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

 

I understand now why Dr. Michael E. 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

9 thoughts on “Hospital Of Central Connecticut’s Psychiatry Unit W-1: Dr Michael E. Balkunas”

  1. Dear Sharon,

    Thank you for your insightful comment. It is all too true, of course, as you learned with Robin…and technically “not allowed” with someone with an axis 1 diagnosis…even though with DSM 5 the axis system is done away with. That said, the doctor went to my brother and my current and longtime treatment provider with that very question, and they both denied that I had any such pervasive patterns of thought or behavior. I would say that my brother and my psychiatrist know me pretty well by now, no? Anyhow, they said, absolutely not, Pam does NOT have borderline personality disorder, or any PD at all. But when he diagnosed it, despite knowing their opinion, I am convinced it was not because it was even his opinion or that he believed it, but more that he had to “justify” the brutal behavioral methods they used to control me. When you use a behavioral care plan that restricts access to any and all art supplies unless and until I do such and such for 24 hours…a nearly impossible thing for a person in crisis who uses art as a good coping mechanism, you know you are in the hands of sadists who will say and do anything…even when they are CLEARLY counterproductive for everyone, most especially the patient. They could see, for example, that every time they put me in restraints or seclusion, my behavior got much worse as did my symptoms. Any “sane” person would recognize that this means you need to take a different approach. But no, they just continued to do as they had been, and worse…Until i was smearing my own shit on the walls and even eating it and flinging it at the guards who abused me there…I will spare you more details as I think you have already quite sufficiently gotten the picture! Thank you again for following my blog and for commenting. Pam

  2. My opinion is that diagnosing anyone with a personality disorder when they are in the midst of an acute psychiatric crisis is often a mistake. Personality disorders (I completely hate that term and use it only as a means of communication) are patterns that are pervasive and consistent across situations. Without a lot of historical or collateral information, it is impossible to know how someone usually behaves and thinks while they are destabilized and in a hospital. Pam, I’m so sorry you have had such painful experiences with treatment.

  3. I never accepted dbt because i knew it was for bpd which i was confident i did not have.. Also cbt fares just as ill, being a bogus evidence based “short term ” treatment that ins. companies gladly pay for but ends up doing little for those with real problems but salving the conscience of treaters who don’t have time for all. In my opinion, neither works for much the same reason. Yes, cbt can be individual based, but rigid and for three months – then voila you are on your own or else you must have hmmm some weird excessive emotional problem like bpd and need dbt…which as you said has been reduced to a bunch of hand outs. I dunno that Linehan intended this initially but it got too big….i really haven’t done a lot of research though, just catch as catch can as i do not feel attached to the bpd label…only offended by it. I largely feel as a hospital label it is a fiction and as you mentioned a very powerful weapon…best never used at all.but weapons have a way of being discharged whenever they are in the hands of the wrong and threatened powerful people. Oh the stories i could tell…just feel still so raw and downright hurt to do so. And who would ever take my part…? Even the doc who started this nonsense actually wrote a personal letter to my present shrink denying my bpd and saying 1 i never had it, that she, hah, never diagnosed it, that it had been difficult to convince other hospital treaters of her opinion….yeah yeah yeah…what a bald faced lie! This lady was the first to write bpd on my chart and explain that the nurses wanted it so they could treat me ” another way”… I was still too ill to understand this or question it. But later on, i did, and challenged her to prove my diagnosis. Well, she said, you cried when your surrogate mother was dying, which proves you ” fear abandonment” ! i seriously kid you not….

    I had had it with her by then. I knew she had some serious issues with me, if not with her self and must have harbored some deep anger with me that she felt she could not deal with…for some reason. I did not deserve this. She was well paid and well compensated, but not well trained. It was the start of my learning i had to leave her. A long process as she was my first psychiatrist and joint sleep specialist which had been immensely helpful to me. But she was authoritarian too, and i came to chafe under that.

