In the summer of 2008, mid-July, I was ready for discharge from Binghamton State Psychiatric Center. Of course, readiness for discharge from a state hospital by no means signals the completion of the healing process, but it does set the stage for what would become a decade of recovery. In July of 2008, the psychosis was beginning to lift, and the mania was controlled or in partial remission. On a personal level, I was ready to pick up the pieces from where I left off and begin the transition back home in Westchester.
For most of the hospitalization process, I was too disoriented and unfamiliar with the state hospital setting to really plan for my discharge. In fact, for most of my time in Greater Binghamton, I had given notes to the charge nurse to request my release from the hospital to a group home. There were many plans in the hospital during the summer that went nowhere. I requested my discharge back to the community several times, with an understanding that I would have to stand a competency trial. Each time, the doctors were quick to inform my family I would not pass the competency hearing.
With all these fragmented plans, I moved forward with my discharge back to my hometown or county of residence. This seemed like the most problem-free plan to date and certainly would be the most beneficial for me to recuperate in my parent’s home, far away from the madness of the earlier year. I was skeptical, however, given the state of relations between my family and myself at the time. A year of paranoia, fear, and irrationality had gotten the better of me and my relationship with my parents. Given that I had no other natural choice for surviving, given my shaky mental status, I agreed to this plan.
On the day of discharge, I was sitting in the treatment mall, as it is called in the state psychiatric centers, where everyone goes for therapy and other programs during the day time. Today, I had no further treatment at the hospital. Instead, I waited for my family to pick me up. Before leaving the hospital, I signed my discharge plan and was given five dollars, the standard issue for people leaving the hospital and starting their lives over again.
At that very moment, the doors to the treatment mall opened, and I felt like a prisoner being released from the state jailhouse. I walked through the doors, out past security, and continued walking outside, where my family had the car parked. There was no ceremony upon release, no ritual to complete, just a self-directed motion to the parking lot and ultimately down the “hill,” as it was called by the locals in the community.
During these early moments, I had no idea what to expect about the risk of relapse or the success of transitioning back home to Westchester. It was a subdued trip back home but a joyous one. When you get released from a hospital at this level, the first impulse is not to party but to enjoy the delights of serenity and peace at the most accessible level possible. When you are tired and battered from spending six months locked away, the effort gets expended on surviving in the moment and feeling okay enough.
Upon arriving home, I picked up the mail from the past day to find my Binghamton degree. I had graduated. All energy could be invested in the healing process and moving forward with a new plan. It was now time to figure things out, something I had not had an opportunity to do since before my hospitalization when I was a prisoner of my thoughts.
No longer a prisoner but fully aware of the dangers of leaving my illness to its own devices, I followed the plan from the social worker in Binghamton and began a partial hospitalization program a few towns over from my parent’s home. This program ultimately paved the way for my return to outpatient mental health and the ten-year journey ahead.
Concerned chiefly with my writing and salvaging my collateral contacts from the chaos of mania a year earlier, I began to organize myself. I needed to figure out what happened and how and why I collapsed in Binghamton. The doctors had their own clinical picture and narrative I was supposed to understand and gain insight from into my “illness”, but that explanation was inaccessible given my unfamiliarity with mental health and also because it didn’t seem to speak for everything that had transpired a year earlier. Regardless, I intended to figure out what had happened.
To do this, I needed help. The first helping hand came from my therapist at the program. It was a full year before I attained enough insight from my therapy sessions to begin putting together a road map for my recovery. The first year of healing was primarily spent on sleeping and getting to appointments to manage my new mental health diagnosis. Given the sedation from my injections, there wasn’t a whole lot of energy left over for other purposes.
I was on half a dozen medications, both more] and Intra-Muscular injections. All of them were sedating. Most of them caused side effects, one of which I experienced often, which was restless leg syndrome. The irony of it all is that if I didn’t rest enough when I was sitting, I wanted to get up and keep moving due to the medication. There was a pill too for that, but I rarely took it, and believed, as I always have, in the strength of will over reality.
Knowing I wanted to be back in school, continuing my education, and knowing I didn’t have the stamina for a long-term program, I enrolled in online education to get situated back to learning, reading, and writing on my own. The course was a graduate class in psychology. In those days, I did the best I could. Often, I didn’t complete assignments due to being stuck in the throws of early recovery and, in part, due to medication management issues, which would be worked out naturally as I progressed forward into finding my pace for sustainable recovery & my own tolerance to medication, etc.
After a year of therapy, injections, and life with a mental health disorder, I decided it was time to begin classroom learning again. Given my run-in with the law during the illness in Binghamton and my desire to perhaps one day go into the field, I enrolled in a one-year paralegal degree program at the local community college. This was progress– I was out of the house, in the classroom, independent for the day’s events, and put back into an environment with people and students. Here, amongst the people at Westchester Community College, I would lay the foundation for future learning and set goals to support the process.
While I didn’t enjoy the material, I enjoyed being back in the classroom again. More importantly, I had access to all the benefits of college enrollment and the space to walk around and get comfortable thinking on my own again. After a year of being voluntarily confined to my home and bedroom mostly, I enjoyed the outdoor campus and the ability to access my thoughts in an environment conducive to learning and education-related goals.
Not long into my certificate program, I realized the next step was to return to Binghamton for graduate school. Knowing I couldn’t return to the English department and believing in redefining myself, I chose social work, the profession that helped guide me during these early moments in my recovery.
I decided on the master’s in social work for a few reasons. Chiefly, I wanted to understand more about my illness from a clinical perspective and gain the insight needed to hurl my recovery further along than if left to my own devices and the mental health system. I knew, given the chronicity of my illness, that I would need to make long-term plans.
A career in social work seemed to be just the right fit. The application process went smoothly, and without incident, I was admitted back to Binghamton University. I went up early the summer before beginning graduate school to adjust back to being independent and in the same town as my psychiatric demise two years ago. That summer passed without incident, with the expectation of the final evening before classes, where I was T-Boned on a highway in Vestal, New York.
The first few hours in the emergency room was a sad constellation of irrational beliefs that I could first walk and, second, take care of myself after discharge and rehab in the hospital, given my pelvis was now broken. I spent a few weeks in the hospital after the accident and was discharged back home afterward with home care, my father, who would be living with me for the better half of the first fall semester.
With my father sleeping on the floor and me paralyzed in the bed from back pain, pelvic pain, and a few broken ribs, we once again embraced recovery and walked the path of healing in the residence hall.
About a week later, I returned to the classroom in a wheel chair, but I was still excited to begin graduate school in social work.
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Max E. Guttman
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