âAt the outset Iâd like to say that if we can be called CMIs - chronically mentally ill - then they, the mental health professionals can be called MHPs. If we must be relegated to a three-letter acronym - and basically stripped of our identity and individuality - then they too can be lumped into one pot. I present a series of vignettes from my history with the mental health system that depict what it feels like to be treated like a CMI.
After the second hospital stay, youâre supposed to come up with a new MHP to follow you. They send you back to the same clinic where you found the first jerk-therapist. You enter a room, and there are two male MHPs seated in front of you. You ask questions; they look at each other and respond to themselves, not to you. You spend the entire hour having the two shrinks talk to each other, not to you, but about you, in front of you. At the end of this hour long frustration, they say they have no openings, that there are no openings in the entire clinic. You wonder why they wasted their time and yours. You wonder whoâs really crazy - them or you. You start to see more clearly: Youâre a CMI.
During your third hospital stay, one of the MHPs approaches you to inform you that theyâve asked - demanded - that your parents come in. Today. This afternoon at 1:30. Apparently your parents have replied that they couldnât. It was the first good planting day and your dad was in the fields. The MHP informs you that the hospital threatened to send you to a big state mental institution, if your parents didnât come in. You express indignation at their ultimatum and defend your parents. They have six kids. Youâre one of them, but your father has to put food on the table for eight people. The MHPs seem alarmed by your defense of your parents. Well, their threat worked: your parents are there that afternoon. Now the MHPs haughtily announce that theyâve changed their minds. Theyâre sending you to a state mental hospital anyway. Your defense of your father was an âadmissionâ that you feel less important than the rest of your family. Your lack of self-esteem is deplorable.
The lesson? A CMI, even a CMIâs family, is powerless next to one or more MHPs. Your parents discharge you AMA (against medical advice) from the clutches of this hospitals self-righteous MHPs. The MHPâs pronouncement of your âlow self-esteemâ is their first lesson in doubting your own basic instinct.
Youâre sitting in a huge lecture hall in a medical school where first-year med students are receiving their first psychiatry lecture. Youâre taking this course as part of graduate studies, and youâre in a depressive phase. A woman who is an inpatient of the psych ward is being interviewed. The uneducated and uninformed medical students find her delusions âfunnyâ and do not hide their laughter but display it openly. You try to hide your crying. But it;s not tears for you or for the woman. The tears are for these future MHPs who will never acquire the education or insight or sensitivity they need to help heal the CMIs in their world.
Then you end up in Psychopathic Hospital - donât you love the title? They tell you you were misdiagnosed. You find out your not schizophrenic, youâre manic-depressive. You tell the new MHPs that the former MHPs sued you for a $3,366.66 bill. They sent the sheriff after you with a subpoena. That you want to sue them. Would the new MHPs testify that youâd been misdiagnosed and mistreatedâtreated with the wrong medicationsâyour symptoms made worse, not better? Oh, no! They wouldnât consider testifying against fellow shrinks. Who knows! Someday they might be sued. They have a collegial loyalty to each other. Their reputations are on the line. Their salaries are at stake.Â
And who are you? One little patient, one little CMI!Â
As an inpatient in whatâs called a âmental institutionâ you go to something they call OTâoccupational therapy. Everything here is called therapyâeven when it isnât.Â
And today itâs âassertivenessâ class! Whoopie! Someone back in the 1960âs decided that the hallmark of a mentally healthy person was being assertively able to choose and refuse, speak, act, and listen. This is a mockery inside a place called a âmental institution,â because here no mental patient is free to choose, refuse, speak, or act. You canât even listen to each other without someone spying, reporting, recording, and charting. And then calling you paranoid if you notice. Or object.Â
And when you refuse an activity or âtherapy"âwhich they tell you is your rightâand which theyâve taught you to do in their "assertivenessâ class, then they badger you by sending nurse after nurse, attendant after attendant, into your room to remind you that âItâs 1:00. Time for OT!â Your refusals mean nothing. They badger you until you either give in and go, or theyâve frustrated you to tears. Or enraged you to anger. And then they can justify calling you by the malignant label theyâve designated you byâresisting treatment or ânoncompliant,â passive dependent, passive aggressive, paranoid, or borderline personality disorder. Theyâre all different labels. But they all mean the same thing: youâre not really you. Youâre just a CMI. And that justifies the MHPâs dehumanization of you.Â
