Chapter 26 — 2007
A psychiatric crisis, changing diagnoses, involuntary treatment and the evidence that later raised serious questions about the diagnosis which survived it.
2007
Some years in a life become reference points.
2007 became one of mine.
It entered my medical history as a psychiatric year: admissions, diagnoses, medication, involuntary treatment and eventually the label “paranoid schizophrenia”.
That label would outlive the circumstances in which it was created.
Years later it would still be capable of arriving in a hospital before I did.
But when I go back to the records themselves, 2007 is considerably less simple than the diagnosis which survived it.
The diagnoses changed.
The explanations changed.
The medications changed.
Some observations recorded at the time appear difficult to reconcile with the label which eventually became dominant.
And my own experience of that year was very different from the shorthand which later appeared in medical files.
Before the Admission
I had already been struggling for some time.
My marriage had broken down. My son Johl was no longer living with me. There were financial pressures, the collapse of parts of my business life, continuing conflict within the family and the resurfacing of experiences from my own childhood.
I had been seeing Sandy Collins for counselling.
I was trying to deal with childhood sexual abuse while at the same time being intensely concerned about what I believed had happened around my own son.
Those things became entangled.
I was distressed, angry, frightened and increasingly unable to keep the different pressures separated.
None of that requires schizophrenia in order to be serious.
Inderal
There is one part of the medication history which began before the psychiatric admission and which I remember quite differently from the drugs that followed.
I had become interested in propranolol some years earlier through reading about post-traumatic stress.
Propranolol is an old beta blocker, commonly known by the brand name Inderal.
I wanted to try it.
The medical record later reviewed by Dr Georgiana Antoce records that on 26 February 2007 I asked for a trial of propranolol for PTSD. The doctor did not regard PTSD itself as an indication for the medication but was prepared to prescribe a low dose for physical symptoms such as tachycardia and sweating.
The recorded starting dose was 10 milligrams twice daily.
By 1 May the same record says that I was doing very well on Inderal. It records that I had increased the dose myself and refers to settling on 40 milligrams twice daily, subject to adjustment.
My recollection is simple.
Inderal helped me.
That experience became important later because the psychiatric drugs I received during and after the admission felt very different.
More Than One Diagnosis
One of the most important things I discovered much later is that there was not one clear diagnosis running through 2007.
Dr Antoce's 2021 review of the Toowoomba Mental Health Service material records a series of different diagnostic descriptions.
They included adjustment disorder with depressed mood.
They included bipolar affective disorder.
They included paranoid schizophrenia.
They also included a drug-induced psychotic episode.
Those are not interchangeable descriptions of the same condition.
They involve different diagnostic ideas and potentially very different treatment decisions.
Yet, of those descriptions, it was “paranoid schizophrenia” that acquired the longest institutional life.
What the Records Also Say
There are other entries in the 2007 material which matter to me precisely because they complicate the later shorthand.
Dr Antoce noted that during the August 2007 admission she could find no documentation of active psychotic behaviour or symptoms apart from repeated references to my concerns about my mother-in-law and my son, and discussion of my own history of sexual abuse within the Catholic Church.
She also noted that conclusions about dangerousness appeared to have been inferred more from those statements and from descriptions of my earlier behaviour than from active threats or behaviour documented during the admission.
The records contain other observations.
A nursing entry from 13 July describes me discussing past sexual abuse and behaving appropriately and without symptoms after validation and counselling.
There is documentation of what was described as regressive or dissociative behaviour, including an occasion on which I was found sitting in a cupboard crying and calling for Sandy.
A mini mental state examination recorded a score of 29 out of 30.
Those observations do not settle a diagnosis.
They do, however, belong in the same history as the diagnosis.
Being Back There
One entry in particular now seems important.
On 19 July 2007 I was recorded as being uncomfortable because I had been told that I would be restrained and tied if I refused treatment.
The same entry records me explaining that being on the medication made me feel drunk and was bringing back painful memories of childhood abuse.
That connection is not difficult for me to understand now.
My childhood contained being tied, restrained, held against my will, physically overpowered and being made unable to leave.
Then, as an adult inside a psychiatric system, refusal of treatment was being answered with the possibility of restraint.
Whatever the clinical reasoning behind that process, my nervous system did not experience it as an abstract medical procedure.
It took me back.
The Cupboard
The image of me sitting in a cupboard and crying can be read in more than one way.
Seen through a psychiatric diagnosis, it might appear bizarre.
Seen through what I now understand about dissociation and traumatic re-experiencing, it looks different.
I had spent much of childhood finding places in which to hide or escape.
I had learned to withdraw when the situation around me became impossible to control.
Years later Dr Julian Lim would diagnose Dissociative Amnesia and help me understand much more about the way memory, overwhelming experience and disconnection had operated throughout my life.
