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Product Details
| ISBN-13: | 9781250053800 |
|---|---|
| Publisher: | Flatiron Books |
| Publication date: | 04/07/2015 |
| Sold by: | Macmillan |
| Format: | eBook |
| Pages: | 320 |
| File size: | 877 KB |
About the Author
TANYA BYRON is a British psychologist, writer, and media personality. She is a frequent public speaker and has appeared on countless British radio programs. She writes a weekly column for The Times (UK) and a monthly column for Good Housekeeping (UK). She advises on international policy relating to young people, mental health, and education, and is currently working in China to develop services for children and their families.
Read an Excerpt
The Skeleton Cupboard
The Making of a Clinical Psychologist
By Tanya Byron
Flatiron Books
Copyright © 2015 Tanya ByronAll rights reserved.
ISBN: 978-1-250-05380-0
CHAPTER 1
THE EYES HAVE IT
I sat in an uncomfortable chair in the first office I had ever had and took a deep breath. The word "office" might be an overstatement. George, the friendly elderly porter who had welcomed me to the outpatient psychiatric department—"Welcome to our happy home"—had pointed out that before my arrival the space had been a storage cupboard.
"Storage for what?" I asked, thinking about asbestos.
"Storage for everything: dressings, commodes, the old drug trolley. It was only when the department had to take on more fresh blood that we converted it—some kind of regulation, I think."
"What kind of regulation allows a windowless office?"
George smiled. "Fresh blood see the jumpers."
"Jumpers?"
"The ones that go straight for the windows."
Why on earth had I thought I could do this?
Alone in my office, I put my head in my hands—perhaps it wasn't too late to accept the researcher's job at that TV production company. Christ, I was twenty-two, in my own flat, living in arguably the best capital city in the world. I could have glamour, a better wage, less responsibility. What the hell was I trying to prove here?
The other people in my training course seemed much more competent. To begin with, I was the youngest out of our group of twenty. Most of them had come from research or other clinical backgrounds and I felt intimidated, even though I'd only just met them; they seemed to know stuff. I wasn't looking forward to our time together. I would obviously be the dunce of the class, just as I had been in high school.
Shit. I knew absolutely nothing.
Feeling sorry for myself, I looked around my cupboard; it smelled musty, a complete contrast to the glass, marble and chrome atrium I had walked through downstairs less than an hour earlier. This was a flagship hospital. It had been like entering another world—calm and clean. Even the signs advising against physically attacking the staff were printed in gentle sans serif, muted and almost apologetic for the crassness of their message.
The staff down in the reception area were friendly too—all smiles and uniforms and endless leaflets about patient rights and complaints procedures. It was not a hospital; it was a shiny, upmarket hotel lobby.
I had taken the elevator up to the eighth floor with several hassled-looking members of staff, none of whom had been even remotely interested in the fact that I had just joined the team. I looked at my new staff identity card and made sure it was facing outward. "Clinical psychologist in training." No one gave a damn. I felt like the new kid on the first day of school.
It had taken me five minutes of circling the four-sided eighth floor before I'd located the outpatient psychiatric department—I had dismissed it on circuits one to three because it looked like the entrance to some sort of supply room. Nothing here reflected the opulence of the hospital downstairs.
The grumpy, round-faced woman who greeted me when I finally got to the psychiatric outpatients' reception managed to thrust me my room key, point to the cupboard door and say, "You see them in there," all without once lifting her eyes from Woman's Own magazine.
"Is everything all right?"
Chris, my supervisor, the woman assigned to mentor me throughout my training, stood over me, jolting me back into the room.
"Oh yes. Hi. Gosh. Sorry." I'd been slumped over the desk, lost in thought.
I scrabbled to my feet.
Dr. Chris Moorhead was renowned for being a brilliant supervisor but one hard-core, fiercely intelligent, no-nonsense woman. In my interview for the clinical training course, she never cracked a smile. She didn't make small talk. And she asked the most difficult question: "Why do you deserve a place in this training course any more than all the other people who want it?" After I was accepted, when we were told who our supervisors were to be, more than a few of my fellow trainees sighed with relief when my name was matched with hers. A few second- and third-years laughed and patted me on the back. "Good luck," one said.
