Beyond Recovery: Stage Five

Pamela Spiro Wagner:

I want to reblog this brilliant post by Anne C. Woodlen and then i will add my own editorial comments if i can in a later post or edit. In the meantime, i think it speaks for itself and says just about what i would want to tell a lot of young people newly diagnosed with bpd or did or add or even bipolar disorder and getting on disability, preparing for a life “in the system” – it sucks and it isn’t worth it unless you are floridly psychotic. And even then, don’t believe what they tell you about antipsychotic drugs. There ain’t no such medication, only sedatives that may or may not quiet things down temporarily. The only way out is through, if you can do it with a wise and caring guide and community. Don’t get stuck as i am, on multiple antipsychotic drugs, addicted to them so that getting off them only means you get more psychotic than ever. Psychosis need not be a lifelong problem, but it certainly will be if you keep taking high doses of the drugs and never explore other options.

Originally posted on Behind the Locked Doors of Inpatient Psychiatry:

Hello,

My name is Dustin and I live in Michigan. When I was seventeen years old my mother put me in a psychiatric hospital called Forest View. The abuse I felt violated me to the core! I felt like I was being raped having to submit to all the rules, the bullying and the emotional abuse. To have your dignity removed when you are an innocent patient and just want genuine, kind, gentle care, and get unprofessional jerks who you can tell are fake and just care about getting paid is a horrible experience.   If anything it only caused me more traumas with the trauma that I already had. I am now twenty-two years old and live on disability while also living my life as a hermit because now I am afraid of people due to the awful treatment I endured.  I was diagnosed with Borderline Personality Disorder by a REAL…

View original 856 more words

TooGoose Lautrec, the Papier Mache Goose and How I will Miss Vermont, the state of my Dreams…

Pam with unfinished paper mache goose, TooGoose Lautrec....
Pam with unfinished paper mache goose, TooGoose Lautrec….    

 

Across the driveway llive some great people...
Across the driveway live some great people…

 

Kitchen and work area in cottage
Kitchen and work area in cottage

 

More of Work area and art area
More of Work area and art area
Stephanie is "gods gardener" or so I call her!
Stephanie is “gods gardener” or so I call her!
Steffie at the state park
Steffie at the state park

 

As my time here comes to an end, I will miss it and my neighbors terribly., I don’t know what I will do without them, and Lydia my wonderful companion. Returning to Connecticut with its horrible hospitals and indifferent treatment just feels like a disaster waiting to happen. I want to move to Vermont but I don’t know how I can make that happen. I have felt amongst friends everywhere here, but isolated completely for years in CT, despite my lovely dear friends there, I wish I could bring them all up to VT with me!

 

 

 

 

 

 

 

 

RIP ERIC GARNER: Man Killed By NYPD for breaking up a fight…

 

This video is pretty sickening and difficult to watch. However it is brief and necessary, if you care about what the police are doing tp everyday citizens in this country… (Need I mention that Eric happens to be African American, which I believe was significant in his treatment, just as a mental illness would have been or other supposedly extraneous factors…

AUDIO Interview with Pamela Spiro Wagner: WNPR on Connecticut Hospitals’ Use of Restraints and Seclusion

(***SEE PAMELA’S COMMENTS AT BOTTOM OF PAGE…)

Connecticut Hospitals Responding to Psychiatric Restraint Numbers

 

“They don’t want you to get out. They pull [restraints] as tight as possible to the sides of the bed.”
Pamela Spiro Wagner

 

Pamela Spiro Wagner’s apartment is full of art she’s made while in psychiatric care. One piece dominates the room. It looks like a painting at first. It shows a threadbare seclusion room and a restraining bed.

 

“That’s made of Vogue magazines. If you look at it, you’ll see there’s a little label of Prada leather on the leather restraints, which was done on purpose,” Wagner said. She made it while alone in a hospital seclusion room. The magazines were the only art supplies she had.

Wagner has schizophrenia. She’s been in and out of Connecticut hospitals for decades, and she knows what it’s like to be restrained. “They use leather, or rubber, or plastic, or whatever restraints that they wrap around your wrists, usually tight because they don’t want you to get out. They pull them as tight as possible to the sides of the bed,” she said.

Wagner was put in four-point restraints. That means each limb is bolted to the bed, and she said she’s stayed there for nearly a day at a time. “I would just scream from the base of my lungs,” she said, “like the screams that if you had any heart, your heart would break if you heard me scream.”

“Restraint is Pretty Traumatic”

Patricia Rehmer, Commissioner of the Connecticut Department of Mental Health and Addiction Services, said the department has cut down on restraint since receiving a federal grant in 2008. “We know,” she said. “The literature is clear; the clients are clear. Seclusion and restraint is usually a pretty traumatic event. If we had our way, there would be no seclusion and restraint. We’d love to get to zero, but that’s not always possible.”

 

Credit WebKazoo / Connecticut Health I-Team

 

 

 

 

 

 

 

 

The Department of Mental Health and Addiction Services oversees state hospitals in Bridgeport, New Haven, Hartford, and Middletown. Rehmer said that because patients stay longer at state hospitals, doctors and nurses have more time to work with them on ways to avoid restraint. “Frankly, there are differences between our hospitals, our hospital beds, and general hospital beds, for example,” she said.

Read C-HIT Report: State Restrains Psychiatric Patients at High Rate

Restraining or secluding patients used to be commonplace in psychiatric facilities, but ten years after a series of deaths nationwide, there’s been a push to lessen the time patients spend restrained. Federal data released earlier this month showed that Connecticut’s rates of restraint are still high compared to most of the country – more than double the national average. The state ranks eleventh nationwide, and third for use of restraints among the elderly.

Connecticut Institutions Adapt

Bridgeport Hospital topped the list statewide. The hospital has a large geriatric unit, and the numbers were high for elderly patients.

“We realized about a year and a half ago that we were really having a problem,” said Ryan O’Connell, Bridgeport Hospital’s vice president of performance and risk management. He pointed out that the numbers only go up to the middle of 2013, and said that the hospital started changing its practices since then. “It was much more common for us to go to some type of restraint,” he said.

O’Connell said the image of the barren room and four leather straps is all wrong at Bridgeport. They’re mostly trying to keep patients with dementia from wandering off and into danger. “I think it’s really important,” he said, “that nobody thinks that we were tying people down [by their] hands and feet.”

Bridgeport is moving toward something called comfort rooms, with colorful wallpaper, toys, games, or comfortable furniture. They’re becoming common alternatives in a lot of institutions, like Connecticut Valley Hospital in Middletown – a state hospital that cut back on using restraints by about 88 percent in the past decade.

In 2002, a patient died after being restrained at CVH. The hospital conducted investigations after the death, but Director Charles Dike said they’d already decided to make a change before it happened. “Our target is to make sure we use it as sparingly as possible, only when it is absolutely necessary, and that we discontinue it as quickly as possible,” he said.

