Posted in Advocacy, Mental Health

‘Bedlam’s’ True Horror History

Today’s post is the first that looks into the history of psychiatry and ‘treatments’ for the insane, mad, mentally ill and neurodivergent, through a brief overview of the history of Bethlem. I think it’s important to share and learn about this history because it helps us to better understand the foundations and influences on psychiatry nowadays, and therefore understand the problems and potential solutions within the mental health system, including abolitionist approaches. I hope you find this little guide to be informing, let me know if you have any questions in the comments! Just a quick trigger warning for psychiatric violence and restraints.

Bethlem Royal Hospital was one of the first lunatic asylums. It’s horrifying history has inspired lots of books, movies and TV shows, most notably Bedlam.

So the real life horror in its history should be evident, otherwise why would it inspire such horror stories? Yet often we don’t stop to wonder about such histories that informed modern day psychiatry. It’s important to learn about this stuff because the legacies can still be seen nowadays in abusive, neglectful, and ineffective systems.

Bethlem was originally founded in 1247, and was linked to the Church of Bethlehem. It’s foundations are muddied and muddled – it was first used to house alms and poor people with religious ties and with the aim to make money. This monetary trend is also something we still see nowadays in many areas of life, including in the mental health system and coupled pharmaceutical industry.

It’s not known exactly when Bethlem was first used for the insane but is frequently assumed that this was from 1377. Management was through ‘keeperships’, with essentially sole control. Jumping ahead a bit, during Sleford’s keepership at the hospital (1579-1598) the buildings fell into disrepair – ‘so loathsomly filthely kept not fit for any man to come into the house’

However, living conditions didn’t exactly improve. Into the 19th century many inmates were left to sleep on straw beds and only permitted to go the toilet in their cells. Simultaneously financial exploitation by head physicians was common from the 17th century onwards – they were getting rich while the people inside suffered. In fact, in the 17th century several patients were found to be suffering from starvation, and staff practices were found to be a significant contributing factor to this. Staff practices are often a main complaint by inpatients today as well – but they are far too frequently brushed aside; once you’ve been labelled as unstable it’s incredibly difficult to reclaim your power and have your concerns legitimised.

While it appears restraints and solitary confinement were used for the insane at Bethlem from the start (and still today!), not a lot is known about so-called ‘treatment’ in the medieval period. However from 1460 the transition to a specialist institution for the insane was mostly complete and more is known from then on. In the 1680s cold baths were introduced as a form of treatment, as were incredibly hot baths later. Patients were bled, blistered, then dosed with emetics (make you vomit) and laxatives indiscriminately during the 18th century.

Perhaps one of the most disturbing parts of Bethlem’s history is that from the 17th century onwards visitors could pay to come and gawk at patients like animals in a zoo. Can you imagine the shame and anxiety of having your distress put on show as amusement for others? How could anyone possibly heal in that environment? We can infer from this a part of the pattern of control and benefit from locking mad people away rather than a genuine care for them as individuals and a desire for them to heal.

There was even an ‘Incurables Division’ added 1725-1738; patients in here could never hope to leave. One approach was rotational therapy: a patient was put in a chair suspended from a ceiling and spun at sometimes more than 100 rotations a minute

Experimental (read: unsafe) treatments were also used on patients at Bethlem. Furthermore modern investigations have uncovered mass graves on the property, dug exclusively for those who died under care at Bethlem.

This barely scratches the surface of Bethlem’s horrifying history of abuse and exploitation. The hospital is still in use today and many patients are still voicing their pain and trauma from their time there – restraints are still used, as are forced medication, and mad voices are not respected. There’s even a museum of patient’s artwork there, and while some exalt this as them respecting the patient’s expression, I have to wonder to what degree is it a modern day version of gawking st misunderstood minds?

We may have come a long way, but there’s still a lot further needed to travel.

