Editor's note: This entry was written in 2008 during a clinical art therapy internship at a forensic psychiatric hospital, before Desertfish had entered the blogosphere.
A solid week of psych hospital orientation can prompt even the dullest person to thinking about some serious issues. My recent completion of 40 hours of First Aid, CPR, institutional safety protocols, natural disaster planning, diversity awareness, lockdown procedures, five-point hold techniques, sexual harassment prevention and the Don't Be a Nurse Ratched video series have led me to a single stunning conclusion: personal hygiene is not a mental patient's top priority. Which if you think about it makes sense, bikini waxing and cuticle trimming being last on the list in times of personal crisis. But clearly I did not think about it enough because now I am nothing short of revolted by the realm of scatalogical possibility I am facing.
If I had thought about it, I might have turned down this position on account of my excessive squeamishness in the face of any bodily fluid that does not mind it's manners and stay inside the body in public like it's mama told it to. I am a mental health intern, people, not a nurse. Give me psychotic delusions of Christ-like grandeur. Give me cyclic episodes of euphoric mania characterized by streaking in odd venues. Give me paralyzing depression or body dysmorphia or heroin addiction or paranoia. But do not, whatever you do, expel something that comes from your body in my workplace unless you are in a bathroom with the door closed.
Consider me schooled. Little did I know of all the vile goings on that can go on behind that razor-wire fence. Like residents throwing their various and sundry bodily secretions about, trying to bite their ward mates with their hepatitis-carrying mouths, and making weapons out of just about anything (a sharpened sparerib from the dining hall was one brilliant product of such ingenuity and craftsmanship). It's a veritable Lord of the Flies out there, if you listen to all the war stories collected through the years and fed to us eager new employees over the course of a few condensed days.
And all I want to do is have them paint some pretty pictures and feel good about themselves. Okay, and maybe express some repressed inner conflicts through the subtle magic of chalk pastels. And maybe just maybe feel the slightest bit more human, respected and supported. Even cherished. My humanistic tendencies flying right over the cuckoo's nest and hitting me smack dab in the face like a bucket of ice water (which is clearly better than a bucket of anything else that could be chucked my way under these circumstances).
Despite the constantly lurking dangers of medieval disease brought on by the open sewer that doubles as a mental hospital, for each day of this intensive three-month residency, I am making an effort to fully immerse myself in every possible learning opportunity. I commit to harvesting every last pearl of wisdom from this clinical bootcamp: diligently studying time-tested approaches, taking risks under the tutelage of various mentors, hanging onto my supervisor's every word, collaging my worries and concerns in my own art journal, cultivating meditation practices to keep myself balanced, asking the deeper questions about insanity and criminality and the ethics of incarceration and what the fuck is a cuckoo anyway.
And contemplating some frequently disquieting answers. Psychoanalysts, who apparently didn't get the memo about not reading too much into things, believe that when you embark upon a rigorous undertaking in the psychology field - an internship at a state mental institution for the criminally insane is as fine an example as any - a theme emerges to draw your awareness to what needs more attention in your life, some sort of unconscious pattern that requires you to stretch yourself emotionally much in the way you are asking patients to do in therapy. This could be anything from a fixed mindset or stale belief system, to a self-soothing habit or prehistoric coping skill.
I halfheartedly expected this to happen, perhaps in the form of a patient who reminded me of a key player in my childhood or some artwork that evoked disturbing primal urges. But for the life of me, I could not have foreseen this. I have gone over it again and again, and I just cannot understand why the theme confronting me has everything to do with feces. I don't mean metaphoric or symbolic feces. I mean literal shit. As in the stinky brown substance that comes out of your back end.
For some reason that only my unconscious knows, dookie has been paying me a visit more times than I wanted to admit. And seriously, it has never been an issue for me before. Not like some old trauma or neurosis that I'd been avoiding all my life. My mother handled toilet training in my early years like a champ. I've never even been constipated. But here it is, scat at every turn. First, finding out that the friendly client I just shook hands with is what we in the clinical world call a "feces holder" (meaning he likes to touch and perhaps even fondle his excrement - which, revolting as it sounds, is considerably better than what we call a "smearer," meaning someone who enjoys doing a bit of abstract art therapy with his excrement, or a "horder," meaning someone who stashes his excrement away for safekeeping). Then there was the geriatric client haphazardly wiping his bum with the bathroom door wide open as I walked past. And finally, just yesterday, the bird who flew by and, barely missing my shoulder, dropped a bomb in the street.
