The Tools of Recovery

Addressing the Need to Know What Works and What Doesn't.

Bearing Witness: Deborah Max's I'm not angry, but sometimes I forget that.

Most days I don’t feel like a mental patient. In itself that might not seem like an odd statement, but when you examine my history or simply the fact that it’s my predisposition to insanity that pays my bills, you might expect that I’d wear crazy year round.

I grew up in the inpatient mental health system. And now I earn my living as the Deputy Director of an agency funded to help people who too are labeled with psychiatric diagnoses. Just like a model relies on her beauty for her bread and butter, my recovery, and maintenance of my mental health is my earning chip. Though it’s funny, in all the years I have done this work I am asked less often than you would think about my health. More often inquiries are related to my illness. What was it like being inpatient for 6 ½ years? Were you really in restraints for months at a time? “It sucked, and yes.” But other than that, what they are really asking for is the gore; the blood and guts of mental illness.

I don’t mind these inquiries, I welcome them. Joking as I often do that my audiences use me: “I’m a whore for the cause” I say. If my story and the atrocities I endured can prevent future violations, then I am willing to relive my past. But I don’t think there is recognition that this past is mine. In fact when speaking, I often distance myself, not realizing that in fact it is my story I am retelling. This is different Deborah I am describing, from a long time ago and in a galaxy far far away.

And my audience seems to view me as a different person too. Maybe they disbelieve my story. Or maybe they just see me as a medical anomaly, an exception to the course that mental illness typically runs. For how else could it be? Is recovery possible? I must be different. That is how they must comfort themselves. Because I share tables with them, I am a colleague. I am a peer. How can I have the same relationship, with those they treat, medicate, and incarcerate?

And yet, I was just like those that some providers have written off as incurable. I was non-compliant, self destructive and disruptive. I didn’t respond to medication, although I consumed it in massive quantities, in all forms, liquid, pill and of course intramuscular injection. I frequented the quiet room on a regular basis, and was often forcibly put in restraints. And yet, now like those of you reading this, I am a functional member of society. Normal as much as normal is. I have a job, pay my bills, and live my life. I am no longer a danger to myself or others.

How did this happen? What got me better? I have worked in the recovery business for over a decade and now when faced with these questions I don’t have an easy answer. I can say without blinking what has been hard. What has always been hard, and what I hate. I hate my medication.

A colleague of mine debated with me for hours over the benefits of my med regimen. He felt I didn’t attribute enough of my recovery to them. Well damn them. And damn him! I hate them. I hate them with every essence of my being. They slow me down. They dull my senses. They have made me fat, incontinent and lethargic. And yet I take them.

I have every reason in the world to be non-compliant with my medication for all the reasons I mentioned and more. But the fact remains I need them. Or something like them. My meds, while they help me maintain my status among the sane are one of the last things remaining that make me a mental patient. I am reminded of my condition every evening when I pour my meds, breaking out tomorrow’s dose into my discreet little gold pill box.

I get my meds at what my boss calls the “ghetto pharmacy”. I’ve been getting my meds there for years now. And now that a new 24 hour CVS with a drive through pharmacy has opened up right by my house, it seems increasingly impractical. My boss doesn’t understand why I continue to go out of my way. He doesn’t understand my need to compartmentalize my existence. My pharmacy knows me and reminds me of whom I was, and am.

I get my makeup and my cigarettes at the new CVS. The pictures I take of me and my boyfriend are developed in its one hour photo lab. I don’t want these people to confuse me with someone on psych meds. It’s bad enough I am treated differently at my lil’ “ghetto pharmacy”. Prescriptions for heavy anti-psychotic meds tend to have an intimidating effect on pharmacists. At CVS, my predisposition to mania is a secret. They only know I have a good looking boyfriend and that I smoke Kools, hard pack.

In the mid 1990’s I went through the rite of passage for bi-polars. I made the unilateral decision that I no longer needed medication. It was a funny thing really the way it snuck up upon me. I can’t really speak for others who too have played doctor, but for me it started benignly enough.

I was facing the stressors of a stressful life, my life. The life for which I was taking these heavy duty meds. And I simply could not fit my meds into my schedule. I missed a dose here and a dose there. In my defense I had every intention of catching up. I promised myself I would go back to my regular dose on the weekend. I had to wait because I needed to have the extra time the weekend afforded me to sleep the day away as my body re-adjusted. The weekends would come and they would go. I would be busy; there were too many demands on my time. And so it went.

