A large part of my training as a Ph.D. student in clinical psychology at the University of North Carolina-Chapel Hill was completed at a state psychiatric hospital in Butner, NC. The hospital, which has been since closed down was located amid tobacco fields, a federal prison, two orphanages (segregated by race even in the 90’s), a “training school” (jail for kids), a residential center for people with severe developmental disabilities, and a drug and alcohol treatment center. It was like this small tobacco town had taken up the industry of institutionalization. It was odd.
The hospital building had previously belonged to the federal government as World War II Army barracks. The federal government sold the buildings to the state of NC for $1. There were no interior signs in the hospital. All of the walls were blank. I have a poor sense of direction. I felt a great deal of empathy for the patients in the hospital, many of whom had trouble getting through the simplest of daily tasks.
I spent five semesters, spread over four years in that hospital. For an entire school year, I spent 16 hours a week there. I remember before I first started training there in the spring of my first year of graduate school, worrying about accidentally hurting someone there emotionally because I was unsure of what I was doing. I thought of psychiatric patients as extremely fragile and vulnerable people.
But then I had a thought. I realized that I would try my best to be kind and compassionate, to try to understand and to listen. I thought of all of the things these individuals had been through. Most of the patients had been farmers. Most of them were dirt poor. Most of them had been subjected to some of the worst imaginable life circumstances. If they had survived their lives up to this point, I figured that they could survive me, a sincere but inexperienced first year graduate student.
We all survived. It was not easy. The hospital environment itself was somewhat of a trial. Smoking in hospitals was still legal in NC during my first years there and then became illegal. During the first couple of years, the hospital was veiled in cigarette smoke (not great for my asthma, by the way) and always smelled at least lightly of urine. When I worked full days at the hospital, I noted that as the day wore on, I was more likely to encounter patients emerging naked from the showers. Many of us who have spent time in hospitals know that privacy is in short supply. Someone is always peering, prodding, or poking at us. But some psychiatric patients lost their boundaries around privacy. They don’t make sure that they are dressed before entering a public area. For many, there is a general disorientation either due to a general numbing or a disconnect with what most of us call real life.
The life stories of many of these patients were those that made soap operas plots sound like the dictionary. I mostly did assessments. But I did have one long term psychotherapy patient. She was 58 years old and it was her 30th hospitalization in as many years. My job was to help her interact in a somewhat normal way. When I first met her, she kept asking me if she was dying and tried to take all of her clothes off. I brought her tea and a deck of cards twice a week. I engaged her in conversation. She told me about being a mother. She was proud of herself as a mom. I knew from her background history that she had been a horrible mother. She shared a bed with her husband while he raped their daughter, night after night and year after year. I knew that this patient, as low functioning as she was would never be able to appreciate the horrors that they inflicted on their now adult daughter. So I just tried to help her interact in a pleasant fashion with another adult and that adult was me.
One would think that this hospital was an extremely depressing place. And yes, the hospital itself was kind of a downer. And the patients, by and large, were very very ill. But I was perpetually amazed by their resilience. The fact that even thought they were in the hospital because they could not care for themselves and many were suicidal, most days they wanted to live. This to me was a testament to the resilience of the human spirit. I found it both humbling and inspiring.
As you know, I often take walks in the forest. Yesterday, I walked in nearby Fauntleroy Park and I was reminded of the resilience of life. Stately maple trees have bulges, also known as galls, looking like tumors along their trunks. They are caused by a number of factors including fungi and injury. They ultimately, shorten the life of the tree. I see trees that have been nearly uprooted by storms continue to grow at unbelievable angles.
People, like trees can be very resilient. They can adapt to severe diseases at times and continue to live. But what I am reminded of in the woods is that there are degrees of resilience ranging from the barest of survival to lush and abundant thriving. But for all resilience does not mean unmarked or unaffected.
I took a couple of films in the woods of examples of resilience in the woods. I find it helpful to make these comparisons. If you do also, you might appreciate the films. Also, the trees are PRETTY.
Very interesting. All those patients you saw back then, I wonder how they are all doing today… I bet you often wonder about that. You work in such a remarkable profession that has such possibility to change lives… And yes, trees are remarkably resilient aren’t they? I love trees. We bought our house a few years back when we moved to WI because of the trees, not because of the house. Our yard is full of towering white pines and I love them. I need to write about trees again sometime. Thanks for the videos too. I can see why you enjoy those walks in the forest.
Thanks, Nancy. I wonder about the patients, too. I suspect that the woman I wrote about is no longer living. It has been over 20 years. She was 58 at the time but looked 20 years older. She was also, incidentally, a breast cancer survivor.
Yes, I would love to read your thoughts about the trees!
dear Elizabeth,
something you wrote in this post was so profound to me I wrote is down. “…resilience does not mean unmarked or unaffected.” lately, my mind has been clouded in thoughts and questions, as I think of my three little words, one of which is resilience. I struggle with just how much I have been marked and affected – by cancers, by sudden widowhood, by what the landscape of my life looks like now, and how I will be able to move forward to create a new life alone and enduring the ravages of treatment. your words remind me that resilience isn’t so simple. and the story of the woman who you saw regularly touched me so, especially your response to her horrific background – that you were so kind and compassionate and brought her tea and a deck of cards twice a week, and that you engaged her in conversation. what a gift you were to her! it gives me hope and fills me with gratitude and makes me think of the abundance of love and concern I am surrounded with, that I am not always alone, and that i will be able to integrate resilience into my life, over time, and with a lot of help.
the photos of the forest are so lovely – and very inspiring; good that you have that place to go to, to soothe your soul and be reminded that though nature imposes great hardships upon all living things, still some trees are like people and just keep growing.
much love and light,
Karen xoxo
Karen, I am touched that this post had so much meaning for you. You are someone I think of as very resilient as well as loving and generous.
Xoxoxo
[…] Elizabeth shares an experience from her clinical psychology training of listening with empathy and without judgment to one of her patients tell her story, and concludes with a beautiful reflection on resilience. […]