Bedlam: Channel 4 documentary on our Anxiety Disorders Residential Unit (ADRU)

so james what does the toilet mean when you see it um i guess if i know if i'm being perfectly honest it's sort of like um almost like i should as enemy but more like a torture really it's sort of like um i've had such a for like as long as i can remember since even before my parents got divorced like when i was you know five years old like i've had a really difficult relationship with it which sounds ridiculous it's just a heaven toilet but even in another southern designer balloon looks slightly comical but i like i sort of hate it it's sort of like yeah there's like a big wanker or like like a monkey on my back or something like yeah i so i yeah [Music] this is the world's oldest psychiatric institution [Music] it used to be known as bedlam the place we hid those we called mad you need some medication now known as the south london and maudslay i need to speak to you it treats 50 000 patients a year any sign you yourself i don't think so and numbers are rising the staff and patients open their doors to show us what bedlam is like today as you said [Music] would you like me to stay here or would you like me to come back [Music] that's absolutely fine it's a condition all of us experience at some point in our lives but imagine if you woke up one day to find your anxiety had taken on a life of its own i i feel a bit anxious because part of my therapy at the moment is tackling opening and closing drawers and doors only once but what my ocd wants me to do is it wants me to open the drawers and check them a certain number of magic times in my case magic numbers are things like 1 2 4 7 11 13 16 24 33 53 and they go on up to 1234. so what my therapist had me do was just try to open the drawer once and put my clothes inside and then close the drawer now my lcd is telling me it didn't feel right closing that drawer so i'm going to want to open the drawer again and then when i close it it has to sound right and it has to feel right so to me that didn't quite sound right so my ocd tells me i need to open it and close it again but now the problem is that wasn't a magic number that was the number three which isn't really good for me why because it doesn't feel right and there's is no other reason than that it's it's all a feeling based thing that three for me is a number that is bad aaron is 40 a middle manager with an oil company he's one of 16 patients on an intensive therapy program at the hospital's national unit it treats the most anxious people in the country do you need anything the top 1 um yeah the front door um now i'm not going to touch it now with these drugs because these gloves are contaminated from being in the kitchen but the cleaning ladies they often to carry the rubbish in one hand and they'll they'll even be using that hand to press the button to get out and then pulling the door open so like that handle is like contaminated by the from the rubbish you know they've been handling excuse me you could nip out now quickly uh well here anything but then how would i get back in so now right now i'm worried about i'm very aware of all these people and sort of watching where they are where they're going so if suddenly someone disappeared around the corner would probably be quite anxious that i'd done something to them to make them disappear and particularly because there's been there there's a rubbish been there there's rubbish been there and there's one here i know where they are so i'm worrying if i've put them in the bean helen is 33 a librarian at the british museum she obsesses about causing harm to strangers is he just then i couldn't see that guy for a minute and i was quite scared oh my god he's vanished but he's there yeah yeah and now i'm thinking is that the same man and so on you you've been with us that whole time so if you said have i done anything to that man we could tell you no yeah it would help a little bit but not probably not absolutely no there's no rushing it's not rational at all like that you know i can't just explain it already to myself six seven now by going to seven i've gone up and down twice which is also four times and seven and four are eleven so that's good i would hide it from everybody i knew because i didn't want anybody to see my craziness why are you letting us see that i know that if this can help at least one person know that they have a problem and they can be helped that it's a good thing really [Music] hmm the news is full of bad stories about us being attacked about pedophiles about people being murdered negative stories are put forward constant to us which increases our perception of danger this could happen to any one of us at any one time we're all on the scale each every single one of us can be tipped over simon said three out of four who came to the unit would improve some would be completely cured the therapy program runs for 12 weeks the theory is that if you can change the way a patient thinks you can change the way they behave james hello james has been with us about two weeks now he's got a long history of very severe obsessive compulsive disorder mainly to do with making sure his bowels are empty making it completely empty and he'd go to extensive behaviors around toileting wiping cleaning to be sure that he's not going to um basically crack himself in public or have a have an accident which would be totally embarrassing and he'd be humiliating to him [Music] yeah let's just go with that james