Some Words on: The Sickliness of Hospital Settings

“Hospitals make you sick”, said a person whom I met during my psychotic break, and whose kindness and understanding make me remember her as some sort of angel who came to shine a light into my darkest moments. She had picked the saying up from her father, and I was soon to find out what she meant by it. Evidently, the main purpose of hospitals is to cure people. Yet, some characteristics of hospital settings are surprisingly out of tune with that mission.

First of all, there is that smell. Even if you are just a visitor, it can turn your stomach inside out. Naturally, hospitals need to be kept clean at all times, and strong disinfectants are to help achieve that – but heck, can’t they develop one that doesn’t make the place smell as if a tsunami of cough syrup has just rolled through? There must be a way of eliminating those sick smells and introducing more pleasant ones. Smell can improve well-being significantly. Otherwise, perfumes or aromatherapy would never have been invented. It isn’t even a new concept. Human beings have used fragrances for thousands of years in the context of religious cults, all kinds of celebrations, in their homes or on their bodies. Essential oils, for example, have been a coveted luxury good for countless generations, and continue to be that. Only think of this: who doesn’t like to use incense sticks, aroma lamps or room fresheners to improve their mood? Who doesn’t keep one or the other perfume in their bathroom cabinet? Scents help us relax, energize, concentrate, and feel sexy; they can make a home feel warmer and a work environment more dynamic.

Remember that we experience life through our senses, including the sense of smell. The stimuli our senses convey to us are immediately interpreted by us as positive or negative, and therefore trigger different emotional reactions. It is all about associations. During our lives, we learn to associate smells with certain circumstances, events, rituals, places and memories. Cinnamon smells of a cozy day at home, sunscreen smells like a beach holiday, burned cookies smell of wasted effort, and hospitals… smell of sickness.

It is true that there is a lot of sickness accumulated in hospitals, so it seems only logical for it to be reflected in the general vibe of the place. Still, hospitals should also be places of healing, and healing can and should be stimulated through strengthening stimuli. Scent is just one of them. Let’s move on to hospital food. It is probably one of the poorest diets there can possibly be. When all the ingredients on your plate – the salad, the veggies and the meat – have the same color, gray, you know they don’t have much going on in terms of nutrients. Vegetables and proteins are usually boiled to death, and salads often consist of canned yellow beans and the likes. Desserts mostly seem to have been made out of some instant powder mixed up with water and typically come in sickly pastel colors. And let’s not even talk about flavors and textures. “Urgh” says it all.

Considering that science already knows how vital good nutrition is for our health, it seems insane how hospitals are still serving food that not only does not help patients to recover, but has the potential of making them even sicker because of its nutritional poorness. Even someone healthy needs a wide variety of vitamins, minerals, fats, and so on. Now imagine someone who has already lost their health and needs to regain it. This does not only go for physical illness, but also for mental pathologies. The brain functions thanks to elements our metabolism derives from what we consume. In every respect, hospital food should be absolute power-food, the very best stuff there is! The emphasis goes on the word “should”.

If you, or a loved one, are currently hospitalized, you may wish to complement the hospital diet with valuable snacks. Get fruit, or have fruit brought to you. Apples are a great choice. They are easily available and keep for a long time, even outside the refrigerator. There are, of course, bunches of other types of fruit, but none seems to be quite as practical as apples. Bananas, for example, are an excellent snack and very rich in dietary fiber, but their intense smell may bother your roommates. Also, they get squishy quite easily and attract fruit flies. Whichever fruits you decide to acquire, eat them instead of that awful, pale-yellow Jell-O with tiny beige chunks in it. Also, abstain from the mummified salad on your food tray. Alternatively, you can have a fresh cucumber cut in slices and with its peel still on. As a snack in the afternoon, you could enjoy carrot sticks dipped in peanut butter. All of these items – apples, cucumber and carrots – are relatively cheap, available all year round and do not need any preparation other than cutting them up. Also, drink a lot of pure water and squeeze half a lemon into it at least once a day. Whenever you have the choice between a soda and water or milk, choose any of the latter two. Avoid adding sugar to hot drinks. All these are small and easy hacks which help you improve your health.

Complementing the hospital diet with your own choices of fresh foods can also be an opportunity for social bonding with your fellow patients. During my last hospitalization, I was sharing a room with three other people. It was summer, so there was a lot of fruit on offer everywhere – cherries and plums from local farms, apples, imported peaches and so on. Spontaneously, some of us would go, buy a big bag of fruit and put it in a bowl on the table for everyone in the room to take. Other patients spontaneously formed salad initiatives. They would throw their money together and shop for ingredients for vegetable or fruit salads, prepare them together and share them among one another. All this does not sound like a big deal, but that little bit of human warmth and joyful interaction can make a huge difference for someone who has hit rock bottom. In this sense, bringing flowers to your room is also a small, but important boost for everyone’s psyche. And guess what, this is where smell comes into play again. The smell of flowers is always beautiful.