Sources:

https://www.huffpost.com/entry/bedlam-the-horrors-of-lon_b_9499118/amp

https://en.m.wikipedia.org/wiki/Bethlem_Royal_Hospital

Porter 2006, Whittaker 1947 

Porter 1997 

Andrews et al, 1997 

‘A view of Bethalem’ 4th December 1598, quoted in Allderidge 1979

Posted in Advocacy, Managing Mental Health, Mental Health, Personal Growth

Journey Through Panic Attacks

The first time I experienced a panic attack I was 11 years old. I had come home early from school that day with a headache and some other physical symptoms I now know were anxiety, and I had gone upstairs to have a nap before dinner. My mum came to wake me up when it was time to eat, but I must have been in the wrong phase of my sleep cycle because I awoke disoriented, thinking it was the morning. We’ve all been there when we wake up not quite sure what’s going on. So I thought it was the morning, and when my mum told me it was time to eat I responded asking about breakfast. There was some confused back and forth with my mum trying to convince me it was in fact dinner time, and still the day before, and I suddenly spiralled into my first panic attack. I don’t remember a whole lot of the details while it was happening, but I do remember how terrifying it was. I remember feeling like I couldn’t breathe; I simply could not get the air into my lungs. I felt faint, and sick, I thought my legs couldn’t hold me up. I don’t know if I had the thought that can come alongside panic attacks where you think you’re going to die, but I knew something was very, very wrong; I definitely thought I was going to faint. Somehow I ended up at the bottom of the stairs, gasping for air and sipping water out of a bottle cap (I think that was the only way I could manage to do it?) as it subsided, and I can still recall the exhaustion after that first one and how foreign it felt. My mum suggested it had been a panic attack, and at that point I didn’t know what that meant. I had no idea they would become such a huge part of my life. 

I have had many panic attacks since this day. I’ve also had some anxiety attacks, which are more prolonged and less intense, and I experience sensory overload too as an autistic young person. Sometimes sensory overload meltdowns and panic attacks can be hard for me to distinguish, and sometimes they overlap or morph into the other, but it’s helpful sometimes to figure out which is which as it can aid in the recovery process both long and short term – for example in a panic attack changing my jumper probably isn’t going to help and may not even be a possibility, but with sensory overload changing the material of my clothing or my environment may help it to subside or avoid it altogether when I feel it building. This year I have felt the strongest mentally overall that I have in a very long time, but I still have panic attacks. Some months I have none; others I have many. For example in May I had seven.

 It’s important to note that while I find the label panic attacks useful, it is a pathologised word. That means there is a certain medical connotation attached to it. However panic attacks are a total overload of our nervous systems; an explosion of tension and anxiety. We cannot talk about expressions of mental distress without recognising that they are often responses to a traumatic and stressful world, whether immediate results of a specific trigger or a build up over time. For example in May I was dealing with exam stress, difficult atmospheres at home, grief for my safe place, and more time on my hands. These all contributed to my spike in panic attacks I have no doubt. Other times I may make it to the other side of a stressful event and then experience panic attacks, almost like a hangover of emotions. It’s not an individual failure, but an understandable reaction to a difficult world. You are not broken for experiencing anxiety. You are not shameful for having panic attacks. 

I am a firm believer that to appreciate life fully we need to be able to laugh, even at the bad stuff. There are certain events surrounding some of my panic attacks that I find kind of hilarious looking back on and that helps me to deal with any embarrassment or regret surrounding them I may have. For example, I have terrible stage fright (despite being an actress, ironic I know). Before the final dress rehearsal for Bugsy Malone – my first show in a proper theatre – I had a panic attack in the wings. I was crouched behind a prop box in heels I could barely walk in and my tailored sparkly dress writhing my legs in pain and sobbing without air. It was a pretty desperate moment, though the juxtaposition itself is amusing looking back. The next thing I remember is a stagehand saying into their walkie talkie ‘can someone please come and remove the fire hazard from the wings?’. I was the fire hazard because I couldn’t move myself out of the way, and I was carried back to my dressing room by my director. Talk about a diva moment. Looking back I cannot help but laugh at the absurdity of the experience. 

That particular panic attack also showed me how loving people can be. I hope that someday everyone experiencing mental health issues gets to experience the pure love and support that I did that day. I had to go on stage just after recovering to do a mic check. I was so exhausted – my bones were heavy; the exhaustion of a panic attack travels to your core and can make you feel like your body isn’t your own – so all I could do was stand centre stage. The rest of the cast sat in the audience as I weakly sang ‘My Name is Tallulah’. Half way through the song I raised my eyes and saw that they were all swaying along, waving their hands in the air; at the end of the song they stood up and cheered and called out encouragement. It was beautiful. No one judged, no one whispered or pointed. They rallied and supported me. That’s what we all deserve. 

