The Power Of Human-To-Human Contact

When I was twelve, I appreciated my need to be locked up. I was aware of the threat I posed to myself. I accepted that a certain amount of my autonomy needed to be sacrificed in the interest of my own safety. I felt safe in the hospital but that safety came with a price. In 1990–1991 I was hospitalized for a year and a half, first on the children’s unit of a private hospital and then the adolescent ward of a state hospital for children. In this article I address those who work to help people with psychological conditions and try to show what helps, and doesn’t help.

The cost of safety was that the hospital dehumanized both staff and patients. This ran counter to their efforts to help children because help cannot be dehumanizing. You are trying to help human beings, not pathologies. One way that the hospital dehumanized children was that clinical attitudes, protocols and language facilitated an us-versus-them divide between hospitalized children and the staff. This made the staff who worked with us on a day-to-day basis seem amorphous and interchangeable. They had power and authority, we didn’t. Their point of view had validity, ours didn’t. Usually we interacted with them and reacted towards them as if their individuality had been submerged into their role as staff. Reflecting back on my hospitalization I realized that you can’t dehumanize someone else without dehumanizing yourself. And mutual dehumanization was the unfortunate modus operandi in the hospital.

Some staff persons tempered their professional roles with human warmth that was more compassionate for the both of us. I was always happy when a staff person didn’t treat me as a walking pathology seething with weird symptoms and bizarre behavioral patterns. It was a pleasure when they treated me as a human and I got to treat them like they were human in return. I treasured those occasions when our encounters and communications transcended our roles and we related to each other as people aware of our shared humanity.

Two examples of the dehumanizing effect of clinical attitudes, protocols and language were apology reports and contracts for safety. My first experience with an apology report was when I was upset by a staff woman’s insensitive way of supervising my shower, staring at me straight on, hands on her hips. When I called her insensitive I was forced to write her an apology report that stated who I was apologizing to and why. The staff didn’t ever have to apologize, unless they wanted to.

Contracting for safety meant not only did the kids have to promise not to hurt themselves or others, but since the contract for safety matched the circumstances under which the kids were restrained, the kids had to promise not to engage in such an objectionable way for a certain amount of time or get put into a “safety coat” (a straight jacket). If you had sworn and verbally abused staff, you had to promise not to swear and verbally abuse staff for half an hour. If you were physically restrained, as I once was, because I had tried to comfort and calm myself by doing yoga, you had to promise not to upset staff by contorting your body in strange ways for 30 minutes to avoid the safety coat. If you broke the contract for safety you were immediately put into a safety coat. To successfully contract for safety it was necessary to calm down or at least be very convincing about pretending to be calm. Most contracts for safety weren’t successful. Many times kids downright refused to contract for safety.

Help can’t be dehumanizing, yet a small amount of dehumanization (with restraints) is necessary, as a last resort, to keep us safe. The use of restraints can be justified by the rationale that they are sometimes necessary to keep kids from hurting themselves or others. Unfortunately, sometimes the hospital put us in restraints for no valid reason, instead of out of the necessity of keeping us safe. For physical and...