A tall, slim, angular woman who had the unnerving habit of maintaining unbroken eye contact, Chris gestured to the man standing just behind her.
"This is Professor Horace Winters, head of the outpatient psychiatric department. Professor Winters, this is my trainee. She'll be here two and a half days per week for the next six months."
The prof offered his hand, making zero eye contact. His words sounded as if they'd been worn smooth by repetition.
"Welcome to the department. I hope you enjoy your time here. I'm always at your disposal. I'm looking forward to the valuable contribution you will make to my team."
With a flourish, he turned and walked out. I wanted to giggle, but Chris clearly wanted further words.
"They very rarely take unqualifieds in this department, but I told them you'd do good."
"Chris, that's so great of you. Thanks."
"Don't thank me. Just don't let me down."
After Chris left, I found a way to wedge some old and slightly damp prescription pads under the tilt mechanism to keep my chair from tipping over. Welcome to the publicly funded great British National Health Service—the NHS.
As I was rearranging my cupboard office, I heard the sound of singing—a small voice growing in volume and then, just as the melody was decipherable, getting fainter again. I could have sworn it was a song from The Sound of Music.
Maybe I was hallucinating. No—it got louder again:
How do you solve a problem like Maria?
How do you catch a cloud and pin it down?
How do you find a word that means "Maria"?
A flibbertigibbet! A will-o'-the wisp! A clown!
It was extraordinary—a little voice, but one with such purity and clarity that it cut through the growing noise of the busy reception area outside my door.
Why was no one else hearing this?
I left my room and looked around. I had two hours before my first appointment, I was alone and I wanted to know who belonged to that voice. But when I stepped out into the waiting area, I was stunned by what I saw, and the song—although still lilting in the background—became peripheral.
If my mother had been there, she would have instructed me not to stare.
When George appeared with two mugs of tea, I was able to tear my gaze away.
"Gender Identity Clinic."
He sat down on a waiting-room chair and gestured to me, telling me to join him, which I did. The sugary orange brew calmed me and brought me back to a clinical state of mind. I inhabit a nonjudgmental space, I reminded myself.
"Gender Identity Clinic?" I asked.
"Yep. The boys come in because they want to be girls. Prof Winters is their man. They get assessed, and if they can live for five years as the gender of their choice, then they get the op, the deportment classes, the whole works."
"The works?"
"Adam's apple shaved, makeup tutorials, how to dress to suit your shape—you can cut off a penis, but you can't rebuild a brick shithouse."
I looked around and had to agree, as much as I hated the indelicacy of George's language. There were some who could only be described as pantomime dames. There were also some incredibly good-looking women here.
There was one mesmerizingly beautiful woman. Slight and delicate, she had the most incredible curtain of straight, shiny black hair hanging down to her waist. She certainly knew how to dress to suit her shape—"classy not brassy," as "my girls," my three best friends, would say. She even gestured in a manner that, despite the slight exaggeration of movement and eyelash flutter, was all believable, even if it was sort of hyperfeminized.
I felt challenged. My clothes—a charity shop man's suit with crisp white shirt, tight vintage Dior belt and Doc Marten shoes—made me feel frumpy.
How can a man look a better woman than me?
I was rescued from this thought by the appearance of two other people coming out of the women's toilets. The smaller of the two was startling. She was wearing the sort of dress that my late grandmother would put on for a family occasion: good material, generously cut, but staid in its blue navy, with a tight, thin red belt, plunging neckline and cheeky sailor-striped T- shirt subtly covering the décolletage. She wore a wig of the brightest yellow perm, held a tiny red clutch in her enormous hand and tottered on blue wedge heels made out of the material that allows room for bunions—the sort of shoe that can be purchased from a catalogue that also sells lawn-aerating sandals, ladies' turbans and slow cookers.
The taller of the two women, at well over six feet tall, was broad, with calves the size of tree trunks and well-defined arms to die for. She wore a tight black dress, lap-dancing shoes with Lucite platforms and vertigo- inducing stilettos, and sported a straight, brown, honey-highlighted Mary Quant bobbed wig with serious attitude.