So, my colleagues and I, art therapists that we are, started wondering just what deep existential message manure had in store for me. (New mantra: "What is shit trying to tell me?") And I started thinking about being full of shit. Those who know me well might not generally think of me as a bullshitter. But my sense is that I am not the only one of our species who can use a tune-up now and again in the authenticity domain. And what better context than being completely out of my comfort zone - living alone in a dormitory, sharing an 18th-century bathroom with several floor mates, eating cold prepared food for 3 meals a day, living 1,500 miles from home, being apart from my husband for 6 weeks at a time, working 45 hours a week in a forensic psychiatric setting? (Also, not being able to wear my earrings, pashminas or strappy sandals to work because once they try strangling you with your fashion scarf from Nordstrom Rack you won't be able to run away in your platform mules, girly girl. And not being able to sip my cozy hot tea all day long because, for one, it's just not culturally sanctioned to be all health foodie yoga yuppie inside the razor-wire fence, and two, it's so potentially filthy in the hospital's public areas that you just really don't want to get anything near your mouth.)
Well, wouldn't you know that, in Freud's eyes at least, all this bizarre pathological behavior with dung has everything to do with control, a particular specialty of mine. My underlying assumption in most things is that I keep my shit together and, unless you're a client on my caseload or under the age of 6, so should you. Admittedly not the most flexible or empathic philosophy, but one that has kept me from feeling sorry for myself or others in some of the extreme circumstances in which I've lived and worked.
Turns out Freud's concept of anal expulsion has been in a Hundred Years' War with my suck-it-up stance. Particularly on a day like one of my very first on the job, when I came across a shy elderly client while walking about the hospital campus. It was an extremely hot afternoon (as in 110-plus degrees), and a group of polite male patients were walking in my direction, presumably leaving a building to return to their home ward, when suddenly and without warning, our otherwise modest gentleman whirls around, drops his pants, and sticks his bare ass in the air just in time to release a most impressive display of projectile diarrhea - right onto the grass. Kind of like that scene in the animated Seuss classic The Lorax, only the output duct releasing the toxic sludge being a real live human rather than an cartoon factory.
And then he pulled his pants back up and went on his merry way, along with the others, none of whom seemed to notice a thing. For occurrences such as this are nothing to write home about at a mental institution (unless, of course, you are me and you are writing this very essay). In fact, even then, as I looked around aghast for staff to help me determine what to do about this pressing public health concern, I was swooning with gratitude that this hadn't happened indoors. This is the kind of desensitization that happens when you work in a psych hospital. I for one am considerably less squeamish than I was only a week ago. Of course, I did need to make a collage featuring some kitty litter and a baby's bare bottom, just to come to terms with it all. We art therapists do what we have to do in times like these.
Due to hospital bureaucracy, I still, several days later, have been unable to track down who, exactly, is responsible for the clean-up. Then it rained like crazy, essentially dissolving the pile of poop into the grass like nature's most perfect fertilizer. Let's just say I no longer take shortcuts across the lawn.
I am happy to report that my world has become considerably less shitty as my internship continues. Sure, shit still happens, but I have somehow become not all that phased about it. Case in point: the startling splash of bird dookie that plummeted from a high branch and landed squarely on the crook of my bare arm as I was walking across the hospital campus. And I didn't even flinch. No nausea, no squirming, no hypochondriasis about spreading a deadly plague of bird flu across half the universe. I was just all Zen about it, like, "Hmmm... bird crap. Isn't that interesting?" and then washed my arm as soon as I made it to the next building. I even entertained the curious thought that my elbow skin might actually be all the better for it, since there is in fact a Japanese spa treatment that charges top dollar for an authentic Geisha facial comprised of purified nightingale droppings. As they say, serenity is not the absence of the (shit)storm, but peace amid the (shit)storm.
It is truly amazing how much more enjoyable life can be without fear, even a neurosis as seemingly harmless as my former queasiness. True, my poop phobia has been both amusing and sanitary. But letting go of it (pun intended, Herr Doktor?) actually made my time at the hospital one helluva lot more fun. Instead of worrying about whether the client I just shook hands with was a holder, horder or smearer, I simply accept that these possibilities are part of the territory in working with severely mentally compromised people. The ranks of who I've recently joined as a compulsive hand washer.
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