Youâre depressed. Youâre feeling suicidal. None of the medications are working. The blackness ushers in suicidal ideation almost without your needing to give any conscious direction to your thoughts. Your thoughtsâtheyâre all negative. Trying to steer them into something positiveâbecause theyâve said cognitive therapy works!âonly ends in bringing up something negative along with it. You catch the negative thought and start over with something new, until it, too, leapfrogs you into another negative one. Itâs as if a whole Pandoraâs box has been opened up in the attic of your mind, only that box is labeled âblack.â And the box labeled âwhiteâ is locked tight, the key thrown away. And you tire of this endless exercise of redirecting the thoughts. Your mind, nerves, and body are fatigued enough as it is. You call a place named Crisis Intervention Services. The person who answers is brusque and unkind. She adds more stressors to your already overtaxed nervous system. You donât want to go on with this life. Youâre told your situation is not serious enough. And besides, she doesnât have time for you. You feel insignificant. You are. Youâre a CMI. And youâre only one CMI in a county with 1,500 CMIs.
You have a cyclical disorder. After the second year at the same job and the second episode, your MHP tells you it would be better if you worked part time. You know you can work more than full time when youâre well, which is three-fourths of the year, and you canât work at all when youâre ill, which is one-fourth of the year. But heâs the MHP, so you go along.Â
Now, youâre working for the Stateâand they encourage accommodating for the handicapped, and you guess youâre one of these. And youâre working at a typist classification, for which job sharing and finding another typist to work the other half-time should be a cinch. But your boss happens to be a big-shot neonatologist. And he insists they need one full-time typist. He wonât budge. And the medical school wonât budge. And their affirmative action officer canât make him budge. And so youâre forced out of the job. Itâs then youâre reminded: Youâre only a CMI.Â
You have severe abdominal pains again in the middle of the night. The last time the Emergency Room (ER) doctor said to come over right away when you get the pains to better diagnose them. So you go. A different ER doctor is there. He asks you the preliminary questions. Then he comes to âAre you taking any medications?â After you name the psychotropic drugs youâre on, his face changes to one of skepticism. Suddenly he doesnât believe the pains are real. He finds nothing in his examination. And he says he doesnât have any notes from any other ER doctor (though your last visit was only a week ago). He doesnât believe you. Youâre malingering, or hypochondriacal, or psychotic, or worse. You know the truth. But the truth canât be believed: Youâre only a CMI.Â
You file a sexual assault grievance against an MHP. The investigation is as painful as the episode, and you are depressed for days. But the examining board finds in his favor. You get the transcripts of the testimony. Itâs said that you have a personality disorder (news to you). Itâs said that you put people in no-win situations. But, he wins the suit and youâve been losing all your life. Itâs his word against yours, and you have a psychiatric label. Heâs the respected professional. Youâre only a CMI.Â
What have you learned as a CMI? Abuseâphysical, emotional, spiritual, sexual, and financial; humiliation; belittlement; vulnerability; lack of credibility; reduced to a three-letter acronym; stripped of dignity; denied your own inner convictions, feelings, and instincts; frustrated; stigmatized; expected to conform; always wrong; put in double binds; given a lack of choice; lack of control; and lack of love; left with nothing; and finding itâs better not to feel, not to try, and even not to live. Until today.Â
Today you speak out. Today you reclaim yourself. Today you begin to heal, to heal others. Today you educate others and reeducate still others. Today life begins anew for you and for others whose consciousness you are trying to raise. Today the patient, ex-patient, mental health consumer movement is reclaiming the dignity and power of the CMIs of this world.â
Betty Blaska, What it is Like to be Treated Like a CMIÂ (published in the Schizophrenia Bulletin and republished in Beyond Bedlam: Contemporary Women Psychiatric Survivors Speak Out)