Finding Hope in the Lived Experience of Psychosis

Reflections on Trauma, Use of Power and Re-visioning Psychiatry

Patte Randal, Josephine Stanton

• Publisher: Routledge
• Year: 2022
• eBook ISBN: 9781000608786
• Topic: Psychologie
• Subtopic: Psychische Gesundheit in der Psychologie

This book offers first-person accounts of the experience of psychosis from the inside and the outside, through the eyes of two doctors, one of whom has experienced psychosis and both of whom have worked for decades in the field of psychiatry.

Underpinned by rigorous academic analysis using an evocative duo-ethnographic approach, the book explores the cultural and subcultural influences from childhood onwards – both traumatic and resilience-building – that have shaped their lives. Both authors reflect on strategies they learned early in life for dealing with challenges, each managing to function at a high level while avoiding awareness of their vulnerability. They reflect on the potential dangers of using their expertise and position of power in psychiatry simply to diagnose mental illness and prescribe medication. The differences and similarities in the authors' stories provide a productive tension highlighting the complexities of this paradigm shift that is happening in psychiatry.

Written in the form of two interacting memoirs, this book is of great interest to researchers, clinicians, and practicing psychologists, as well as a general audience with interest in psychosis.

Part 1Becoming Ourselves

Patte’s Story 1951–1980 (Birth to 29)

1Trust and BetrayalThe Divided Self

DOI: 10.4324/9781003153788-4

In which Patte’s experience of different forms of love, power and intimacy plant the seeds of later extreme states, and her life patterns of being superhuman and focusing on caring for others set the ground for induction into the culture of medicine.

It’s 7 October 1945, almost six years before my birth. My imagination paints an unruly picture of the couple who are to become my parents. She’s 18, curly black hair tied back off her freckled face, her arms around his chest as they sweep along the gravel road in dusty, parched Palestine. The handsome young man is 14 years older than his bride of three weeks. Their unborn baby, nestled between them, settles into the birth canal as the roar of the motorbike drowns out their laughter. Within hours this premature infant boy arrives.

My mother was born in Haifa in 1926, one of the first of the new generation of Jewish people living in what became the land of Israel. One of her grandfathers was a rabbi. Many of her extended family perished in the holocaust. Again, the history-making part of my mind flicks into hyperdrive. It’s 1935. I see a little girl, nine years old. Her mother – my grandmother – has just died unexpectedly during surgery for the removal of her gallbladder. An open grave receives the limp body, wrapped in the customary white burial shroud. The child watches silently from her place beside her grief-stricken father. As the rabbi sings, she turns away, lost, alone; unable to cry. A thought crosses her mind. Existence doesn’t care about us. This shattering idea takes up a central, guiding place. Even though she is still so young, my mother knows that she must become the author of her own life now. She must find her own way.

Her father soon remarried, but my mother never bonded with her stepmother. During my parents’ wedding feast nine years later, instead of joining in the celebration of love and commitment, the stepmother insisted on ‘sitting shiva’ (the week-long mourning period in Judaism for first-degree relatives). We had always believed that this was because my father was a British policeman serving in the Palestine police force. He was the ‘enemy’ as far as Jewish settlers were concerned. The unearthing of our parents’ long-concealed marriage certificate recently exposed the 75-year-old secret of my brother’s conception. We had all believed the wedding had taken place in 1944. At long last, what happened makes a lot more sense for a traditional Jewish family. Our mother had not only married a British policeman but also got pregnant out of wedlock. The effects of this secret reached through time, etching their imprint on my own as yet unconceived life.

Soon afterwards our parents and their baby boy left Palestine bound for England. A couple of years later my older sister came along. By this time, our father had gone to Burma to pursue his career as an engineer. Our mother, virtually alone in a foreign country, lived in a caravan with her two small children. At the age of 23, she and her two little ones eventually set off to join her husband. However, life had a different plan, as my older brother contracted polio. He would get better care and opportunities in England.

The young family arrived back in England in 1951. I can picture the scene. A ship berths at Liverpool docks in the early morning of an English summer. Sweet-smelling pink roses and pastel hollyhocks bloom somewhere in unfamiliar manicured gardens not far away. The foghorn blares. The sun breaks through the mist and warms the chill air. Tall and well built, my father manages two large, battered suitcases that have seen half the world and better days. A small boy with a calliper on his leg sits in a yellow pushchair, skilfully manoeuvred by an exotic-looking young woman. On her hip swings a cherub-faced toddler clinging tightly to her mother, afraid to let her go. The bulge of another baby is visible through the green linen dress. This was me.

What no one can see in my mother’s youthful face is the grief of multiple losses. The loss of the two babies between me and my sister – one a miscarriage and one stillborn; the unresolved grief of the loss of her own mother when she was nine; and the loss of her dreams of becoming a lawyer, cut short by her first pregnancy. My mother’s remaining family were all by now in Israel. Our father’s mother had also died when he was a boy of seven, and he had left home as a teenager. In the intervening years, there was hardly any contact with his father, siblings, and stepmother. Despite this, my father’s younger brother was there to greet them, bearded and hardly recognisable after all this time, doing his best to welcome his kin.

