The authorities will claim that psychiatric hospitals are for the benefit of the patients. I'll concede that this is possible in some cases: maybe some people have such dysfunctional home lives, or would otherwise be living on the streets, such that the psych ward is actually a better place for them.
-For most people of my social class, I don't think this is plausible; if the welfare of the crazy person were the primary criterion, almost everyone would be better off with their friends or family, in a familiar environment with people you know. Rather, psych wards make sense as being for the welfare of friends or family who are _sick of putting up with living with a crazy person_. It's a form of responsibility laundering: if there's a designated institution for taking care of crazy people, you can dump your loved ones there to be _someone else's problem_ (at least for a few days), with a clean conscience. Anything bad that happens inside of an institution, isn't anyone fault.
+For most people of my social class, I don't think this is plausible; if the welfare of the crazy person were the primary criterion, almost everyone would be better off with their friends or family, in a familiar environment with people you know.
+
+Rather, psych wards make sense as being for the welfare of friends or family who are _sick of putting up with living with a crazy person_. It's a form of responsibility laundering: if there's a designated institution for taking care of crazy people, you can dump your loved ones there to be _someone else's problem_ (at least for a few days), with a clean conscience, because anything bad that happens inside of an officially sanctioned institution, isn't anyone fault.
It's important not to be misled by the name, psychiatric "hospital". The word _hospital_ gives the impression of a place where medical procedures are performed, like how real hospitals do surgeries and set broken bones. We don't really have _procedures_ to treat mental illness—not ones that are held in high regard these days, anyway.
It's a jail—a place where you lock up undesirable people where they can't impose costs on anyone who isn't being paid to deal with them. And precisely _because_ I was modeling it as a jail, my social performance was a lot better this time around than in 2013.
+[TODO psych ward scenes—
+
+A nice thing about being a free citizen that you don't notice until you've lost it by being kidnapped and thrown in jail, is having a sense of where you are in the world. When visiting an unfamiliar place, I at least know _how_ I got there, how this place _connects_ to everything else in my model of the world: I may not be familiar with this building or these streets, but I know the train or highway that I took to get here from places that I do know—at worst, if I brought my phone, I can pull up Google Maps to see where I am.
+
+In psych jail, this sense of connection is suddenly absent. You don't know what route the ambulance took. You're locked in a building with strangers. There is no Google Maps. You could be anywhere.
+
+...
+
+
+Even things that are more-or-less genuinely intended to be for your benefit, are harder to recognize as such when you're _insane from sleep deprivation_ and rattled from just having been _kidnapped by armed men_.
+
+When being checked in, they confiscate any belongings you have on you. I remember one of the psych ward employees counting the money from my wallet in front of me.
+
+In retrospect, I can appreciate this practice as the system trying to offer evidence of its trustworthiness: they don't just steal your stuff; they _document_ the items they're confiscating, and give it back to you afterwards. (I have in my possession a yellow carbon copy of my "Patient Valuables Record", form A7026, which lists what they took.)
+
+At the time and in context, I wasn't prepared to appreciate it; the employee counting my bills in front of me seemed like an Orwellian ["There are five lights"](/2018/Aug/interlude-xii/) dominance display, intended to undermine my connection to reality—and maybe, I didn't trust that _she_ knew how to count.
+
+...
+
+
+When I tried to complain about the injustice of my confinement to staff, I was once told that I could call "patient's rights". I didn't bother. If the staff weren't going to listen, what was the designated complaint line going to do?
-[TODO psych ward—
- * I often have a sense of "where I am" geographically (not just my immediate surroundings, but also knowing how my surroundings relate to the world, what city I'm in; what freeways connect to that city; doesn't exist when kidnapped)
+About a year later, Scott Alexander published a _Slate Star Codex_ post, ["Navigating And/Or Avoiding The Inpatient Mental Health System"](https://slatestarcodex.com/2018/03/22/navigating-and-or-avoiding-the-inpatient-mental-health-system/), which claimed that patient rights advocates _do_ advocate for patients in opposition to the rest of the system. ("Usually the doctors hate them, which I take as a pretty good sign that they are actually independent and do their job.")