CVH started using comfort rooms years ago. Dike said that instead of putting a patient in restraints, they try to encourage a patient to spend a little time alone doing something relaxing. He said, “If somebody says to me, when I’m not doing so well, I like to go into my room and play music, and that helps me calm down…” He said that nurses will remember, and bring it up if the patient starts to lose control.

Dike doesn’t expect to stop using restraints. He said there will always be outliers — patients who come straight from emergency rooms and prisons.

Ellen Blair is the nurse director at Hartford’s Institute of Living, which is part of the Hartford Hospital system. Figures for 2013 show Hartford Hospital restrains patients at a little over the state average, but she said they’ve cut back since then thanks to new training programs and more comfort rooms.

Blair said that when a patient does go into restraints, they’re looked after. “I personally go and make sure I know that patient,” she said. “We all talk about it at least every couple of hours, because we don’t want to keep it going any longer than we have to.” She said patients aren’t left alone, and that restraint is only used as a last resort when patients are dangerous to themselves or others.

“Every day,” Blair said, “we come here thinking, okay, we’re going to have a good day. We’re going to prevent people from getting agitated and having to go to that level.” Restraint, however, remains a last resort these hospitals said they don’t plan to take off the table entirely.

AVENGING ANGEL: NEW ART

Avenging Angel in Gouache - Abstract approximately 7 by 8 inches
Avenging Angel in Gouache – Abstract approximately 7 by 8 inches

 

Lots to say about the situation I am in up here in Vermont, where my assistant, the person hired to help me and make sure things go okay turned out to be a common criminal. But I am too tired and worn out by having to deal with the mess left in her wake to write about it. Suffice it to say that she stole my debit/credit card number and racked up multiple charges, was apparently drinking even in the mornings without my knowing it, and driving me at the same time. She had a hand bag full of narcotics not all of them prescribed to her, but even if they had been, what was she doing, taking narcotics and drinking and driving?!

 

Things were even worse than that, but as I said, I am exhausted and cannot go into it all now. Needless to say, she has been fired and is gone, is out of here…But she has left a mess and misery in her wake all around. What a mess maker! And I think she was the one who was stealing from me all the while last winter when I had people staying with me to prevent a hospitalization…Why did  I once trust her implicitly? Where do I find these people and WHY do I trust them at all?

 

I should have known something was wrong when I saw her handbag full of Percocet and Xanax and VIcodin and fentanyl patches etc. It was ridiculous…and then to have her buy a case of beer? But I thought “well, a beer once in a while is harmless.”…I didn’t know she was drinking at breakfast and also while driving…I am such a dimwit!

Avatar therapy for persecutory auditory hallucinations: Can It Work?

Sometimes the voices are so loud, you just have to scream...Collage made at Yale Psychiatric Hospital 2013, from scraps of magazines and glue.
Sometimes the voices are so loud, you just have to scream…

Novel ‘Avatar Therapy’ May Silence Voices in Schizophrenia

Deborah Brauser

July 03, 2014

LONDON ― A novel treatment may help patients with schizophrenia confront and even silence the internal persecutory voices they hear, new research suggests.

Avatar therapy allows patients to choose a digital face (or “avatar”) that best resembles what they picture their phantom voice to look like. Then, after discussing ahead of time the things the voice often says to the patient, a therapist sits in a separate room and “talks” through the animated avatar shown on a computer monitor in a disguised and filtered voice as it interacts with the patient.

In addition, the therapist can also talk by microphone in a normal voice to coach the patient throughout each session.

In a pilot study of 26 patients with treatment-resistant psychosis who reported auditory hallucinations, those who received 6 half-hour sessions of avatar therapy reported a significant reduction in the frequency and volume of the internal voices ― and 3 reported that the voices had disappeared altogether.

“Opening up a dialogue between a patient and the voice they’ve been hearing is powerful. This is a way to talk to it instead of only hearing 1-way conversations,” lead author and creator of the therapy program Julian Leff, MD, FRCPsych, emeritus professor at the Institute of Psychiatry in London, told meeting attendees.

Dr. Julian Leff

“As the therapist, I’m sharing the patient’s experience and can actually hear what the patient hears. But it’s important to remind them that this is something that they created and that they are in a safe space,” Dr. Leff told Medscape Medical Newsafter his presentation.

Two presentations were given here at the International Congress of the Royal College of Psychiatrists (RCPsych) 2014 the day after the study results were released in the print edition of Psychosis.

Regaining Control

According to the investigators, 1 in 4 people who hear phantom voices fail to respond to antipsychotic medication.

Dr. Leff explained that this program started a little more than 3 years ago, after he had retired “and could start thinking clearly again.” He had been interested in the phenomenon of phantom voices for more than 40 years.

“Our mind craves meaningful input. That’s its nourishment. And if it’s deprived of nourishment, it pushes out something into the outside world,” he said. “The aim of our therapy is to give the patient’s ego back its mastery over lost provinces of his mental life.”

 

The researchers used the “off-shelf programs” Facegen for the creation of the avatar faces and Annosoft LIP-SYNC for animating the lips and mouth. They also used a novel real-time voice-morphing program for the voice matching and to let the voice of a therapist to be changed.

In fact, Dr. Leff reported that one option the program provided changed his voice into that of a woman.

After a patient chose a face/avatar from among several options, the investigators could change that face. For example, 1 patient spoke of hearing an angel talk to him but also talked about wanting to live in a world of angels. So the researchers made the avatar very stern and grim so that the patient would be more willing to confront it.

Another patient chose a “red devil” avatar and a low, booming voice to represent the aggressiveness that he had been hearing for 16 years.

For the study, 26 participants between the ages of 14 and 74 years (mean age, 37.7 years; 63% men) were selected and randomly assigned to receive either avatar therapy or treatment as usual with antipsychotic medication.

The length of time for hearing voices ranged from 3.5 years to more than 30 years, and all of the patients had very low self-esteem. Those who heard more than 1 voice were told to choose the one that was most dominant.

Pocket Therapist

Dr. Julian Leff shows examples of faces used in avatar therapy at RCPsych 2014.

 

During the sessions, the therapist sat in a separate room and played dual roles. He coached the participants on how to confront and talk with the avatars in his own voice, and he also voiced the avatars. All of the sessions were recorded and given to the participants on an MP3 recorder to play back if needed, to remind the patients how to confront and talk to the auditory hallucination if it reappeared.

“We told them: It’s like having a therapist in your pocket. Use it,” said Dr. Leff.

All of the avatars started out appearing very stern; they talked loudly and said horrible things to match what the patients had been reportedly experiencing. But after patients learned to talk back to the faces in more confident tones, the avatars began to “soften up” and discuss issues rationally and even offer advice.

Most of the participants who received avatar therapy went on after the study to be able to start new jobs. In addition, most reported that the voices went down to whispers, and 3 patients reported that the voices stopped completely.