I was born later that year on 15 November at Mile End Hospital in London, under the sound of Bow Bells. Technically that makes me a ‘true Cockney’. Actually, I never learned to speak Cockney. Our mother loved languages and her English was excellent, although she grew up speaking a mixture of Yiddish and Hebrew. Her intention was to teach us ‘the Queen’s English’. So, the way we spoke always differed from our neighbours in Harold Hill, Essex. Two younger brothers were subsequently born within three years of me. That meant there were seven of us living in a small three-bedroom council house, along with our father’s various electrical motors and motorbike parts. Our parents slept in the sitting room.

Our mother always used to tell us that she and Daddy wanted to create their version of the 12 tribes of Israel, and to give us the opportunity to become ‘free thinkers’. It turned out to be the six tribes of Essex instead, and we have since spread out with our own partners and offspring from one side of the globe to the other, but our parents did create a large vibrant family. We have remained deeply connected and loving towards one another over the past seven decades. Our father was a reserved, introverted man. Once back in England, he spent the rest of his working life as an engineer for Ford Motor Company in Dagenham. We children seemed to be mainly our mother’s business. I don’t know how active a role he had in this ‘twelve tribes’ idea, except that they seemed to keep making babies, which had to be partly his business too. How he felt about marrying her and having all us children, we can only guess at. Our impression, though, is that they always loved one another very much, despite their many differences. And, as parents, they were both utterly committed to us.

Our accents were not the only thing that set us apart. Although our mother did not practise the Jewish religion, she had imbibed the culture during her own growing up years in Haifa. Jewishness is handed on through the maternal line, and she saw us as ‘the chosen people’ – different and special. Although neither ‘better’ nor ‘worse’, this meant that we were not to consider ourselves to be like our neighbours. We were Jewish, whether we liked it or not.

I now know that losing a baby can affect the relationship between a mother and her next child (Markin, 2018). My mother had lost two babies before I was conceived. She told me that her family doctor prescribed vitamin E to protect this pregnancy. She was determined that I was going to thrive. She used to describe my early development in glowing terms, as if she believed she had created a superchild. She said that I was talking at six months; drew a picture of ‘Daddy’ at 18 months; and at three years announced that I’d been thinking about how people came to exist. Apparently, I figured out that my mummy’s mummy must have given birth to her, and her mummy’s mummy must have given birth to her mummy and so on, but the very first mummy must have grown out of the ground. I wonder now whether there was an element of idealisation of me in the context of her unresolved grief for the babies who died. Maybe it left me without much permission to be an ordinary little girl. My childhood memories are mainly of happy times. It is only in retrospect that I have understood the challenges I negotiated in my childhood.

With all her investment in me as this special superchild, she must have been beside herself when I developed asthma at six months after a cat slept on me when I was asleep outside in my pram. Often, my mother had to be awake at night trying to soothe me, and once or twice had to take me to the hospital for treatment, leaving my younger siblings at home. My asthma abated eventually, but as a young girl, I would often be unable to breathe, especially when anything exciting was happening. My breathing difficulties weren’t helped by the fact that cigarette smoke was considered harmless, and both our parents smoked in those days.

One of my earliest memories is of all sorts of monsters under the bed. I regularly woke up screaming, until the family GP suggested I should sleep with my sister. Our mother would put us all to bed around six o’clock at night so that she could have some ‘peace’. My sister and I grew close during these years.

My older sister was a compliant ‘good’ little girl, whereas I was much more demanding. There is a story about me crying fiercely because I couldn’t have a little bottle of milk like she had when she started school. I always had strong feelings, and my mother hadn’t had the benefit of more recent parenting ideas like validation and helping a child to self-soothe.

‘Temper, temper, temper!!’ she repeated on more than one occasion.

I also recall the stinging sensation of getting slapped around the legs when I was a bit older. One day I was smacked lightly on the cheek at the dinner table, for something I can’t remember. Leaning my head to one side, I cried out, ‘You’ve broken my neck!’ I stayed in that position all afternoon. Gentle mocking followed. In my childish way, I was demonstrating that I needed a different sort of response from my parents.

Daddy, as we called him, never raised his voice. He was often silently hidden behind a newspaper. My mother energetically ran the family. It seemed to work pretty well most of the time, although a terrifying angry scene has survived in my memory as a reminder that things were not always in control for my over-stretched parents. Our mother was yelling at our father and threw a hot grill pan full of almost-cooked lamb chops across the room. This extreme behaviour only happened once, but I don’t remember feelings being talked about, or conflict being resolved openly between my parents. Despite the lack of this kind of modelling, I eventually learned to control my temper. Sucking my thumb was my preferred method of managing my emotions in those early days.

