Pat Mullan grew up in rural north Derry, and now lives at Eadestown near Naas in Co Kildare with his wife, Patricia. They have 3 adult children. Pat is interested in short stories and flash fiction. e-mail firstname.lastname@example.org . Twitter @pat_mullan.
Good for Me
By Pat Mullan
They said it would be good for me and that the time was right. I wasn’t so sure. It seemed like crossing over a line. What “coming out” must be like for gay men.
I had been doing O.K., I thought. Just about. There have been extremes. Like the economy, or the weather, its cyclical, with no one knowing how long or short each cycle is going to be. When I’m within the normal range, life is manageable; it’s the peaks and troughs beyond the norm that spell trouble for me.
The troughs are unbearable and what I fear most. Even when I’m well the troughs are like a dark cloud hanging over me – you never know when the cloud is going to burst, but you do know it’s inevitable. Days are endless. Nights can be even worse. Drowning in a slough of despair that you believe has no end. Everything is problematic. Even daylight is a threat as I lie in my bed day after day, night after night with the roller blind down and the curtains drawn. I have interest in nothing. My books lie unopened, the television off, the laptop abandoned and the phone battery dead. Eating does not seem necessary. Or living. Time is at a standstill. Without hope. I was only emerging from it, when they started talking about St. Matthews being good for me.
The peaks are unbelievably enjoyable – at least for me. Everything is positive and rosy and all’s well with the world. I can do no wrong. I excel at everything that I do. My creative mind kicks in. Write fabulous songs, beautiful poetry and my singing voice improves beyond recognition. The life and soul of the party, all day every day. I need little sleep. I invent new things. Design and build them. My energy knows no bounds. Everybody loves me. I am in the zone. When I’m there, I can do anything.
Elaine takes my bank and credit cards away now once I reach a certain point on the upward spiral. I have no issue with this. In fact it was my suggestion after America two years ago – one of my more eventful highs. We were in Boston and had been discussing hiring a car over dinner the night before. I was on an upward trend for the previous week and needed little sleep. I got up at five in the morning for a run while Elaine slept. As I was heading back to our hotel three hours later I passed a car showroom offering a shining 1999 Cadillac Deville for $3,000. I had to have a look. Twenty minutes later I came away with the keys and a Visa slip for $2,500. She was a beauty – 4.6L engine, power recliner seats and lumbar supports in the front, cruise control, sun roof, air-conditioning – the works. We could use it any time we are in the States, I thought. (We had never been in the States before, nor have we been back since). I couldn’t wait to show Elaine and tell her about the bargain I’d got.
It’s over six months now since my last high.
My most recent dip lasted an agonising eight weeks before the mist began to slowly clear. It was then that they began the process of getting me to agree to go into a facility to evaluate the effects of the medication I’m on and for “stabilising” me. They also spoke about “observation.” – Elaine and Dr. O’Brien, my consultant, are a formidable combination and would brook no argument. They talked of group therapy options. A structured residential programme they called it. A minimum stay of two weeks. A long time to be away from home, I thought.
How could I go into a psychiatric facility and keep it under wraps? There’s my job to consider. There’s the kids too. While friends and colleagues know I have a medical condition that is affected by stress, they are not aware of the extent of my mental health problems. When they hear I’m in hospital they’ll want to come and see me –in among a bunch of loopers. I can’t have that.
I must admit, the brochure, the discussion with Dr. O’Brien (“Call me Noel” – I never do) and the conversation with the services manager were all very impressive. The menus looked enticing and, following the visit to view the facility, most of my objections had been addressed – at least to Elaine’s satisfaction.
“It’ll be grand Mick. It’s approved by the health board. You’ll have a single room with an en-suite. You’ll have your privacy and company in the day room if you feel like it.”
“Not sure about keeping company with the types they’ll have in there.”
“It says TV, daily newspapers and access to a full medical team to get this thing sorted once and for all. It’s a fabulous facility. If it’s not working out you can come home. No one is forcing you to stay.”
