In 1973, at the age of 23, I attended school to study to take the state examination for a license as a Psychiatric Technician (PT). The classes were subsidized by, and took place at, Atascadero State Hospital (ASH) in Central California. College credits were given through the local J.C., Cuesta College in nearby San Luis Obispo. In conjunction with the classes, students were allowed, and encouraged, to work 20 hours per week in the hospital, as a supplement to the clinical hours required to complete the courses. So began my journey in the mental health industry, and unknown to me at the time, down the path to darkness…..

The hospital at Atascadero is a maximum security facility that houses up to 1200 individuals, who are committed to the bleak, prison-like hospital by the state courts, having been judged as being either unable to stand trial due to being unable to understand the charges, or because they were unable to cooperate in their own defense, due to mental illness. Some of these men (it is an all-male facility; women in the same legal categories were housed in another facility) were also committed by the courts as being Not Guilty by Reason of Insanity, or were those who had manifested symptoms of mental illness after being convicted of crimes and sent to prison. A very few of them were not insane, but were master manipulators, career criminals with very good lawyers who had convinced the court to send them to the hospital rather than prison. These individuals caused a great many problems, as they would manipulate their less functional peers into giving up their property, or doing their will, or  incite them to violence, just to watch the results from a safe distance, for amusement.

Working in a maximum security facility as a therapist is possibly one of the most difficult jobs man has ever created. A prison-like environment makes it difficult to create the ambiance necessary to allow the men being treated to feel safe and comfortable enough to deal with their individual problems. The danger of housing so many people with mental illness is an ever-present and overriding concern, as one of the primary characteristics of those with these types of diagnoses is a lack, or even absence, of impulse control. As a result, managing assaultive behavior becomes a necessary adjunct to treatment.

The Department of Mental Health, working with employees from all the state hospitals, developed a policy for dealing with the issue; subsequently, training in Management of Assaultive Behavior (MAB) was given to every employee who came into contact with the committed individuals. Since the facility was classed as maximum security, the training was especially important for the Hospital Police, who were responsible for maintaining the security of the physical plant, and for the therapists (psychiatrists and psychologists, nurses, psychiatric technicians, and ancillary staff such as occupational and rehabilitation therapists) who were the primary care-givers for the individuals. These teams were taught specific techniques for recognizing the warning signs of impending violent behavior, how to re-direct when possible, and methods for physically controlling individuals who were acting out in a violent manner, without causing or sustaining injury.

Most of these principles and techniques, if not all, were very similar to the Judo and Kung Fu that I had been taught, so my prior training and experience became valuable tools for me, helping me to be skillful in keeping safe both the aggressors and victims involved in the violent episodes so frequently found in settings such as ASH. I became one of the people who specialized in MAB, which necessarily meant that whenever a violent incident broke out, I was one of the first to respond, as I was adept at controlling the situation without any of the participants sustaining injury, the primary goal in such instances.

Working in such a high stress environment as a maximum security hospital was both physically and emotionally draining, and after three years at ASH I had had enough. I moved north to work at Napa State Hospital, in order to get back to being a therapist rather than a glorified cop. I obtained a position as a PT in a treatment program for adolescents at NSH in 1976. To me, it was  a wonderful change; the kids in the program, lived ina co-educational environment, and were smaller as a rule than the full-grown men I was used to; in addition, there were far fewer individuals who had already learned to resort to violence, compared to those who were housed at ASH. It was also different for being co-ed, as I had previously not worked with any women, or girls, in a therapeutic setting. Because of my experience in MAB, violence on the unit where I worked became a non-viable behavior for the adolescents, and after a few months the number of incidents that took place on the unit were greatly reduced.

After a few years at NSH, I decided to take an extended sabbatical from working as a PT, and traveled around California for a few months, until not working became a bore; I was raised to be productive, and needed to get back to work. I applied to and was hired to work in another state hospital in Camarillo, a relatively small town near Ventura in Southern California. At CSH I once again worked with adolescents, as they had a similar program, patterned after the one at NSH. My martial arts training, which I had continued all this time, once again proved to be a valuable tool, and I again became the first responder at any outbreaks of violence among the individuals under treatment.

However, the damage to my psyche that had accumulated through the years had by this time reached an unprecedented and dangerous level, and I was finding it extremely difficult to maintain the now uncertain equilibrium I had achieved. My experiences had left me burdened with an indelible, hidden wound in my soul, in my very center. The experiences to which I’d been exposed eventually culminated in one specific incident that brought all of my pent-up stress to the surface, and affected me so deeply that I still feel the effects today……I became, quite literally, one of the “walking wounded”, a condition with which my generation, due to the Vietnam War, had become all too familiar. It was a single incident, that happened one night in 1984, and to this day I have never fully recovered…..

To be continued…..