shaky X on every form we asked him to sign.
This is how my mornings went. We could see three or four patients in a morning. Ms. Gardner and I split up the paperwork. I ate lunch alone, working as I ate. Dr. Allen's office felt oppressive. Its dark walls closed in on me and the flickering neon lights gave me a chronic headache.
Reality therapy seemed like a joke to me. Katie led me through the steps. Apparently, every morning and afternoon she went to all the patients’ rooms and recorded information on how they were keeping up with their hygiene, whether or not they were keeping up with their rooms, whether or not they were waking up, etc. New laws had made it impossible to force the patients to do anything they did not want to do, but everything they did was watched and recorded and noted for later.
Katie told me a story that exemplified this. Legally, every patient had to have access to a phone at all times and allowed to call 911. One patient had a number of paranoid delusions that centered on the persecutory nature of the hospital staff. So, he began calling 911 seven or eight times a day. The operators called and complained. The police called and complained, but the hospital was helpless to prevent him from dialing. Most of the time, he would call and tell them that Ms. Gardner was trying to plant microscopic bugs in his brain that forced him to steal from other patients, but the story varied and became more eclectic over the years. The phone was a payphone, so the patient could only call toll free numbers and when 911 stopped being interesting, he started calling all of the toll free lawyers he saw on TV. This problem went on until the patient was discharged to a group home, where, as rumor has it, he still calls 911 on a regular basis.
So, when we did reality therapy, our primary goal was to sucker the patients into showing up and staying any way we could. It was also our goal to convince the patients that it was in their best interest to try to learn things like how to bathe, to eat with silverware, and to ignore the voices in their heads.
Katie showed me the files for the patients who were supposed to attend reality therapy before group began. There were 45 files in all.
"Is this one for real?" I asked her as I looked through them.
"Afraid so," Katie answered.
"Mr. Craig Fat?"
"His father was Chinese or something," Katie answered. Katie was a pixie of a creature who couldn’t have been more than 23. She had a Bachelor's degree in Psychology and did most of the grunt work for the first floor chronic ward Psych team. "His name will seem even funnier when you meet him," she said.
The group members trickled into the therapy room slowly. They sat down in the farthest corners, away from each other, that they could find. When Katie finally closed the door, there were no more than six patients present.
"Is this all?" I asked.
"This isn't the acute ward," Katie answered. "Most of the patients here have been here for years and there is no reason for them to care."
"Can't we give them some incentive to come? Six out of 43 patients are coming to group? That isn't even funny," I said.
"We try things all the time. The patients can't get grounds privileges unless they come. They won't leave unless they come. They don't care. They only have to come twice a week and we have it twice a day. A lot will put in the mandatory two, but many won't even do that."
Katie stood up suddenly and closed the door to the group room. She slowly approached the group.
"Alright," she said. "Who remembers how we are supposed to sit in group?"
Mr. Fat raised his hand eagerly. "We’re all supposed to sit in a circle."
The other patients tried to ignore the suggestion. "Get up and move into a circle facing forward," Katie said in an almost military tone.
The patients obeyed her order with a series of noncommittal shuffles and half-assed attempts at moving chairs. In the end they weren't quite in a circle, but at least they weren't
This is how my mornings went. We could see three or four patients in a morning. Ms. Gardner and I split up the paperwork. I ate lunch alone, working as I ate. Dr. Allen's office felt oppressive. Its dark walls closed in on me and the flickering neon lights gave me a chronic headache.
Reality therapy seemed like a joke to me. Katie led me through the steps. Apparently, every morning and afternoon she went to all the patients’ rooms and recorded information on how they were keeping up with their hygiene, whether or not they were keeping up with their rooms, whether or not they were waking up, etc. New laws had made it impossible to force the patients to do anything they did not want to do, but everything they did was watched and recorded and noted for later.
Katie told me a story that exemplified this. Legally, every patient had to have access to a phone at all times and allowed to call 911. One patient had a number of paranoid delusions that centered on the persecutory nature of the hospital staff. So, he began calling 911 seven or eight times a day. The operators called and complained. The police called and complained, but the hospital was helpless to prevent him from dialing. Most of the time, he would call and tell them that Ms. Gardner was trying to plant microscopic bugs in his brain that forced him to steal from other patients, but the story varied and became more eclectic over the years. The phone was a payphone, so the patient could only call toll free numbers and when 911 stopped being interesting, he started calling all of the toll free lawyers he saw on TV. This problem went on until the patient was discharged to a group home, where, as rumor has it, he still calls 911 on a regular basis.
So, when we did reality therapy, our primary goal was to sucker the patients into showing up and staying any way we could. It was also our goal to convince the patients that it was in their best interest to try to learn things like how to bathe, to eat with silverware, and to ignore the voices in their heads.
Katie showed me the files for the patients who were supposed to attend reality therapy before group began. There were 45 files in all.
"Is this one for real?" I asked her as I looked through them.
"Afraid so," Katie answered.
"Mr. Craig Fat?"
"His father was Chinese or something," Katie answered. Katie was a pixie of a creature who couldn’t have been more than 23. She had a Bachelor's degree in Psychology and did most of the grunt work for the first floor chronic ward Psych team. "His name will seem even funnier when you meet him," she said.
The group members trickled into the therapy room slowly. They sat down in the farthest corners, away from each other, that they could find. When Katie finally closed the door, there were no more than six patients present.
"Is this all?" I asked.
"This isn't the acute ward," Katie answered. "Most of the patients here have been here for years and there is no reason for them to care."
"Can't we give them some incentive to come? Six out of 43 patients are coming to group? That isn't even funny," I said.
"We try things all the time. The patients can't get grounds privileges unless they come. They won't leave unless they come. They don't care. They only have to come twice a week and we have it twice a day. A lot will put in the mandatory two, but many won't even do that."
Katie stood up suddenly and closed the door to the group room. She slowly approached the group.
"Alright," she said. "Who remembers how we are supposed to sit in group?"
Mr. Fat raised his hand eagerly. "We’re all supposed to sit in a circle."
The other patients tried to ignore the suggestion. "Get up and move into a circle facing forward," Katie said in an almost military tone.
The patients obeyed her order with a series of noncommittal shuffles and half-assed attempts at moving chairs. In the end they weren't quite in a circle, but at least they weren't
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