A Night in the Psych Ward (or "A Pleasant Evening of Holiday Crafts")

In my neighborhood in Dallas, where I owned a house for 14 years, we had a syndicated comic writer. I actually met him because he was asked to give a talk at a social club to which I belonged. It was while talking to him afterward that I learned he lived a few blocks from me in his lovely Tudor style home. I ended up taking something to his house soon after, I forget what; perhaps an honorarium. Later, neighbors told me that he sometimes helped with fund raising at his kids' elementary school by auctioning off the opportunity to be in one of his comics. His bizarre comics were syndicated in many large newspapers, but not all. At the time I went to the web site for his comic. His picture of himself was of some guy twenty years older and said he lived in New York. He actually looked rather like the comic character shown in the first panel of the Sunday version of his strip.

We also had a battered women's shelter in our neighborhood. It was in an unmarked building that had once been a medical clinic. The shelter eventually moved from there, so it's OK to describe it. Apparently many in the neighborhood knew what it was, but ironically, the folks who were most likely to tell battering husbands/boyfriends where it was, were cops – to other cops.

I volunteered one evening a week at the shelter for four and a half years. At first it was just a convenient place to do good deeds, but I stuck with it even after they moved a couple times. I worked with the kids doing “non-directional play therapy.” Part of the purpose was merely to babysit while the mother's were in group therapy, but after appropriate screening, the volunteers were given a full day's worth of training and then worked with the full-time counselors for a couple months. It was a little like an internship. A big part of the “non-directional play therapy” was to merely provide a safe, accepting environment where the kids could express themselves through play. We were taught “active listening,” which is that odd sounding way to show that you're understanding what the other person is saying but not expressing opinions about it. But we also wrote up evaluations each time. We evaluated how the kids interacted with others, whether they acted appropriately for their age (too old or too young), and whether they seemed to lack developmental skills appropriate for their age. The kids were infants through about twelve years, but most were four to ten years old. The playroom where this took place was full of toys for all ages. It included many uniforms for dress up, building toys, drawing materials, play kitchen, dolls, trucks, and even a small sandbox. The kids could be and do as they felt inclined. Kids aren't good at even knowing what they feel, so the idea was to let them express their feelings by doing and being how they felt. There were limits of course, like no hitting. And the twelve year old obsessed with diapers was only allowed to put them on OVER his pants.

Most of the time, the play therapy seemed positive. Despite the physical and sexual abuse that some of the kids had experienced, and despite some emotional and developmental problems that were obvious, they still knew how to be kids. They knew how to play. But one girl still haunts me fifteen years later. She was probably four. She just played at the sandbox. Lots of kids do because both sand and water are emotionally soothing. But all she did was pore sand from one kid-size kitchen pan to a large cup and then back again. She did that for an hour and a half. She was in a room full of great toys and few rules. There were other kids there having fun in many different ways. There were interesting toys in the sandbox at which she stood. But she didn't play; she just poured, back and forth. Some kids are shy. They are hesitant to do much of anything until they get a feel for the new territory. But that usually lasts all of ten or twenty minutes, not ninety. And even the shy ones hold a doll or a book or a truck for comfort. Mere sand and containers seemed quite sad to me.

So one evening, perhaps the only time I did so, someone decided that we would just have a pleasant evening of holiday crafts instead of play therapy. Colored paper, pine cones, and glitter were ready and waiting. Kate stayed to help. Kate worked there full time with the kids, mostly during the day. One eleven year old boy, “Ben,” didn't want to do crafts, so he went back to the bedroom with his mother, “Sarah.” That didn't last long because Kate and I had to go back and restrain Ben because he was beating on his mother. Some other mothers took over the crafts with the other kids.

Per training, kids get restrained when being violent, partly to protect them, but also to preserve a feeling of safety by the occupants at the shelter. Restraining kids is not a big deal: you cross their arms in front of them, hold their wrists while sitting in a chair with them in front, facing away. It is mostly just to prevent violence until the kids recover control of themselves. The method of restraint was meant to NOT be a punishment or countermeasure. Actually, sometimes offending kids or observing kids tried to make it happen for the hug-like nature of the restraint. In those cases, the misbehavior was obviously half-hearted and we would play along.

But Ben was genuinely angry and seriously resumed the hitting whenever released. The only reason he gave for his anger was that his mother had promised to take him to Burger King but didn't. Kate was plenty capable of restraining Ben, and took her turns, but her lesser height made her more susceptible to butts to her chin from the back of Ben's head. I'm over 6'3” so it seemed reasonable to use my height. Besides, I suspect her breasts were also getting sore from all the struggling. Ben was strong and persistent. It became obvious that we were only accomplishing postponement of behavior, not changed behavior. Kate was experienced with kids but decided to call the professional shelter counselors at home for guidance. They said to take him to the psychiatric emergency room at the county hospital. Even if that was extreme for the circumstances, it is the first step to getting ongoing, funded psychiatric care. We had been restraining Ben for over an hour and half. Something had to be done.

Actually, by the time we left, Ben had calmed considerably. Maybe he was just tired, but it seemed like he was starting to develop an understanding that this was not a contest of wills. I think a little bonding started because of some blood under my thumbnail. Ben saw it and asked about it. I told him that a couple months earlier, I re-roofed my house, sometimes hitting the wrong nail. He asked if it hurt and if I yelled when I hit it. When I said I didn't yell, he mockingly said something like “So you're a tough guy?” “No. After several times, it hurt so bad that it even brought tears to my eyes. I'm just not the kind to yell when it hurts. But I had to continue because I had to get the roof on before the rains came. It's like doing this: I have to put up with getting head butted on the chin to prevent you from acting out of control.” Maybe I'm over-interpreting, but it seemed like he gained an understanding that evening that guys try to be tough, not just for show, but to do what has to be done. Or maybe he just felt guilty. For a little while, between the decision to go to the hospital and actually leaving, I was able to convert Ben to being unrestrained but in a corner of a room from which I could keep him from escaping. I gave him something or another to let him do something with his hands while he waited. The corner also wasn't punishment; it was merely a way to retain control over violent behavior but still acknowledge and affirm the reduced struggling he was showing.