    Two or three months after i sent for my records, from her, she sends this letter, denying she had ever ever diagnosed bpd, despite all our in and outside hospital arguments about it. Plus the fact that she had confirmed the bpd diagnosis over and over with my treaters at other hospitals…so what was this bullshit? If i had a lawyer and this lying was litigable, as having destroyed my treatment and my life, i would take her to court. I have the records to disprove her words, and the damning letter. But I DIDNT DIE. SO WHO GIVES A DAMN. Right? That she treated me with 4-point restraint routinely for more than 24 hours would mean nothing to nobody…

  4. This is the medical model’s problem, the legacy from its onset within Modernity – that is that it’s a bunch of egos, floating around, discharging wisdom, never listening, constantly judging, hierarchical, middle class morons, thinking they can measure, change, and control human experience. Dodgy. I put as much faith in them as I put in finding rocking horse shit.

    My lifesaver was training as a psychotherapist, and moving away from the medical model, and diagnoses. After all, we all exhibit ‘symptoms’ at times, and it is far healthier, I believe, to approach people with a thought about their ‘process’ rather than their label. Who cares anyway, it is never consistently so, but people can just not handle uncertainty within the medical profession. You should see what they do with kids!

    Pam, I hear your pain, frustration, and anger.

  5. I have some pretty major issues with Marsha Linehan, too. DBT treats you like you’re stupid. I think it can be helpful when somebody is just starting treatment, especially if they’re trying to get control of destructive behaviors. But now it’s being treated like it’s the perfect treatment for everything, and a lot of treatment centers now use DBT exclusively. So then once you’ve outgrown the rudimentary usefulness of DBT, you’re left in the lurch. Either you keep going through the same modules and the same photocopied handouts ad infinitum or you’re left with no treatment. It is, from my point of view, irresponsible treatment.

    But it’s popular for the same reason a lot of things are: money. DBT is one size fits all, so treaters don’t have to spend the time it would take to develop truly individualized treatment plans. It’s mostly group-based, so you can bill more patients during the same block of time. They can do less work but make more money.

  6. Just because the clinic diagnosed you, doesn’t mean it is true, please don’t include yourself as one of “us” (bpd) and i don’t include myself either…unless you think it fits. I do not believe it. Not from your writing…do you? The docs can be wrong, even evil. they are not gods…quite the opposite, i went to med school. I know how arrogance and stupidity can mix together often and badly.

  7. Hope i could say mountains about this…just did but cant find my
    Password to get it past my own wordpress censor! Anyhow, marsha linehan might say that bpd is a real illness but in hospital i think it just describes someone who is difficult, too intelligent and disliked. Put that together with the devious and manipulative label and you have ingredients for torture and real crazymaking!

    Pam

  8. Personality disorders, particularly borderline, are often “weapon” diagnoses, in my experience. Once they’ve diagnosed you with BPD, they use it against you. Any time you have an emotional reaction to something, they tell you that’s a symptom. If you ask for something, you’re accused of being manipulative or attention-seeking. And if you get upset about being treated that way, they note that down as an “inappropriate and excessive display of rage.”

    I spent three months at the Menninger Clinic in Texas, and that was how they treated me there. I had an outpatient therapist back in Cambridge who was great, and I called her in tears about it. Her response was, “Look, Hope, you and I both know you’re not borderline, but you’re doing a damn good job of impersonating one right now.” Because when the people you’re around all the time treat you a certain way, you start to act that way. There are all kinds of studies on that.

    And they use it as an excuse not to offer any real treatment. Conventional wisdom is that borderlines never really get better, so that’s used as an excuse not to treat us. That just reinforces the stereotype–borderlines don’t get better, but it’s because they’re untreated or not responsibly and compassionately treated, so OF COURSE they don’t get better!

    As you can tell, I have strong feelings on this issue. I’m sorry you’ve had to deal with it too.

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