Hospital Restraint procedures – a survivors perspective

Trigger warning : some people may find the contents of this post distressing.

Yesterday during a meeting I was asked questions about my time in hospital, one question though was really tough and related to my being restrained. It’s so hard for me to describe in detail my experiences of constant observations and restraint procedures, these are the most difficult of experiences that I have ever encountered in hospital and they stir emotions and feelings deep within.

Being manhandled by other human beings who weald control and hold all the power is impossible to forget, in fact it’s hard to not feel the panic that I felt at the time of those events all over again. Watching others being restraint was scary enough but then when it happens to you it seems so unreal and yet so terrifying. I know that at times I dissociated during these episodes such was the triggering element they contained. I thought it might be helpful to write about the impact of those days so others might understand what it’s like.

It’s hard to choose which incidents to write about but I have chosen two incidents as they reflect I think the many other such times I was forcibly restrained by the so called caring profession.

Having been returned to the unlocked acute ward following an attempt to leave the unit I was manhandled by the police officers from their vehicle to the ward. Nursing staff took over the responsibility of me and a posse of nursing staff grabbed hold of me, in an agitated state I was placed in the locked high dependency area of that ward. I hadn’t threatened anyone indeed I hadn’t done more than choose to leave the hospital environment which had been my home for some weeks. Once behind closed doors the staff laid me on the black solid seating face down and then let go, I immediately began to pace up and down and I did keep telling them I wanted to leave. 2 rather burly nursing staff began the task of looking after and observing me and one kept barking orders at me to sit down and stop pacing. A senior nurse came back into the room holding a medication pot and told me to take these as he moved the meds pot towards me. I refused saying I wanted to leave and I didn’t want their medication it would only dope me up. He told me there wasn’t a choice but at this time I wasn’t sectioned and so I felt he couldn’t make me take anything, how wrong was I. After a few minutes he left still holding the meds I had refused, and I continued pacing.

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What happened next startled and frightened me, it happened at such a speed I had no control and no indication it was coming. Suddenly a number of staff appeared in this small area and pounced, I was forced to the floor and held face down. It felt like I couldn’t breathe, hands seemed to be everywhere and they were hurting me. Not being able to breathe is absolutely terrifying, no matter how hard you try it’s impossible to move your head to catch a breath and I honestly thought I would die. I felt someone pulling down my clothing and then as I fought and fought and they grabbed and pulled and hurt I felt a stabbing pain. Whatever they gave me I’m not sure, but I know they injected me with some kind of drug and it’s aim I guess was to calm me down. I had been agitated before this happened but now I felt even more agitation and I had been triggered too. I am a victim of abuse and being hurt in this manner by staff some of whom I didn’t know was too much to bare for parts of me. A whole cacophony of emotions raced through me and thoughts of are they going to rape me filled my head. I had no control, no rights, no one listened to my cries for help or to stop, they just carried on doing what they did whilst talking to each other. They continued to hold me on the ground for sometime though they turned my face to the side their hands still held me as if in a vice. After a while they lifted me up to my feet my arms still held tight, they manoeuvred me to the seating bench and laid me down. Barking orders about staying still and behaving they released their grip on me, laying there I felt drugged and confused. Most of all I was terrified, my arms felt heavy and sore, my legs were hurting and my head too, my trousers were still not fully pulled up and yet I dare not move to do this.

These were nursing staff who were meant to be looking after me, instead they bullied and terrified me. I no longer trusted them or had any faith in their abilities I had been degraded and treated and manhandled like a piece of meat. In a police station this would be classed as overly forceful in a locked hospital room it’s called acceptable and necessary, police stations have camera to record conduct of officers – hospitals don’t.

If staff had allowed me to talk, to express why I was agitated, to understand my feelings,  the reasons behind those feelings and behaviours then they wouldn’t have needed to restrain me.  If they’d been more observant they’d have seen my distress earlier in the day and supported me more appropriately so I wouldn’t have left the ward in the first place.