Another amusing panic memory was when I fell on my face in the mud on a rainy day trying to escape prying eyes and instead drawing them all to me; again, it wasn’t as embarrassing or well remembered as I feared it would be. Or when my teacher gave me their scarf to wrap around me and help me feel safer and I immediately snotted into it – I got to keep that for a while rather than immediately returning it. Or the time I went to get help while having a panic attack but there was already a girl in the office having a panic attack and it became like a queue for a very strange and unwanted product.

 I’ve been alone on bathroom floors, writhed my legs, hit my chest, backed myself into literal corners to try and feel a bit safer, thought I was going to die, taken off most of my clothes because I thought my skin was going to burn, and just general cried and made weird sounds while trying to breathe. Point of all of this is – I survived. And each one has become a little easier to recover from. The worst a panic attack will do is make you pass out; it cannot kill you. Remember that – it cannot kill you. If you are having one, it is horrible and tiring and painful, but you are safe. And if you are with someone experiencing one it’s ok to remind them of that; if you can recognise what it is and call it what it is. Tell them it’s a panic attack and that they are safe. Often it helps not to try and suppress it either but rather to ride it out, let it be. Because they are not the end of the world, but they are super scary and it’s ok to recognise that too. 

I hope that maybe reading this has helped someone feel a little less alone in their experience. If you’d like a more in depth guide on how I deal with my panic attacks let me know in the comments below! Sending love and support to you all today! Xx

Posted in Managing Mental Health, Mental Health

How to Support Someone With Mental Health Issues

It can be extremely hard to watch someone you love and care about going through a tough time regarding their mental health. It can also be painful if someone close to you discloses their mental illness or mental health struggles and you had no idea about it. You may feel like a failure yourself, like there’s nothing you can do, like you are useless. Essentially it may start to impact your mental health as well. That’s why the most important thing to remember when supporting someone with mental health issues is that you need to look after yourself as well. You have to.

1. Look after yourself

Sometimes we want to rush in and save the whole world – fix everything – but this simply isn’t possible. Perhaps at first it may seem like a good idea to try and take on the other person’s issues entirely as your own, without giving yourself the space needed to process your own emotions. In fact for a short while this may actually help the other person – but that’s not sustainable; long term it will lead to you burning out, struggling yourself or becoming resentful, likely making the entire situation worse. That’s why it’s so important to look after yourself, even if this is just journaling at the end of the day to help you sort out the feelings of the day, or doing a hobby once a week, the possibilities are limitless and you have to find what works for you. The important thing is that you do find it. And putting in boundaries with the person you are supporting can also help this, and most likely will help them in the long run too.

2. Listen to them

Many people with mental health issues, especially when they are first opening up about them, doubt themselves, feel ashamed or invalidated. By listening to them with an open mind you can help lessen these feelings. And by listening, I mean just that. Not everyone wants (nor even needs) advice or solutions all the time, sometimes they just need to be heard so they feel a little less alone. When having a conversation about their emotions/ experience it can be really helpful to ask the question ‘would you like me to offer advice or just listen to you?’. Validating their experience through listening to them can have a huge impact for someone struggling and give them confidence and reassurance. Remember that they are the one that lives in their brain, and they know what they are going through better than anyone else; it’s not your job to dictate to them what they are undergoing. However, linking to my last point, it is important that you don’t take on all of their feelings for yourself, so placing boundaries can be really helpful – for example requesting that before they talk to you, they ask you if you are in a place to have that conversation.

3. Involve them

Going through a tough time mentally can feel very isolating, and our brains can make us feel very lonely and rejected. That’s why it’s important to continue to involve someone who is struggling mentally. This could mean continuing to invite them to social events while making clear there is no pressure or expectations placed upon them to attend. If they accept and invitation, it might then mean making some accommodations for them, like helping them order food if that’s a point of anxiety for them or giving them some space if they need it for example. It might also mean offering to meet them one on one for a while if that’s easier for them, or talking with them about plans to keep them safe and checking in with them regularly. To relate to my last point, if you’re unsure of what to do, you can always ask them if they have any ideas or if there’s a way you can accommodate them better. This is a huge sign that you care for and accept them still.

4. Research their experience

If the person you are supporting has a diagnosis or has disclosed to you specific symptoms, it can be helpful for your own knowledge to research this. A quick google search will bring up symptoms lists and examples of how these might affect them, but I would also encourage you to look beyond this and read up on the personal experience of different people from different walks of life to get a clearer picture. This can help you understand the person you are supporting better without the worry that you are prying to much, and it can help them to feel seen as this informs how you support them.