The patient who confronted the red devil avatar reported that the voice had disappeared after 2 sessions. At the 3-month follow-up, he reported that the voice had returned, although at night only; he was told to go to bed earlier (to fight possible fatigue) and to use the MP3 player immediately beforehand. On all subsequent follow-ups, he reported that the voice was completely gone, and he has since gone on to work abroad.

Another patient who reported past experiences of abuse asked that his avatar be created wearing sunglasses because he could not bear to look at its eyes. During his sessions, Dr. Leff told him through the avatar that what had happened to the patient was not his fault. And at the end of 5 sessions, the phantom voice disappeared altogether.

Although 1 female patient reported that her phantom voice had not gone away, it had gotten much quieter. “When we asked her why, she said, ‘The voice now knows that if it talks to me, I’ll talk back,’ ” said Dr. Leff.

“These people are giving a face to an incredibly destructive force in their mind. Giving them control to create the avatar lets them control the situation and even make friends with it,” he added.

“The moment that a patient says something and the avatar responds differently than before, everything changes.”

In addition, there was a significant reduction in depression scores on the Calgary Depression Scale for Schizophrenia and in suicidal ideation for the avatar participants at the 3-month follow-up assessment.

A bigger study with a proposed sample size of 140 is currently under way and is “about a quarter of the way complete,” Dr. Leff reports. Of these patients, 70 will receive avatar therapy, and 70 will receive supportive counseling.

“In order for others to master this therapy, it is necessary to construct a treatment manual and this has now been completed, in preparation for the replication study,” write the investigators.

“One of its main aims is to determine whether clinicians working in a standard setting can be trained to achieve results comparable to those that emerged from the pilot study,” they add.

“Fascinating” New Therapy

“I think this is really exciting. It’s a fascinating, new form of therapy,” session moderator Sridevi Kalidindi, FRCPsych, consultant psychiatrist and clinical lead in rehabilitation at South London and Maudsley NHS Foundation Trust in the United Kingdom, told Medscape Medical News.

Dr. Sridevi Kalidindi

“I think it is a novel way of approaching these very challenging symptoms that people have. From the early results that have been presented, it provides hope for people that they may actually be able to improve from all of these symptoms. And we may be able to reduce their distress in quite a different way from anything we’ve ever done before.”

Dr. Kalidindi, who is also chair of the Rehabilitation Faculty for the Royal College of Psychiatrists, was not involved with this research.

She added that she will be watching this ongoing program “with great interest.”

“I was very enthused to learn that more research is going on with this particularly complex group,” said Dr. Kalidindi.

“This could be something for people who have perhaps not benefitted from other types of intervention. Overall, it’s fantastic.”

International Congress of the Royal College of Psychiatrists (RCPsych) 2014. Presented in 2 oral sessions on June 26, 2014.

Psychosis. 2014;6:166-176. Full text

Original Article From MEDSCAPE:

http://www.medscape.com/viewarticle/827797?nlid=60566_2051&src=wnl_edit_medn_psyc&uac=63563AN&spon=12

Curling Ocean Waves in Red Room: Painting in Gouache

 Curling Ocean Wave in Red Room - Painting in Gouache
Curling Ocean Wave in Red Room – Painting in Gouache

 

Not sure what to make of this painting, but I enjoyed doing it…What do you think? It is 8 by 12 inches, approximately, in gouache on Ampersand board (essentially gessoed masonite).

Luna Moths rescued for another day….in Vermont

Luna Moths are Giant Silk Moths, Actias, which live after eclosing from their pupae only about 4-7 days.
These are Giant Silk Moths, Actias Lunas, which live after eclosing from their pupae only about 4-7 days.

These huge 3-inch to 5-inch moths are not endangered but you have to find them after midnight in or near the woods, before the birds eat their bodies in the early hours of the morning. If you can preserve them for another nighttime, you may rescue these mouthless, non-eating creatures for their prime task, which is mating. The males live to breed and will mate and mate again, but the female, once she has mated, will go on to lay eggs anywhere she can until she is eaten or simply dies at the end of summer. When you rescue a single male you can almost hear the noise made by the rasping bristling antennae as it searches for the scent of the female, which is the one that gives off pheromones of desire for the male, then waits for a mate to come calling on her.

 

Steffie rescued these two from her house’s outer walls. And I photographed them inside the bucket where they were safe, we thought, until one got scared or attracted by the scent of a female and flew off (despite it being the middle of the morning when they are almost always inert.) The other survived over the day and was revived the next night in order to go out and to find a mate.

Rocking Away a Tidal Wave of Troubles: a Painting

Rocking Away a TIdal Wave of Troubles - gouache on archival mat board scrap
Rocking Away a Tidal Wave of Troubles – gouache on archival mat board scrap. 

I  was told by Marc and Steffie, with whom I am staying, that the sea or water represents the unconscious in some schools of thought. Which certainly makes sense to me, given how I titled this very small painting. I painted the blackbird in the stormy sky last, and can see that as a sort of link between the world of life and death, like Van Gogh’s black birds in the fields in his final paintings. But also the notion that the rocking chair can calm the stormy waters, indeed the raging tidal wave of waters outside the room, so that they become only waves but not so disturbing inside, seems to me significant. So, two questions for the pychologically or analytically minded: Why is the room red, one, and why is the chair empty? (I am serious. If you have any ideas or suggestions, I would be curious and eager for your and any interpretation. No need, just interested.)

In any event, in my sleeplessness last niight, I panicked, because I “knew” I couldn’t paint. so I put aside my decent ampersand boards, coated this bit of matboard with black to “ruin” it first, then just went to town, painting the first thing that came to mind. The chair was in the living room, but the rest was purely my imagination. If I knew what I was doing, I confess I would have painted the chair last, ON TOP of the  background, but of course, I had no idea what I was doing, so I had to paint it and repaint it as ideas came to me…Hence the messiness! Hope you enjoy!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Seclusion Room: Cell or Sanctuary — Amazing Article from 1959

This supermax prison cell is better appointed than the seclusion rooms I have been put in...NO toilet or sink or blanket or bedding!
This supermax PRISON cell is better appointed than the HOSPITAL seclusion rooms I have been put into naked…which had NO toilet or sink or blanket or bedding, and was freezing cold!

THE SECLUSION ROOM – CELL OR SANCTUARY?

By HUMPHRY OSMOND, M.D., 1959

Superintendent The Saskatchewan Hospital, Weyburn

 

SECLUSION ROOMS, found in most psychiatric hospitals, too often look as if they were intended as temporary quarters for wild animals, or perhaps as storerooms for dangerous chemicals, rather than as shelters for sick and distressed humans.

 

 

Yet, the purpose of seclusion is clear and admirable. It is intended to reduce interaction following a rupture in interpersonal relationships between the patient who is being secluded and other patients, or members of the hospital staff.

 

 

Seclusion usually occurs when there has been acting out or a threat of it. While skilled psychiatric nurses can often handle such situations without using seclusion, it is proper that a patient, in an explosive situation, should have an opportunity to withdraw to a suitable spot to be alone for a time or in the company of someone he trusts.