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On one of my nights in secure services I became upset, I was on constant observations and a male staff member sat a few feet from my bed. I didn’t want to be on constant observation, I couldn’t understand why this was needed I hadn’t harmed or shown any signs I might do so. Having a male sat in my room so close to my bed was terrifying in it’s own right, I stated I was unhappy and I said I wanted him to leave. The situation escalated as he became frustrated and moved his chair nearer to me and I became more and more distressed. In sheer frustration I began banging my head against the wall, other staff including some males appeared demanding to know what was going on. I tried to be calm to say I wanted to stop being watched, to say I didn’t feel safe with a male, but my rational pleas for understanding fell in deaf ears. Once again I began hitting my head but by now there were a number of staff and 1 of me, they pounced and grabbed me. Holding my head forward from the wall and pushing it down towards my chest, others held my arms and others my legs. I screamed and pleaded with them as they hurt and yet they didn’t care, I recall one of them shouting at me as if barking orders. Stop fighting, stop screaming, stop…..stop…

A doctor arrived yet another male and began asking me questions, by now I wasn’t struggling I was compliant. Still held down I talked to this doctor and cried buckets, I felt so afraid I hated this place and I hated me. The doctor said I was going to take extra meds one way or another and I knew by now what that meant, I swallowed the pills or they’d forcible inject them into me. I guess I was learning because I agreed in fact I think I begged to be allowed to swallow his pills, I promised I wouldn’t mess about and I’d behave. That night I lay in bed with staff either side of my bed, my arms had to be visible as did my neck. I lay in this quiet room vulnerable and scared and terrified yet again I’d be hurt and no one but no one would know.

If staff had helped me to understand their observation policy, taken account of and respected my fears about a man so close to my bed I wouldn’t have got frustrated and hurt in the first place. It could have been prevented but the staff approach wasn’t to prevent such incidents but to forcible deal with them.

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These two experiences demonstrate the full horrors of being restrained by nursing staff on a mental health ward, at no time had I ever attacked or hurt staff and at no time have I ever been charged with any criminal offences. Yet I feel being restrained was a punishment and a gross abuse of power. I do understand that if a patient is unable to be calmed down or reasoned with in a safe manner the staff need to have a solution, but it shouldn’t be restraint in this way. It’s often used too quickly, too often and inappropriately. Things need to change, because right now patients are being held down, forcible medicated and hurt all under the guise of providing care.

I know on both of these occurrences there were other things that could have been done to help me, namely asking me how I felt, why I felt that way and listening to my fears, concerns and taking them seriously. Instead staff chose the heavy handed option I don’t understand why.

As I have said I was restrained on a number of occasions and I don’t believe it ever got any easier, the harsh reality is that fear grips you each and every time whether that be the first or the tenth occurrence. For anyone restraint procedures are terrifying but I truly believe for those who have suffered trauma or have complex dissociative disorders it is even harder to endure.

copyright DID Dispatches 2014

 

 

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CHANGE

CHANGE

 

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Facing a period of change & uncertainty – I am slowly realising why I find change so hard

This week I have faced some changes in my daily life, for the past 21months I have had a regular Personal Assistant one who all parts of me had become used to. This was a person who we felt comfortable being ourselves with, a person who wasn’t going to run a mile if we suddenly switched alters, and who seemed to understand D.I.D. This week that person has moved on to pastures new and thus the search now begins for a new person to help support me.

This of course is not so straight forward, finding people who want to support someone like me is never easy and I need someone who is doing this as a vocation and not just for a wage. I have had my fair share of support staff since I left hospital and we have had seen both good and bad examples of support staff.

Given I am trying to lead as normal a life as is possible with Dissociative Identity Disorder I don’t need people to treat me as if I’m incapable or some sort of invalid, I need people who empower, encourage and support me. I guess I need them to help me redevelop skills that I lost during my lengthy stays in hospital when I did become institutionalised and to learn skills which because of my past have never really fully developed yet.

My PA’s are the lifeline that helps particularly when I switch alters to ensure we keep safe, that help us when we struggle and find ourselves ruminating or with thoughts of desperation and self harm. They are if I’m honest a crucial element of my being able to stay out of hospital, I don’t think that I could have stopped that revolving door of admissions without them.