5. Make them a happy kit

I’ve made a previous post on this, which you can read here. A happy kit is essentially a little collection of things that can help someone process their emotions, get through a crisis moment, or just generally cheer them up. It can include some things that they find calming or cheering, and maybe a list of distractions and mini coping exercises to try. Distractions are also a really great way to help someone with a mental health issue – it’s not a long term fix but it can help them escape their brain for a minute and feel more ready to face the day. If a distraction is creative it could also be a way of helping them to express themselves, and feel less alone if you’re doing it together.

6. Help with small tasks

Small tasks such as cleaning, ordering food, or remembering deadlines can become seemingly impossible for someone experiencing a mental health struggle. If you feel up to it you can offer to help them with these small tasks, even if that’s just by doing it with them (for example cleaning together one afternoon, or going food shopping together). As always, asking them how best to help is always a good idea, and if they’re not sure offering something specific – such as sending them a reminder text – might appeal to them.

7. Show them you care

It’s simple, but one of the most helpful and meaningful things anyone has ever done for me during my own struggles has been showing me they cared. This could mean writing someone a supportive letter, or making them a playlist. Just something simple that lets them know you care.

7. Be patient

We all have mental health and it can be a long term challenge to face for many. Someone in the midsts of a struggle isn’t going to overcome it overnight, but with amazing people like you willing to support them, they can find their way through. Keep in mind that you need to be patient – one of the reasons why looking after yourself is so important – and that their struggles are not a comment on you, ever. Eventually the sun will come shining through!

Posted in Advocacy, Mental Health

Reducing Mental Health Stigma

I have been fortunate that I have not personally come up against too much explicit stigma throughout my mental health journey so far – and when I have, there has been an incredible amount of supportive people surrounding me. However just a quick trip online reveals how much stigma still exists around mental health, and backhanded comments such as ‘just snap out of it’ or ‘you don’t look mentally ill’ are far too common. Sometimes I am afraid that I will be left out from job opportunities or educational experiences in the future because of my struggles. And so it is important to me, for my benefit and the benefit others, that I do what I can to reduce stigma in my advocacy. For me that means sharing my story, educating myself (especially on the intersectionality of mental health in society), and being open in conversation. Here is my quick guide on what anyone can do to reduce mental health stigma.

  1. Change your language

It might insignificant, but language holds power. What I mean by this is avoiding calling someone who is mentally ill ‘crazy’, and instead validating their experience. Another way to adapt our language is to avoiding using conditions as adjectives. For example instead of saying ‘I’m a bit OCD’ say ‘I like things to be tidy’, and instead of saying ‘She’s so bipolar’ say ‘she’s a bit moody today’. Changing our language can signify a shift in how we approach topics, and encourages us to be more mindful of how what we say can impact someone.

2. Educate yourself

Education is a powerful tool. Educate yourself on the warning signs of mental health issues, different conditions, and the reality of the lived experience of those struggling with their mental health (they’re not the dangerous, horrible people that some media may lead us to believe they are). And educate yourself on the fact that everyone has mental health, and everyone deserves to look after it. Furthermore, educate yourself on how mental health is intersectional with identity and social issues. Here is a post from my instagram that has some basic statistics on this.

3. Listen

When someone speaks up about their mental health, listen. Actively listen. Do not try to shut them down or tell them to toughen up. Listen to what they need and what they are experiencing.

4. Speak up

If someone says something ignorant in a conversation about mental health, try to gently educate them. If you are able to, speak up in your workplace or school to ask for better training for employees on mental health, and policies to support employees/ students.

5. Speak to power

Sign petitions that lobby for better and more inclusive mental health support nationwide and in our communities. Write an email to your MP (or other political representative) about improving mental health systems.

8. Support mental health charities

Whether this is by donating, sharing their campaigns, or engaging with their programmes, their work is so important.

7. Carry openness in your life

Include people in your workplace; continue to invite friends with mental health issues even if they don’t always come along. Treat everyone with dignity and respect, and offer them encouragement in their day to day life and when seeking professional support. Never blame anyone for their struggles. Be kind.

Thank you for taking the time to read this post. All of my love and support to you today,

Millie xx