+This was _not at all_ obvious from the inside. I'm reminded of an article I once read in the racist[^racist-magazine] magazine _American Renaissance_, [by a public defender complaining about the behavior of his predominantly black clients](https://archive.is/HUkzY):
- * Even things that are for your benefit during the check-in process are hard to appreciate as such—I remember them counting my money in front of me, and feeling like it was an Orwellian exericse to undermine my connection to reality; maybe, I didn't trust that _she_ knew how to count?
+[^racist]: I think they would prefer that I say _racialist_? But I also think that, when pressed, they would concede that _you know what I mean_.
- * trying to complain to the staff—got told to speak to patient's rights; I didn't even bother, because I didn't think that was real; a later SSC claims that patient's rights is supposed to be adversarial, but that wasn't clear from the inside; I'm reminded of that AmRen article [article by a public defender](https://archive.is/HUkzY); I empathize with the defendant https://slatestarcodex.com/2018/03/22/navigating-and-or-avoiding-the-inpatient-mental-health-system/ "Usually the doctors hate them, which I take as a pretty good sign that they are actually independent and do their job"
+> If you tell a black man that the evidence is very harmful to his case, he will blame _you_. "You ain't workin' fo' me." "It like you workin' with da State." Every public defender hears this. The more you try to explain the evidence to a black man, the angrier he gets.
+
+After my psych ward experiences, I deeply empathize with the clients here. In the defense attorney's worldview, he's working to protect his clients' interests, and is frustrated that they don't appreciate that. What the defense attorney doesn't see is that his work only benefits the clients from _within_ the terms set by a system of power that looks arbitrary and unjust to those on the other end of it. From the perspective of a client who doesn't think he did anything particularly wrong (whether or not the law agrees), the defense attorney is _part of the system_.
+
+So I think my intuition was correct to dismiss patient's rights as useless. I'm sure _they_ believe that they're working to protect patients' interests within the system, and would have been frustrated that I didn't appreciate that. But what I wanted was not redress of any particular mistreatment that the system recognized as mistreatment, but to be _let out of psych jail_—and on that count, I'm sure patient's rights would have told me that the evidence was harmful to my case. They weren't working for me.
+
+...
+
+ * wanted to avoid taking medication, put on a magician-like "show" to nurse to try to trick her, it didn't work
+ * in retrospect, the medication was a good idea
+ * I ended up with a booklet that claims I have the right to refuse medication, but this isn't actually true in practice
+ * paper claims that I "self presented due to your suicidal thoughts"; this isn't true; getting stopped by the cops while trying to
+
+...
* First facility—separate rooms with beds for men and women; me tapping at the walls trying to teach; pacing, thinking I was one of the most important people in the world
* Taken to a separate facility; _very_ lucky to get my own room
- * paper claims that I "self presented due to your suicidal thoughts"; this isn't true; getting stopped by the cops while trying to
+...
* "Now memories are blurred, and their faces are obscured"
* racist/sexist intuitions: avoid the gaze of males; males physically smaller than me are OK
* black woman named "Tone" asked what we had for breakfast
* black man saying something about his mother, I explained that his mother probably did love him, he got angry, and I hid behind my door
* doing better than in 2013 precisely because I was modeling the place as a prison
- * wanted to avoid taking medication, put on a magician-like "show" to nurse to try to trick her, it didn't work
- * I ended up with a booklet that claims I have the right to refuse medication, but this isn't actually true in practice
+ * trying to demonstrate that I was a trustworthy agent
+
+...
+
* asking Anna on the phone whether I was a political prisoner "Really?" "Really really?" followups (if I were a political prisoner; she might not be able to say so)
* mother visited, mother was cranky, Michael Vassar visited; Michael said that rape doesn't really happen in this kind of facility, and I believed him; I handed him papers (which I thought was necessary to escape the powers that be)
* vision of needing to pull the fire alarm?
projects / Ultimately_Untrue_Thought.git / commitdiff