Content warning: Suicidal Intent, Overdose.
My consultant psychiatrist and I decided last week that it would be useful for me to get some practice at remaining safe and in-control. One of the challenges we agreed on, that I’d need to successfully accomplish before being discharged from the hospital ward, was that I would spend a couple of hours by myself, be it an afternoon at my home or elsewhere.
I woke up on the day my ‘lone leave’ was planned for, and immediately my mind narrowed-in on one particular thought: “I can’t do this.” My new medication regime has been making me incredibly sleepy, and I wanted nothing more than to take a nap that lasted for the entire day. No. Instead I challenged my thoughts and sternly told myself, “if you don’t do this now, it will only become more difficult to accomplish.” I spoke to the nurse in charge, and we agreed that I would still be going out alone for a few hours that day. I’d decided it was now or never. I was going to take a slow, mindful walk into town, grab a coffee, maybe visit the book shop, and see how things went.
Mindfulness. Noticing, being in, the moment. Trying gently to push away any particular thoughts that come to the mind. It’s much more difficult than it sounds. It requires a lot of practice. But I was going to give it a go.
I scribble my name on the ‘patient sign in/out’ booklet, listening to the nearly-empty pen scratching on the paper. I receive a reassuring nod from both of the nurses in the office, who are seemingly impressed by my bravery. “Treat yourself to something that you really want”, one of them suggests, and I smile because it’s a lovely idea. I deserve a treat. I set off towards the ward doors before I get any chance to reconsider my plans; I push open one door, then the other, and I’m outside. It’s my first time stepping outside since being admitted to this ward over two weeks ago, and at that point I was being escorted by paramedics. I breathe in the fresh, crisp air – my nose feels cold almost instantly. Winter. A few more deep breaths, and I set off towards town.
A memory. The last time I walked on this exact path, it was the morning of 14th December ’16 and I’d just managed to talk my way out of the ward adjacent to the one I’m staying on now. Same type of ward, same ‘type’ of patients; very differently managed, though, and with a ghastly consultant (such descriptions are only my opinion, of course). Earlier that morning, I’d bravely spoken of my plans to end my life, and had expressed my intention to act on those plans as clearly as possible. “I do not feel able to maintain my safety, because I have a solid plan in place to end my life and I want to act on that plan as soon as I can.” I was slightly conflicted; I wanted advice on how to cope with such strong intentions, and my partner had begged me to tell them of my plans as he thought it would ensure that the ward kept me safe. It was very clear to anyone that I still needed to be in hospital; I was a risk and I wasn’t stable. But the ward were not going to help me; the consultant had already made the decision to discharge me that afternoon, and none of the staff were willing to take into account the obvious risk that I was to myself on that day. I don’t remember much of what happened, it’s all just a blur of pills and sirens and A&E. Essentially, though, I shoved my belongings from the ward into bags, and asked the nurse who’d told me I was being discharged that day to unlock the doors of the ward (who did so without even questioning my mental state at the time). I vaguely remember dropping my belongings at the door – I wouldn’t need them if I were dead – and running away. Along this very path.
The path. It’s covered in salt grit; it must have been below zero last night, slippy. With every step I take the pavement crunches beneath my worn-out converse trainers, the soles of which are now so thin that I can feel the sharp edges of the salt digging into the base of my feet. I continue walking right off the hospital grounds with my chin held high, and I step onto the housing estate between the hospital and the town centre. My heart is pounding in my chest and my hands are clenched in the pockets of my warmest cardigan, but I’m feeling brave. I can do this. I can.
A thought. This used to be my route from work each day. My desk in the office, where I worked until I was signed off by my doctor as being too ill, was a mere 60 second walk from the hospital bedroom I’m now staying in. I used to spend some of my time looking at the statistics and performance indicators for the hospital, and the rest of my time project-managing the development of an online portal for hospital staff. Now, I’m a patient on the very wards I used to monitor the statistics for, I myself contributing to the patient data that my colleagues need to analyse as part of their day jobs. The sheer idea of that is unsettling, even though I know the confidentiality policies better than I know the back of my own hand. I’d gone from staff member to inpatient in the space of under a week nearly two months ago. The two identities aren’t necessarily mutually exclusive for everyone, but they seemed to be for me; I still hadn’t managed to get back to work. I’m doubting whether I’ll ever be able to do my job again, and that’s completely aside from the fact I’m uncertain about whether I even want to return.