let's just go with that but what if there was if he's saying if there was a brown stain because i had and that would be back home james has been spending up to seven hours in the toilet he's dropped out of university he's lost a lot of friends and basically be stuck at home with his mum in a very isolated situation where he's just spent a lot of his life around that toilet he's had extensive treatment in the past as well and nothing has really worked in the long term i thought actually what would be better for you to go and get some lunch oh really yeah like everyone here james lives in a perpetual state of anxiety i think yeah because i'm i'm worried because i i because apparently i what basically i think the underlying thing is i want to go to the toilet and have all and then like go go like have a shower and get dressed and do all this out before the community meeting at one we should say like just over 45 minutes away and i'd i'd see is have you guys had lunch or you're going to be having lunch soon but i'm thinking but then you should say oh no you need to go when you have the urge the word is there but it's maybe not strong it should be so about okay then usually when you eat it it's get stronger so maybe i should eat or maybe i don't know it's hard because i'll be taking oh should i go social or not because i'm thinking this probably wants to really go before the community meeting at one actually i won't have enough time to do it and i don't want to be sat in community community because i hate all the all the sessions where we just sat round in a circle really difficult because i because i'm just sat there and most of the time you're sort of passively just listening i probably should go to lunch i probably should because like yeah the edge isn't that strong like i should go to the ghost hole i just focus on my thoughts i'm just ruminating the whole time what's that sensation what assistance is do i need to go to the toilet you sort of have to be able to well at least for me i find i know i need to be able to just say okay come on you know almost give yourself a pep talk like i've got to be able to do this myself because if i don't i'm going to be stuck doing this forever i'll go to lunch what could i do tony yes yes probably yes yeah no because yeah because i won't obviously community meeting then and then yeah [Music] oh yeah i'm like yeah i should get yeah yes i'll have some lunch yes a normal person would well go to lunch he kept himself very much to himself um he'd play on his own for hours absolutely hours and he was asking what he was doing and he'd say he was playing in his head and with hindsight now i thought to myself i wonder if that was particularly normal whether it was a portrait of things to come [Music] i'd end up walking around with with pictures of him when he was little um and just looking at him and the photographs and thinking how has this happened how how has how has it come to this [Music] after all i lost i lost my james i lost my little happy loving little boy morning how are you um [Music] how that will go should we let you get on is that right yeah so far james's therapist anna has been coaxing him out of the toilet but now four weeks into treatment she wants him to try and get out by himself she set him a target of seven minutes the average time most of us spend in the loo so how long ago is that you know probably about three years ago and what's your boyfriend's name les helen is being treated for an irrational fear that she's harmed people specifically that she's put strangers in rubbish bins would you ask him to check things like bins and yeah yeah that just built up and built up until um he got sort of fed up with it completely fed up with it and yeah took me home to my mum do you love him yeah i do yeah still do we were together for about eight years various times he sort of tried to prove to me that you can't fit people in bins for example by standing in bins in the middle of them supermarket car parks himself um yeah sort of screaming and railing them [Music] since the break up helen has lived as a virtual recluse she hasn't left the house or been to work for two years today she's doing a practical experiment confronting her fear head-on she's heading to a busy part of london where she'll be surrounded by strangers if you're going to walk down the street just kind of walk i want you to kind of wander in and out no stopping no no pausing just kind of continuous what's your prediction what do you think might happen that i'll see people that i'm worried about and i want to check so you are going to feel anxious and if you're not we're not doing the right thing right okay how was that all right quite bad i'm worried about a man and a woman that went into disney store yeah what do you think you could have done putting the man in a bin and his wife would be missing him it's almost like a physical urge when i'm walking down and people are going past streaming past i feel like every now and then catch somebody and it's like a physical worship at least to turn around and you're getting kind of in the corner of your country and it's at some point that person will have insight today i know this is stupid but i know i'm not going to do anything but at the time it feels like it so there's a difference that the feeling is not a fact is what they have to learn it feels real and it feels dangerous but actually it's not and they feel responsible and it feels that the fact is real but it's not we and that's