“Beautiful” is my cue for the next unfortunate aspect of hospital environments: visual ugliness. It must be acknowledged that, given the requirements of cleanliness and good illumination, the off-putting linoleum floors and ghostly light from uninspiring neon tubes are probably necessary evils. Still, a lot can and should be done to make hospitals look less cold and morgue-like. After all, it is in no-one’s interest to have patients slip even further into depression. Some clinics do make attempts to create a more mood-enhancing environment. Large windows, plants, colorful artwork and cozy sofas with coffee tables and magazines here and there go a long way. The access to green outside areas is another huge plus. Sometimes, all it takes to make someone feel less gloomy is to sit on the in the sunshine on a lawn or on a bench in the shade of a tree for a while – alone or with others.

And last but not least, hospital setting should offer ample opportunity both for socializing and for introversion and retreat. The last clinic I was in had generous outside areas with a park, benches and Ping-Pong tables, as well as an indoor sports court which was constantly open to patients who wished to organize volleyball matches or other activities. This was not a fancy private clinic – it was a public, if quite renowned, one. Admittedly, the place was guilty of giving out horrible food and committing several esthetic atrocities, but the overall intention was right. Another thing they did well was that the staff kept close contact with the patients. Not so much in a controlling way, but mainly by being available for communication and socialization. Patients would get to talk one-on-one with the treating doctors several times a week, and every morning both patients and staff would meet up to comment among one another on how everyone felt and on some randomly picked topic. Once every week the arts therapist would direct a huge cake bake-off, followed by a collective cake and coffee binge. On one occasion, as the weather was hot and sunny, all staff and patients from the station decided to go for a pick nick in a nearby park. You may guess by now this was not a closed facility, meaning that patients were not physically restrained or thought to be a danger to themselves and others. Still, some of them had symptoms comparable to those of people I had met in a closed facility some months before, possibly meaning that this clinic simply encouraged and trusted its patients more than other institutions. Along these lines, I remember being invited to a former patient’s birthday party on the other side of town. I commented to the nurse at the entrance that I might be back really late, and she just smiled and wished me a fun evening! All over, I felt that the staff of this clinic was more interested in motivating patients to return to functional life than in isolating them from it. This should be one of the core objectives of psychiatric hospitals, but as things are you have to be very lucky to find a place like this.

Being hospitalized at any psychiatric h clinic is always difficult and scary, because you are often so hopeless that you just can’t fathom a way out of your crisis. But definitely, the attitude of a psychiatric clinic towards its patients is crucial for your recovery. Being guarded by an institution whose staff works against you by violating your dignity and undermining your trust can be the last nail in your coffin. I am certain such places don’t even contribute to the destruction of their patients on purpose. They fall prey to an intellectual fallacy by thinking you have to recover by yourself, and all they have to do is medicate you and lock you up. If the day they examine you again you haven’t improved, they just assume you need some more drugs and additional time behind closed doors. Being locked in by people who disregard your personal integrity could drive a healthy person bonkers. Now imagine what it does to someone who is already weakened. If anyone ever comes out of there cured, it is a miracle rather than a medical success. Such clinics fail to recognize their role as active participants in your healing process, and therefore contribute to your sinking even deeper into illness. On the other hand, staying at a clinic that practices an attitude of encouragement and support towards its patients helps you greatly, if not decisively, in putting your act back together.

In my belief, the biggest shortcoming of hospital environments is how they isolate patients from life. When you are confined to a clinic, you logically cannot participate in society the way you do living freely. But it is that very sense of being stuck in limbo that can worsen feelings of depression and hopelessness in patients. Who if not the very institution our society provides for healing should allow the ill to gather new strength and return to active existence? I am sure the more life is brought to a hospital in the shape of social and artistic therapies, fresh foods, biological life such as plants, comforting scents, natural daylight, cozy areas for relaxation and fresh air, the more curative it will be. Staying at a psychiatric clinic may not allow you to be immersed in everyday life, but it must offer the clear perspective of equipping you for it.

Right now, many hospitals make people sicker. My acquaintance’s father was right about that. The practice of medicine and psychiatry is often still not humane, not loving, not caring, enough. To a culture devout to science and rational thinking this sounds amateurish and cheesy. Yet, it is a profound truth. If science has not been able yet to define or measure love, compassion, health and vital energy, it is by force also unable to produce those. It is one thing to give someone a pill for their intestinal cramps. It is another to attempt mending someone’s broken spirit in the same way. Our health system still has a lot to learn.


