Sometimes, I get the impression that the treatment we get in a psychiatric institution is done for its own sake only. Like, yesterday I was irritable. I tried to communicate that I wanted the radio to be turned off. No-one was in the room except for a nurse, who went like: “Have you discussed with your therapist how you can cope with this?” She meant coping with overloading noise. I went totally defensive and defiant and told her I wasn’t going to cope with the freaking radio if no-one was there listening to it. She told me the other clients were coming soon so the radio was on in case someone wanted to listen. Well, WTF? This whole thing gave me the impression that the only reason the radio was on was to teach me distress tolerance.
Let me tell you one thing, the real world isn’t there to teach people distress tolerance. If you want me to be prepared for the real world, then don’t create these fake situations that have no meaning outside of the hospital. The nurse meant to tell me to communicate my wisht o have the radio turned off differently, but then tell me so and don’t go like: “In the real world you’ll have to live with others who want to listen to the radio.”
I know that the psychiatric institution is not like the real world. No-one beyond college age in the Netherlands lives with ten people on a hallway with just their own room. In the real world, you have to negotiate radio-listening time sometimes, but not with a nurse whose ultimate goal is to annoy you so you can learn distress toleance – unless you’ve got a two-year-old or a teenager, maybe. More importantly, real-world dynamics are not reflected in the psychiatric system, so don’t pretend that they are. Stop pretending to prepare patients for the real world when you aren’t. Institutional dynamics are the first thing that need to go if you want to prepare people for the real world. Since these are not going out the window anytime soon, let’s just stop assuming you’re preparing us for anything other than institutionalized life even if it means institutionalized in the community.