Category Archives: Health

Staff Personality Disorder

I am reprinting this here because it is so true, and because it cannot be located elsewhere on the net, at least not via Google…The author was brilliant but, alas, I can find no name for attribution. A BIG Thank you to Anonymous!

 

 Criteria for Staff Personality Disorder

Personality Disorders

Staff Personality Disorder 601.83

A pervasive pattern of condescension, degradation of others, and controlling behavior beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Condescending or degrading use of body language, vocal inflection, and behavior.

2. Presentation of two or more markedly different personality styles based entirely on context.

3. Persistent protection of people in positions of power even if such people have done something unethical or illegal.

4. Employment in one of the “helping professions”, or other situations in which a person has or can secure power over others.

5. Rigidity in application of rules and explanations to other people

6. Persistent or stereotyped use of euphemisms, jargon, deceptive language, and double standards in language

7. Persistent use of degradation, ridicule, and violence, either gratuitously or grossly out of proportion to the situation

Diagnostic Features

The essential feature of Staff Personality Disorder is a pervasive pattern of condescension, degradation of others, and controlling behavior that begins by early adulthood and is present in a variety of contexts.

Individuals with Staff Personality Disorder display condescending or degrading body language, vocal inflection, and behavior (Criterion 1). They may use a patronizing “contaminated” smile, a sing-song voice, or the forms of language use described in Criterion 6. This behavior would be considered patronizing when directed at the average individual.

Individuals with Staff Personality Disorder present two or more markedly different personality styles based entirely on context (Criterion 2). For instance, while dealing with “clients”, while alone, they may be vicious, punitive, and controlling. When dealing with the general public, they may adopt a saintlike persona. It is not at all uncommon for the antisocial behavior of people with Staff Personality Disorder to go unnoticed, even when that behavior extends to torture or murder.

Individuals with Staff Personality Disorder will persistently protect people in positions of power, even if those people have done something unethical or illegal (Criterion 3). This may consist of putting up a “united front” to clients or to the public. People with this disorder will hide or excuse antisocial behavior in others with the disorder. Hiding may take the form of altering logs and failing to report abuse. Excusing may involve character assassination directed toward victims of mistreatment or abuse, or diminishing their credibility in some other way, while making it seem as if the behavior is the only logical response to certain sorts of people. They will also use these techniques of hiding and making excuses, to justify and rationalize their own behavior.

Individuals with Staff Personality Disorder are often employed in one of the “helping professions”, or other situations in which a person has or can secure power over others (Criterion 4). People with this disorder are disproportionately represented among psychiatric technicians, group home workers, home health care aides, social workers, special education teachers, counselors, nurses (especially psychiatric nurses), direct care staff, and institution staff. People with this disorder may also be grammar-school teachers, prison guards, and other professionals in positions of direct power over others. These positions may be either the cause or the result of the disorder.

Individuals with Staff Personality Disorder are rigid when applying rules and explanations to other people (Criterion 5). This, curiously but characteristically, may not extend to others with this disorder. Individuals with this disorder are likely to use a narrow set of rules to understand the behavior of others, particularly clients. They will see most ordinary behavior as manipulative, attention-seeking, or non-compliant. When confronted with something like violence on the part of clients, they will fail to differentiate between malice, self-defense, and frustration at being trapped. This may result in across-the-board application of punishments such as are described in Criterion 7.

Individuals with Staff Personality Disorder may display persistent or stereotyped use of euphemisms, jargon, deceptive language, and double standards in language (Criterion 6). They euphemistically refer to others as special needs, challenged, or consumers. They prefer jargon to ordinary language, and describe the behavior of others using clinical and psychiatric jargon, often loosely adding such jargon into everyday conversation, e.g. saying that someone they dislike has a Borderline Personality Disorder. They use deceptive language, for instance referring to prisons as hospitals and violence as treatment. They use double standards in language, e.g. referring to themselves as getting bored but to clients as going off task. They may apply certain words in a stereotyped fashion, repeating over and over that others are non-compliant, attention-seeking, manipulative, or playing games, without apparent regard to context or motivation.

Individuals with Staff Personality Disorder display persistent use of degradation, ridicule, and violence, either gratuitously or out of proportion to the situation (Criterion 7). Degradation may take the form of degrading language such as “retard” or “psycho”, denial or pathologization of the existing identity or roles of others (for instance telling someone that thinking he is a writer is a delusion of grandeur), treating people like children, or assigning humiliating tasks. More advanced forms of degradation involve using elaborate methods to thoroughly confuse a person’s sense of reality or self on all levels. Ridicule might include laughing at the aspirations or humiliation of clients, or laughingly dismissing their communication or behavior. Violence includes physical or sexual assault, mechanical restraints, chemical restraints, and solitary confinement. These things may be undertaken gratuitously, on a whim, as a result of boredom or frustration. They may be out of proportion to the situation, such as restraining someone for making eye contact with staff. These things are often justified using the means described in Criterion 3.

Associated Features and Disorders

Individuals with Staff Personality Disorder may have a tendency to take care of people who don’t need taking care of, or imposing their idea of care onto other people regardless of context or other people’s wishes. They may have a tendency to rationalize their own behavior in terms of helping others and be apparently unable to see their victims as fully human. They can be highly manipulative, especially to those they regard as inferior. Staff Personality Disorder may be associated with Stockholm syndrome and complex post-traumatic stress disorder in individuals who have been subjected to abuse by people with the disorder. Thus, a significant minority of people who are in institutional situations may develop features of this disorder or the full-blown disorder. Staff Personality Disorder is sometimes seen in the prodromal stages of developing full-fledged Psychiatry Disorder. Non-disabled children who participate in “Circle of Friends” and other helping-based friendship programs are more likely than other children to develop Staff Personality Disorder by adulthood, as are children who have been raised to be caretakers to disabled siblings or parents. People who go into the “helping professions” or who work in institutions are at high risk of developing Staff Personality Disorder, even if they have shown no signs of it in the past.