So off to the hospital. It was about 9:00pm by now. Sarah went because she was Ben's mother. I went to “handle” Ben as needed (Sarah obviously couldn't). Kate went because she was the shelter's employee and needed to handle paperwork. Kate was great. At only 19, she stood up to the county ER nurse who demanded information that a battered women's shelter isn't willing to give. I hope she got lots of overtime.

Obviously, Ben couldn't stay alone in the ward with the evening's other psychiatric admittees, so I sat with him while Kate handled paperwork and Sarah sat in the waiting room. The ward was a large open room with several tables in it. Surrounding the room on a couple sides were smaller 8' by 8' rooms with just chairs. The side room didn't have doors or opaque walls, but they allowed some separation and privacy from the main room. Ben and I were at a table in the main room. One patient came over, said he was brought in by the police after a traffic stop and asked if he seemed OK to me. Later, Kate joined me and Ben while waiting for the psychiatrist. Another patient came by and said that if we gave our lives to the Lord, me, my wife, and son wouldn't be having these problems and not need to be there. I didn't say so but I was a little confused by the logic (so why was he there?) but I told him that we were not married and Ben was not our child. He seemed confused (I would be), so I told him that it was complicated and I was not at liberty to explain.

About that time, I noticed the woman with whom I had had my worst date was there. One short, mild piece of the date, but illustrative of the rest of the date, was when I changed from tennis shoes to hiking boots because we were about to hike. She said my beige, Timberland boots were “intimidating.” Nope, not a patient. She worked there. She was the intern or resident or whatever med students are before getting there MDs in psychiatry. There was a full psychiatrist there too.

Eventually, the psychiatrist talked to Ben while I sat in the waiting room with Sarah. She talked a little, but I wished she didn't. She mentioned some psychological problems she had had. And she said that her husband hadn't physically abused her but she mentioned emotional abuse. Considering that I'm only a volunteer and I'm only there to work with the kids, should I let her be talking to me about stuff? She seemed like a very emotionally weak person looking to me for strength. Should I go along or avoid that? And is emotional abuse enough to justify being in a shelter? I still don't know, but it later became irrelevant. I'll get to that.

When the psychiatrist was done with Ben, I went back into the ward. A side room was now available, so we sat in one of those. I sat and watched and protected and waited while Ben slept in a chair. I'm glad he slept. At one point a gentleman with a lesion-covered, shaved head came by. He sympathetically asked why Ben was there. I mildly said “I can't really talk about it. It's not a big government secret or anything, but I promised I wouldn't discuss it with others.” Then he loudly blurts out “But did you promise forever!” I stood up to get him to leave our little room, which he did. I asked the psychiatrist to help keep him away from Ben. She talked to him for half a minute, which was sufficient. He didn't seem violent, but I wanted to keep his shallowly buried issues from my protecttee.

And I watched as the psychiatrist sent a patient home. She told him that he has his medication and seems OK now and could go home. She asked if he had his bus pass. He starts looking for it. Left front pants pocket. Nope. Right front pocket. No. Left back pocket. Right back pocket. Left jacket pocket, right jacket pocket. Front shirt pocket. Nope. So he starts again. Left, right, left, right, left, right, shirt. Nope. Psychiatrist patiently watches. And again. Left, right, left, right (I'm thinking: come on buddy, give up. You ain't got it!), left, right, shirt. No. And again. Left, right, left, right, left – he found it! He pulls it out of the same right jacket pocket he had already checked three times and victoriously holds it out in front of himself. It's certainly sad that anyone needs that much medication but otherwise was reminiscent of an old time comedy skit; Laurel and Hardy maybe.

Ben and my little room had a phone in it. A polite teenage girl came in to call someone. She seemed rather happy to be telling her friend that she was at the hospital after a suicide attempt. I wondered whether it was just some good happy-drugs or she was happy she got the attention that she craved.

So at about 2:30am, Sarah and the psychiatrist join Ben and me. Kate was probably taking care of more paperwork. The psychiatrist is going over a few things with Sarah. I'm only there because of Ben, who is still sleeping. I'm looking down and in Ben's direction, ignoring as best I can. Ben's mother, Sarah, indicates that she wants to talk and does. (Why does it sound like Sarah is talking in my direction and sound like she wants my approval? I don't want to look up.) She starts talking about the night she was arguing with her husband. (Why are they talking about this with me and Ben there?) The husband blocked the way when she tried to leave their house to go to the neighbors. (Am I suppose to be hearing a conversation between a women and a psychiatrist?) So she “hit him with a knife.” (What? And what does that mean?) The police came and made her leave the house. (Umm?) A couple days later, without telling anyone, she picked up Ben at school and went to our battered women's shelter. (What the hell? We can't be accomplices to a domestic kidnapping!) So finally, the psychiatrist takes Sarah to a different room and talks a little. Kate comes in, apparently apprised of the situation. I carry sleeping Ben to the room from which the psychiatrist and intern watch the main room. And Kate drives me and her back to the shelter, no Ben and no Sarah. And I drive home at about 3:30am. Just a pleasant evening of holiday crafts.