When I first came out of hospital I hadn’t made a meal or a drink in more than 2 years, I had literally done no activities of daily living unsupervised for over 30 months it was so deskilling. I remember at the start asking for permission to make a simple cup of tea, I felt intimidated by the kettle, I hadn’t used one in what felt like forever and I certainly hadn’t been allowed to just get a drink at anytime of the day or night.

Hospitalisation was dehumanising in so many ways, imagine having to ask for every single drink being forced to drink from a plastic beaker and knowing the staff control everything and could and did quite often say No to a drink. Well that was what life was like for me in the secure units, it was simply controlling, demeaning and soul destroying. Acute wards were slightly better there was a drinks machine that operated set hours and as long as it worked offered some choice, but still the staff or the hospital managers dictated the times we could drink, often 8am till 11pm. One ward I was on allowed 6 drinks per patient per day which worked as long as no one used your allowance as well as their own, thus robbing you of a drink. The staff seemed unable to see the injustice if a patient managed to use all their allowance and other patients too. It was just simply impossible for extra drinks to be provided it felt like a form of control and one I never quite settled with.

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So when I came home it did take a while to get use to the fact I didn’t need to seek permission anymore, that I had freedom and choice. It was the same with food, I’d lived in a regime of set meal times, set food and often not that tasty either. If I’m honest the control I endured was similar to that I faced as a child, my main abuser was a primary care giver and she controlled most of what went into my mouth. Food wasn’t fun very often in fact it was a form control and punishment, thus to this day I have a problem with eating. Being in a controlling hospital environment didn’t help me deal with my eating issues it just exacerbated them and recreated traumatic situations and triggered past memories.

Because of the control in hospital and the deskilling it caused my support staff are important and they help me in so many ways, I am certain that currently they are a necessary part of my life and so finding a new one is a challenge. I need to replace my PA as quickly as possible in order to maintain progress, this is an important issue I am so determined to maintain the progress  I have made thus far. The departure of a PA is  always going to result in a period of change and uncertainty, it’s simply impossible for such events to not cause change and uncertainty, but this is something we have to deal with.

So now as one chapter ends my family and I face a bit of a challenge as we search for a new PA, and belief me that isn’t easy especially for someone with Dissociative Identity Disorder. As one of the difficulties that I have is that I find trusting people really tough and of course it’s not only me who has to trust but all the alters too. Now yes I understand my alters are parts of me but all those parts need to learn to trust individuals and because of the past we all have issues with uncertainty, new relationships and having to basically learn to trust a stranger.

Then of course there is the issue of change, having a new PA is a change which won’t be straight forward or easy. I find change really tough to cope with be that a new person, new place or new situation change is fraught with anxiety and leads me to feel really unsettled and destabilised. I’m already having to do work internally about the changes we face in preparation of a us finding a new PA. I have spent the past couple of weeks preparing myself and my alters; the other parts of me, for the departure of the PA who had become part of our regular routine.

Change is tough for many reasons, but I guess I lived in chaos for years, my childhood was filled with change, be that different homes, schools or abusers. Change usually meant something bad in those days and I believe it has shaped how I view change to this day.

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In the past year I have faced many changes, I have lost one therapist and gained my psychologist, a significant friendship has ended, a relative has died, my care plan has changed and now this current change. Yet if I’m realistic we have coped with all the other changes this past year we have dealt with them and survived so there is a chance, a good chance that we will deal this latest change.

I am aware of the issues, aware of my difficulties with change and trust and I have the support of my family who want so much to ensure we employ the right person to help me keep moving forwards. Perhaps we are slowly over time getting better at dealing with change, it’s just a challenge after all that we have to face and deal with.

Hopefully in a few weeks I’ll be able to write about how I’ve coped with this change to my daily life, hopefully it will be a positive update. I guess I can hope that this change is going to be ok of course I don’t know and that’s what’s scary, but then in all truth nothing in anyone’s life is ever certain. My main task right now is to try and keep all of me settled so that we can deal with this change, so that we can overcome this legacy from my past of fearing change and learn to deal with the issues of trust and change. Wish me luck!

Copyright DID Dispatches 2014