what we do in the behaviour experiments and testing that out let's find out if that is the case are you getting on james um well i've had more than the amount of a lot of time for going to blue i'm just trying to remember all the things that are sort of helpful the things that i'll never say or and just the sort of things that you know take the risk you know and you know james's fear is that he might himself in public if you do yourself you know it's not the end of the world you know because it's a safe environment he's been in the toilet for almost an hour but it's hard because you sort of you keep thinking oh oh but then after i'm in the shower i'm gonna get dressed and now if i'm getting dressed i'm gonna be outside and around while something happens then his arrest by a police investigation the jesus [Music] it's his whole life since he was about 16 17 has been completely ruined by it and that's the only way i can describe it it has he hasn't had a life it's like somebody being in prison [Music] the first person to be arrested as part of the investigation which is following up 400 lines of inquiry all these times he's ever gone in anywhere it's it's been absolutely heart-wrenching to to take him and leave him somewhere and walk away and especially an actual you know mental hospital [Music] james lives with his mum on an isolated farm in the cotswolds run by his grandparents as a teenager she watched him go in and out of various psychiatric institutions each time he came out james would feel better until his ocd took hold once more i guess i just need to ask one question last year his condition became so severe he had to drop out of university where he just started a drama degree it's not what it's not it won't get any marks well then you have to do it and work to that one essay now i don't understand why do i need to do more work if i want to do you one again well you're stupid that's right because they want you to live here too that's up to you you're gonna end up not even going back to university oh we can't sit in this you'll be a student here thirty [Music] christmas [Music] why i decided i'm sure that he can beat this because he really needs to get back to university he really really wants to get on with his life and i really really hope that that this helps but i know that because he's relapsed before that it would be completely unrealistic of me to think this is the cure to end all cures and he'll be all right because ocd never goes away he's got to learn to manage it i just now i feel like it's been with me long enough and that because if i don't get on top of it now then well that's it really i'm just gonna be sort of uh stuck with the ocd and not being able to do anything like i really don't want to be a sort of a waste of a human the police currently have eight formal allegations against jimmy savile and six of indecent assault but they say information helen has been making good progress but a car that's been abandoned outside the hospital has set off another anxiety but somehow she's caused a road accident all morning i've been worried and i dreamt about driving worried if it was real not a dream that i've been out somehow taken stolen in the castle and driven in and now there's an abandoned car out there so it's like it must have been me i think it must be done since it was true i must have driven in oh my god when a patient starts to obsess the therapists are trying not to give reassurance it risks turning something completely irrational into something real it must have been me myself is to another explanation for it nothing you may have done it i'm not saying you didn't but what's the likelihood quite likely how serious and you've gone out without knowing about it despite me salutation across your door well i had dreams about driving okay we all have dreams i don't know if it was a dream must have been real maybe it is but we're never gonna know so you're gonna take a risk might be true the week's up until now i've been doing well so and then maybe it's just evening out i don't know but yeah not so good helen's condition like many patients here is driven by a less well-known aspect of ocd called intrusive thoughts so who's this this is our ocd bully and it symbolizes what people here are trying to fight every day often they think of people like it's like a devil the oecd inside them the question mark on its head is there for the intrusive thoughts that people have the mobile phone for often gaining reassurance from people i mean words one of the important ones is pedophile written right around here because that's a really common intrusive thought people have about the fact that they think oh my god am i a paedophile if i have a thought like that and so that's a common intrusive what people have most people having trees of thought i get one quite regularly on the way to work i pass this little school and um sometimes there's a nice zebra crossing and there's a lollipop lady there and these little girls come out and they're all holding hands and they're dressed in school uniforms and if i'm at the front in my car i have this intrusive thought sometimes just to put my foot down and ram them all because they all look so nice when i say that you just have this new thoughts go on just ram you know run them down it doesn't mean anything and i don't worry about that at all it's a normal intrusive thought to have but if somebody thinks oh my god does that mean i'm some sort of child killer am i lied to that they may