 

 

When children quarrel with siblings or parents, they are often sent or asked to go to their room and be alone with toys and playthings. Adults retire to a bedroom, a study or even to the toilet. Although it was once common practice, it is no longer thought admirable to lock a child in a dark cupboard. In his own room, he gets comfort from his toys, just as an adult will soothe himself with a book, a pet animal, possibly with music, or just by being alone.

 

 

The mentally ill person, who has had a rupture of interpersonal relationships, likewise needs space under his own control where he can “pick up the bits.” The best place would be a room of his own, with familiar furnishings and his personal possessions easily visible. Wherever his retreat, it should give external stimulation as well as support and comfort.

 

 

Bare, Drab Rooms Affect Perception

 

 

Seclusion rooms in many hospitals are built to some stereotyped plan, and are poorly-lit, bare, drab rooms of a curious cube-like construction which makes them seem unduly high. There is little or no furniture, often only a mattress. Walls are usually tiled in one color only, and this sometimes white. Windows covered with heavy screening, ceiling lighting often high and remote beyond the patient’s control, heavy imprisoning doors sometimes the same color as the walls, and in the middle of the floor a brass grating over a drain hole―no wonder these rooms are suggestive and frightening. Such rooms strongly resemble the reduced environment described by Hebb* in which even well people can experience major 18 changes in thinking,. perception and mood, larked in certain non-experimental situations, notably brain washing, such environments are deliberately used. to. encourage alterations in perception. Surely then it is un-wise to place psychotic people in a situation which, since it will not afford them even minimal external stimulation, is likely to increase the perceptual disorder which many of them already have.

 

 

The need for sufficient stimulation, particularly of a visuo-auditory type, combined with carefully selected tactile and olfactory stimulation, is strongly suggested by Goldfarb’s recent work at the Ittleson Family Center with children. His work indicates that many schizophrenic children tend to inhabit a tactile-olfactory world, rather than the more common and culturally acceptable visuo-auditory one. It seems probable that schizophrenic adults may be in much the same position.

 

 

Clearly then we must provide our disturbed patient with an adequate amount of pleasurable visuo-auditory experience while in seclusion, and also let his environment be rich in socially acceptable tactile-olfactory pleasures, lest he seek the only remaining gratification―tactile-olfactory ones from his own body. Specifically, let us imagine a patient, greatly disturbed, shut up in a bare room, with bare walls, little or no clothing, and possibly only a mattress or blanket as furnishings. The visuo-auditory and tactile-olfactory enjoyments to be obtained from such surroundings are very small. Is it surprising, therefore, if his seclusion results in apsophilic (auto-erotic) activity, in the tactile experience of staff members or even in reviving a tactile and olfactory interest in his own body products of urine and feces?

 

 

These apsophilic activities, the touching and snuffling on the nursing staff, and the handling of feces and urine are likely to produce great anxiety and great resentment in those who must care for the patient. He will naturally interpret this as dislike and rejection, and a vicious circle is established. He is driven deeper and deeper into his tactile-olfactory experiences, and probably also into full hallucinatory experience. Since we are woefully short of really sophisticated staff, we must make .very vigorous efforts to see that this type of “reduced environment” seclusion is banished from the mental hospital as quickly as possible.

 

 

The seclusion room, therefore, must be not merely pleasant, but the very best room on any ward. There are several reasons for this. For one thing, if the room is pleasant, it will take away the idea of punishment―not merely by a verbal gesture, but by a change in the attitude of everyone on the ward, patients and nurses, who will both be far more impressed by the fact that the seclusion room is the best on the ward than if there is simply lip service to the effect that seclusion is not punishment. Money invested in making this room conspicuously better than other rooms “because it is for those who are the most unwell” will indicate to both nurses and patients that the hospital particularly concerns itself with those who are the sickest. The fact that the room is an object of pleasure and satisfaction to all the patients on the ward will exert considerable pressure on the disturbed patient to use this joint possession properly. This pressure will be extremely effective in preserving the room from damage.

 

 

Dimensions and Decor Important

 

 

What, then, should this “best room in the ward” be like? Particular attention must be given to its size and proportions. A small room of great height is extremely oppressive to most people. and if such a room must be used, perhaps a false ceiling should be built in. The lighting must be good, and must, at least in part, be under the patient’s own control. The walls should be pleasantly painted in bright and reassuring colors. There should be pictures on the wall, and a mirror (a metal or unbreakable mirror is permissible). The bed should be comfortable and the bed cover pleasant. Sheets, pillows and mattress must of course be provided. There should be chairs and a desk, the chairs self-colored and if possible, textured. Patterned material is best avoided, since it may have a disturbing, Rorschach-like effect. (Until we know more about the effect of patterns on patients’ perceptions, we should be cautious about patterned materials.) A carpet or rug, preferably nylon, should be on the floor, which may be of tile or linoleum, but should be light in color. To avoid uncertainty about the passage of time, a clock and a calendar should be clearly displayed. If a toilet cannot be readily available, a modern commode chair may substitute, if it is explained to the patient.

 

 

It is important here, as elsewhere in the hospital, for the furniture to be light, strong and elegant, rather than heavy or cumbersome. Heavy furniture quickly becomes a challenge to some patients to see if it can be broken. It encourages all patients to lose one of the most important skills which we all acquire in childhood―the ability to maneuver through complicated mazes of furniture. This ability includes all sorts of skills, especially subliminal psychomotor movement. Mental patients frequently lose this ability through disuse, and all too often the arrangements in the mental hospital give them no opportunity to re-acquire it, or what is even more important, to correct early the tendency to lose it. Experimental work shows that, given the opportunity, people frequently correct perceptual errors on their own. But a bare room, fitted with one massive piece of furniture affords neither encouragement nor motive for correcting an error of any sort.

 

 

In the seclusion room, the patient should have diversions from the very start. Games, books, perhaps a slide projector, a television or record player under his control are all possibilities. Cut flowers and potted plants should decorate the room. Writing materials should of course be available, and if the patient has difficulty in writing, as some psychotic people do, he might be provided with chinagraph (grease) pencils and an ample supply of paper. Part of the wall might be processed for drawing. which people sometimes find pleasant when they are upset. Plasticine and paint should be provided. A way might also be devised for the patient to brew his own coffee or tea. A tape recorder could be provided to allow the patient to hear his own voice, and get accustomed to the fact that he really is there, though this should be handled with caution, because some people find it rather a disturbing experience.

 

 

All these measures must, of course, be combined with friendly interaction with a member of the hospital staff, one with whom the patient feels comfortable and can speak freely, but who, like the room itself, will keep him as close to reality as possible.

 

 

In brief, the seclusion room is ideally a place where the patient, after a rupture in interpersonal relation-ships, can re-assert his adultness and recover his poise, rather than a place of punishment where he is treated like an abandoned child in a dark cupboard or a bear in a pit.

