PERSONAL VIEWPOINT
\
The
Forgotten
Ones
by
of
a
dialogue
between
and
my
hallucinations. The publication of this book brought me letters from people who wanted to know how a nurse could work efficiently while being a schizo-
phrenic. Getting the schizophrenic a job and helping him to keep it are very important tasks for psychiatrists and social workers. The way has been paved by the setting up of workshops within hospitals, so that patients can begin to test their capacities while being paid. Hostels for newlydischarged patients are also important, although the idea didn't appeal to me personally. I went against everyone's advice and soon after leaving hospital?where I had been after a suicidal attempt?I applied for, and obtained, a nursing post in a psychiatric hospital. This is the work I want to do, and I think I have some inside knowledge which can make me an asset rather than a liability to my employer. I am now quite happy in my
strained, and I would sink into depression and increasing apathy where any activity too much trouble. I have had to resort to deceit, in that 1 did not confess my past when applying for a job. I had to think up many weird and wonderful reasons for those gaps in my career, but I have enough faith in my abilities not to feel conscience-stricken. For those who have a relative or friend who is a schizophrenic, there must be a constant temptation to tell the patient to was
patients.
hospitals twelve times since
psychiatric my
as
employment to want to return to this state. I would stay in bed for about 22 hours a day, and live on tea and cigarettes. My relationship with my family would be
work, and in my free time I write articles and books. I don't think I am being too presumptuous, for although being a schizophrenic does not endow one with a special insight into every other schizophrenic, I do believe that the basic symptomatology and feelings are the same for all such I have received treatment in
(
patient's
Schizophrenic
myself
1
well as those of the staff. * would not say that my case is typical, because I feel that I have not deteriorated to the extent that many schizophrenics would have done after so many acute episodes. I have been helped by receiving constant out-patient treatment, which consisted of E.C.T. and tranquillising drugs (for which I have a high tolerance)My history is such that obtaining a nursing post was not at all easy. But I have had too much experience of un-
problems,
Nurse, which was published in June 1965, I tried to show how it felt to be schizophrenic. This was not an easy task, and eventually I decided to write the book as a
Clare Marc Wallace
breakdown in 1955 when I was twenty* two, so I know something of the
I am a schizophrenic. I am also an S.R.N., and a trained psychiatric nurse. Several psychiatrists have remarked upon this being a unique combination. I suppose it is, for when I am not going in and out of psychiatric hospitals for treatment, I work in them as a Sister. In my book Portrait
t
first 288
"pull himself together", to stop being lazv, or dirty, or uninterested in outside affairs. This advice is useless and only makes the patient feel more guilty and worthless. One would like to be normal and go out and have friends, and feel secure in one's home environment. One does not choose to be an isolate; one is so because childhood experiences have taught one to feel that the world and the people in it are alien. One is afraid to talk and mix with people. One feels that one would be overwhelmed. Patience, love, and an attempt at understanding are better than cliches about "bucking up" and "snapping out of it' Most of the time, well-wishers use these words only because they are anxious and ?
afraid. Schizophrenics seem so cut off from reality, so wrapped up in a fantasy World, that relatives and friends can't get
through
to them
by ordinary
methods.
I believe that the solution lies in group meetings, say in a hospital out-patients' department, where patients, relatives, social workers, and psychiatrists can get together and discuss mutual difficulties. It is often a great relief to relatives to know that their husband, wife, daughter, son, mother or father is not the only person to behave in this way. By talking things over, the patient and his relatives are helped and encouraged. Unfortunately, such groups are very few at present, although the need is great.
aim of everyone in the team is to keep the schizophrenic out of hospital, and functioning at a normal or near-normal level outside. The
chief
therapeutic In my worst
opinion, hospital life is usually the thing for the patient, unless he is completely unmanageable at home?for and example, aggressive, depressed suicidal. Hospitals cannot give the individual care that a patient needs. Schizophrenics need love and the interest of someone they can trust, even though they may appear completely indifferent to everyone and everything. Fortunately, with the advent of the tranquillisers, there has been a change of feeling amongst psychiatric staff towards schizophrenics. At one time, these patients were mostly regarded as hopeless cases and deterioration was regarded as inevitable. The patient would be shunted from one ward to another, sometimes given E.C.T. or pumped full of
sedatives to make him easier to handle, until eventually he would finish up on a back ward and probably be forgotten. One has only to stroll through the grounds of any large mental hospital to see "burnt-out" schizophrenics, who are chronically institutionalised and terrified if anyone tries to change their dull routine of bed and wandering around. The new approach is to get to grips with the illness before the patient has a chance to drop into this state of hopelessness and apathy. Drugs, E.C.T., group meetings and supportive psychotherapy,
a rehabilitation programme from the moment the patient enters hospital, mean that schizophrenics are now treated far more optimistically. Stay in hospital is
plus
reduced from half-a-lifetime or more to a few months, or even weeks. This is as it should be, but much more research
is necessary. If the cause and
could be found, our psychiatric hospitals would be more than half emptied. Why is there such public indifference to this research? People give freely for cancer research, but the money set aside for schizophrenia is paltry and pathetically small. Perhaps this is because schizophrenia is not a killer, though thousands of people in this country go into hospital every year because of it. To obtain accurate statistics is almost impossible?I know, because I have tried. Nobody seems to know exactly how many hospital beds cure
are
occupied by schizophrenics,
any more
than they know the exact amount spent on research into this illness. One thing is known?so many patients?so little money. Schizophrenics seem still to be the
forgotten
ones.