start going a different way or really worried about if i act on that thought it gives credence to the thought has validity and has some sort of meaning so with intrusive thoughts once you get one that gives you anxiety if you act on that anxiety and do anything about it it's more like to carry on i just i get intrusive thoughts and and it's sort of you know thinking oh maybe you could do that or like suggesting like you know you're in your house and then [Music] like the thought of incest might pop into your head for some reason and um and you think why the hell is that there i you know i don't want to do anything like that and you then you try and get rid of it because you thought why is it there because like i'm i'm a freak i'm abnormal why would i have to talk no one else has these fours you don't talk about that you sometimes get these thoughts for no reason and then you you just you start thinking of trying to waste trying to deal with anxiety that was the most distressing aspect of all of this when he was in the room with us we were triggering all these thoughts off and that you can't even put into words how that made me feel and hannah it was just terrible [Music] james has never spoken to anyone about this other than his mum and sister hannah his unwanted thoughts feed off each other escalating from incest to james's worst fear that he could become the thing he despises most what i've done is i've printed off just some articles i've got one on well i've got the wikipedia on joseph fritzel right um a picture go glitter an article about sort of jimmy savile and gary glitter but also we've got um a picture in this one of joseph ritzel like the toilet obsession the therapy continues to be about confronting the fear avoiding it makes it grow stronger james just just talking about them what's that brought up for you i don't know if i that i could be like them if i don't ritualize or try and control my thoughts in some way i might be like they might have thought oh they're nice people i or something like that i don't know um so just even thinking about them as making you feel well i've been virtualizing every time i see the picture it's sort of like i'm always being infected by like some sort of i don't know black tarry sludge or something coming into me i'm a cement like the the sort of the chant i have but i'm not such a second rapist like a pedophile ancestors necrophilia so i feel like if if i just give give one inch or one millimeter of of anything then that will be the start of like a slope where i'll be falling for precipice and i would that would lead to me becoming a beatle or wanting to be one or something like that [Music] oh [Music] he couldn't deal with seeing any family pictures or anything else because of the intrusive thoughts so i put all the pictures in here if you ever came in here let me use this for an example he picked that picture up and he'd look at it and cover it up and they look at it again and cover it up and try and cover it with something and then you'd look it again and cover it up and that could go on for well 20 minutes half an hour even longer this jimmy savile thing's not been brilliant and i've got the point in the end where i wouldn't have the news on because nine times out of ten there would be something about that and then it would trigger it all off again though it seems absolutely incredible to anybody else outside he absolutely genuinely believes that that is what's going to happen no matter how ludicrous it is we know that ocd always goes to the most disturbing place and if it's not to do with um the thing he's worried about the moment with children it'll get worse and worse and worse it always will try and go to the lowest common denominator that's how our thoughts work particularly things like worries about being a paedophile that's everywhere at the moment everybody's concerned that you know everybody's cut all these people that we respected are suddenly becoming paedophiles so we worry if we have thoughts any even anywhere near that we must be bad to have the thoughts about it in the 80s when i started this work people worried about how have i caught hiv you know any they would be suddenly worried about anything that was read oh my gosh that's my source of blood am i going to get hiv and intrusive thoughts there and nowadays there is the kind of media obsession with pedophilia and rooting out and finding it a much more rife than it is and so it's quite natural that it's around that those are the concerns that people have [Music] so i placed my water bottles popping over the northern door can we open the window little curtains a little bit um was that tricky can we can but i shouldn't be getting like this once you get into your glove mode you can see here i've got my clean gloves set out leon is a vegan i'll just take off this pair which actually already a bit icky over time his beliefs have spiraled out of control and what are you using that there's disinfectant down there what how often are you using that for what don't tell the therapist this [Laughter] she's saying have you been using that does it factor is it my main thing i don't using disinfectant that much obsessed by the idea of being contaminated by anything that's dead even an insect is that about a week's worth or less oh this is only about days of us at 55 he was older than most patients in the recycling bin it didn't seem as desperate to change get rid of these your hands are so translucent now it's difficult to tell