I slowly came off the medication completely. The longer I went without it, the better I felt. At least for awhile, and then I spiraled. I became increasingly enraged, hateful of me, and hateful of my life. One night after placing a panicked call to my therapist I was taken away by the New Rochelle Police and brought to a local hospital ER.

I refused to be admitted, dodging the inquiries of the frustrated attending psychiatrist regarding any plans I had to harm myself by saying that I didn’t want to answer her questions “out of fear that I might incriminate myself”. I was released early that morning and I signed myself into the unit run by my psychiatrist that afternoon.

I was manic. I signed in and was asking for help but in contrast with my other admissions, this time I was an adult and a voluntary patient. This time help would be granted on my own terms. I filled out my health care proxy forms immediately upon admission. I assigned my employer at the time, who was an attorney, as my proxy. My detailed legal directive delineated a course of treatment of my own personal design. Taking the old drugs was not an option. The proxy prohibited my doctor from prescribing me the “wonder drug” to which everyone attributed my health. His hands tied, my doctor prescribed me a newly approved medication that I had researched and requested. I was released within a month.

I felt ownership of my recovery. I had successfully outwitted the psychiatric profession, I reigned supreme. Energy I hadn’t had in years returned. I was losing weight. I felt good. I minimized the fact that I was awake the first 48 hours after my release. I attributed this to post discharge excitement. But the insomnia continued. My energy levels continued to rise. Soon this energy turned into something ugly. I became rageful again and full of hate. And within two weeks I called my doctor, tail between my legs asking for help. I’ll go back on it. I told him. Whatever you say, I’ll do it.

That day goes down as a sad day in the annals of Deborah. I admitted defeat. I caved to my dependency on this intolerable drug. A drug that forces me into the mental patient role on a bi-weekly basis as I sit in my phlebotomist’s chair while blood is drained from my bruised right arm. My doctor could have been smug. Instead, he felt my defeat and on some level, though it ran counter to all his research and faith in this drug, I think he wanted me to win my little battle. He may never openly admit it, but I think he was cheering silently from the side lines. Regardless, my shrink who is known to be a braggart and who doesn’t comprehend the value of couth on a good day, said simply: “well, it’s better sooner, than later.”

I will probably have to be on medication the rest of my life. I recognize this sad fact. I also realize the important role that my meds have played in my recovery. Yes, the actual drugs help, that goes without saying. But the value of my non-compliance is under-recognized and largely misunderstood. Non-compliance is an affirmation of me. Mental patients do not have much to barter with. We are stripped of our rights. We often don’t have much in the realm of material possessions. For many of us, cigarettes and coffee are the crux of existence.

What power do we have? Med refusal is key. The action of asserting oneself is healthy. Saying no, feels good. Ha ha! I’m going to do what I want. Asserting and reclaiming power is vital. Unfortunately in the mental health system asserting yourself is dangerous, it can be retaliated upon with force and restraint. But for me, a vital part of my recovery was this non-compliance. Not acting out as I had in the past, but having the opportunity to be an informed consumer. The chance to make a choice regarding my meds was the first time I had occasion to make an uncoerced decision to seek and obtain treatment.

And now I choose to be on this god-awful debilitating drug that I loathe with every bit of hatred I can muster. Is it the drug that is making me healthy? In part yes. But a greater part of my health I attribute to the fact that I choose to take the med. And that I made this decision, however mournful it may be, on my terms.

For the record this drug hasn’t transformed my life into sunshine and happy days. Some days I find that I have little patience for anyone or anything. I could pathologize this I’m sure, as I’m certain some who are reading this are doing. Once on a particularly crappy day I found myself bitching about work while waiting on an incredibly slow moving line at the supermarket. I was exhausted and in a foul mood. “I hate stupidity.” I muttered. “I hate stupid people.” And then I uttered the coup de grace "I just hate people PERIOD!"“ The kindly customer behind me in line asked me what I did for a living. “Oh” I said, smilingly sheepishly, “I’m in human services”.

I’m generally not an ANGRY person, though I do have a temper. Nor do I think I’m a mean person. I’m compassionate, though I know I’m no Mother Theresa, not by a long shot. But my anger, that is something I have grown to nurture. I have a respect for it. Because it’s my anger that has truly saved my life.

