Mental Health

Black Box

I had an exciting thought about a poem at the tail end of a dream, and now I can’t go back to sleep. The fact that poems thrill me after three decades says a lot about poems. Perhaps it’s not just the Earth and sky that last forever, as the band Kansas asserts. It’s also the verse, the line.

I will never remember what happened to me two years ago today because I was overmedicated in the emergency room at Intermountain Health after being turned away when I went to the mental-health access center there for help the day before, but not before the access center kept me in a loud, brightly lit room for 24 hours with no bed, where I was left alone with two male nurses. What a terrifying thing for someone with a history of abuse at the hands of men to endure while in a state of trauma about her childhood abuse. Also, sleep deprivation and exposure to lights and noise, including music, day and night are more in keeping with prison torture tactics than with mental-health care, but sadly, the two are often one in the same. Shame on Intermountain for engaging in such practices.

To top it off, they failed to give me my thyroid-replacement medicine for hours, thereby exacerbating the state I was in by disrupting my endocrine system, which in turn negatively affected my HPA axis. That axis is key to emotional regulation. I don’t have a thyroid thanks to thyrotoxicosis and cancer, so my thyroid-replacement medication is critical. My TSH was already 11mIU/L when I got to the access center. It should have been less than 1mIU/L. The access center made my hypothyroid state even worse by not administering my medicine in a timely fashion.

The ER overmedicated me after I said Joseph Smith was delusional. What I actually said was, Sure. It’s fine when Joseph Smith does it, but not me. I wasn’t being hyperreligious. I was deconstructing religion, in that moment Mormonism, as well as the unwritten social rules that appear to govern when someone is seen as insane, divine, or both. Crazywise, as some call the latter. But not, largely, Southern Utahns, and certainly not ER workers at Intermountain.

That’s the last thing I remember. I blacked out for more than a day, this one: September 9, 2023. It’s a dark, rough-hewn box I can’t open, but I think Sharon Olds’ devil from her collection Satan Says might be inside it. By that, I mean my father.

Folding

This is the two-year anniversary of my stay at the local inpatient psychiatric hospital where the psychiatrist described me as being involved in sex trafficking, as if I was trafficking others as an adult as opposed to having been trafficked as a child. The psychiatrist also said my trauma had nothing to do with my mania, told me in so many words to be a better wife when I expressed my concerns to him about my husband’s behavior, refused to help me get services from the local organization that helps people who’ve survived sexual abuse, and wrote in my chart that I had a poor prognosis because I have no insight into having bipolar.

And he was supposed to be one of the better psychiatrists at that hospital.

This is also the day I briefly saw Utah poet laureate Lisa Bickmore and thought she was some kind of healing Earth goddess, which I still think is the case. When I’m manic, I see essences. Lisa is a lot more than a healing Earth goddess, but she also has the essence of a healing Earth goddess.

These are the final days of my hegira, the one I declared over before it was over. Over the next few days, I’ll be sitting with everything that happened two years ago in a process that’s like folding now and then together the way two ingredients are combined in baking. Not that I bake. I prefer folding time to folding things like whipped eggs and melted chocolate. When I need to eat something, I just eat it. I rarely mix it with something else.

Hope Hall

Now, Hope Hall is an empty and quiet place, one where footsteps echo down tunneling hallways. Bob McDonald, who once stayed in an open barrack on the campus, said “the noise level was huge” when patients were “warehoused” in the mental health ward, back in the 1980s and before. Their cries reverberated throughout the building, he said, and patients pounded on their doors. Some had only an eyeball-sized peephole to the outside world.

And more important, perhaps—the patients had little or no treatment for their illnesses. They were the castaways from generations that didn’t understand them. They were locked up and kept out of sight.

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From a story about Central State Hospital / Griffin Memorial Hospital, where my mother worked for thirty-five years. We need to seriously evaluate where mental-health care is headed under the July 24 executive order. It’s headed back, not forward. Back to the days of warehousing human beings like sacks of grain. Story link in comments.