whether you've got gloves on or off i can tell you know this shakespeare thing we said madness creeps in little by little it does [Laughter] james was still a young man halfway through his 12-week course his anxiety seemed to be improving over the last week he'd been getting out of the toilet in less than 15 minutes but with the unit closing for christmas it was time to return home to his mum how are you feeling about going back for a couple of weeks quite anxious actually i guess because christmas is right like you're supposed to everything's supposed to be fine and good and happy and wonderful and i feel like there's there's a little bit of pressure thing because i so wanted by the time i got to this stage i'd be like it's not better but like in a good enough thing that my mom could really notice and like i wouldn't up christmas not that i ever had but like last year uh i got up and i was like oh i was in the toilet and i didn't have my christmas dinner until like after three o'clock because i was in the bathroom up until then so uh i hope that won't happen this year we'd arranged to visit james back at home over christmas the morning we arrived he was stuck in the toilet things hadn't been going well jamie james how are you doing do you want me to come give you a shout in five minutes okay and do you think you might be ready then okay i'll give you a shout out in five minutes then wednesday night there was a film on the television about um alfred hitchcock i call a girl and he's a a big fan of alfred hitchcock and his films and he watched it and he just went into meltdown afterwards because i didn't see it but hannah said what a horrible man and it was um about his relationship with tiffy hedren and james just he just freaked completely he was he's saying he had to get away he he was he was a horrible person meaning james was a horrible person he might be like alfred hitchcock he was horrible he was awful um and i ended up having to lock all the doors and hide all the keys the film portrayed hitchcock as a sexual predator watching it had triggered james's intrusive thoughts he's getting angry frustrated shouting screaming at my sister telling me i wanted to die for house i wanted to die i mean i just i feel um [Music] you know bringing that one mom insists i'm having interest so the rest of the family i've been seeing i just i just feel guilty for having his intrusive thoughts and i really wish i wasn't having them and in the end i managed to persuade him to to get him to bed and he got to go because he was fully closed still and i thought if he gets into bed maybe he'll go to sleep and calm down and he did and when hannah manuel was asleep then we went to bed but we both sat up on the landing for ages how are you doing jamie okay do you want me to give you another shout right so you don't want me to come and give you another call in five minutes oh he says that's not helping so he's been in there for nearly an hour now when you're doing all this treatment and everything else and i guess this is what ana's told him is that the the last thing that actually goes we go is the actual intrusive thoughts and the anxiety about it he said you've got to go through everything else to get to that well now that makes sense so if that's the point he's at now this is why all this has happened and if that's the last thing he's got to let go then hopefully in the next six weeks or whatever that will also go and then then hopefully he should be able to move on i'm layla hussein and this is my mission it's called female genital mutilation to stop this barbaric custom you've got to get enough evidence for a prosecution once and for all rich girls are being cut right under our noses fgm is child abuse we are not going to let it go the crew cut wednesday at 10 45 on 4. after a major relapse at christmas james's returned to the anxiety unit he has just four weeks of treatment left he can't seem to beat the ocd bully that's controlling his anxiety so just imagine the moment the bully the self-critic of yours is over there you know what james um you you you know you need me um because if it wasn't for me you know firstly um i mean god knows you know what horrible evil things you would have done and second um you know that's you know you probably would have yourself long ago and you know third you know if it wasn't for the you know things to do you know you'd be deluding yourself thinking you were good at anything that people liked you that um that um you had any friends because you know you don't uh you know everyone hates you really um and that that really you know you're a worthless human being really aren't you i mean let's face it you know um skinny scrawny um and just um pretty degraded you know piece of dirt so um if it wasn't for me um you know you'd be in a really position [Music] i don't have a sense there's lots more information we can give you it's actually about you now taking what you've learned and doing doing doing and practicing practicing practicing repeating repeating repeating it's not as being sort of mean or harsh it's about saying let's kind of switch gear now so it really becomes something that you're you're kind of um you've absorbed everything and you're applying it are you scared i'm scared i'm scared for him i'm scared for what the future might hold because if if this fails for any reason where else do we turn [Music] helen's time at the unit has come to an end so you know john's been at him over extension i'm really sorry