Some Words on: Psychiatric Violence

The term psychiatric violence, or psychiatric abuse, describes the mishandling of power and authority health care professionals in psychiatry, or entire institutions, can expose their patients to. It comprises all sorts of aggression – active or passive. Psychiatric violence can occur on all levels of interaction between treating professionals and patients: social, psychological, chemical or physical.

Progressive thought currents in psychiatry advocate equality between the treating and the treated. More and more often, the right of patients to make choices and utter demands is recognized and respected. However, the outdated model of an authoritative doctor and his dependent and subdued patient is still very much alive.

Psychiatric violence occurs wherever doctors and nurses assume that someone who has been diagnosed with a mental illness is a person of diminished worth and respectability, and where psychiatric institutions consider it their main purpose to keep the mentally ill our of society’s way, as opposed to helping them reintegrate. Violent psychiatry robs distressed individuals of their humanity and punishes them for being dysfunctional. Humane psychiatry, on the other hand, dedicates to them attention, support and empathy – in short, authentic interest. I have experienced both models in action and guess what: humane psychiatry is the one producing positive results.

I’ve mentioned here on my blog that I was hospitalized a bunch of times during my psychotic break, in three different clinics over the course of nine months. The first two institutions operated quite a lot through psychiatric violence, which ranged from physical restraint to psychological abuse. Ironically, one of those two clinics had posters in its hallways, inviting patients and the general public to talks on psychiatric violence! It was the first time I ever heard of the concept.

Violent psychiatry will attempt to coax patients into compliance. In fact, their definition of mental illness hinges on the degree of compliance (or non-compliance, for that matter) an individual under examination displays. The discourse used reminds of the twisted logic of medieval inquisition trials: if you admit to being mentally ill, well then you of course are. And if you insist you’re just fine, that belief in itself will be considered a symptom of your craziness. Catch twenty-two! The same goes for the acceptance of psychiatric medication. If you are docile and willing to take your pills, that’s recognizing you are ill. If you refuse, it means you’re mentally deranged, too, because your fail to admit you need them, so your perception of reality must be distorted! In other words, if you come across the wrong sort of psychiatrist, you are destined for disaster the moment you set foot in their office. One way or the other, you will be diagnosed with something – accurately or not.

On occasions, psychiatric violence can get rather blatant and bizarre. During my second hospitalization, a doctor yelled in my face in front of a group of fellow patients that I was sick to my head. An arts therapist at the same facility communicated to the prescribing doctors that I had “distorted vision” – she was convinced that every time I looked in another direction but hers, I was actually looking at her! In retrospect, I think it might have been nice of me to offer her some of my antipsychotic. Unfortunately, the prescribing doctors and higher ranking staff believed her without subjecting me to any kind of exam. They had no interest in finding out if I really had “distorted vision”. After all, the arts therapist was a qualified health care professional and I was just a nutcase whose words were not to be trusted, and who had been caught displaying yet another weird symptom of craziness.

Another genius of a psychiatrist asked me a handful of questions to find out if I showed any symptoms of schizophrenia. I answered all but one or two with “no”. His diagnosis after barely 10 minutes: “You’re schizophrenic. But that I already knew when I saw you sitting in the waiting-room.” And then, he added: “Oh, by the way, you’ll have to take pills for the rest of your life. I assume that’s clear to you.” I may have been psychotic at that time, but that made me neither stupid nor insensitive to inappropriate behavior. Fuck you very much, Doc! Or, yet a bit more blunt: during my first hospitalization in a “renowned” private clinic, I got physically restrained by one guy (who was a favorite patient and watchdog to the psychiatrist in command of the place), another man forced my jaw open and the doctor himself poured a medication cocktail into my mouth in order to knock me out. Again, I may have been psychotic, but I could still feel dread and I also remember the scene perfectly. That same doctor also had the unsettling habit of interviewing patients in his office with the blinds closed and sunglasses on. Even for someone perfectly stable, this setup would have been disconcerting.

Psychiatric violence goes far beyond treatment. In fact, critics of the psychiatric discipline accuse not only specific institutions, but the entire legal system of allowing for psychiatric patients to be robbed of their autonomy, their dignity and their human rights. This, the argument goes, is the case even when healthy patients are wrongly diagnosed.

For example, in some countries, legally assigned caretakers look after psychiatric patients. They are usually social workers who are authorized to decide on the patient’s behalf (yet not always in their best interest). They control communication with the prescribing doctor, survey the medication plan, and are authorized to have their protégé hospitalized whenever they deem it necessary – or convenient because they are planning a vacation and therefore need to get rid of the ill person for a week or two. I know this sounds cynical and certainly does not do justice to the many social workers who actually do have sound work ethics. Yet, I have come across sad cases. Families can turn to the legal system to have their problematic relatives hospitalized by court order and forcefully kept there for quite long periods of time. If they succeed in legally establishing the “insanity” of their kin, they gain complete control over his or her possessions and decisions. Families may legally be the closest instance to an individual, but they aren’t necessarily protective and well-intended. In fact, dysfunctions within the family are suspected to be a major cause of mental illness. Yet, by default, the legal system considers them the first ones who are entitled to decide in the ill person’s name. Thereby, family members can become yet another source of psychiatric abuse.  When a legal system is lenient towards psychiatric abuse, all sorts of parties can acquire power over the patient – psychiatrists, clinics, family.