That later diagnosis does not automatically explain every behaviour in 2007.
But it provides a serious alternative framework which was not available to me in the psychiatric ward.
The Diagnosis
I dispute the diagnosis of paranoid schizophrenia.
I do not dispute that I was distressed.
I do not dispute that some of my behaviour could have appeared unusual.
I do not dispute that I was overwhelmed, that traumatic memories were intruding into the present, or that I could become intensely focused on what I believed had happened.
Those are different questions.
The question is whether the evidence supported schizophrenia.
For many years I did not have the knowledge or the records necessary to ask that question properly.
Eventually I did.
Knowing My Own Voice
There is one aspect of the schizophrenia diagnosis which has become more interesting to me as the research has developed.
I have always had an internal dialogue.
I think things through.
I argue with myself.
I rehearse possibilities.
I question conclusions.
I sometimes return repeatedly to a problem until I feel that I understand it.
But I have never had difficulty knowing that this dialogue belongs to me.
I do not experience my thoughts as somebody else speaking to me.
I do not mistake my internal dialogue for a voice coming from somewhere outside myself.
I have never had difficulty distinguishing the two.
That became interesting when I began reading research into auditory verbal hallucinations and schizophrenia.
One continuing line of research examines self-monitoring and what is called corollary discharge: mechanisms by which the brain predicts and identifies the consequences of self-generated actions, including speech.
Some models of auditory verbal hallucinations propose that a failure in these mechanisms can contribute to internally generated speech or thought being misidentified as coming from an external or non-self source.
This was not simply an old hypothesis which disappeared from psychiatric research.
Research continued over subsequent decades, and studies published in 2025 and 2026 were still reporting abnormalities in corollary-discharge, reality-monitoring and inner-speech systems among people with schizophrenia-spectrum disorders, particularly those experiencing auditory verbal hallucinations.
That research does not provide a simple diagnostic test.
A person cannot be declared free of schizophrenia merely because they recognise their own inner speech.
Not everyone diagnosed with schizophrenia experiences auditory hallucinations, and not every hallucination is explained by one mechanism.
But the research interests me because this is one area in which my own experience has always been very clear.
I know my internal dialogue as my own.
I always have.
Not Just My Recollection
The absence of hallucinations is not merely something I now say while looking backwards.
Later medical records contain mental-state examinations recording no hallucinations or perceptual disturbance.
Dr Julian Lim, who treated me over many years rather than during one period of crisis, has reported that he did not observe the psychotic features that would support schizophrenia.
That longitudinal observation matters to me.
A diagnosis made during a period of extreme distress should not be insulated forever from what became observable during the years that followed.
Flashbacks Are Not Voices
I have experienced intrusive memories.
I have experienced flashbacks.
I have experienced dissociation.
I have experienced periods during which an event from childhood became so immediate that the present seemed to lose its proper place.
I have experienced emotional states which arrived with extraordinary force.
Those experiences are real.
But they should not automatically be translated into hallucination or psychosis.
An intrusive memory is not an external voice.
A flashback is not an external voice.
Dissociation is not automatically psychosis.
An intense internal dialogue remains an internal dialogue if the person knows it is their own thinking.
Those distinctions seem obvious when written that way.
In a psychiatric record they can become much less obvious once a diagnostic label has already been attached.
The Treatment Followed the Label
Whatever uncertainty existed around the diagnosis, treatment had immediate consequences.
I was given risperidone, including depot Risperdal Consta injections.
The later review of the records refers to doses including 62.5 milligrams and 50 milligrams by intramuscular injection every fortnight, together with oral risperidone at different times.
Other medications were also used during the broader treatment period, including antidepressants, diazepam and propranolol.
In my own later descriptions I have sometimes grouped the antidepressants together as SSRIs. The documentary record is more complicated than that. Some of the medications used, such as Effexor, belong to a different antidepressant class.
That distinction is worth preserving.
I do not want to correct an inaccurate psychiatric record by creating an inaccurate medication record of my own.
Risperdal
My experience of Risperdal was profoundly negative.
I felt that my world became darker.
Rather than separating me from the childhood material which was overwhelming me, the treatment seemed to drive me further into it.
I felt drugged.
I felt less able to protect the boundary between the present and the experiences which were returning.
I objected to the medication.
An August 2007 entry later reproduced in the medical material records me as agitated and unhappy with treatment and reporting side effects from Risperdal.
It also records the warning that treatment would be enforced if necessary.
That word — enforced — belongs beside the childhood history.
For somebody whose earliest experiences included being physically held, tied and overpowered by adults exercising authority, forced treatment was not psychologically neutral.
Consent Inside a Psychiatric Ward
One of the enduring problems for me is the difference between a treatment being legally authorised and the person receiving it experiencing that treatment as consensual.