no i think no today i realized it's time to go anyways yes well i think it is time yeah you've had the longest extension of anyone i've ever worked with had a good one pushed it as far as i can get it if we kind of reflect on the first day here yeah that's the thing to remember yeah how long would it be before you left home two years yeah yeah not leaving the house that's about you kind of having that confidence because it's kind of really up to you now um i really don't want to go give me a hug the thing is she's taught me what i should do and what i shouldn't do that's it you know it's just entirely up to me now to to implement what i've learned and not be doing i shouldn't be doing what i'm doing still but somehow i can't sort of get over the last hurdle of it james has reached a critical point in his treatment anna is going to challenge his fears around the toilet in the most extreme way so just just keep giving me feedback on on what's happening james he's now he's like taking it stage further now she's yeah yeah to really try and kind of um recapture that um or those sensations but also that really sort of uh risky i suppose feeling for him that you know he's making it even more likely he's going to himself um and then what he's going to do is just get up and leave the toilet so kind of really sort of pushing things as far as he can really [Music] keep going games there's a fair bit of poo but i haven't worked and is that okay that's just what we agreed to keep going james have you got your trousers up yet yeah okay you ready to come out not really but yes go for it [Applause] okay should we go and try and sit down [Music] james you've done absolutely brilliantly have a seat well done [Music] i can't wipe until i actually go to the toilet properly again yeah absolutely this hopefully will actually be something that kind of stays with you because it was quite a difficult experiment yeah what is perhaps really important is you leave from here now and you write down exactly what you've learned thank you anna [Music] we've been told the key to making people better here was when they finally got insight when they saw their greatest fear it was just a fear and not a reality it felt like maybe james had got to that point okay today i did experiments i was on the loo moving sat in one position one position gone strained no wiping just got out straight away and been around knowing that there was probably almost 100 percent of probably his faces on almost but that's the world didn't end as soon as i sat down for the first time because i felt like it was going to and remember that i remember that i've done that i've done that i've done that um and it's okay [Music] when james came to the bethlehem royal four months ago he told us this was his last chance to get better today he's finally ready to leave i would i would like to say um thank you to to each and every one of you when i had my assessment i i i was thinking back of mine i probably wouldn't be allowed to come here and then when i got here i didn't think i would probably end up making that much progress and though yes i mean it's about me doing it on my own and that's that's all that but but i don't i i i wouldn't have been able to do i wouldn't be it yet to do what i've done or um basically be able to yeah have a have a life now and and i'm sort of now i'm able well i have the the chance to do um what i i want in my life and i the ocd hopefully won't stand in the way and that's that's that's down to all of you you basically transformed my life for the better and for that i think i will i will always be eternally grateful sort of till the day i die so thank you certainly the best i've ever been since i've had ocd [Applause] i'm sort of getting there i am i guess fully discovering myself and not taking into account the ocd the ocd isn't coloring who i am or my behaviors or anything it's i am becoming the person who i am this is almost like a a good like i've been for a nightmare for god knows how long and now i'm entering sort of like a good dream uh but it's but that's all it is it's a dream and it might be taken away from me so i just still want to let that happen yeah [Music] is it hard really yeah [Music] [Music] [Music] for those we'd met at the hospital it wasn't so much about finding an absolute cure it was about learning to deal with the anxiety and then staying on top of it [Music] although helen was still struggling with her thoughts she'd actually made it back to work after two years of being stuck at home [Music] she still hopes she can get back together with her boyfriend aaron's anxiety hasn't gone completely but it doesn't dominate his life anymore and he no longer hides it from those closest to him [Music] as for james six months on he's returned to university in exeter to redo the first year of his drama degree so far he's kept his ocd in check and is enjoying a life free of anxiety [Music] i see this may seem a bit weird but yeah i just um yeah i'll just do it thank you and bedlam continues next thursday at 9. if you've been affected by the issues raised in this program support can be found at channel4.com support next tonight the late night unsung heroes helping us out when we need it the most gp's to break down mechanics we're up all night with those who are on call you're gonna take me

Channel: Dr David Veale

Views: 448,620

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Id: E2W9guFmheI

Length: 47min 47sec (2867 seconds)

Published: Sat May 22 2021