It is stressful working in these institutions. Over the years I've gotten better at handling the patients. I've subscribed to the stoic's idea that you can't control what happens, but you can control your reaction to it. If they curse and abuse me, I ignore it. I block it out so well that later, I can hardly remember what they said. However, I can't escape this feeling of failure when things go wrong, when I don't handle things the way I wish I could.
Once a month, all us supervisors have an appointment with a psychiatrist. They call it a 'wellbeing appointment' - where they check in and make sure that we are coping okay with the challenges of working here.
Dr Reynolds is bald and has wire rim glasses. He offers me a glass of water from the jug on the side table.
'How are you coping?' he asks, as way of a greeting.
'Okay,' I say. 'You know how it is, there's good days and bad days.'
He nods his head. 'What does a bad day look like for you?'
'It's one of those days when nothing goes right, when I feel as though nothing I say has any resonance, where everyone does the opposite. I feel helpless and insignificant. The other day, Melina had a meltdown, it was dreadful, she was crying and screaming and scratching me. She grabbed a stick from the garden and she was going around and shouting and smacking that stick against those signs near the tennis court and it was the greatest racquet and there was nothing, absolutely nothing, I could say to calm her down. And then two security men came and had to sedate her, and I felt like I'd failed. I shouldn't have let it escalate to that. If I'd been better at my job, it wouldn't have gotten to that point. Even after all these years I feel like an imposter.'
'But you have to understand Sylvie, that we are dealing with the unpredictable here. It's a team effort. You're not responsible for any one patient. It is a combined effort of psychological support, medication, eating well, sleeping well, exercise and friendship. You are not responsible for one meltdown. You shouldn't take this upon yourself. You have to look after your own wellbeing.'
He pauses and checks his notes. 'What else is bothering you?'
'There's another supervisor, Bernadette, who is always undermining me in front of my patients.'
'In what way?'
'I have a patient, Brenda, and she has severe PMDD. It was her time of the month. So you know ... she's moody. I mean, off the scale moody. It's a real condition. I hadn't heard of it before. Apparently she tried to kill her husband. Anyway, I'm already walking on eggshells around Brenda, because anything can set her off. We were having a green lunch picnic outside on a picnic rug and some of the male patients had joined us, as a way of 'socialisation' for the ladies. Anyway, Brenda was being very rude and sullen, and I was feeling the pressure to steer the conversation very carefully in case she had an outburst.
'Bernadette's group was on a rug nearby, with their male group also next to them. And nobody was talking in their two groups at all. You see, Bernadette doesn't set a very open and pleasant environment for her patients to feel comfortable to converse. Anyway, I was talking about a book on architecture that I'd read from the library, about futurism design in Italy, and it was all very interesting, Mike, in particular, with schizophrenia, was very interested as he'd travelled to Italy with his wife. Anyway, we are all really enjoying ourselves when Bernadette came over and said, 'Sylvie, stop dominating the conversation.' Which is ironic, when nobody, literally nobody, in her group was talking at all.'
'So how did it make you feel?' he asks.
'It felt humiliating to be told off like that in front of everyone, like a child, when really, I'm the only one in those god forsaken groups who was talking about anything of interest at all.'
'Were you dominating?'
'No, god no. I was steering. For Brenda. She was having a tough day.'
Dr Reynolds flicks a sheet over on his clipboard.
'What would have happened if you hadn't been talking about futurism design?'
'It could have been awkward. There might have been nothing for anyone to say. Brenda might have felt uncomfortable about all those men.'
'Sometimes we just have to sit in silence,' Dr Reynolds observes. 'You don't need to feel responsible for every conversation. It's meditative to be comfortable in silence.'
I look at the analog clock on the wall.
'Last time we met,' Dr Reynolds says, 'we were talking about your mother, and the emotional neglect you suffered as a child. I feel like we should pick up on that ...'
I put my hand into my pocket and draw out a tissue. I keep it scrunched in my fist. We've spent the last three sessions on my mother and I find it tedious and cliched and misogynistic to draw a fault line from the matriarchy. But I have a 45 minute session, and he never seems to want to talk about my patients or Bernadette, so I humour him and talk at length about my mother and how busy she was with her job and how she lacked sentimentality and always preferred my sister to me.
At the end of the 45 minute session he decides to up my anti-anxiety medication.