 

 

(See link to original article for photo of music therapy session.)

 

*Dr. Donald Hebb, McGill University, conducted experiments in which the subject was placed on a bed in an air-conditioned box with arms and hands restrained with cardboard sleeves and eyes covered completely with translucent ski goggles. Hallucinations and delusions of various sorts developed, mostly in those who could stay longer than two days. Many subjects left at about twenty-four hours

http://journals.psychiatryonline.org/data/Journals/PSS/20510/18.pdf

Thoughts on DESIDERATA and More

Desiderata
Desiderata

Desiderata

© Max Ehrmann 1927 ?

Go placidly amid the noise and haste, and remember what peace there may be in silence.
As far as possible without surrender be on good terms with all persons.
Speak your truth quietly and clearly; and listen to others, even the dull and ignorant; they too have their story.
Avoid loud and aggressive persons, they are vexations to the spirit.
If you compare yourself with others, you may become vain and bitter;
for always there will be greater and lesser persons than yourself.

Enjoy your achievements as well as your plans.
Keep interested in your career, however humble; it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs; for the world is full of trickery.
But let this not blind you to what virtue there is; many persons strive for high ideals;
and everywhere life is full of heroism.

Be yourself.
Especially, do not feign affection.
Neither be critical about love; for in the face of all aridity and disenchantment it is as perennial as the grass.

Take kindly the counsel of the years, gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with imaginings.
Many fears are born of fatigue and loneliness. Beyond a wholesome discipline, be gentle with yourself.

You are a child of the universe, no less than the trees and the stars;
you have a right to be here.
And whether or not it is clear to you, no doubt the universe is unfolding as it should.

Therefore be at peace with God, whatever you conceive Him to be,
and whatever your labors and aspirations, in the noisy confusion of life keep peace with your soul.
With all its sham, drudgery and broken dreams, it is still a beautiful world. Be careful. Strive to be happy.

 

 

 

“Desiderata” defined means things wanted or needed. A partial version of the poem hangs on the wall of the place where I will be staying for a while and while the piece is well-known, and indeed I have seen it before, the painted version here caught my eye and moved me. For some reason, however, I suspected that this particular version was a quotation only in part, so I looked up the entire poem. What I found struck me to tears.

 

Tears? Why?

 

Well, let me explain.

 

There are important lines that are missing in the poem on the wall here (important to me):

 

“You are a child of the universe, no less than the trees and the stars;
you have a right to be here.
And whether or not it is clear to you, no doubt the universe is unfolding as it should.”

 

Also this stanza is followed by the critical word, “Therefore…be at peace with God…” whereas on the wall, the “therefore” has been taken out. But what a difference it makes to keep it in.

 

The important thing to me in reading the poem in its entirety is that I do not feel I have a right to be here, do not feel I am in any sense “a child of the universe.” I feel instead that I have ruined the universe, and that if I had not been born the world would have been better off by far. That is one critical thing.

 

The other salient point the poet makes, which made me weep, was his belief, stated well before anyone thought about global warming, but presumably he would have said the same thing even so, if he truly had the courage of his convictions that “no doubt the universe is unfolding as it should.”

 

TO the contrary, it feels to me completely tragic that the world should be ending in our geologic time, that we should be living in the end days, not something that was meant to be or unfolding as it should. ( I say “end times” without any religious intention to those words, only the sense that we have brought about the end of the living world upon ourselves by over-consumption and massively pig-headed over-population.) Of course, the “universe” is much bigger than humanity or even generally speaking the living blue planet called earth, but as a human living on it I have no other way to feel or see but from my puny human perspective. To lose Life on earth, all or most of it at any rate, to global warming feels utterly devastating. Who or what gave humans the right to destroy what might have been the tiniest fraction of a chance at existence, life itself, to throw it all away through the over-consumption of fossil fuel (in the brief span of 2 centuries) and making too many babies, and eating too many cows?

 

It sickens me that I am so much at fault, that I ought not to have existed at all, that much of this could have been avoided by my never having been born. But it also sickens me that as a species, humans have collectively, since my birth, ignored all the consequences of our “eating the earth” and now we have no earth for our children’s children to inherit…

 

Vis a vis another line in the poem, I cannot “be gentle” with myself. I do not deserve gentleness! That way disaster lies!

 

“With all its sham, drudgery and broken dreams, it is still a beautiful world.” Maybe… But the world is fast losing its beauty and sometimes i think it is only beautiful to those wealthy enough to be able to willfully blind themselves to all the ugliness and injustice around them: blinding themselves to the dying oceans and all the starving homeless people…to name just two out of many.

 

Nevertheless, the poem is still a miracle of inspiration and remains so after nearly a century. Though not really new to me, it newly struck a chord, though I am sure that  people in the know would call it an “old chestnut” of a poem, nearly hackneyed and familiar as that other O.C., “Invictus”by William Ernest Henley, though I suggest Desiderata has always been far better written than Henley’s “chest-beater” of a poem (for all that it is a favorite of many thousands..).

Pencil Art done under Barbaric Conditions at Hospital of Central CT: Brutal Aversive Conditioning.

CLICK ON THE PICTURES TO ENLARGE THEM.

 

There were few rewards for behavior that toed the line at New Britain General Hospital (HOCC). Mostly it was punishment. If I was found with even a stub of a forbidden pencil, I was carried off to the Supermax seclusion cell, stripped naked and left alone.

 

At that point, being teeth-chatteringly blue with cold, I would swat a nurse in such a way that she would feel assaulted and bring on the goon squad of “I want to hurt someone today” guards to put me in four point restraints.

 

Why would I induce this? Because then they would at least cover me up afterwards with the mercy of a sheet, for modesty not warmth mind you, and I would beg for a blanket in vain. But at least my body would be protected from head to toe from the blasts of the A/C up full bore, and I could rest after I had had screamed out my lungs and my despair for a lonely twenty minutes or more.

 

No one cared, no one heard or paid any attention. The doors were double, and the cell was utterly soundproof. NO one ever even knew I was locked in there. When my screaming was too heart-wrenching for the softer ones of the staff down the hall in the room where they had retired to, they simply turned down the monitor and intercom so they didn’t have to listen.

 

I know, because I heard when the telephone rang, telling the person sitting outside the inner door they could turn it back on now (after I had quieted down). This was brutality of the nth degree. But they always called it treatment for safety, though I mentioned the CMS regs to the security guards one day as they were inflicting their usual pain in order to bring me to the room, and they stopped in their tracks.

“You’re kidding,” one said, “Its true that the only legal reason for seclusion is Imminent Danger to self or others?” (I had been brought there for disturbing the peace…)

 

I nodded, Look it up. She looked gravely at the others. but proceeded o do what she had been ordered to do anyway. And I proceeded to behave in a wildly immodest and terrified fashion likewise…knowing I would be left alone and freezing for at least two to three hours, no matter how fast I calmed myself.