“What do they mean – a full medical team?”
“Let’s see…here it is – multi-disciplinary teams of psychiatrists, occupational therapists, nurses, psychologists, behavioural therapists and counsellors.”
“Yea, not sure about the counsellor types though.”
“…optimising pharmacological and psychological treatment in a high quality and patient friendly environment. …staffed by specialists of all sorts”
“Medication and talk therapy then?”
“Listen to this, Mick – mindfulness based cognitive therapy, acceptance and commitment therapy, group psychotherapy.“
How could I possibly resist?
“I can’t wait,” I said.
In the main, they’re a bunch of well-heeled depressed addicts of one sort or another. Tomorrow will be my sixth meeting. We have two a week in the day room.
I’m wary of talk therapy types and all this feelings and emotions stuff. The belief that there’s a deep-seated underlying reason to explain everything which must be unearthed. These psycho-analytical, counsellor do-gooder types that sit there listening and watching you. Gentle and calm, almost serene. Even socially, you feel they are analysing you, trying to put you into a box. I’ve no intention of being put into any box except the one that brings me out feet first.
Up to now I have been sticking to my principles fairly well. I keep my arms folded; politely and briefly answer any direct questions put to me, without giving much away. But it’s getting more and more difficult to hold back at the sessions. Ursula is doing her job– trying to get us talking about our problems and to steer the discussion. The patients too, are doing their best in difficult circumstances.
On my first day Ursula met me before the group session. She outlined how the group therapy sessions would work and the ground rules.
“You don’t have to share anything if you don’t want to. It’s up to you, but the more you put in to these sessions and engage the more you’ll get out of them. Don’t interrupt people who are sharing and no hanky-panky with the female – or indeed the male – patients. Everything is strictly confidential. Just be yourself. And enjoy it.”
She introduced me to the group. We meet in the day room where the chairs are arranged in a large circle so that each member can see every other person in the group. The day room looks out on the beautifully tended gardens of St. Matthews, stretching down to the river and the farmland beyond. The room is bright and modern and the leather chairs are soft and comfortable.
“The last day we were discussing Tom’s problem, Mick. Tom is a developer and his wife has asked him for legal power of attorney so that she can make decisions about the business while Tom is with us. It needs to be sorted quickly as there’s a bit of prime development land that’s up for auction in two weeks. Tom, have you any further thoughts about what you should do?”
Tom is a big dark broad shouldered 40 year old from Mullingar in runners and jeans with sunken eyes and a haggard look on his face. “Not really, I still think there’s more to this than she’s telling me. I’m not fit to look after the business, so I don’t have any option really…do I? So let’s move on.”
“Any other comments from Thursday’s meeting, anyone?…No, OK so. Would you like to let the group know a little about yourself, Mick and why you are here?” She hadn’t prepared me for this. So much for not having to share anything unless I want to.
“Hello all. I’m Mick from Co. Wicklow. I’m here …um…as an observer to see how this group therapy thing works.” I folded my arms and sat back in my chair.
“OK…anything else you want to tell us, Mick?” I shook my head. “Now, anyone want to begin today’s session? Phil.” Phil the Rapper removed his earplugs, ran his trembling tattooed hands through his tightly cropped hair saying in a sad sing-song voice,
“This new shit they have me on is crap. Four weeks of it now. I’m tired all the time, I have joint pains and the craving is back. And I’m not sleeping…” and on it went. Problem after problem thrown out by the participants and Ursula and the others feigning interest and sympathy. God, it would do your head in.
There are seven in the group – four men and three women. All must have access to ready cash, given the exorbident daily rates and mandatory weekly up-front payments in St. Matthews. I’m here courtesy of Charlie McCreevy and his maturing special savings incentive scheme (the SSIAs), and Elaine’s single-mindedness. How could she think a place like this would help me?
