, without sympathy and Bills of Rights, and though sometimes I came back gratefully to the increasingly welcoming wards, I needed to go out with all the vestiges of pride I had left.
For those who were forced to stay in, there were also endless hours of boredom and television. Round the claustrophobic corridors men wandered like trapped bluebottles and rocked and sang to themselves. I got used to the strange, immobile walk of the heavily medicated and to the jerky sounds of someone sobbing somewhere. For much of the time, the agonies of self-examination and the necessity of peace from the babble after the groups and meals meant that people retreated to their rooms and slept or shuffled in circles, stuck with the contents of their unstuck minds.
In some ways the clinic exacerbated each person's already eggshell state of mind, in other ways it soothed it, partly with the comfort of being among one's own kind, but mainly with drugs. Most of the patients were heavily doped, the detox patients coshed out on costly tranquillisers from which they awoke physically and financially cleansed, the panic attackers and the depressives often drowsy from their personalised cocktails.
Partly out of the stubbornness that had got me here in the first place, partly out of terror of saddling myself with another addiction, I always refused the drugs on offer, and rapidly grew expert at working out how recently each person had been dosed, and with what. Most of the time, it was like being at a strange party where everyone around you is drunk and you're driving.
But despite the distractions of the groups, their sudden blinding intimacies, my fellow patients and the forays into the outside world, there was still a great deal of time - too much for comfort. Dinner was finished by seven and between then and insomnia, there was what every true depressive dreads - time alone. Removed from the oblivion of work, social life or even the washing up, we had nothing to do in the clinic except sit back, relax, get an EastEnders habit and go barmy all over again.
Usually in the evenings, there was a brief visit from one's personal shrink, who mopped up the day's shambles and gave one a little more emotional insight for good measure. I wasn't very good, I discovered, at emoting all over everyone else in the groups, but in privacy I could weep with the best of them, lose all my precious control, and it didn't matter at all. They'd seen it all before, heard the thousand-
times-worse stories, listened to the denial and sorted out the darkest thoughts, so what did I think I was giving them that they couldn't take?
During the early nights, when I stayed in my room too zonked to talk and too disorientated to make sense, the hours seemed like a threat, and a piece of criminal neglect on the part of the clinic. I darned, wrote, read, watched television, smoked, wrote some more, used up tissues and took my mind on stern lecture tours round unhelpful self-help books. Later in the week, when I had convinced myself that I wouldn't be assaulted by a psychotic between medications every time I crept from my room, I went and sympathised with fellow patients. There was also a kitchen in which patients would sit and get bored and I could contemplate my relationship with the contents of the fridge. On my first night, I had considered it somewhat alarming to be told casually that there had been a suicide attempt and a couple of self-mutilations that day. By the end of the first week I was blase about such tales.
Some nights, when I was feeling anti-social and unable to take on the contents of someone else's mind, I went in search of the nurses, who would come and chat between rounds. Most of them loved their strange jobs, I discovered, and told me stories about their work and lives before their bleepers went. I capitalised on a rising interest in other people later on in my stay by questioning them endlessly, still stuck for the reason why they wanted a job from which there was the daily prospect of not returning in great physical shape.
Who were the worst patients, I asked Emma, a comforting Jamaican night nurse. The psychotic depressives, she said, because they have no insight into their own state of mind, and when the newsprint or the walls speak to them they get quite tetchy if you point out that walls don't in general communicate. I thought of Rebecca down the corridor, who told me a couple of nights earlier that she'd been to the newsagent's, seen a packet of Death cigarettes and the Nike ad slogan, 'Just Do It', and had had to be forcibly prevented from drawing her own bloody conclusions.
I asked Emma if anything had changed in the 20 years she had been working. Only the drugs and the treatments; she spoke warmly of the new anti-depressants on the market and the movement away from doping everyone stupid instead of working out why they needed doping in the first place. She said that she'd even heard that they had started experimenting with the brain's original blueprint now, and perhaps in 20 years' time would be able to remove before birth the wayward genes from the mind, aborting insanity and leaving only the pleasant, the well-adjusted and the light sides of humanity. 'I'd be out of a job,' she said gloomily, and we both agreed that if perfect people wasn't enough of an excuse to get gone from this world, nothing was.
Rarely, there were more alarming noises during the nights, from new and protesting clients, euphemistically called critical admissions. There were only a few patients, I discovered, who had been sectioned under the Mental Health Act - most admitted themselves, driven here by instinct and desperation. Those who took unkindly to being told that they were ill were invisible presences, apart from the occasional thud or muffled yell, and the evidence of shredded wallpaper down the corridors the next morning. Until they had been persuaded that this was in their and the public's best interests, these patients generally stayed ominously silent in their rooms.
But midnight would come, as it always did, and the drugs worked and people went to bed. I stayed awake, thinking myself into pointless pitfalls that I knew were illusions but couldn't prevent with all the Venn diagrams and cognition in the world. In the small hours, there were only the sounds of the shuffles of a fellow-insomniac, and the quiet hourly clicks of the door as the night nurses checked that no one was doing anything the clinic might be sued for. I did, in general, sleep, though, better than for months, exhausted by self-absorption and removed from all the things that drove me into wakefulness at home - and for that alone I was grateful.
They say that the darkest hours are when you travel furthest. One particularly ghastly night, feeling bleak and self-piteous, I went and found one of the nurses, still desperate then for an instant fix solution before I persuaded myself to do something silly. Why, I bawled, couldn't I solve it with learning, why was I born with addict's blood, how did I get through the days? She didn't euphemise, just told me straight that there were no instant solutions here or anywhere else, that nothing except the will to live and the drive to find out would give me answers, that this particular trip took as long as it took, and that the best I could hope for was the knowledge of the once-bitten. I swallowed that, I suppose, and thought as I usually did that another 24 hours wouldn't do me any harm.
In the end, I stayed for as long as the money would allow, reluctant like everyone else to return to the treadmill of existence and brown envelopes on the doormat. The feeling of being understood sucked me in and warmed me up, and I made friends and found sympathisers. Sometimes I felt like the Ancient Mariner, with not one but a thousand albatrosses falling from my neck every day, halfway through an inexplicable penance that still wasn't done. I could return, I knew, like many did, with the job unfinished and the theory unpractised, but the clinic had shifted things enough, opened enough doors to make calling myself a victim any longer pointless.
There was, in the end, no great knowledge that the clinic had imparted to me that I couldn't have absorbed somewhere else, no answers that they gave that I hadn't heard before, no miracle cures in the groups or the pills. If it worked, it worked because I had been ready to listen, and had gone looking for answers and people and wisdom. As I got into the taxi to go home, I did, I think, understand how to go on, to sort out the obsessions, to live with the depression and to beat the grip of anorexia, knowing that I was still only halfway down the road, and that if I didn't stick to the principles I had been shown, perhaps I'd be one of the critical admissions. After all, I thought wryly, at least it makes a good story. -