 

They didn’t care. it was PROTOCOL…

 Angry at me, the doctor put me in Four point restraints the first day I was there, freezing cold and thirsty , in physical pain, and mute...No one responded to my plight.
Angry at me, possibly justifiably, for slamming the door on him (I had been brutally restrained and secluded in the ER for NO reason the night before) the doctor put me in four point restraints the first day I was there, freezing cold and thirsty , in physical pain, and mute…No one responded to my plight. This drawing picture got stained from my efforts to save it from the trash, because every time they put me in seclusion the nurses would tell Housekeeping to throw my art and journals away. “It ‘s just trash” they would tell the cleaning woman, even though I begged them to preserve my work. Finally I wised up and mailed out everything I wrote and drew to my friends on the outside. Also I should mention that my rage at Dr Balkunas stemmed from his walking in to my room and pointblank telling me he would not let me communicate with a pen and paper, and would not sit with me at all unless I spoke with him…so my  rage, both from the restraints the night before and his  brutal dismissal of me, just exploded.

 

 

 

 

 

 

No one could hear me or see me in the Supermax Seclusion Room, or so I felt..since no one ever communicated with me in my agony...
No one could hear me or see me in the Supermax Seclusion Room, or so I felt..since no one ever communicated with me  when I screamed in cold or pain…only to tell me to shut up or lie down.
This is what the voices really instructed me to do...
This is what the voices really instructed me to do…
The Behavioral Care Plan was so torturous that if I was found with even a magazine or a pencil stub I was put back to Square one, no matter how far I had come...this happened at least ten times in 3.5 weeks.
The Behavioral Care Plan was so torturous that if I was found with even a magazine or a pencil stub I was put back to Square one, no matter how far I had come…this happened at least ten times in 3.5 weeks.
They had a camera in my room, supposedly to monitor me all the time, so how did this happen? I thought they were telling me to do it!
They had a camera in my room, supposedly to monitor me all the time, so how did this happen? I thought they were telling me to do it! Nevertheless, all heads and backs are turned away from me, and the room is empty.but for the hospital bed, which could be conveniently used for four-point restraints and often was.

How the MISDIAGNOSIS of Borderline Personality Disorder, WEAPONIZED, Damaged Me and Nearly Ended My Life…

FROM BPD CENTRAL:

Hallmarks of BPD

Following are hallmarks of borderline personality disorder:

1)Intense fear of abandonment, real or imaginary.

I do not fear abandonment. Many friends have passed through my life on their ways to distant ports of call in their lives’s journeys and I have always said, Well that is fine, we will simply continue to be friends on paper. I love letter writing and these days,what with email and skyping it is easier than ever to stay in touch. I still have a friend I met at folk dancing in 1972 who lives in Arizona, and we still talk occasionally and even meet every ten years or so. The thing is, we still consider ourselves friends. When my surrogate mother Lynn Levine died, I admit I cried, it was a very sad day and we had grown closer than ever over the two years of her dying.  I was sad that she was gone, but not fearful that she was abandoning me. (Dr Mary B O’Malley, in her insane need to brand me with the BPD diagnosis, before she removed it altogether in a letter to Dr Angela, unbeknownst to me, insisted angrily to me in a session that my tears were symptomatic, right then and there of my “intense fear of abandonment.” Rather than understandable grief than a lovely woman had stood in for my own mother during the years when she, my mother, had largely abandoned me due to my real mental illness of schizophrenia. (About this Dr Mary B O’Malley said nothing, zilch…Why say anything about a real abandonment that i had handled as well as anyone could?)

Having intense relationships with lots of conflict, and seeing the other person as “all-good” or “all bad.”

I have one friend who has dominated me for many years, and she may indeed have borderline personality disorder and suffers from it greatly. She demands that I not have other friends, despite the fact that I have many. And she bad mouths the ones Ido. She wants my narcolepsy drugs because they are stimulants and she believes these drugs are the only things in the world that make her “happy” but in fact NOTHING makes her happy. With all my other friends — my 60 birthday party was filled with 16 good personal friends who came to celebrate, not boyfriends and wives to fill in the space, but just my own friends. And they loved each other, though they had rarely met. I do not have conflict with any of my friends, and they would be appalled to have anyone insist that our relationships were filled with such extremes. They all tell me they love me dearly and that the biggest problem is that I do not love myself.

 

If the below is true about BPD, count me out. I do not feel empty. I feel too full of ideas of things to do and think about. I feel sad about the environment and the world, which I feel is dying due to humanity;s lack of caring and concern. But I definitely do not feel EMPTY. Hardly. I wake each morning feeling ready to start the day and having much to do and excited to do it.

 

The behaviors in this next paragraph mean NOTHING to me. I hav never done anything impulsive, except when driven to flinging shit in hospitals, because of their extreme trauma behavior. Engaging in impulsive “pain management” behaviors, such as going on spending sprees, having promiscuous sex, driving recklessly, abusing drugs or alcohol, binge eating, breaking the law, threatening suicide or making attempts, and engaging in self-harm — NONE have ever occurred to me. (When I harm myself it is exclusively in response to voices i hear telling me to do so, or when I hear people telling me to that I mistake for real people instead of understanding they are the voices.

 

I take Topomax, a seizure control drug, for a SEIZURE disorder and NOT for a mood disorder, despite what Michael Balkunas wrote on my discharge summary. I have never taken a seizure drug for mood stabilization. ONLY for temporal lobe epilepsy.

I have indeed been date raped under very unfortunate situations three times in my 20s when I was extremely innocent and did not understand that I had a right to be rescued by the security guards who asked me, and had any right to say No.

 

I have also been extremely traumatized and abused by caregivers and major people in my life whom I trusted and gave myself into their care. I should not have,. They were therapists and doctors. but I did not know better and suffered greatly. Now, I suffer under the ministrations of abusive doctors like Michael Balkunas who reads my PAD and decides to abrogate every single part of it because he KNOWS ME BETTER THAN I KNOW MYSELF.

 

To his dismay, I became loud and combative and fought his “help” every step of the way. So to take revenge, he added the BPD to my diagnosis. But it is a lie. He knows nothing about  me, no more than any other abusive in hospital doctor who have read what Mary O Malley Md PhD wrote in her discharge summaries when she was playing the nurses’ game at Norwalk Hospital and decided to let them treat me, who did not, even in her opinion, have BPD, with extreme behavioral protocols and seclusion and restraints. and dismissive ignoring of everything I said. Even today it resounds in my care. I feel it, I know it. Nothing is fair because of what she did, but she got a way with it…and I cannot litigate what she did more than a decade ago, lethal or nearly lethal though it was. But some day I will write her a letter and let her know the consequences of her actions.I do not believe she will care. People like her do not have consciences. Not even the Rev Dr Mary B O’Malley. She got away with it, She even wrote Dr Angela a letter denying it. But I have the records, I know she was lying, or trying to color things in a different way.