She was the Adam/Felicia character in Priscilla, Queen of the Desert, or Tony Curtis as Josephine in Some Like It Hot. The smaller woman, however, only managed Terence Stamp and Jack Lemmon—Bernadette and Daphne.
I was mesmerized. "Josephine" caught my eye, winked her giant eyelashes, poked the end of her tongue out from between her red, shiny lips and smiled. I felt hot and looked away.
Someone flew past me singing and then disappeared behind the central lift shaft.
How do you solve a problem like Maria?
How do you catch a cloud and pin it down?
"That's Edith," George explained. "She's an RDP."
"A what?"
"A revolving-door patient."
"And that is?"
"She is admitted by court order and taken into the inpatient ward on the other side of this floor. She is stabilized. She takes her meds independently. She is discharged. Care in the community takes over. There is no care in the community. She drops off her meds, frightens the neighbors, so she comes back in. Revolving door."
I looked thoughtfully at George. He was in his seventies, I reckoned, perhaps ex-military, with his white cuffs visible a precise and equal distance under a pristine black sweater.
"Hello, Edith," said George, looking up at the person whose beautiful voice I'd heard.
"Well, hello, George. And who might this pretty lady be?"
Edith had wandered into the outpatient department and I found myself taking the hand that had been offered by the sweetest-looking woman that I had ever seen.
"Edith Granville, please say hello to our fresh blood."
"Hello, my dear. How are you this blessed day?"
Edith was so small and so smiley and had eyes so sparkly that I was almost too enchanted to reply. This tiny and compact black woman had a crisp white pillowcase pinned to her head. The pillowcase, I soon realized, was an attempt at a nun's wimple. Edith was Mother Superior.
"I know what you thinking, girl, and you's wrong."
"What am I thinking, Edith?"
"You's thinking that I Julie Andrews!" Edith cackled. "Oh, Georgie Porgie! She think I Julie Andrews!"
George was wheezing, bent over double, and coughing up many years of Player's Navy Cut.
"Oh, Edith, no, I don't think you are Julie Andrews. No, not at all!"
"Well, good for you, girlie, because:
When I'm with her, I'm confused,
Out of focus and bemused.
And I never know exactly where I am.
Unpredictable as weather,
She's as flighty as a feather. She's a darling!
She's a demon—
"She's a lamb!" I sang out as hard as I could. Bugger clinical training—there was nothing that an entire childhood of Christmas showings of The Sound of Music couldn't prepare me for.
Edith clapped her hands together as George beamed and I bowed.
"This your first day here, girlie?"
"Yes, Edith, it is."
"So what you think?"
"I think I don't know what to think."
"George, you say she fresh blood?"
"Yes, Edith, that is what I would say she is."
Edith threw her arms around me and held me tight. "Oh, sweetheart, you just joined. So new. Let Edith help you in." Edith took me by the hand, linked arms with George and skipped us all into my cupboard.
"Ah, we called this 'the Shithole.' Commodes, medication—all the shit was here. Yes, indeed, I think it were better when it were a cupboard."
Over the next forty minutes, as I perched gingerly on my chair and George brought us all another brew, Edith initiated me into the realities of my training by telling me her life story.
Born in Tobago in a small village by the Caribbean Sea called Black Rock, Edith was the second-youngest child of nine children. Her father, a Baptist minister, was a man of compassion to his flock, but not, it seemed, to his children. Father—that was his name apparently– traveled far across the width of the island from Plymouth to the capital, Scarborough, and the length from Charlotteville to Sandy Point. He held Bible meetings in Roxborough and Parlatuvier on the beach, and performed miracles in Moriah and on Cinnamon Hill. Father saved lives, and when he was away, the family was also at peace.
But when he wasn't away ministering, he struggled to contain the sin in his home. Edith told of the "whoopin's" and "beltin's" and beatings that had been part and parcel of her childhood. Especially for a young girl prone to daydreaming—a sin, said Father, when in church—and to singing—a sin, said Father, when not a hymn.
Poor Edith—the youngest of the sisters and the favorite of her mother, she was the first to be sent to live with her father's sister, Aunt Charisma, in Shepherd's Bush. It was there that Edith was to really understand how undesirable she was. At this point in the story, Edith broke into song again:
She'd out-pester any pest,
Drive a hornet from its nest.