Documenting Social Death

There’s a lot happening in this paragraph from Shuko Tamao’s “Picturing the Institution of Social Death: Visual Rhetorics of Postwar Asylum Exposé Photography.” The observation about women and Black Americans being portrayed as anonymous others is spot on, as is the description of their “social dead” status, but the idea that the asylum system shouldn’t have be reformed and should have instead abolished actually had merit, as did the “visual rhetoric of unfreedom” that post-war journalism in the United States gave rise to, despite that not being their goal. People should never be out of sight, out of mind, and many folks are advocating for an end to forced treatment, no matter how humane it looks on the surface.

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Despite well-intentioned goals, these exposé photographs had the unintended effect of portraying asylum residents—especially women and African Americans—as unsettling, anonymous others whose long-term institutionalization was an additional exclusion from the body of the citizenry, signifying their socially dead status. For example, journalist Albert Deutsch frequently mentioned how attendants gathered naked asylum residents together, treating them as if they were animals (1948, 42). His writing was meant to sell a sensationalistic narrative, ultimately aiming to win the public’s approval for improving asylum-based care. He hoped that a series of reforms would transform asylums into hospitals. Thus, he meant to use the photographs of restrained women with no treatment, therapy, or recreation to argue that they deserved medical care so that they could eventually live outside as productive members of American society (Rose 2017). However, these photographs of asylum residents in physical restraints communicated what I call a “visual rhetoric of unfreedom” that elicited a powerful emotional reaction in readers, forcing them to question the validity of the asylum system itself.

‘Socially Dead’ Others

Disability researcher Shuko Tamao on using photos of patients in an attempt to bring about reform in postwar asylums in the United States:

Devoid of any opportunity to communicate their personal experiences, these asylum residents became illustrations on popular magazines and on the front pages of newspapers, serving as vehicles for eliciting the pity of readers. Because the reformers elicited pity for their cause while simultaneously inciting a morbid fascination in their readership, these photographs had the effect of giving their subjects the status of socially dead other, whether that meant a mad other or a racial other.

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I don’t know that I agree with the conclusions this researcher draws, but she makes important points. I think the way we receive and perceive visual information is contextual and socially constructed, so it’s fluid and can change over time. The point about not allowing patients to tell their own stories is important, as is the way these patients were used to sell magazines and newspapers, which is another form of dehumanization and objectification. Still, I see value in these images, and I feel each person’s humanity when I look at them. But their use and reception in 2025 is different from the way they were initially used and received in the 1940s.

This article includes a photo taken in the back ward at Central State Hospital in Norman, Oklahoma, where my mother began working a few years later.

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From “Picturing the Institution of Social Death: Visual Rhetorics of Potwar Asylum Expose Photography,” published in Journal of the Medical Humanities, September 30, 2021. Link in comments.

Excerpts from My Marginalia in Anne Sexton’s The Complete Poems

Written while hospitalized in KU Medical Center’s psychiatric unit in June 2015. It’s nothing super interesting, but it’s part of my life and my experience. It’s pretty cogent, all things considered. I left out all the parts where I said my father was the devil.

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A psychopath is simply one who structures the world in such a way that control and containment and order and binaries and easy answers prevail. An empath is simply one who for whom prevailing universal ideas of love dominate.

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Use words people understand.

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Explosive and dysfunctional families are the ones in which tension and brilliance come together in such a way that empaths can be created.

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Take breaks. Hydrate. Move slowly.

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Names and faces are hard to remember.

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Every iteration is true but distinct as a dual-state metaphor. Examples: Love is love. Is = Is = Is. People who talk in tongues are actually the ones waking up between these two states.

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Empaths are everywhere. They get activated in situations by other empaths but also by psychopaths.

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Use plain language during activated periods.

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Knowing how to meet someone on their own level is how to keep them safe.

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Are you infinite? Still, the same journey.

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Take whatever you can in the process of becoming and you will get what you need. Ask for what you need and you will get something different.