Hope was right when she said BPD was a weapon used against the intelligent and the disliked in hospitals. She said,if you objected, you were displaying symptoms of the diagnosis, and were dismissed, and when you objected to being dismissed, you were being manipulative. You couldn’t win, and even your rage at being not listened to was symptomatic… It is enough to make me want to pound my head through a door! (you see how it goes…)

 

Thank god I am out of HOCC, and I hope that  the blog post about Michael Balkunas has had some success at reaching them on the unit, I hope he and Jessica have had a chance to read it. Dismiss it though they certainly will, I want them to read it!  Fuck them, I have something to say and they need to know what that is.

Hospital Of Central CT: Smearing Shit at W1: An Angry Poem but an Honest one.

HOLY SHITE AND URINE TEAM

 

Her cool wordless RN face expresses nothing

as she scoops the ice cream turd  and quickly disinfects.

But I think for her, thinking, knowing this:

“Asshole, shithead, you think

your shit don’t stink…” While I have no working sense of smell,

I know I’m an unofficial pain in the ass here

because no one can be officially PIA

on a psychiatric ward, not even I, the wild shit smearer

who knows no disgust first hand

for not smelling it.

 

What I know well and sadly is

the consequences of disgusting others,

the distancing, the shunning,

how killing the ultimate loneliness is, double-locked away

in a soundproof seclusion cell.

Shackled naked into leather 4-point restraints, I shriek my soul away,

from the bottom of my lungs for 20 minutes straight.

The illegally silenced intercom remains dumb.

Even the 1:1 monitor positioned behind the door.

peering lazily  through the judas-eye of a small plexi-port-hole,

doesn’t really pay attention. Why bother, the shit smearer

gets what she deserves.

 

Oh, I know I disgust them, what with my out of control turd throwing

and my illegible scribbling with my feces on the wall

but they refuse me so much as a marker and board,

and they won’t sit down to listen when I speak.

Mute for 16 days, I will be heard now, one way or another.

But this is no way to think, and i think without thinking, just do with do do, mindlessly, enraged by trauma.

I foul myself because no one cares,

because their disgust is threaded, even so heat-felted with hatred

they have long forgotten I’m just another patient

with problems bigger than the shit I fling.

Instead, cucumber skinned nurses sneer their disgust,

Bad dog! Bad, bad dog!

 

But I know dog is just God spelled backwards.

And God created the living world

from dust and mud and excrement.

I am no god, I am Live backwards to Evil:

I create chaos from utter chaos within.

There are always turds to form and fling.

And in the end all they can do is kill me.

Fuck me! Do me a favor you turds, kill me!

But first, you have to silence the hate on your faces,

 clean the smeared walls,

and pretend I am nothing to you.

 

When you came in to take me down,

restrain me for any excuse, even for just wanting a blanket.

you had to breath in my shit, that fear,

and knew what it could do to you.

You’d heard the stories, deadly E-coli, C diff.

Something in me might kill you,

I don’t know what scared you more, my wildyelling

or my excrement.

 

That was always the struggle. Shit stinks. I stank.

You hated me for my smell. You feared me for what I did.

I know your fear. It was: what would happen if you

lost control of yourself.

Would you, control freaks,

too  dance naked in dung?

Hospital Of Central Connecticut’s Psychiatry Unit W-1: Dr Michael Balkunas

 

I understand now why Dr. Michael Balkunas, the psychiatrist at New Britain General Hospital (Hospital of Central Connecticut) W-1, general psychiatry, gave up on me. He decided, even after eliciting my brother’s opinion both from a professional and a personal standpoint, and Dr Angela’s equally professional opinion that I do not suffer from Borderline Personality Disorder, to diagnosis me secondarily as exhibiting that disorder.

 

Oh, he knew I had come in with an acute exacerbation of schizophrenia and that I had PTSD. He knew that I had in my electronic medical record documents stating from other psychiatrists that I do not and never did have any personality disorder, despite in-hospital “behaviors.” But I know why Dr Balkunas diagnosed one. He did it for the same reason the other hospitalist psychiatrists have done it in the past: 1) in order to justify the use of a Behavioral “Treatment” Plan that was tantamount to torture and 2) to excuse his liberal use of seclusion and restraints in instances when they went against all CMS regulatory guidelines. And 3) in order to dismiss me and call my behaviors “manipulative and devious” instead of taking me and what I said seriously.

 

 

I also suspect, for all the second shift RN Barbara’s telling me that Michael Balkunas MD is a caring man and “never gives up on a patient” that he DID in fact give up on me. In fact I suspect that he never really tried to deal with or treat me at all, that from the first time he resorted to seclusion and restraints, he knew he had opted to terminate any treatment alliance.

 

 

But how did I figure this out? Well, it isn’t as if there ever had been any kind of alliance between us. From the first day after he admitted me from the ER, when he came into my room while I was still mute, he just walked away, saying dismissively, “I won’t talk with you unless you speak.” Immediately I understood that this man was willing to jeopardize everything about me and about my treatment in order to assert his power.

 

 

The same thing came into play after I began speaking about a week later. Now the issue was that he would not speak to me, would not deal with me at all but would immediately leave the room if I became angry and spoke with anything resembling a raised voice. (Argh, this was so many shades of Amy Taylor MD at the Institute of Living last year! — and Dr Balkunas tortured me in similar ways with predictable ineffectiveness — but powerful people behave in predictable ways, right? It seems I must have threatened their sense of entitlement. Why else take it out on me? Who am I? I’m a big fat nobody! They could have ignored me or just treated and released me, like anyone else. But instead they did their damnedest to crush me and destroy me. Why? Because in the end, I think I must have triggered some underlying feelings of resentment and impotence in these two psychiatrists and you know you do not threaten to unearth the feelings of a psychiatrist, or at least not with Michael Balkunas MD or with Amy Taylor MD …)

 

I learned very quickly, but not quickly enough, that everything about the Hospital of Central Connecticut W-1 Unit at New Britain was about coercion and control. Not about trauma-informed, patient-centered care. I don’t know how other patients managed to be discharged from there within a few days, but it would never have been possible for me. Mostly because I was simply too out of control to BE controlled by people who used such methods to undermine any possible calm and stability I might have achieved in those early days. They did NOTHING to help me but take away the very coping methods and objects that might have helped me. They used the carrot-and-stick method liberally, but mostly they used sticks. The very fact that the ED staff had seen fit to seclude me, give me IM meds twice and also to four-point restrain me naked to a bed tells you something about the brutality that reigns supreme there.

 

You know the very first thing I did was give the ER and the W1 staff a Psychiatric Advanced Directive. It was supposed to help them to help me. But instead they seemed to resent my knowing myself, and wanting them to know how to help me. They reacted badly and worked against it in every way possible, instead helping me. It appeared to anger them that I knew myself, and instead of using it, they did everything in their power to abrogate each and every section of it, right up to the section where it asked them to notify my doctor and my brother when and if they used seclusion and/or restraints despite the warnings.