\
The
Forgotten
Ones
by
of
a
dialogue
between
and
my
hallucinations. The publication of this book brought me letters from people who wanted to know how a nurse could work efficiently while being a schizo-
phrenic. Getting the schizophrenic a job and helping him to keep it are very important tasks for psychiatrists and social workers. The way has been paved by the setting up of workshops within hospitals, so that patients can begin to test their capacities while being paid. Hostels for newlydischarged patients are also important, although the idea didn't appeal to me personally. I went against everyone's advice and soon after leaving hospital?where I had been after a suicidal attempt?I applied for, and obtained, a nursing post in a psychiatric hospital. This is the work I want to do, and I think I have some inside knowledge which can make me an asset rather than a liability to my employer. I am now quite happy in my
strained, and I would sink into depression and increasing apathy where any activity too much trouble. I have had to resort to deceit, in that 1 did not confess my past when applying for a job. I had to think up many weird and wonderful reasons for those gaps in my career, but I have enough faith in my abilities not to feel conscience-stricken. For those who have a relative or friend who is a schizophrenic, there must be a constant temptation to tell the patient to was
patients.
hospitals twelve times since
psychiatric my
as
employment to want to return to this state. I would stay in bed for about 22 hours a day, and live on tea and cigarettes. My relationship with my family would be
work, and in my free time I write articles and books. I don't think I am being too presumptuous, for although being a schizophrenic does not endow one with a special insight into every other schizophrenic, I do believe that the basic symptomatology and feelings are the same for all such I have received treatment in
(
patient's
Schizophrenic
myself
1
well as those of the staff. * would not say that my case is typical, because I feel that I have not deteriorated to the extent that many schizophrenics would have done after so many acute episodes. I have been helped by receiving constant out-patient treatment, which consisted of E.C.T. and tranquillising drugs (for which I have a high tolerance)My history is such that obtaining a nursing post was not at all easy. But I have had too much experience of un-
problems,
Nurse, which was published in June 1965, I tried to show how it felt to be schizophrenic. This was not an easy task, and eventually I decided to write the book as a
Clare Marc Wallace
breakdown in 1955 when I was twenty* two, so I know something of the
I am a schizophrenic. I am also an S.R.N., and a trained psychiatric nurse. Several psychiatrists have remarked upon this being a unique combination. I suppose it is, for when I am not going in and out of psychiatric hospitals for treatment, I work in them as a Sister. In my book Portrait
t
first 288
"pull himself together", to stop being lazv, or dirty, or uninterested in outside affairs. This advice is useless and only makes the patient feel more guilty and worthless. One would like to be normal and go out and have friends, and feel secure in one's home environment. One does not choose to be an isolate; one is so because childhood experiences have taught one to feel that the world and the people in it are alien. One is afraid to talk and mix with people. One feels that one would be overwhelmed. Patience, love, and an attempt at understanding are better than cliches about "bucking up" and "snapping out of it' Most of the time, well-wishers use these words only because they are anxious and ?
afraid. Schizophrenics seem so cut off from reality, so wrapped up in a fantasy World, that relatives and friends can't get
through
to them
by ordinary
methods.
I believe that the solution lies in group meetings, say in a hospital out-patients' department, where patients, relatives, social workers, and psychiatrists can get together and discuss mutual difficulties. It is often a great relief to relatives to know that their husband, wife, daughter, son, mother or father is not the only person to behave in this way. By talking things over, the patient and his relatives are helped and encouraged. Unfortunately, such groups are very few at present, although the need is great.
aim of everyone in the team is to keep the schizophrenic out of hospital, and functioning at a normal or near-normal level outside. The
chief
therapeutic In my worst
opinion, hospital life is usually the thing for the patient, unless he is completely unmanageable at home?for and example, aggressive, depressed suicidal. Hospitals cannot give the individual care that a patient needs. Schizophrenics need love and the interest of someone they can trust, even though they may appear completely indifferent to everyone and everything. Fortunately, with the advent of the tranquillisers, there has been a change of feeling amongst psychiatric staff towards schizophrenics. At one time, these patients were mostly regarded as hopeless cases and deterioration was regarded as inevitable. The patient would be shunted from one ward to another, sometimes given E.C.T. or pumped full of
sedatives to make him easier to handle, until eventually he would finish up on a back ward and probably be forgotten. One has only to stroll through the grounds of any large mental hospital to see "burnt-out" schizophrenics, who are chronically institutionalised and terrified if anyone tries to change their dull routine of bed and wandering around. The new approach is to get to grips with the illness before the patient has a chance to drop into this state of hopelessness and apathy. Drugs, E.C.T., group meetings and supportive psychotherapy,
a rehabilitation programme from the moment the patient enters hospital, mean that schizophrenics are now treated far more optimistically. Stay in hospital is
plus
reduced from half-a-lifetime or more to a few months, or even weeks. This is as it should be, but much more research
is necessary. If the cause and
could be found, our psychiatric hospitals would be more than half emptied. Why is there such public indifference to this research? People give freely for cancer research, but the money set aside for schizophrenia is paltry and pathetically small. Perhaps this is because schizophrenia is not a killer, though thousands of people in this country go into hospital every year because of it. To obtain accurate statistics is almost impossible?I know, because I have tried. Nobody seems to know exactly how many hospital beds cure
are
occupied by schizophrenics,
any more
than they know the exact amount spent on research into this illness. One thing is known?so many patients?so little money. Schizophrenics seem still to be the
forgotten
ones.