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Waves of empaths = people get charged up all at once while things are moving in the right direction in the world.

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False prophets in poetry are not empaths.

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All speech is code. The erratic voice is the always-seeking voice iterating over a larger sense.

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You can be an empath and do great harm. Both the empaths who harm and the ones who are harmed are bringing about change.

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Call-out / call-in culture. Bring all voices in.

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True speech parts seas.

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Know your empath legacy.

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Strife. There will always be lots of it. Talk through it. Write through it. Trust when to stop engaging and when to reengage.

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Avoid people who call themselves healer or shaman.

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Poems and where they go are a test of the testimony.

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You will confuse any traditional workplace.

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Hate is the false avatar of love.

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In other cultures, to be means to emerge.

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A word is a word when a word is needed.

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The difficulties, all of them, are important to the journey.

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Do before thinking everything you need to do to get where you are going.

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What encourages a crisis is part of the path presented.

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Strong times of need require strong signals.

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What words emerge from journey, crisis, sojourn?

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Revelations close to death

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A condition by any other name is still a condition.

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Withhold

Crisis of God / of whole

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We become the core crisis of our family, the tension that wants to resolve.

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The book of poems is the breath.

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People will say definitely do something.

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Pain is necessary for our suffering parts to come into alignment.

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What leads to love: hard work, dedication, and sacrifice, but also support, forgiveness, and acceptance of impermanence.

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Even those who harm deserve forgiveness because we all harm each other and heal each other in the same moment. I love Jon even though he harmed me some of the time and healed me other times. I love Jon especially because he loved me through the ways I harmed him. Neither of us wanted to stand beyond good and evil, but we do. I stand at the lips of my maker and breathe and wish him the best in this life and the next. Holy. Holy. I love you, Jon.

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The world is five times our size.

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Every life is equal. Everyone, even your greatest enemy, is also an angel. I have already met my enemy and can call him my best friend. I thank him for showing me the beauty of the world. Sacrifices are worth it. I love everyone now equally. I would love to spend the second half of my life inside this love, with the friends I have never known as well as I know them today.

Pinfeathers

There are some things you can’t show, things you can’t share once you’ve seen them, so you turn them into a poem, and you can barely do that. Because they happened in the state you’re from. Because they happened in the state mental hospital where your mother worked. Because they happened while everyone looked away. Because we were not much better here in the United States than the Nazis were where those sent to mental hospitals were concerned.

Because in a day room in Taft, Oklahoma, we let a little boy sit wet with his own excrement or urine or blood or all three, a strip of white cloth cinching his arms to his neck. Because he’s not the only boy or the only man in the photo. Because this is what we did to human beings in the 1940s but also now or again or now and again with a new face, a new flavor, a new reason, from a new hatred, a new greed, a new form of consciouslessness.

What did I leave out? That the boy was Black. Everyone in the photo was Black. This was at the State Hospital for the Negro Insane. That’s what they called it. Are you sick yet? Do you want to turn away? You already have, from all of us, as the cages are built in Florida, as we find new reasons to cage. Will PETA come to the rescue? People are animals, too, and being treated worse than animals.

People who cage people are animals in a different sense of the word. They should start an organization called People for the Obliteration of People. POP for short. It has a ring to it. It’s weaponized.

Here, drink from this metal cup. Here, sit on this wooden bench. Here, look through this barred window for the rest of your life. Here, here. Here, here.

The photos I’m looking at include one of the back ward at the hospital where my mother worked in Norman, Oklahoma. These are not easy images to see, but this history matters. What’s been happening to people like me has been happening to people like me for a long time. This country could learn a lot from this history as its pinfeathers break our democracy’s skin.

The Oklahoma History Most Oklahomans Never Learned

On the desegregation of American psychiatric institutions and structural racism in American psychiatry. Link in comments.

