Subtheme Three: The Battle and Resistance – Under Attack and Refusal

This subordinate theme is developed as some participants distinctly pondered upon their struggle and a fight with the hospital staff and/or the system. The current theme witnesses the use of language that has references to war or a battle. The theme also resonates the experience that is characteristic of the strong refusal to submit and a ept o e s i u sta es a d ordeal or fate. Thus, the theme continues to struggle with the issue of coercion and encompasses feelings of hurt and anger, as related to a deep sense of injustice or even oppression noted by some individuals.

Cait delivers a rather poignant metaphorical depiction when asked to paint a picture that best captures the essence of her experience in the ward. She describes it as an image filled with darkness, which can be symbolic of loss, grief, emptiness, wickedness (as related to the shifts in self-image), depression and fear and this interpretation appears to connect with the e ai i g the es that e e ged f o Cait s i te ie . Black colour is also reminiscent of the unknown as the absence of light points to invisibility and perhaps being hidden from the world. Thus, through this image, Cait clearly describes being under attack. It feels as if the picture represents her as a prey that portrays the story of vulnerability – in other words, a target that is being poked at, punished or even symbolically executed. Arrows are also redolent of penetration, as they constitute a potent reminder of hunting, war and death. Finally, both darkness and the arrow are also suggestive of power and authority that one is under:

I would probably paint lots of arrows because (…) I did feel like I was being just shot at all the ti e a d the e e e lots of thi gs that see ed to just… ake ou feel like ou were being got at, or you know being misjudged and being treated the way I was; you

feel as if people are literally taki g hits at ou… ... It would probably be very black and just lots of arrows are atta ki g so eo e e ause that s ho it felt at ti es… it

Participant 888 (30: 1199- , hose efe e e to ei g a te de p e draws a similarity ith Cait s illust ations (as shown above), and depicts his resistance and refusal to submit to a coercive situation that is deemed unjust. Thus, participant 888 unfolded the following scenario, which although in the first instance may appear humorous, but contains a profound sense of pain and a desperate attempt to regain some control, which may have manifested itself in some retaliatory endeavours k o i g the ules a d pla i g the s ste . The a ou t also o e s so e a ge and possibly hurt that bubbles through the surface. At the core of this excerpt, lies the injustice and pathologising practices, which 888 described being subjected and that led to an infliction of trauma (here restraint being categorised as an assault):

os as a hild ou a t oppose your parents, but as an adult, you can… so umm I ealised afte the assault, ight oka glo es off, o fu ki g ules, fi e e e go a fucking play with you; I know when the emergency alarm goes off you have to fill in a

epo t a d ou do t a a do a o k, ou a a sit on your ass and watch TV, so e ause the ig o ed the patie t, I as like ight … so pi k a ti e he it s ha do e laughs , os the e o upied. “o it s like ight, up to that end of the ward there is an emergency alarm next to a toilet, you wanna take that one, yeah okay (…)I take this

o e it s ight e t to oo , so e set ou ala …. .. a d the got u sti g i to ou oo , ou p essed the e e ge ala ?! ith a e t, shouti g – Oh and you called me mentally ill, did you see me press the emergency alarm? (888, 11-12: 438-

458)

Some participants like Sally and 888 reflected upon their experience of the power imbalance and the dynamics that occur between them and the staff in the ward. Sally (who also reported on her continuous futile fight to get through to the staff in order to establish dialogue and more equalised relation with them) cogently concluded that her experience was that of a division that was characteristic of a conflict rather than cooperation (Sally, 18: 680-682, 28: 1055-1057). Participant 888 described his experience as being reminiscent of a battlefield as he realised that the staff-patient relationship on the ward had persecutory qualities that he had to shield himself from:

Oka I k o hat the ules a e, it s ou against us, not us against you (…) (888, 5: 195- 196) (… if ou e e e ee o a battlefield, ou e got o idea. (888, 18: 710-711)

3.3.4 Subtheme Four: The Absurd

This theme reproduces the common threads described by most participants - the paradoxical nature of the system and the manner in which the ward is operated, which individuals needed to adapt to. The theme focuses on the features of the experience that have been portrayed as unacceptable, incomprehensible and inappropriate. They were directed to a sense of dismay and risibility and at times also seemed to contain disturbing and warped elements. In this respect, the theme aims to capture the contradictory and confusing qualities and the inconsistency and rigidness of the environment and its rules. Finally, the theme links to the sense of being double bind and tapping into the experience of powerlessness.

For instance, both Buster and Valerie contemplated upon the parts of their experience in the ward that was classed as preposterous and described through the lens of the absurd and the thoughtless. Valerie highlighted the issue of being caught in the farcical process of satisfying bureaucratic administrative requirements rather than assessing the actual merit of the activities taking place. She pointed out how art the ap ep ese ted a o ti ki g e e ise that as a eal i sult to her intellect that brought her back to he she as fou ea s old (Valerie, 19: 724-730). This denotes being treated instrumentally and with the lack of respect. In other words, there seems to be an experience of disparagement and absurd infantilisation that Valerie refers to – a sense of receiving patronising and inconsiderate treatment. Buster also recounted her memory and was reminded of the heedless and inconsiderate treatment she felt she was being subjected to. The particular incident she recalled suggests that it felt very derogatory and disrespectful to her and was centred on the sense of being neglected and not being paid proper attention (as well as being a burden to staff, as suggested the o ds to shut so e od do ). This probably resulted in indignation about the entire scenario:

Once (…) I was colouring with some colouring pencils, and they were all blu t … it s disgusti g ou just do t sit so e od do to shut the do ith lu t pe ils …)

so eti es I thi k the e is ot a lot of thought, the e as t ou know. (Buster, 19:

725-731)

Some also identified their experience of the ward as instilling or adding to the confusion of the existing psychotic state. Buster (19: 722-723) pointed out how some lo ks e e told the ight ti e . In this respect, one may further wonder about the mirroring and the parallel processes; perhaps the system is depicted as unwell, troubled or disconnected in some way and therefore contains some psychotic elements on a symbolic level, as illustrated by the following:

You know the ironic nature (…) the TV room had a sign saying Smoking Room and the Smoking Room had a sign saying TV Room… and I said this is absurd! (888, 44: 1722-

1726)

Some participants reported being placed in an anomalously inconceivable context that appears not only paradoxically twisted and warped, but also characterised by a double bind and a no-win situation, he e o e s effo ts o a tio s a easil ut unexpectedly backfire. For instance, Sally (37:1448-1452) recalled her dismay when she informed the staff that a fellow patient had been involved in an incident and it was interpreted as i te fe i g ith the othe s patie t s a e . The existence of the distinct and incomprehensible implicit rules has also been highlighted by this incident. Sally (9: 322-325) further recounted how a member of staff was told off fo ei g too

soft ith patie ts . An expectation that patients should be approached more coarsely

and with unbendable attitude is ridiculous, but at the same time part of the world, one becomes accustomed to. The following extract further illustrates such phenomenon of an inverted mountain:

You put ou self i the az e i o e t he ou e ei g a used….you say he … ou k o if this happe s to ou o a tu e o a us, you stand up and say- this is

unacceptable! But in a psychiatric unit, this is considered to be a symptom of an illness… (888, 26: 1025-1030)

Fu the o e, “all s a ou t aptu es a common experience among participants that pretence and false compliance seems to be the only plausible way out. This seems to signify the paradoxical, but also sad and an alarming survival strategy that may be employed by some patients, which are a titheti to o e s ell-being and recovery process:

If you want to get out of here – you just need to tell them whatever they want to hear… (Sally, 18: 661-662)