She could throw a whirling dervish out of whirl.
She is gentle!
She is wild–
She's a riddle,
She's a child
She's a headache—
Edith suddenly stopped singing, and as her head fell backward, her eyes simultaneously rolled up until I could only see the whites. This seemed serious; I tried not to panic.
"Who's a headache, Edith? Tell me."
Edith's eyes closed and screwed up, and tears trickled down her cheeks. Mouth open, she began a low moan, before singing again:
She is wild–
She's a riddle,
She's a child
She's a headache!
She is wild–
She's a riddle,
She's a child
She's a headache!
She is wild–
She's a riddle,
She's a child
She's a headache!
Between bouts of singing, Edith told scrambled stories. "Stinging" was a key word. "Stinging" and "down there." The "downstairs department." Aunt Charisma and scrub, scrub, scrubbing. No dreaming. Bad dreaming. No singing. Bad singing. Only scrub and sting and Lysol.
"You lie, you Lysol. You lie, you Lysol," Edith kept repeating.
In my mind, I tried to sing ahead, to remember the words, as Edith kept repeating the lyrics, her needle stuck in the groove:
She is wild–
She's a riddle,
She's a child
She's a headache!
She is wild–
She's a riddle,
She's a child
She's a headache!
She is wild–
She's a riddle,
She's a child
She's a headache!
I got it and belted out:
She's an angel!
She's a girl ...
Then there was a complete stop. Not a pause but a stop. Silence. No song. No moans. No lies or Lysol.
The small woman stood with dignity and straightened the pillowcase on her head. She looked me directly in the eyes, and despite the streams of tears still coursing down her cheeks, she extended a hand. "A pleasure speaking with you."
"And a pleasure meeting you, Edith."
"Please call me Maria."
And Maria walked out of the cupboard and across to the other side of the lift shaft, where the inpatient psychiatric department welcomed her with its familiar revolving door.
Seeing her go, I felt really sad. I thought about some of the recent lectures exploring diagnosis and ethnicity we'd heard at school. It had shocked me to learn that there were disproportionately high levels of psychiatric diagnosis and hospital admissions among black and ethnic minorities living in the UK. African or Caribbean immigrants were up to five times more likely to be diagnosed with schizophrenia, due to the cultural insensitivity that was ingrained in our diagnostic procedures. Poverty, racism and culturally rigid definitions of mental illness all contributed to these troubling statistics and I wondered whether Edith was herself a victim. After many years cycling through the revolving door, had her diagnosed illness become a self-fulfilled prophecy?
"As I say," said George, breaking the moment, "welcome to our happy home."
* * *
Alone in my cupboard once more, I shut the door and applied myself to getting the space to look more like a consulting room. As it was, I worried it might be slightly insulting for anyone who came in to see me.
"Welcome to the outpatient psychiatric department. We have designed your treatment environment to match the way you feel about yourself," the office seemed to be saying.
I tidied up: old prescription pads, patient leaflets about fifteen years out- of-date, a guide to electroconvulsive therapy. The thought sent shivers down my spine. I opened a small cupboard next to my desk and shoved the whole lot in.
The chairs needed replacing, so I wandered across the department to see what I could find. In an empty lecture room, I discovered a couple of low chairs. They would do nicely: no disparity in height between my patient and me. I dragged them back past the reception desk without anyone looking up or asking me what I was doing; I probably could have stripped the place entirely and taken it home piece by piece, and no one would have noticed.
(Continues...)
Excerpted from The Skeleton Cupboard by Tanya Byron. Copyright © 2015 Tanya Byron. Excerpted by permission of Flatiron Books.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Contents
Title Page,Copyright Notice,
Dedication,
Introduction: My Grandmother's Frontal Lobes,
One: The Eyes Have It,
Two: At the Bottom of the Deep Blue Sea,
Three: Practice Tales,
Four: Harold and the Nazis,
Five: The Skeleton Cupboard,
Six: Dodging Stones,
Epilogue,
Acknowledgments,
About the Author,
Copyright,