My two adorable younger brothers had arrived in close succession. Though only 17 months older than the middle one, it felt natural for me to take up a role as carer for them both. One afternoon, when I was not yet four years old, our mother put us all down for a nap. Waking up to discover we were alone in the house, I dressed the two tearful little boys and, carrying the one-year-old, took the other toddler by the hand and headed off down the street to find our mother. Maybe this tendency to take care of my little brothers was the beginning of forming the superhuman identity later to be expected of a doctor in the twentieth century. Our busy mother had popped next door to plan dinner with Betty, our neighbour, as they communally shared household tasks.

Having put the rituals and practices of Judaism behind her, our mother did her best to assimilate into the local culture and community. We celebrated Christmas each year with stockings filled with post-war treats such as pink sugar mice, oranges, and walnuts, but the closest we got to religion was that our father used to say, ‘Good night, God bless’, when we were tucked up in bed. A rare and special moment of closeness. For a short time, we were sent along to Sunday school. This came to a sudden end when I was found standing precariously on the windowsill saying: ‘Please God make me die cos I want to go to Jesus’.

At five years old, I started ‘infants’ school. My thumb sucking had become almost continuous by this time. Bitter aloes had been applied to deter me, but to no avail. My thumb was corkscrew-shaped and my teeth were crooked, but there was no way my thumb was coming out of my mouth! My mother told me that children at school do not suck their thumbs and I would look very silly doing that in the classroom. The day I started school I stopped the thumb-sucking and never resumed, not even in bed at night. However, I cried every time any teacher as much as looked at me. I remember the overwhelming feeling of vulnerability. How I learned anything is a mystery to me.

One day a favourite teacher, a red-faced grey-haired Irish man, asked the class a question.

‘What does “eggifullapie” mean?’

My hand shot up. The teacher asked me what I thought. A cold, clammy, sickening sense of shame filled me. I felt undone. I had no idea what it meant. Little did I realise that it was a made-up word with no meaning. I had pretended to know the answer in front of the class and been found out. At that moment, I decided that I must always know the right answer, and never make a mistake. This idea has taken a lot of unlearning.

When our mother became pregnant again, our parents moved to a bigger house. Our youngest brother was born shortly after we arrived at our new home. I remember the pleasure of seeing the tiny pink baby in my mother’s arms, wrapped in his white shawl. As with all of us, he was breast-fed on demand, but quickly settled into some sort of routine that fitted into family life. My mother was occupied with him a lot of the time, so, in the pattern of being a superchild, I took it upon my seven-year-old self to keep my two younger brothers out of her way as much as possible.

The new house was built in a cul-de-sac that used to be the orchard of a manor house. The street was surrounded by the original high red brick wall that enclosed the orchard, and all the gardens had fruit trees. I used to climb the apple trees with my two younger brothers and regularly put the heel of my shoe through the hem of my hand-me-down dresses. The orchard was bounded by a wooded area. We three children thought of it as an exciting enchanted forest and spent many happy hours there after school and at weekends playing adventure games together, with me in charge of my little brothers. One day we caught a snake. We were convinced it was a viper, the only species of poisonous snake to slither across the British Isles. Much later, the realisation dawned that it must have been a slowworm but in our childish minds we were heroes who had narrowly escaped death. We proudly paraded our conquest in a glass jar for all to admire.

By now, I was growing quite tall and skinny – my long, thin arms and legs often bare despite the cool summer weather. My toothy smiles were self-consciously hidden behind my hand. With a colourful ribbon tied around my neck, and a pink rose picked from a neighbour’s garden behind my ear, my walk to school was always an adventure. A pretty girl friend invited me to her house one afternoon. There she was, in her bright cotton frock, sitting happily on her father’s lap. My own typically Victorian father was a remote figure in my life. Although he always brought sherbet lemons and toffee bonbons home from work on Friday nights as a family treat, I could not imagine sitting on his lap.

At around that age, I began to steal sweets from the shops when my younger brothers and I were allowed to go on our own to spend our sixpence weekly pocket money. One day I noticed a shop assistant pointing at me. Shortly after this, my brother began to tell our mother what I had done. Before he could say more, I stopped him. I went into a rage and kicked him, accusing him of telling lies about me. Was it fury at his betrayal? Was it shame or guilt? I could not bear the thought of my mother knowing. Was it my fear of failing to live up to her shiny image of me? To my relief, she never questioned me about this misdeed. But that didn’t help over the next couple of years as I lay in bed, listening for a knock at the front door. Terrified, I imagined that one day the police would be coming to arrest me.

Gradually I developed strategies to help manage these fears. I decided never to steal things again and always to tell the truth. A habit of shallow breathing made it easier not to cry so much. I think a lot of children do this as a way of managing vulnerable feelings. The problem was, I think it eventually made me forget how to cry at all!

In my eighth year, my mother realised I was short-sighted, and I got spectacles. Being able to see transformed my school experience. I won a handwriting competition. I started to enjoy the hours I spent at school much mor...

Table of contents

• Cover
• Endorsements Page
• Half-Title Page
• Series Page
• Title Page
• Copyright Page
• Contents
• Acknowledgements
• Introduction
• Part 1 Becoming Ourselves
• Part 2 Becoming Doctors and Choosing Psychiatry
• Part 3 Learning from Experience
• Epilogue: It’s About Time
• References
• Index