I was being told that I could be restrained.
I understood that refusal did not mean the treatment would stop.
I was injected with medication I did not want.
The institution may have had a legal framework for doing that.
My experience remained one of being overpowered.
Both propositions can exist at the same time.
That distinction would become increasingly important to me in later health care.
The Problem of Cause and Effect
Once medication begins during a psychiatric crisis, another problem appears.
Which experiences belong to the original distress?
Which belong to the illness being proposed?
Which belong to sleep deprivation, fear, confinement or trauma?
Which belong to the medication?
Which belong to withdrawal from the medication?
Those questions become particularly difficult when an adverse reaction is itself interpreted as further evidence of psychiatric illness.
I cannot now reconstruct every hour of 2007.
I can say that I experienced some of the medication as making me markedly worse and that I repeatedly tried to communicate that.
Propranolol Again
Propranolol remained different in my experience.
After leaving the ward I continued to regard it as useful.
My recollection is of taking about 40 milligrams twice daily during part of that period.
The surviving medical material broadly supports a dose in that range, although doses changed over time and the records need to remain the authority for exact prescribing dates.
I do not claim that propranolol reversed Risperdal or somehow chemically removed the effects of the other drugs.
That would go beyond what I can establish.
What I can say is that I experienced it as helping me manage the physical and emotional intensity of the period while I tried to regain a sense of myself.
Getting Clear
My recollection is that recovery from the entire period was not quick.
For four or five years I remained conscious of what I regarded as the after-effects of the psychiatric treatment and the disruption surrounding it.
That is my retrospective experience, not a pharmacological claim that Risperdal itself remained in my body for years.
The distinction matters.
A drug can leave the body long before the consequences of the period in which it was administered have disappeared from a person's life.
What Dr Antoce Found Later
In 2021 Dr Georgiana Antoce was asked to conduct an independent medico-legal psychiatric assessment.
Her report became important for reasons I did not initially expect.
She went back through a substantial quantity of earlier material, including the 2007 psychiatric records.
Her review did not present 2007 as a simple, uncontested case of paranoid schizophrenia.
Instead, she recorded the changing diagnoses, the limited documentation of active psychotic behaviour, the role of collateral information, the references to my childhood abuse, and behaviour which she herself described in terms which included dissociation.
That did not automatically erase the old diagnosis.
But it reopened the record.
The diagnostic certainty which later files seemed to contain was much less obvious when the underlying material was examined.
The Difference Between a Record and an Event
This is one of the lessons that has followed me from 2007.
A record can make uncertainty disappear.
A clinician considers several possibilities.
Different diagnoses appear during different parts of an admission.
Observations do not always fit neatly.
Collateral information may be accepted.
The patient disputes parts of what is happening.
Medication changes.
Then eventually one diagnosis is copied into the next record.
Years later somebody reading the file may see only:
“Paranoid schizophrenia.”
The uncertainty has vanished.
Not because it was necessarily resolved, but because it was not copied.
The Diagnosis and the Person
I have sometimes wondered what would have happened if the people involved in 2007 had possessed the later understanding of dissociation that became available through my work with Dr Lim.
That question cannot be answered.
It would also be too easy to replace one retrospective certainty with another.
Dissociative Amnesia should not simply be used as a label capable of explaining everything that happened in 2007.
What it does provide is a framework for experiences which were previously difficult to understand:
separated periods of memory;
traumatic material returning with great immediacy;
disconnection from ordinary awareness;
loss of continuity;
and behaviour organised around an earlier danger rather than the present environment.
Those things deserve to be considered before they are translated into psychosis.
What I Can Say Now
I cannot travel back to 2007 and conduct another assessment.
I cannot know precisely what every clinician saw or why each person made the decision they made.
I can examine the surviving record.
I can compare it with what I experienced.
I can compare the diagnosis with the observations recorded at the time.
I can compare it with the many years of psychological treatment that followed.
And I can distinguish experiences which I know I have had from experiences which have been attributed to me.
I have experienced trauma.
I have experienced dissociation.
I have experienced flashbacks and intrusive memories.
I have experienced severe distress.
I have experienced medication which I believed made that distress worse.
But I have never had difficulty knowing that my internal dialogue is mine.
That fact does not by itself disprove schizophrenia.
It belongs among the evidence.
Why 2007 Still Matters
If the events of 2007 had remained confined to 2007, this chapter might have been primarily a history of a difficult psychiatric admission.
They did not.
The diagnosis survived.
It entered later medical records.
It influenced the way later clinicians could read my behaviour, my distress, my recollections and eventually even my physical complaints.
A description made during one period of crisis acquired a life which was independent of the circumstances that produced it.
That is the next layer of the story.
The question is no longer only how the diagnosis was made.
It is what happened when the diagnosis began to travel.