The interface between psychiatry and the legal system acts very much like a fly-catcher: once someone gets stuck there, it will be very hard for them to ever free themselves and recover their autonomy. This is not an idea I have made up. Countless psychiatric patients spend years or their entire lives in and out of clinics, supported living facilities and under the “protection” of restrictive court orders. I need not go into detail about how that affects their chances of ever finishing an education, pursuing a career, or building a relationship and founding a family with a significant other. When I expressed my fear of ending up just like that to a nurse at an abusive clinic, she readily answered: “Well, the moment you set foot in here that became the track you’re bound to travel.”

Last but not least, another form of psychiatric violence is simple neglect. My second hospitalization was at a clinic where the prescribing doctor saw you for ten minutes once a week, if at all, and where the nursing staff refused talking to you if you had already addressed them with some kind of problem earlier in the day. Their therapeutic program was also utterly stimulating (yes, I am being ironical): the once weekly “gardening” activity consisted of grazing the parking lot for trash and discarded cigarettes for an hour or so. Hell is a place on earth.

Another feature of violent psychiatry is its propensity to sucking patients into a downward spiral of aggression and forced treatment. Whatever is done or said to you is supposedly all “for your own good”. How can psychological cruelty and neglect ever be for your own good? If your common sense is still functional enough to make you unappreciative of this kind of “help”, it is interpreted as another symptom of your desolate mental state. In short: if you allow psychiatric violence to be applied to you, you are being compliant and it is understood that you recognize you need it. If you speak up when feeling mistreated, guess what? You are deemed to be too ill to speak for yourself and the intensity of aggressions will likely be increased until you finally give in and shut up. Sounds familiar? I’ve talked about old school psychiatry’s witch hunt logic at the very beginning of this article.

The million dollar question is how to protect yourself or loved ones from psychiatric abuse. The keyword is “information”. Ignorance equals impotence. Gather information about your diagnosis and learn about your rights and treatment options. There is a lot of literature on psychiatry which is comprehensible and helpful for laymen (see the sources & reviews page). Luckily, mental health has gone from being a purely scientific matter to becoming a subject of general interest. If you are already caught in an abusive dynamic, your attempts of self-empowerment may be judged as paranoid, especially when you suspect your doctors or your family to be harmful to you. Even then, do not let anyone discourage you. Some doctors are in fact careless and some families are in fact harmful. As long as you are kept in the dark about your circumstances you will never be certain if you are as paranoid as they say or whether you are simply recognizing things for what they are. Do not let yourself be labeled as pathologically distrustful, ungrateful or obsessive. Seek information. You may eventually come across a piece that helps you find a new perspective, communicate more efficiently with your therapists and take informed decisions. In the end, it is irrelevant whether your inquisitiveness springs from paranoid ideation or healthy hunger for knowledge. It is your fundamental right as a human being to educate yourself about your condition. You are the one who is most deeply affected by it, so it is only fair if you know what is going on.

Psychiatric violence is a vast topic. I will stop here, at the boundaries of my personal experience with it. If you are interested in reading more, you can browse the internet or look for literature in online or local bookstores and libraries. If you Google search “psychiatric violence”, you will find that an overwhelming number of entries are about psychiatric patients developing violent behavior as a consequence of their illness or as a side effect of their medication regime. Searching for links on “psychiatric abuse” or “violent psychiatry” may yield better results. To save you some effort, I put together a small selection of links that offer information and are a good starting point for further research:


Webpage on psychiatric abuse in English:

Website in English on human rights in mental health:

Webpage on different types of abuse, including psychiatric abuse, in English language:      

Website of the Citizens Commission on Human Rights in English. Apart from getting information, you can also report psychiatric abuse here:

Webpage in German, strongly biased against conventional psychiatry:


Wikipedia entry on involuntary treatment in English:

Wikipedia entry on the psychiatric survivors movement in English:

Article in the Journal of Medical Ethics:

Article in English by The Guardian (British newspaper):

Article in German by the weekly magazine Spiegel (you can run it through a translation program):


A British mother shares her experiences with psychiatric treatment in the UK:

Personal experience of a former psychiatric patient in the USA:


Interview with a survivor of psychiatric abuse by the Citizens Commission on Human Rights: