Monday, September 18. This was my first day at McLean Hospital, a preeminent psychiatric facility. It took about six years for me to get here. About six years back was when my OCD started, or at least when it took a turn toward severity. For six years I “lived” a double life. One life spent functioning as normally as possible, professionally and in society. The other life spent in perpetual anxiety and avoidance as an OCD sufferer. I think one of the reasons it took me so long to seek the kind of professional attention that requires checking into and residing in a psychiatric facility is that mental illness isn’t as tangible as a physical ailment. For instance, when one has diabetes, there’s no denying it. With a mental condition such as OCD, there is a massive amount of denial involved. Then there’s also the huge stigma attached to mental illnesses versus physical ones. When one has cancer it’s tragic and people feel awful for those afflicted with such a disease. With OCD, people usually think your behavior is “crazy.” Terms relating to mental illness terms are often used as insults, but not so much with physical ailments.
So there I found myself in Boston, Massachusetts. It’s a long ways away from my home in Los Angeles. The hospital is actually just outside of Boston proper, in the affluent township of Belmont. The walk from where the bus had deposited me to the hospital grounds was short. My duffle bag suitcase was on wheels, so it wasn’t too much of a strain to pull it along. When I reached the picturesque guardhouse at the gate entrance, I paused. There was a small non-descript sign that read “McLean Hospital” and near the sign was an opening to the gate. The guardhouse must have been a relic of a time in McLean’s 200 year past because it wasn’t occupied.
I was initially surprised by how accessible the hospital grounds were. After all this was a mental institution. I stepped inside the gate and onto a paved winding path that I assumed would lead me to the hospital. I couldn’t really see much of the hospital as it was situated atop a large hill and I was still at the bottom of the hill. My initial view consisted of the paved path, some light-posts which resembled 19th century gas lamps lining the path, and woodsy forest on either side of me. As I started to climb the paved path leading up the hill, I was taken aback by how winded I felt. Gasping for breaths and needing to pause every fifty feet made me very aware of how out of shape I was. But the hill was surprisingly steeper than I would have thought. Also it was an unseasonably warm day and the sun high above was blazing enough to make my light jean jacket feel like a full-length wool trench. I removed my jacket and tucked it into the pull handle of my duffle bag suitcase. As I did so, a few almonds from the pack I had opened earlier fell out of my jacket pocket and onto the paved path and one or two of them ended up on the dirt road that the path cut through. I moved on.
I eventually climbed enough to where I had a good vantage of some of the buildings. They were huge brick and stone cottages covered with ivy that looked like the kind of mansions that housed generations of moneyed New England families. They were all architecturally unique and varied in size, but they matched enough so that there was a tasteful uniformity throughout the grounds. I felt like I was trespassing on a very exclusive gated neighborhood.
I located the Administration building, the place where I needed to check in. It looked like a colonial mansion made of pale yellow brick. When I reached the front of the building, I opened the door and walked into a small entryway. There was another door that led to the interior of the building. It was locked. I noticed an intercom on the side of one the walls in this small entryway. I pushed the button labeled “reception” and announced my name when prompted. I was buzzed in. When I walked inside there was a middle-aged woman sitting in a small reception office, protected by plexiglass. She acknowledged me with a brief smile and then handed me some forms attached to a clipboard through a pass window.
“Please fill these out and then I can let you know where to proceed,” she said.
“Ok. Thank you,” I said.
I filled out the forms. They asked standard questions: name, date of birth, occupation, address, and so on. The forms on the application, which was fifty plus pages long, that I filled out and mailed in to get here contained much more exhaustively psychological questions. That extensive application form asked me about any suicidal tendencies, paranoia, severe depression, recurring nightmares, hallucinations, cutting myself, the impulse to harm others, thoughts of sexual deviance, counting and repeating words and phrases until they “felt right,” quantifying things according to a formula that made things “feel right,” perfectionism, need for symmetry, and on and on until by the end of the application I felt I needed a sedative and a long shower.
The questions on this form however were rather basic and standard hospital protocol. That is all except for a question on the last form. It was a confidentiality agreement combined with an exhaustive liability waiver and acknowledgment that I was checking myself as a patient into psychiatric hospital and would be released when it was determined appropriate by my team of hospital physicians, therapists, and staff. I paused on this last form. I hadn’t ever signed anything quite like this before. I had to let the idea sink in that I was essentially committing myself and consequently signing many of my rights away. I stared at the signature line for an amount of time that was starting to feel too long. I blinked one more time and then I signed it.
When all the forms were completed I slid them back to the woman. She flipped through them making sure I entered all the needed information. Then she looked up.
“Ok Mr. Ascari, you’re all set. You need to head to the building marked North Belknap. That’s where the OCD Institute is located. It’s just a short walk up from here, on your right,” she said very matter-of-factly without any trace of a smile this time.
“Ok. Thank you,” I said.
I walked out of the stately Administration building and up the path toward the right as instructed. Despite being on wheels, my duffle bag felt heavier than just minutes before. As I trudged further up, I took a moment. Wiping the sweat from my forehead I glanced around. The grounds were really beautiful. The leaves on some of the trees were just starting to turn shades of amber and agate, with some even further seasoned toward colors of coral and crimson.
The only thing miring a complete sense of fall was the excessively warm sun. Why was it so hot? It didn’t feel right for it to be this hot. It’s September in New England for fuck’s sake! Why would the sun be beating down on the exact day I was to check in, dragging around luggage? Why couldn’t it have been warm yesterday when I didn’t have any luggage to drag around and be the normal temperature today? If it were the normal temperature I would be wearing my jean jacket instead of having to take it off and drag it around along with my luggage. If it wasn’t warm then I wouldn’t have had to take off my jean jacket then the almonds in the pack I had opened earlier and kept in pocket of the jacket wouldn’t have fallen out and I would still have a snack to eat in case I get hungry later. Stop it! I knew I was starting to reel so I made myself stop. I don’t mean I stopped thinking about having avoided the consequences I was currently experiencing if a sequence of events had just been a bit different, because that doesn’t ever stop. However, I stopped it from being at the forefront of my thoughts and returned back to the task at hand. That task was to reach North Belknap and that’s what I had to try and return the main focus of my thoughts to.
After I caught my breath and felt calm again, I continued up the path and came across a small sign. “North Belknap / OCDI” it read with an arrow underneath the text. I took a few more steps and at last arrived at the foot of North Belknap. A few stone steps led up to a brick Tudor mansion that had decorative gables and sculpted stone masonry along the exterior. The entire building was covered in green and red ivy.
I walked up the steps to the front door. Before stepping inside I glanced around. North Belknap overlooked a large grassy expanse interspersed with tall, aging trees. It was so pretty. I became misty eyed, but I knew it wasn’t because of the scenery. I took a deep breath and walked inside where I found myself in another holding entryway. I rang the intercom and was buzzed in without any question this time.
After I entered the second door, I walked into a common sitting room area. There were people of various ages milling about inside but no one was talking. It looked like everyone was in some sort of trance. For a moment I thought I had entered the wrong facility. This ward was probably for very psychologically disturbed individuals who were heavily doped up on drugs. I noticed that most of the people would briefly look me up and down and then carry on in seemingly semi-conscious activity.
A couple people were sitting on a couch writing in notebooks. They were a man who looked to be in his late forties and a woman in her mid-twenties. Behind them stood a guy who couldn’t have been much older than eighteen. The teenager was standing and holding onto the talk-piece of a rotary phone affixed to the wall. He was holding the phone with both hands, but not doing anything else to indicate he was attempting to call someone. He didn’t move. He stood there frozen, staring at the phone which he clasped with both his hands. The people on the couch paid no attention to him, as if holding a phone and being very still were perfectly normal.
My attention was thankfully diverted to an older woman who was walking down a hallway on my left that led to the common sitting area. She must be a nurse or something I thought. I would ask her where I needed to go. As she came down the hall toward me, she paused. Then she knelt down and plugged what appeared to be a cell phone charger into an electrical outlet. Then she pulled the charger out and plugged it back in again. She kept repeating this action of plugging the charger into the electrical outlet and pulling it out again. Her face had a pained expression on it as she did so and I noticed she was starting to perspire. She was no nurse. Some panic started to come over me and my flight response kicked in. Just as I was about to head for the exit, a preppie young man came up to me.
“Hi, can I help you?” he asked.
“Hi. I’m looking for the OCD Institute. Can you please let me know where that is?”
“You’re here. This is it. Are you checking in?”
“Yes,” I said as my panic started to return.
“What’s your name?”
“I’m Ben Ascari.”
“Hi Ben. I’m Chris. I’m a counselor here. I was informed you would be arriving sometime today. Let me show you to your room.”
“Ok. Thanks,” I said.
Chris must have discerned from whatever expression I held at that moment that I was somewhere between mildly bemused and intensely terrified by the behavior of those around us because he smiled and volunteered an explanation.
“You have arrived during the first E.R.P. session of the day,” Chris said.
“Ok,” I said.
Chris smiled again and continued, “That’s when the patients engage in Exposure and Response Prevention exercises, which is what E.R.P. stands for, so you probably will see some unusual things during this time.”
“Ok,” I said.
“Do you want anything to drink? The kitchen is right over there.” Chris said pointing to a dilapidated room containing a school cafeteria dining table surrounded by horribly ugly chairs. I noticed a cabinet of mismatched dishes and cups that resembled something one would find at the garage sale of a soup kitchen that was going out of business. Before I could notice anything else in the kitchen, I forced myself to turn away.”
“I’m fine thanks,” I said.
We made a left and continued down a sterile corridor that had rooms on either side. The doors were all closed. The flooring was typical of what one would find in a hospital, white with various shades of grey speckling. The walls were white.
“Your room is at the end of this hall. You don’t have any roommates yet, so it’s just you in there for now,” Chris said.
“Ok, “I replied as some relief came to me with that revelation.
As Chris started to open the door to what I assumed was my room, I noticed that the door of the room next to mine was decorated in hand-made art that, at a glance, resembled the kind of artwork made by very young children which proud parents place in their offices, or the more sensible ones, on their fridge at home.
At first I thought my neighbor must be very young, but then I remembered one had to be at least eighteen to be a patient here. I was curious, so I moved closer to examine the colorful drawings. As I viewed them more closely, I felt my heart sink and knew my face must have turned a near white as the drawings invoked a fear that I can’t adequately describe. One drawing was of a multi-colored rainbow that had the text “I AM GAY!” written in purple below the rainbow. The overall effect was highly sinister, like a clown with homicidal tendencies. Another drawing was two intertwined symbols for male with text below it reading, “GAY PRIDE!”
When my OCD took a sudden, unexpected turn toward extreme severity, it acutely honed in on the fear of HIV/AIDS. I knew why and what triggered it, but I wasn’t wholly accepting of the reasons yet. And a consequence of that self-denial that OCD brutally enforced via the irrational fear it invoked, was avoidance of any demographic my OCD associated with HIV/AIDS. Inducing such extreme, irrational fear was OCD’s fool-proof method to longer deny me a sense of authenticity–to keep me locked in. So as I looked closely at what should have been an innocuous, even joyful drawing, I felt panic creeping in. The deepening sensation was briefly interrupted when Chris called to me from inside my room.
“Yeah, coming,” I said hesitantly.
I walked into the room dumbstruck. Once inside the room things only worsened. The aesthetic of the room was a visual punishment and general assault on my senses. This room was a brutal slap in the face of anyone with even a remote sense of good taste. My head was swirling. I vaguely heard Chris talking, his voice made less audible by the thick shroud of fear enveloping me.
“You can drop your bags off and walk around the grounds if you want,” said Chris. “There’s a cafeteria right behind this building in case you’re hungry. Or you could just unpack and rest. Basically you have some free time until the End-of-Day-Group-Session, which is at 5pm. I will bring you some linens for your bed and some more paperwork that you need to fill out.”
As I was still in shock, I couldn’t speak. If I could speak, I would say to young clinic counselor Chris, “Um, excuse me kid. I have OCD which means my intrusive thoughts and compulsions are triggered by things such as, oh I don’t know, soiled holding cells one imagines are still found in parts of the developing world. For this to work, I will require a room with a modicum of the sanitation standards deemed minimally acceptable by average Americans in the 21st Century, let alone a hospital. Oh and I also can’t be within close proximity to entire populations of people, such as my innocent gay neighbor as my OCD makes me irrationally terrified to contract what it has deemed as deadly, easily transmittable diseases associated with these large swaths of the global population.”
Yet I used some diplomacy paired with reasonable-sounding language instead and leaned in toward Chris and said in a confidential tone, “Chris, I’m not sure if you’re familiar with my case yet, but if you check my application or chart or whatever, I think you will see that I have definitely been placed in the wrong room. Can you check my chart to verify where I should be? I’m sure it’s just a mistake, but I really need to change rooms as soon as possible. If you just quickly check my chart I think it will explain everything.”
Chris calmly smiled and said he knew it was an adjustment and he would leave me alone and allow me to get settled and unpack.
Wait, what? I was confused. Didn’t I just make a clear statement emphasizing a degree of urgency? After Chris abandoned me so that I could get “settled,” I really felt panic stricken. I thought to myself that there’s no way I’m living in a dingy room that looks more apt a setting for indigent squatters than for patients at a New England clinic. Then there’s the issue of my probably very kind and loving neighbor that OCD has cruelly, yet effectively categorized as a terrorist.
Stop. This isn’t how you think. This isn’t what you believe. You don’t judge people like this. This isn’t who you are. This isn’t how you see the world. This isn’t how you want to live your life. These are all hateful, intrusive OCD thoughts manipulating your mind to ruin your life. Please don’t give in. Fight.
I glanced around my room sweating even more than I did when I was hiking up the hill to get here. I was grasping for any visual that could possibly placate some of my fear. Something to indicate that this place really was a hospital affiliated with Harvard University and not the setting for a low-budget experiment. Yet when I looked around my room more closely, all I could see were a couple of beds that held mattresses covered in a heavy-duty blue plastic with pillows also encased in the same plastic. There was a bureau and desk that made Ikea furniture look like rococo Louis the VI in comparison.
Attached to one wall was a mirror the size of my hand. Oh and the mirror was scratched, probably by the overgrown fingernails of the room’s former resident who couldn’t stand the sight of himself after doing a stint at this place. All this may have seemed like perfectly lovely ambiance for say, a mistreated P.O.W. post rescue, but for me there was absolutely no question that I just couldn’t stay here.
While the appalling conditions of the hospital interior were cause alone to invoke extreme discomfort, OCD targeted my would-be neighbor as a reason to trump every sense of calm and reason I would possibly have been able to muster at the moment. As much as I tried, I couldn’t bring my own values and beliefs to the forefront. OCD was occupying all the space with blaring alarms that made calm reason impossible. I suppose it didn’t help the situation or my perspective that I had stayed at the Four Seasons Hotel the night before.
I had arrived a day early in Boston as I wanted to have some time to myself in my new city before I checked in to McLean. I mean I didn’t want to get off the plane and head straight to a mental hospital to “unwind” from the long trip. The Four Seasons hotel is where I decided to spend the night before heading to McLean. I felt a night of luxury would calm me and allay some of my apprehensions. I was right. The moment I walked into the Four Seasons hotel, I knew I had done the right thing. Sure this was a splurge but when it comes to hotels I’m a snob and I can’t compromise. Of course in self-defense of my character, I will qualify that admission by acknowledging that much of my predilection toward fancy hotels has to do with my having severe OCD.
Let me put it this way, I would rather set myself on fire than enter, let alone stay at, a lodging facility in the vein of a Motel 6. If I notice a stain on a foreign sheet, my mind immediately races toward the dark place and it forces me to deduce that the stain has to be blood or sperm, or a combination of a few bio-hazardous bodily fluids and therefore I have some way suddenly been exposed to AIDS which OCD has effectively manipulated into cause for unquestionable terror. So my need to stay at a hotel with a reputation of having the utmost measure of clean bedding, fresh towels, and good taste in décor is a necessity for mental sanity. The Four Seasons tended to my every neurotic need. I mean when I called housekeeping to request a pair of scissors to cut some tags off of new clothing, a porter promptly arrived at my door with scissors on a gleaming silver tray.
Somehow I felt I wouldn’t be afforded the same courtesies here at McLean. If I requested a pair of scissors here, my request would likely be met with the same distant smile Counselor Chris had just given me, probably followed by a mandatory psych evaluation. Nope, no sharp objects would be brought on silver trays to my disgusting, unsanitary, ramshackle Spartan room here. I just couldn’t stay here. I mean I wasn’t expecting the Four Seasons in coming to McLean, but this?! I had been deceived. McLean had a reputation for being the finest residential psychiatric facility in the country with a roster of A-list former clientele. Ok so what the hell happened? Where the fuck was the quaint little posh mental hospital I had read about?! Sure the grounds and the exterior of the buildings were real fancy, but those were just facades covering the horror that lay within.
The actual interior of the buildings, the place where I would actually sleep and spend most of my time, was horrifyingly similar to the funny farm places one sees portrayed in American Horror Story or those Lifetime movies. I wasn’t in a Lifetime movie and wouldn’t subject myself to such squalor. I needed to flee before my luggage was infested by vermin. I walked out of my room and down the hall to locate Chris. Across from the dilapidated kitchen was the Counselor’s Station. Through a window I could see Chris was inside cajoling with a few other counselors. I waved to him and he waved back. All the counselors were now smiling and staring at me. When my awkward presence at last made Chris understand that I needed something from him, he walked out of the Counselor’s Station and closed and locked the door to it behind him.
“Hey Ben. There something you need?” asked Chris.
“Um, well, yeah,” I said. “See Chris I don’t want you to infer this the wrong way, but the thing is I can’t room next to someone who is gay. Now I absolutely don’t have anything against gay people. I promise you I really don’t. I mean I live in L.A. and well, there’s a lot of other reasons I don’t. I mean I wouldn’t and couldn’t ever be someone who judges someone else that way, I promise….”
I had to pause because I knew I was rambling.
“….but the reason I’m here, at McLean I mean, is because my OCD specifically has to do with fear of contracting AIDS. As a result anyone who is in any demographic associated with AIDS is um, well it’s very difficult for me to be around them. Now I feel tremendously shameful and guilty about that. I actually hate myself for allowing such thoughts to enter my head and I don’t understand why I can’t stop them from doing so, you see. Which is one of the reasons I’m here, obviously. To get better I mean, and not have that irrational fear or those horrible thoughts, but I can’t stay here and receive the treatment I need if I’m already this uncomfortable. Do you know what I mean?”
“Ok,” said Chris. “Here’s what we will do. When you have your first meeting with your Behavioral Therapist, you can let him know how you feel and he can make any needed adjustment to your housing situation. It’s not up to me or any of the other counselors to allow any room changes. That’s the best I can offer right now, ok?”
Well it wasn’t ok but what choice did I have? I gave Chris an empty thank you and walked back to my room. I carefully averted my eyes from the drawings on my neighbor’s door.
I called my friend Kelcy in a panic. Kelcy had survived the worst form of pain, the untimely death of a very close loved one, her husband, so she would understand my current predicament. I received her voicemail and left what I can only describe as a very curt message asking her why the hell she wasn’t answering her phone when I needed her and consequently questioning what her sense of priorities in life had become. Even more worked up now, I called my friend Aliza and thankfully she answered!
“Hi Ali? Ben here. Just listen, there’s not much time. This place isn’t right for me, so let’s devise the most efficient plan for my departure before they confiscate my phone or a cockroach crawls into my ear.”
Aliza calmed me down. Having done a stint at a rehab facility herself for different reasons (abusive relationship), she was familiar with these places. She reassured me that it feels horrible the first day, but it really would get better. She reminded me that I elected to come here because I wanted to get better. To have one normal life.
On a side note, I don’t want it to sound like my friends are all rehab junkies with a slew of issues typical of therapy seeking urbanites. Quite the contrary, my friends are all very well-adjusted individuals from very functional and supportive families. However, after we graduated from college, we encountered “real life” and for most of us in my group of friends, this included a form of unexpected pain. A curve ball that skidded our normal lives off their planned paths. In my case it’s the OCD that derailed my life. If it wasn’t for my family and friends, it could have also ended it.
Since I was given some time to myself to roam the facility and get adjusted, Aliza advised me to find somewhere I could feel comfortable and write about how I felt at that moment and the feelings I felt before coming to McLean. She said writing out my thoughts would clear my head and really reflecting on the painful past that brought me to McLean would allow me to get past the immediate panic and anxiety I felt to see how much worse not being here and getting treatment would be for me. So that’s what I did. After hanging up with Aliza, I grabbed my notebook from my duffle bag and went into the cafeteria building that Counselor Chris referred to and I started to jot down my thoughts.
I think writing about why I’m here right now, or at least peripherally writing about it, is keeping me from having to think about it. Thoughts have been betraying me these past six years…I mean OCD thoughts and I don’t want them to get control today. Not today. My first day toward receiving tangible, professional help. If the thoughts take over, they will make me run, just as I was about to do before Aliza calmed me down. But the thing is, I know that running away is futile. Wherever I am, I’m in prison. A mental prison accompanies you wherever you are, at every moment of the day. There’s no solace in hoping for physical escape. That’s why I’m here afterall – because I had nowhere else to go. I should be looking at being here as a really good thing. I’m here to get better. Really better this time.
Still, being here is daunting. I mean when did I reach the stage in life when I required living at a mental institution? Me! It’s me I’m talking about here. How did this happen? How did it get so bad? I’m actually a patient at a mental hospital. Tears are welling up in my eyes as they often do when I ponder the surreal reality that is now my actual life. I actually should qualify that last statement with quotation marks around many of the words. Certainly around the word “life” as the past six years it has held mostly the mere biological definition. “Functioning” or rather dysfunctioning with OCD is not living. I think the best way to describe an existence with OCD is as being among the Living Dead. Sure there is a heartbeat and brain activity (the brain activity is actually the main problem) but it’s not really being alive. I have not been living. I have been existing. I have been struggling to exist in a painful, tortured life. A desperate, despondent, guilt-ridden, maddening, anguish-filled, and ultimately tiresome life. I have been coping, struggling, and in the end, failing. All the while time passing me by.
I stopped writing in my notebook. I could feel the tears about to fall, but before they could, I regained my composure and held them back. The frustration and sadness of being this way had caused me to get misty-eyed often, but I tried to curb full on crying. As long as I didn’t shed a tear, it wasn’t completely losing. I often failed and did cry, but only privately. My friend Regina used to call me a heartless robot because I would control myself and not cry at sad movies. Get teary-eyed, sure. Cry, no. I recall the many times we went to maudlin movies together and she looked at me in disbelief that I wasn’t a bawling mess like her. She was baffled that I didn’t cry at all during “Titanic.” I thought about the last time I was in a movie theatre with Regina in L.A. We went to see James Cameron’s “Elizabethtown,” which made her weep and made me really annoyed. Now I was here. I was in a modern-day sanitarium. Hell, let’s refer to it as what it was called when they founded this place. An insane asylum. I was one of the patients now. I was one of the insane.