 

 

No one ever called anyone in each instance that they chose to restrain or seclude me, even though I begged them to verbally at the time as well, and this document, which was at the front of my chart all along, stated in no uncertain terms that I wanted both people to be notified.

 

 

It was the worst hospitalization I have ever had, and I say that having had many serious and difficult stays. I was not just a difficult patient, I was a pain in the ass, but this was a direct result of the trauma I experienced in the ED and immediately following it on the floor. If I had not been traumatized, on the unit and in the ED, I feel certain that my “behavior,” outrageous, “disgusting,” and out of control as it was, would never have been so damaged. But because everyone saw fit to go against everything advised in the PAD, and do everything they could to re-traumatize me– even after I had a conversation with a nurse about my three experiences with date rape, even after that, she decided to seclude me, involving the forcible removal of me from my room by brute guards who bodily threw me into a cell without any mean s of communication with the world — because of this, they got the regression and degeneration and worsening of symptoms that my PAD predicted would happen. What did they expect? That I would simply thank them?!

 

 

I realized, though, the Monday morning of the week he discharged me when he came into my room and asked me how I was doing, that Dr Balkunas, who “never gave up on a patient,” had given up on me. Now, my brother had indicated to him that the “kindness” Dr Balkunas was offering to me by means of involuntary commitment to CVH would be devastating and destructive to the max. I think “Balkie” had had to think about the wisdom of actually sending me there. So he also had to think about whether he actually had any tools at all to “fix me” or cure me as he had promised. Indeed he was no miracle worker and had never held out anything, NOTHING AT ALL, by way or therapy or treatment modalities beside commitment to the state hospital to help me…so without that threat he had nothing to offer me.

 

 

The man never once sat down and even talked to me calmly and caringly. I say this because when he sallied forth with his usual opening that Monday morning, How are you? (I had decided finally, with my brother’s encouragement to “play the game.”) I answered with the socially acceptable, “fake” answer, my game plan, not expecting any real psychiatrist worth his salt to accept it, but trying to “play the game” anyway, as I was desperate to be discharged. My answer?

 

“I’m fine, thank you. How are you?”

 

Balkunas really didn’t bat an eyelash, the completely social answer was good enough for him, because he had given up trying to help me. Indeed, he had never even tried. So he proceeded, “How are you eating?”

 

“Fine.”

 

“How are you sleeping?”

 

“Fine.”

 

“Well, if things continue this way and there are no meltdowns I think you can go home on Friday.”

 

 

There were indeed meltdowns, even the night before I was discharged I had a meltdown over my supper tray. But Dr B was not on the floor much and didn’t hear of those, and everyone was so sick of me that they didn’t write them up, knowing I was to go home. And I persisted in answering those three magic questions “correctly.” Socially, as I had been taught, against my will, years ago. He never asked me a single other thing, and never talked about anything else at all after that.

 

 

The day of discharge came, and the great and caring Dr. Michael Balkunas popped his head into the room. “How are you?”

 

 

“I’m fine thank you. How are you?”

 

“Okay, I will write your discharge papers now.”

 

 

The very minute he said that and turned to leave, I put my sunglasses back on, as I saw that taking them off a week prior had served its purpose and it mattered not whether I wore them from that point on or not. I still wear them today, to protect people from my evil…

 

 

Dr. Michael Balkunas may talk a great game about helping people but he has very few tools to do so and really it is all pretence. He has medications, which are by and large bogus (though he has been educated by Big Pharma for so long he fails to understand this), and he had commitment proceedings to the state hospital, unless he happens upon a millionaire family willing to spend on their family member. I was not one of those, nor worth it. CVH – for those who are not in the know, CVH—Connecticut Valley Hospital is the last state hospital and the only long term facility for adults on Medicaid in Connecticut – being sent there would have killed me and he and my brother both knew it.

 

 

The difference was that my bother was decent enough to care while Balkunas honestly thought it would be good for me to lose my life there. And that was his treatment? Bullshit. He was a bad doctor and despite the cant, he gave up on me to boot. Well, thank god he did.

 

 

But you know, I do not forgive his accepting my social “I am fine thank you. How are you” so easily. That was insulting. He was sick of me, and considered me willfully manipulative and devious, otherwise he would not have diagnosed me with the damning BPD diagnosis, which in his hospital means just that you are a PIA, no less and no more. But he might have at least pretended to be a psychiatrist and not just a social buddy. How are you? Fine thank you, How are you? What sort of answer is that? ON the other hand, if he had asked me, what could I have said? We both know I had to get out of there and there was nowhere to go but home. He was not interested in finding out how I was, in talking to me. Not from the first. All he wanted was to medicate me. Which he did. So fuck me. How are you, I am fine thank you how are you? And it wouldn’t have made a rat’s ass worth of difference if I had not been okay, which I wasn’t, so long as I said I was fine, thank you, how are you’

 

Like I said, it was a game. That was the name of it, Play the Game…

 

So fuck Michael Balkunas. He is worthless to me, and his add-on personality disorder diagnosis means less than a fig to me. He knew I had schizophrenia and PTSD. He knew the hospital was abusing me. He knows nothing about me, never spent more than 3 minutes with me on any given day. He knows nothing. And I don’t give a flying femtogram about HOCC (the former New Britain General Hospital) except insofar as they ought to ask me back to educate them and improve the situation vis a vis their abusive use of seclusion and restraints, not trauma-informed patient-centered care at all. However since even supposedly trained Nurse Manager Jessica came around to not objecting, and approving their use, I can see that it might be hopeless to do so. Willing though I would be.

 

 

Barbara, RN on the second shift. You alone were a lifesaver and a light in a dark tunnel. I wrote in the scraps of paper I called a journal of your kindnesses again and again, and I forgive your being blind to the cruelty of seclusion and restraints, because you have lived with that culture too long, You just need to be re-educated. But you saved my life. Had you not been on duty that weekend before I was discharged, I might not have calmed enough to say to Dr. Balkunas the socially acceptable “I-am-fine-thank-you-how-are- you” mantra that was the magic ticket out of there.

 

 

I know no one on W-1 remembers me with anything but relief that I am gone and a great deal of disgust and anger. Ditto for me. I still wake screaming from nightmares about the place and a great deal of anger that I don’t want to let go of. I want to hold onto it long enough to fix the situation of W1, before I forgive anyone. Then we will see.

 

 

But for now I am off to Vermont for six weeks to stay with relatives. I hope to heal. I hope I can heal…

 

 

Take care of yourself Barbara. You would do well to find a kinder and better place to work and train. I thank YOU for everything. I mean it when I say you saved my life and sanity.

 

 

Blessings on you alone, Barbara, the rest of you can FYandGTH.

 

 

Miss Wagner

WAGblog: While I breathe, I hope": Surviving Schizophrenia

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