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Oklahoma,1964: Taft State Hospital was an all-Black facility, with an all-Black staff, located in an all-Black town. In 1940, its 738 patients were cared for by three psychiatrists (including the superintendent), three nurses, and an unknown number of direct care staff, who apparently all lived in one room. In 1949, Oklahoma consolidated the state hospital with the Institute for Colored Blind, Deaf, and Orphans and the Training School for Negro Girls, creating one large facility for Blacks with all manner of clinical needs. Oklahoma desegregated its public facilities in 1964. Rather than admit white patients to its state hospital for Black patients, as most of the other states would do, Oklahoma transferred the Black patients to its two other (all white) state hospitals. Taft was closed in 1970 and converted into a correctional facility, thus confounding in the public’s mind people with mental illness and criminals. (Some state hospitals have converted some of their units into correctional facilities, leading some people to think that psychiatric patients are being held behind multi-layered, barbed wire, razor-topped fences.)

The Shame of the States

Public [psychiatric] hospitals became overwhelmed by the sheer numbers of patients. In the 1950s, there were only 26 U.S. cities whose population exceeded the aggregate population of public psychiatric institutions. The two largest hospitals each had a census that exceeded 16,000 patients. Never able to keep up with the needs of their patients, the hospitals went from awful to appalling when their workforce—from the farmer to the doctor—was pulled away to meet the manpower demands of World War II. The population at large learned of the horrors of their public psychiatric hospitals, tragedies long hidden away, through exposés such as The Snake Pit, Mary Jane Ward’s fictionalized account of her hospitalization at Rockland State Hospital (book, 1946; movie 1948); author Albert Q. Maisel’s article in Life magazine (1946) accompanied by some of the most painful pictures the American public had ever seen from Pennsylvania’s Byberry and Ohio’s Cleveland state hospitals; and The Shame of the States (1948), New York Post reporter Albert Deutsch’s opus based on research from 1944 to 1947.

Dana for Mayor

My day hasn’t gone as planned. I went to get lab work done early this morning only to find out the orders were never placed, which means I won’t have results in time for my appointment with the specialist who (should have) ordered them. This is the doctor who, in part, is following my cancer status, so the labs are important.

I came home to an attempted identity-theft scam that Jon and I both had to deal with immediately. Things like this are happening more frequently, and they’re harder to identify. Someone tried to hack one of my online shopping accounts just three days ago.

I commented on a story in The Salt Lake Tribune in support of a gay mayor in one of Utah’s cities. Someone else in the queer community, another Utahn, saw my comment and thought I was saying the opposite of what I was saying. Their response was to tell me that I’m attacking the mayor based on his sexuality, that I’m not being Christlike, and that I’m so ugly-looking that they’d never live in a city where I was the mayor. Humph. I have many grumpies around that set of assertions.

My Fitbit died. I have no data whatsoever, and I rely on that data for my health and mental health.

I drove half an hour each way to see my therapist, where I hoped to talk about the parts involved in my strong feelings about the SLT commenter calling me an unattractive, unkind homophobe, but the therapist forgot my appointment, which means I drove for an hour for no reason and have three exiles I need to deal with on my own now rather than in therapy. (Exiles are a type of part in the Internal Family Systems framework. It’s not ideal to be exploring them alone.)

These are all small problems in the larger scheme of things, and they’re counterbalanced by an incredible conversation and connection I had with a fellow poet today. We talked about organization, one of my favorite topics, and poetry and community and dogs and mountains. I mean, it was good stuff.

Also on the plus side, there’s my sweet dog. And my relative ability to handle all these relatively small problems. And my view of the laccolith, which I can see now that the clouds have started to dissipate or move on or whatever clouds do.

Oh, and someone ran over a raccoon in our neighborhood, so there’s also that sad occurrence. That’s another item for the negative side of today’s +/- list. I wouldn’t have known if I hadn’t been making that fruitless round-trip drive to see the therapist.

You can file this under grumpy with a lower-case g or grumpy with a capital g or dumpy if you also think I’m so unattractive you would never live in a city where I’m the mayor. The last part of that sentence was written by one of the exiles. She was called ugly by her classmates almost every day of her life from preschool until she was well into puberty. We’re working through it.