Two thirds of the way through a painting degree with the Open College of the Arts, I needed some text to insert into a large painting/collage illustrating the idea of rifts. Previous pieces in this series have been geo-political, socio-political, and imagined; this one is about mental capacity and health.

I’ve spent my professional life as a clinical psychologist working with adults with intellectual disabilities. When I began in the 1980s, they were still ‘mentally handicapped patients’ housed in huge, bleak, emotionally barren institutions. The classification was an improvement on previous terminology, much of which has found its way into the language of abuse, but has been updated with such regularity it has the feel of a hare keeping one step ahead of the hounds.

Searching on the terms of abuse, an uncomfortable thing to do but I wanted the ignorance people faced to be represented, I came across ‘lunatic asylums’, ‘colonies’, ‘spaz’, and The Sun’s roundly criticised, ‘Bonkers Bruno Locked Up’ which presumably the newspaper thought would go down well with its readership.

What I also came across was a smattering of old buildings housing ‘the insane’ and the ‘defective’, and I knew them because I’d worked there. St Lawrence’s in Caterham; the Bethlem (Bedlam) which landed up in Beckenham; Darenth Park in Kent; and the Royal Earlswood in Surrey where two of the Queen Mother’s cousins were said to have lived out their lives. All of them huge, impersonal, and smelling of cabbage and wee. But all of them home, as we discovered when trying to bring a group of elderly men back to some form of normality after nearly 70 years in the institution. They were angry with us because we didn’t understand and they were right. We assumed that this lovely new group home where they had their own rooms and could choose their own furniture would be greeted with gratitude. But we forgot about what they’d lost: their Friday cinema, the concerts put on by staff, the huge grounds where they could wander, and critically to some of them, the in-house services of washing, cooking, and cleaning that they would be expected to do for themselves in this new place.

This is what happens when you forget who’s the most important person here. That what looks good to you might look like devastating loss, bereavement, dislocation, and abandonment to someone on the receiving end.

We ran a group to let them tell us about their lives; how it was, how they lived. And at first this was full of the fun things, the happy memories; gradually thought the reality of the lack of individuality, the discriminatory behaviour, the abuse, the disrespectful terminology – being called ‘boys’ when they were adult, and not being permitted contact with the ‘girls’.

They made adjustments, got used to having their own TVs in their rooms if they wanted them, and being able to join clubs, choose their meals to eat when they wanted to. One man turned up at their house warming looking cool as mint and could have been straight out of Miami Vice, right down to the sunglasses which he wore all evening.

Unfortunately, cooking, cleaning, and laundry was still ‘women’s work’ to many, and a point of some discussion when expectations on both sides were not met!

For some of the text collaged into this piece of work I have used two short stories which draw on this experience alongside direct contact with people whose mental illness was florid and only barely imaginable. In each, I’ve tried to do that imagining to construct the internal dialogues that might give rise to misunderstandings and misperceptions among those there to help.

‘Noise in a Darkening Mind’

This piece reflects the encounter many of us have had with a client who seemed uncommunicative, or who expressed only occasional sentences amid long silences. What was happening on the inside? What was the internal dialogue?

Down here, time presses like an anvil on your chest; inescapable, slow, giving you time to think. You start with the outside things like trees and ponds

and fresh air, kites in the sky.

And birds.

But when the dark overpowers them and you forget how to conjure them up, you move on to the inside things, by which I mean anything from the skin inwards. Things such as your bowel twisting itself around and growling as if it’s become a living thing in its own right. It at least makes sounds, albeit somewhat slithery and not as reassuring

as a heartbeat.

Eventually, the silence is broken; initially by chatterings and chirpings then later by voices that seem to come from speakers or headphones – or maybe implants.

It’s possible to converse although you can never be sure where to address yourself so sometimes I shout, other times I whisper into my hands because I think maybe when I cup them they act like microphones.

I’ve even used Morse code

tapping out words on my knee

I don’t actually know Morse code so I’ve had to invent it again but it seems to work because it was a tapping noise under my skull bones that saved me from drowning. More like drumming really so I think it must have been an angel

although I’m not religious.

maybe angels can’t speak to non-believers so they have to drum instead.

I’ve had conversations though; one with someone who hated French cuisine with its snails and frog legs. I used to hate that too but now I’m not so sure. When you argue against your own belief you can end up changing your mind

I’ve heard that somewhere.

I like the conversations, I think they may be stopping me from going mad.

‘Silent Noise’

This story is part imagined and part experienced, and exposes the miscommunication that can occur between a therapist and a client whose mental ill-health is causing disruption to his way of hearing and responding to words such that they generate rhymes, and that makes a running commentary on his behaviour. As he articulates some of these, often in isolation, his therapist tries to make sense of them and responds without knowing the context because she only has a quarter of the conversation. Text in bold is the therapist; text in italics is the client’s internal conversation, and non-italic text is his spoken response.

Please come in, Phil. Take a seat take a seat very neat over here look at him he’s walking funny lame bastard

Phil, talk to me, what brings you here today?

Piss off! What do you care? in her lair you walked in Walking.

Walking, Phil? Talk walk you’re an orc ha-fucking-ha What are you looking at?

You’re all the same, think you know I know you know we knows your nose Your nose is a rose. rose up crazy cow jumped over the moon loony high tunes

Fuck off out of it, crazy cow don’t talk to her she’ll knock you out lock you up look at her eyes devil’s eyes those are

Devil’s eyes. Devil’s eyes?

Whose eyes are Devil’s eyes, Phil? don’t tell her keep it secret we’ll know ho ho say it lo Secret. Tell me about the secret.

What’s the secret, Phil?

Secrets haven’t always been good things, have they? finish her off she’s sucking your mind out of your ears Ears. Shears. Cut them off. Very funny. out of your ears

Ears

go on do it Ears, Phil? she deserves it interfering old witch

Ears

look at him crazy as a loon loony lunatic tock tick

Piss off. cut them off Cut off she deserves it witch bitch snitch Cut what off, Phil?

devil’s eyes devil’s ears Your phone? Did they cut your phone off? seeing through walls telling god devil’s tongue all rotten maggots for teeth

Your teeth are wicked. My teeth are wicked? What do you mean, Phil? maggots in that hole bet she eats shit bet she screws corpses bet she screws you Phil, do you need to stay with us again? I can find you a bed. Screw you. Succubus she’s going to suckubus the life out of you you’ll be dead dread bed Bed. Good decision, Phil. Let me just call the ward, get your life back on track.

your life give her the knife your knife take her life bitch witch

My life, your life, witch bitch. Who’s the witch bitch, Phil? Whose life are we talking about? life wife devil’s wife she’s got devil’s spawn in her cut it out evil bastard cut it out Cut it out. What do you want to cut out, Phil? Something bad? Bad is sad. Very sad. You’re sad? Sad is bad. poke it out cut it out devil’s cub slut whore mother mary Comes to me. Words of wisdom. Well, I think you’re very wise. It’s good you can say you’re sad, Phil. Maybe we can help. I need somebody. That’s good to hear, you’re not alone, Phil. see they’re all listening not alone walls have ears fears shears cut her open cut the devil’s whore rip out the antichrist Christ. Christ’s mother. Mary? is a scary fairy ha ha ha kill the bitch You’re carrying a bastard. What, Phil? What do you mean? Mother Mary comes to me with poison in her womb. cut it out cut it out get rid of the stinking pup and its bitch whore mother Bitch whore mother fucked the devil. Cut it out now, bitch whore mother. Bitch bastard double trouble

Phil?

Don’t worry. Be happy.