45 years ago, Christine Lawrence started her career as a psychiatric nurse at Knowle Hospital near Fareham. Later in life she would publish Caught in the Web, a fictionalisation of those early experiences. How did Christine make this unique journey from practising mental health to writing about it?
I started nursing at a time of great changes in mental health care, but there was still much more to be done. My first experiences were in a ward that was still locked, although most of the patients were allowed out to go to the occupational therapy or industrial therapy departments. Some were permitted to walk to the town of Wickham, or the hospital shop.
From the late 1950s my mother worked in the same hospital. I remember visiting her on occasions. You entered the long ‘gallery’ ward with small rooms all along one side, large dormitories and a ‘day room’ on the other. There were high ceilings with tall windows allowing in plenty of light. The ‘backs’, which were the bathroom and toilet block, were off the side of the ward which housed over 100 patients. Long-stay ‘chronic’ patients on each ward would work with the staff, making beds, cleaning, setting tables, clearing away, making tea and generally helping nurses with the day to day care of the less able patients.
The wards were segregated – a female nurse would never see a male staff member during a shift, only in the canteen during their break. Even then the staff sat apart from each other. Sisters would sit together and not mix with staff nurses, staff nurses would sit together and not interact with the junior staff. Nurses called each other by their surnames. Doctors had a separate restaurant which was waitress service only. This only changed during the 1970s.
My father also began working at the hospital in the early 1960s. With one parent on night duty and the other on day shifts, it was a strange childhood, spent creeping around the house after school trying not to wake whichever parent it was who was trying to sleep at that time. At work, their paths rarely crossed.
During my childhood there were many occasions when we attended parties and discos at the hospital, mostly during the Christmas period. These would be in the large ballroom or the entertainments hall. There was a pantomime each year that the staff would take part in. I remember Dad being cast as the Giant in Jack and the Beanstalk, and being terrified of him as he came into the audience in huge boots which had inbuilt platforms. I still find it amusing to think that I was more afraid of him than of the patients who were sitting beside me.
Patients walked about the grounds all the time – I was used to seeing them wandering about. Women’s hair was cut in straight pudding basin bobs, and they wore loose, shapeless cotton dresses. Men’s trousers always seemed to be too short. The patients mostly walked with a strange gait – a result of the long-term side effects of their medication, although I didn’t realise this until much later.
In 1973, I started my own training. My novel, Caught in the Web, begins with my first day working on a ward. Although the book was written from my recollections, all the characters are fictional and my priority was to tell a dramatic and intriguing story. In that period, mental health treatment was improving all the time and, as well as the physical treatments, we were using more and more talking therapies, particularly group work, much of which was held in outpatients and day centres. Most of the wards now had an open-door policy and were gender integrated. Numbers had reduced to 30 patients per ward.
During my training, we were expected not only to learn about group therapy – we had to experience it. Each time we were in the training school, we had to attend such sessions with our peer group. Sometimes it was enriching, other times traumatic, but it gave us an idea of what it was like to be ‘in treatment’ and we certainly bonded as a group.
At the onset of the Care in the Community programme, I shadowed community psychiatric nurses, visiting those who had been discharged from hospital into the community – often unsuitably placed in bedsits in Southampton, with nowhere to go during the daytime. That said, Southampton had an effective day centre that gave good support to those patients. Many more – who may previously have been admitted to hospital instead – were treated in the centre as outpatients.
I started working at St James’ Hospital in 1986. By this time, community mental health services were in full swing and my job for a time was to run clinics across the city of Portsmouth, giving patients who were living independently in the community their depot injections. The injections were long-acting phenothiazines which were designed to keep the patients ‘well’ and able to function without having to be treated in hospital, or to rely on taking medication orally. I worked for the next eighteen years in Substance Misuse Services, both in Portsmouth and in Southampton, mainly in people’s homes, helping them to deal with their drug or alcohol problems.
I have also experienced the other side of the fence, as it were, although I have always felt that there is no fence as such – most of my colleagues have experienced mental health issues themselves. In my twenties, whilst still training as a nurse, I suffered from depression and was treated with anti-depressants. I was told that I would never become a nurse. I did.
In 2001, I was attacked by a patient and was afterwards diagnosed with post-traumatic stress disorder. I was off sick for two years before I was retired due to ill health. In addition to the assault, the problem was work-related stress. I’d been leading the drug and alcohol services in Southampton – not an easy job. They said I would never recover. I have. Although sometimes I do suffer flashbacks, I have a good life and have learned to live with the trauma.
Part of my recovery plan was to go back to university and study English literature and creative arts. After that I completed an MA in creative writing. I was 61 years old. This was the beginning of a new and delightful career.
Working towards an MA was a great motivation and having the luxury of feedback from peers and tutors was brilliant too. I ended the course with 40,000 words of a novel, so finished it off after I graduated. Much of the novel is descriptive and inspired by my memories of the places and people of that period 1955 to 1975. I researched films and music of the time as well as pregnancy testing. Fashions, places, medications and treatments were dredged from my memory. I used the internet for much of my research, but also read many books and used the Portsmouth University library to search for journal articles. I spent a lot of time talking to my mum about her memories of working at Knowle and read accounts of staff and patients who lived and worked in both Knowle and St James.
Caught in the Web is available worldwide on Amazon and can be ordered through many good bookshops. Marketing is a massive part of writing a novel – if you want people to read what you’ve spent all that energy working on, it’s worth doing well. So I contacted the local news, Radio Solent and Express FM. I organised book events for myself at several bookshops, cafes, Fareham Museum, and appeared at Portsmouth Bookfest. I talked in working men’s clubs and at other local organisations. I attended a Re-Authoring workshop which led me into joining the Portsmouth Writer’s Hub, Writers@Lovedean and New Writing South. And, of course, I write articles and stories for Portsmouth’s own Star & Crescent.
These connections have led me to perform at many writing events: Day of the Dead, St. Valentine’s Day Massacre, Portsmouth Fairy Tales for Adults launch and promenade, the Edward King project, Holmesfest, Premature Articulation and DarkFest. This year I have become involved in the organisation of writing events, together with a team of wonderful writers. We organised this year’s Premature Articulation and St. Valentine’s Massacre and are launching a group of performance writers under the name of T’Articulation, so there will be even more exciting events to look forward to.
Do I make money out of writing? Last year I earned £860. This was mainly from talks and readings, although I did get paid £200 for my Edward King story and I’ve recently taken a course in journalism, so maybe there is a financial future there!
Images courtesy of Christine Lawrence.