A squirrel is standing on its hind legs, its pose similar to that of a meerkat on guard for its clan. It then hops along the grass, and I imagine in my mind the trace that it would make if its hops left a stream behind. Lots of little joined up arcs, like a dozen tiny rainbows in a line, each joined to the next by its base. I continue through the housing estate; two new play parks have been installed since I last paid attention to this route. A person – presumably a child – is sprawled like a starfish on the hammock swing, rocking back and forth.
A wish. I wish for the same sense of wonder and curiosity – and naivety – as that of a child. A memory. I remember myself as a child; I spent a fair share of my time alone, hanging far upside-down on swings such as the one I’m watching now. An awareness. I am aware that my mind is wandering again.
Mindfulness. It’s difficult to put into practice, but the most important thing is to not get frustrated when you find your thoughts wandering – instead just try to bring your mind back to the present moment. I tried to be as mindful as I could that day, even filling in a page in my “Mindfulness Moments” book by Emma Farrarons which suggested sitting in a coffee shop at the window and writing notes on any observations. But as we can see from this post, thoughts and memories (the italics) can easily disturb your focus and shift it from the present moment. I think it’s just as important to accept that it’s perfectly normal and OK for your mind to wander, as it is to try to reign in your thoughts and resume your focus to the present.
I’ve included a photograph of the page I wrote on in the Mindfulness Moments book below, not because it’s interesting to read, but because it shows my efforts at practicing mindfulness on my day of ‘lone leave’ from the ward. I was anxious and tense that day, and at first I felt very reluctant to even leave my hospital bedroom – but as soon as I made the commitment to just try to focus on things one moment at a time, things got a little easier.
For those interested, my couple of hours off the ward went better than I expected them to. I went to Costa, grabbed a coffee, completed the aforementioned mindfully-noted passage of text in my book. I went to Waterstones afterwards, and noted down the titles of a books that seemed interesting (so that I could look into ordering them online for less than half the price later, because on statutory sick pay you aren’t exactly rolling in money). I did buy myself a journal, though; I decided that this counted as the “treat” to myself that the nurse had earlier suggested I buy. Whilst I felt a little guilty buying a present just for myself like that, I recognised that I’ve been through a lot and I’ve struggled recently so I decided that I did deserve it. The idea of the journal is to write down 3 joyful moments that happen each day, the moments can be big or small. I then went to Boots, brought some makeup for myself (I haven’t even worn make-up since Christmas day, and even then it was only because I felt I had to make the effort) and some tweezers (because quite frankly, my eyebrows are a disgrace). In the queue my anxiety spiked, a LOT, but I successfully managed to ground myself just enough to be able to complete my purchase. After that, I decided that I’d done plenty of ‘time alone’ that day and I was fast nearing the limit of my ability to cope, so I decided to head back to the ward. When I returned about 5 or 6 different members of ward staff asked me how I’d got on, and they were so pleased to hear about my successes. I was particularly proud when telling the ward psychologist that I’d used the grounding techniques she’d taught me to get me through that wobbly moment in the queue in Boots.
The first entry on the first page of my new ‘3 good things’ journal is “I discovered that Costa now put white chocolate ganache in the middle of their raspberry and white chocolate muffins, instead of just jam. It used to be a white chocolate chip muffin with a pool of jam, but now it has a rich white chocolate goo in the centre, too”. Because that genuinely made me happy that day, as small as it is. (10/10, would recommend that muffin!) The second entry is that I saw a tiny puppy on my walk back to the ward, a little black springer spaniel that was clearly out on one of its first walks on the lead. I stopped still in the street and smiled, watching the owner of the puppy patiently encouraging good behaviour whilst the puppy excitedly tripped over its own feet. Bless. The third and final entry describes a moment where I cried with laughter – something that I haven’t done in such a long time – whilst talking to a friend I’ve known since I was sixteen. We were just having a catch up, but we always have such a good laugh and I giggled in my hospital bed for a solid 15 minutes. The tagline on the front of the journal book is “A journal for tiny moments of joy”, and I’m going to do my best to fill it in whenever I can, because recognising the tiny joys in life will hopefully help me through its bigger hurdles.