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🎧You Decide to Change the System
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Around the room are weights, massage tables, a stationary bike, a treadmill, and yoga mats. Resistance bands hang from the wall. In the corner sits an enormous, inflated exercise ball.
Colleen, the physical therapist I’ve been assigned is very nice and very pregnant. She’s also very fit. She’s a runner and still runs long distances in her eighth month.
It’s my third time seeing her. I take off the boot and lie on the massage table on my back. I had visions of physical therapy being restful and relaxing, but it’s tedious and painful. Colleen is more taskmaster than therapist.
She stands next to the table and commands me to point my toes fifteen times. Restoring range of motion is the first step of physical therapy for a broken foot. Next will come strength and balance.
“Flex—then rotate left and then right,” she says.
Dr. Patel said I could be out of the boot as soon as my next appointment, so I do as I’m told.
An elderly man lies on the massage table next to mine. Liver spots dot his balding head and hands. A physical therapist moves his body, which is so thin it looks as if his bones might break.
Pain shoots through my ankle as I let my toes return to neutral. I wince.
“You don’t have to push so hard.”
The physical therapist gently rotates the man’s arm. The man’s face is passive, accepting.
When I’m finished, Colleen hands me the exercise band and tells me to do the same exercises using it as resistance. With her arm resting on her belly, she walks away.
I loop the band under my foot and, holding it, point my toes and return to neutral. Point and return. Point and return. My ankle is stronger. It has to be.
Colleen doesn’t know how important healing is right now. It’s not just my foot; it’s my brain and my mind. I’m determined to heal from serious mental illness, too—a possibility my new psychiatrist gave me after I’d spent twenty-five years in a mental health system made up of too many clinicians perpetuating the myths that psychiatric disorders like major depression and ADHD and bipolar disorder and OCD and anxiety and schizophrenia are biological, caused by a “chemical imbalance,” and lifelong, which they’re not.
Colleen comes over and asks how I’m doing.
I tighten my grip on the band, rotate my ankle left, and return to neutral. “I can do another set.”
Her brow furrows. “You don’t have to.”
Clifford Beers has become one of my heroes—in a way. Beers’s memoir A Mind that Found Itself is a harrowing account of his breakdown in 1900, his suicide attempt (he jumped from a second-story window, feet first), and hospitalizations in one asylum after another. The conditions Beers met with in the asylums made him worse. He was put in straitjackets, physically abused, emotionally berated, and isolated in a padded cell, among other injustices. While at the Connecticut State Hospital at Middletown, he vowed to get well and write a memoir campaigning for reform so no other patient would experience the horror he did. His descent into hypochondria and depression and panic and paranoia and finally mutism make my experiences of mental illness pale in comparison.
A Mind that Found Itself doesn’t tell only of madness, as so many mental-illness memoirs do; it describes how he healed:
“I have already described the peculiar sensation which assailed me when, in June, 1900, I lost my reason. At that time my brain felt as though pricked by a million needles at white heat. On this August 30th, 1902, shortly after largely regaining my reason, I had another most distinct sensation in the brain. It started under my brow and gradually spread until the entire surface was affected. The throes of a dying Reason had been torture. The sensations felt as my dead Reason was reborn were delightful. It seemed as though the refreshing breath of some kind Goddess of Wisdom were being gently blown against the surface of my brain. It was a sensation not unlike that produced by a menthol pencil rubbed ever so gently over a fevered brow. So delicate, so crisp and exhilarating was it that words fail me in my attempt to describe it. Few, if any, experiences can be more delightful.”
I know that sensation in the brain. I can’t relate to “a menthol pencil rubbed ever so gently over a fevered brow,” but I’ve felt the delicacy, crispness, exhilaration, and delight of becoming well—fully well.
For twenty-eight years, Beers worked tirelessly to eradicate the inhumane treatment patients suffered and improve attitudes toward those with mental illness. He joined forces with the eminent psychiatrist Adolph Meyer and the philosopher William James. Together, they founded the National Committee for Mental Hygiene, which researched the causes of mental disorders, trained medical students, and helped pass legal reforms on behalf of patients. The mental hygiene movement sought to move away from strictly biological explanations of mental illness and examine the patient’s history, community, and environment as potential causes and cures. The National Committee for Mental Hygiene later became the patient advocacy group Mental Health America (MHA).
The mental hygiene movement had a serious dark side. It later focused on eugenics. Citing the supposed permanence and heritability of mental illness, the movement sought to prevent people with mental illness from procreating by sterilizing them. This, too, lent to the mistaken idea that mental illness is hopeless and lifelong.
Beers’s life didn’t end happily. In 1939, he succumbed to depression and nervous exhaustion. He eventually committed himself to Providence, Rhode Island’s Butler Hospital, a psychiatric institution, where he died four years later.
Maybe he didn’t fully recover, but I will, and I’ll help change the mental health system.
Dr. Patel stands smiling before me, flanked by a resident—this one as boyishly young as the others. The office seems larger than it did before, less medical, more pleasant.
We’re in phase three: the remodeled phase. Solid bone will continue to grow, and blood circulation around where the break occurred will eventually improve.
He turns to the computer monitor and clicks the mouse. Onscreen is the x-ray of my ankle. The bones don’t look as if they’ve joined correctly. Dr. Patel explains that they’re supposed to be uneven.
“How long will it take to heal completely?” I hop off the examination table.
“It depends. It can take six months or longer.”
“How much longer?”
“To be fully cured, it can take years.” He types something. The words logging out appear onscreen. “It’s a slow process. It’s actually the majority of the healing time.”
“How many years?”
“You won’t need to come back in, but you’ll continue physical therapy.” The screen goes dark. “Gradual weight-bearing exercises are encouraged.”
I stride down the hallway on my out, carrying the boot. It’s a sunny early-summer day, not too hot. In the first trash can I see, I toss the boot.
Along the lakefront path, I walk and walk. There’s pain, but I ignore it. The fresh air seems fresher, the lake bluer, the sky brighter.
By the time I get back to my apartment, I’m limping. The room is dark. Out the window, my sliver of sky is starting to cloud over.
“You shouldn’t have done that,” Colleen says at our next appointment.
Holding onto the exercise band looped around my foot, I point my toes.
“Now rotate right,” Colleen says. “You have to think long-term and not push it.”
She wouldn’t understand that I think only about living as someone already healed.
“You aren’t out of the woods yet,” she says, echoing Dr. Patel. “The remodeled phase takes time.”
I rotate my ankle once, twice, counting, taking my time to reach fifteen.
That night, in my apartment, I sit at my computer and begin what will become my obsessive desire to know everything about psychiatric diagnoses. On the right of the screen is an internet window with open tabs, each a different scientific study from a peer-reviewed journal.
I open a new Word document. Before I can even start to talk to people about healing from mental illness, they need to know the truth about psychiatric diagnoses—that they’re constructs at best, not meant for patients to over-identify with. There’s no such thing as “having depression” or “being ADHD.”
At the top of the page, I format the title. I type Book. I erase it and type Pathological.
Read the prequel to ‘Cured’—‘Pathological’ (HarperCollins):
Read all available chapters of Cured.