Anger is a terrific motivator. Granted it was my self hatred and irrepressible rage that landed me in the Looney bin and locked me away in quiet rooms in two states and restraints of all shapes and sizes, but it was my righteous anger that freed me. Intractable folk like me are the oil to the water of the mental health practitioners. Though it’s not said out right anywhere in any social work program or any credentialed psychology program, most mental health practitioners are conditioned to pacify patients. Mental hospital walls are painted in shades of blue to calm and soothe. “Compliance” is rewarded with privileges and the squeaky wheel’s complaints are pathologized and punished. My anger caused me to rise above the supremacy of the institutions and the system.

Prior to entering the inpatient system I had a lot to be angry about. My father was dead. I was poor. I wasn’t very pretty; to say I was homely was being generous. My mother seemed to resent me, and showed me nothing more than disdain on good days. I didn’t have any friends. I recognize that this laundry list may sound like things to contribute to a paralyzing depression, things to make me sad. And I guess they could. I’d be lying if I said they didn’t. But had I allowed the sadness to envelope me and take hold, then I would still be a drooling mess, sedated in my own urine in the corner of some back ward somewhere. Of that I am certain.

I was locked up for the first time shortly after my thirteenth birthday. The 4 ½ year inpatient stint that followed gave me tons to be angry about. Though my mother visited me on a fairly regular basis during my first hospitalization, the visits decreased over time. This was due in part to distance, part the restrictions of the facility and my therapeutic needs and part I’m sure due to her sheer lack of interest. In her defense, my mother faced a difficult situation. She was a single mother of two, trying to maintain a middle class existence in our orthodox Jewish world in Kew Gardens Hills. Her self injurious, crazy daughter certainly didn’t help her acclimation into this world.

I always felt substandard with regards to my mother’s perception of me. In my young adult life, my mother continued to see me as I was rather than who I had become. My recovery was a non-issue. Mom, was stuck on crazy. My tireless efforts, the struggles with the meds and all the problems they bring in their wake seemed inconsequential. I was still the crazy one. I’d be dishonest to say this didn’t hurt. But all that hurt ever produced for me was armfuls of scars. I would be a success in my own right and then show her. I would meet and exceed any expectation she had for me. Granted this was an unattainable brass ring. I realize that now. My mother still sees me as sick. And I have to accept that this has less to do with me than it should.

I am not really angry at my mother anymore. My anger at my mother fueled by years of hurt propelled me to be a success. It generated the energy I needed for a decade of work with energy to spare. It served its purpose and for that I am grateful. I don’t mean to suggest that I am endowed with Solomonic wisdom. I am not noble nor am I particularly forgiving. But I am pragmatic. I was forced to fend for myself from a very young age, without fiscal or emotional support from anyone. With that my focus was on the most basic thing: survival.

With survival as my focus and anger as my motivator I protected myself and sought after and attained the things I wanted. As cold as that may sound I am not a bitter person, realistic yes. A bit pessimistic, that too. But I am also grateful. Not having support helped me to face the atrocities of the system. Had I familial support would I be successful? If I didn’t have to fight for all that I have?

I’m afraid my answer to what it is I attribute my own recovery may have left more questions than answers. Should we abandon those we love, let them play doctor arbitrarily and subject them to abusive treatment? I’m not saying there is one standard route of recovery. Nor am I saying that my way is the right way. I wish I didn’t have to be angry to survive. I wish I could have been motivated by peace and love and all that good stuff. But my reality was not one of love and kindness. It is changing though, and on most days, I’m happy. Just remind me of that.

Deborah Max is the Deputy Director of CHOICE of New Rochelle, Inc.

CHOICE of New Rochelle is a 501(c)(3) non-profit community based peer run organization located in New Rochelle, NY, which provides peer advocacy, case management and homeless outreach services to adults recovering from mental illness living in Westchester County. Its mission is: helping, encouraging and supporting persons who, like ourselves, have used mental health services. We bring our programs to people who have been underserved and require assistance to obtain vital services. We seek to help people become fully empowered, independent and integrated into the wider community.

An abbreviated version of this articile originally appeared in ABILITY Magazine.

Contact info:

Deborah Max

CHOICE of New Rochelle, Inc.

420 North Avenue

New Rochelle, NY 10801

Phone: (914) 576-0173

Email: deborahmax@optonline.net

Website: www.choicenr.org

>>Bearing Witness Archives