After three weeks I’m struggling with the daily routine. I see Call Me Noel twice a week and I am on a new medication mix. I don’t like him – he won’t look you straight in the eye, but keeps watching you stealthily and tries to get you to talk. I have blood tests every third day. Other than that, and the two therapy sessions every week, there is little to do in the place apart from reading, walking and listening to music. I avoid engagement with the other members of the group between meetings. But this is becoming more and more difficult without being rude. Elaine calls at some stage every day to see how I’m doing, and with news of home. She tries to ensure she’s there when I meet Call Me Noel to ensure he gets a balanced picture.
Last week he asked me why I was not participating fully in the group therapy sessions. “The more you participate, Mick the more you will get out of them. Ursula feels that you’re holding back.”
“Well, you know I’m sceptical of this kind of treatment. It’s doing nothing for me.”
“We can put you in another group if this one isn’t working out.”
“That won’t make any difference”
“Well, maybe we should try CBT ? I know it’s not normally prescribed for your condition but the coping skills could be very beneficial.”
“That might be a worth trying, Noel as Mick really isn’t happy with the group therapy thing”, said Elaine, as if I wasn’t there. I glowered at her.
“What’s CBT in English?”
“It’s cognitive behaviour therapy. It looks at how we think, how we feel and how we behave all interact together. Our thoughts determine our feelings and how we behave. The therapy helps you develop skills to minimise negative thoughts and change the way you see certain situations. It helps reduce psychological stress.”
“Jesus H Christ! Do youse still not accept that my problem is a chemical imbalance in my brain? It’s NOT an imaginary illness that I have dreamed up in my head that can be cured just by thinking positively. I’m not like the addicts you have me in here with, you know. Do you really think me spending four hours a week in therapy sessions with junkies and alco’s is gonna help me? ”
I stormed out of the consultant’s office slamming the door. Elaine caught up with me as I headed for my room to pack.
“Mick, just cool it. Noel is only trying to help.”
“I’m outta here. Jesus! CBT? Does that man know anything about what I have?”
“He has the best reputation in the business. We need to listen to what he says. If we don’t agree with him then we tell him and we discuss it. At the end of the day, we can walk away. But I don’t think that would be a smart move for you, Mick, right now,” said Elaine.
“OK, I know the new drugs are working. But he still hasn’t the dosage right – the liver reading was still high this morning. That’s what he should be focusing on, not all this talk therapy crap.”
“He will get it right. Sticking with the regime and the tablets this time will level out the peaks and troughs. That’s what we want. That’s what you need. Nobody’s forcing you to do anything you don’t want to do. But you have to stick with taking the medication every single day. You know what has happened before. I know three weeks is a long time in a place like this but we just have to get you stabilised.”
“O.K., O.K., I know you’re right. I’ll give it another week – but none of this CBT stuff. And I’m not apologising to Call Me Noel.”
On Monday when Elaine came in, I knew something was up. She threw the paper on the bed saying, “Have a look at page 4. Back in a minute.”
” Top Mental Health Specialists Struck Off For Malpractice,” was the headline. I was half-way through the article when Elaine returned. It was all about Call Me Noel and another doctor from St. Matthews!
“Look at this, Elaine, Call Me Noel and prescribing addictive drugs for patients that never existed. Call Me Noel’s a bloody addict. I knew there was something not right about that little bollix”.
“Keeping patients too long in residential treatment. That’s me – in here for no good reason.”
“I know, Mick”. Head in hands.
“Look, prescribing medications and treatments that are inappropriate for the patient’s conditions. Jesus. He could have poisoned me. No wonder my liver readings are high!”
“I know. How was I taken in so completely by O’Brien? He’s so plausible.”
“Call Me Noel struck off for malpractice. Who’d have thought? That fella had a shifty eye from day one.”
“We need to get you outta here and we need to get you a new consultant”, said Elaine. “Let’s get packing.”
Home. What a waste of time and money.
Back to square one, yet again.
This time I’m picking the consultant. And making any decisions on the treatment.
Matthew’s good for me? I don’t think so.