Specific Culture, Age, and Gender Features

The pattern of behavior seen in Staff Personality Disorder has been identified in many settings around the world, but is especially common on the top end of unequal power situations. Children imitating adults may transiently show signs that seem to point to Staff Personality Disorder where none is present. In the past, it seemed that Staff Personality Disorder was more prevalent in females, but it is now accepted that due to cultural pressures, it can present differently in males and females.

Prevalence

The prevalence of Staff Personality Disorder is estimated to be about 5% of the general population, about 80% among individuals who work in outpatient settings, about 95% among individuals who work in inpatient settings and other total institutions, and about 20% among inpatients and other people who experience prolonged abuse at the hands of people with Staff Personality Disorder.

Course

While there is considerable variability in the onset of Staff Personality Disorder, there is almost no variability once it becomes entrenched in a person’s identity. The most common pattern is that a person seeks a job in any of a number of “helping professions” and is gradually molded into the behavior patterns that typify Staff Personality Disorder. There is a window of opportunity in acclimation to these behavior patterns, in which a person may still have the insight to quit their job or resist further indoctrination. Once these behaviors become entrenched, they are self-justifying and rarely respond to reason or therapy. This is enhanced by the fact that many people with Staff Personality Disorder spend a lot of time socializing with other people with Staff Personality Disorder. A minority of individuals, when presented with the evidence of the harm they have caused to others with their behavior, truly become cured of Staff Personality Disorder, although literature indicates this requires constant vigilance to avoid falling into their old behavior patterns. Some people with Staff Personality Disorder acquire a disabling condition or another mental disorder and recover after learning what it is like to be subjected to the behavior of people with Staff Personality Disorder, but others will maintain their staff identity even within the inmate role.

Familial Pattern

Staff Personality Disorder is about five times more common among first-degree biological relatives of those with the disorder than in the general population. There is also an increased familial risk for Psychiatry Disorder.

Differential Diagnosis

Staff Personality Disorder often co-occurs with Psychiatry Disorder, and when criteria for both are met, both should be diagnosed. In instances where it is related to the development of post-traumatic stress disorder or other trauma-related disorders, it should be diagnosed in addition to those disorders with a notation that they are connected.

Other Personality Disorders may be confused with Staff Personality Disorder because they have certain features in common. It is, therefore, important to distinguish among these disorders based on differences in their characteristic features. However, if an individual has personality features that meet criteria for one or more Personality Disorders in addition to Staff Personality Disorder, all can be diagnosed. Although Histrionic Personality Disorder can also be characterized by manipulative behavior, Staff Personality Disorder is distinguished by condescension. Paranoid ideas or illusions may be present in both Staff Personality Disorder and Schizotypal Personality Disorder, but in Staff Personality Disorder these ideas are limited to concerns about the behavior of those under the person’s control (often inmates). Although Paranoid Personality Disorder and Narcissistic Personality Disorder may also be characterized by an angry reaction to minor stimuli, the reactions in Staff Personality Disorder have to do with specific situations related to the staff role and distinguish these disorders from Staff Personality Disorder. Although Antisocial Personality Disorder, Borderline Personality Disorder and Staff Personality Disorder are all characterized by manipulative behavior, individuals with Antisocial Personality Disorder are manipulative to gain profit, power, or some other material gratification, the goal in Borderline Personality Disorder is directed more toward gaining the concern of caretakers, and the goal in Staff Personality Disorder is to maintain control over a specific person or group of people. Also, while individuals with Antisocial Personality Disorder rarely show remorse for their antisocial behavior, individuals with Staff Personality Disorder make heavy use of specific rationalizations to justify their behavior to their conscience. However, some people with Antisocial Personality Disorder may have co-morbid Staff Personality Disorder and both should be diagnosed in that case. Personality Disorder can further be distinguished from other personality disorders by the typical pattern of protecting others with the disorder and persistent use of euphemisms and jargon to describe one’s actions.

Staff Personality Disorder must be distinguished from Personality Change Due to a General Institutionalized Condition, in which traits emerge solely in the institutional environment due to the direct effects of people with Staff Personality Disorder on an inmate’s behavior.

It also must be distinguished from Factitious Staff Syndrome, in which a person without Staff Personality Disorder masquerades as a person with Staff Personality Disorder in order to assume the staff role and effect change for the better for those under the power of people with Staff Personality Disorder. Factitious Staff Syndrome does not qualify as a mental disorder, but individuals practising it unwarily may develop Staff Personality Disorder.

We Are All Beings Of Radiant Light

997B86F1-2487-4CAA-83DE-B2816CF87FD6Why the name, Phoebe? asked Inkbiotic in a comment on my last post. Thank you for this question; it meant a lot to me. The name Phoebe is the feminine form of Phoebus, which is Greek in origin and means, “bright, shining, radiant.”

I have not always understood why I needed the name Phoebe, not in fifth grade. But it has always felt “given” to me, and in that sense my True Name. To explain, I offer the last lines of Rainer Maria Rilke’s poem, which ends, in translation, “from here there is no place that does not see you. You must change your life.” These lines have always called to me. They meant that I, my “me-ness,” needed to die to the artificial self and become what it is, a being of love and light, I needed to change the “false self” full of memories, of deep woundings and petty gripes, of anger and dreams of revenge to a self of pure light and boundless forgiveness and love. In a similar way, just so my name change, from Pamela, which is Greek too, meaning “ All Sweet”, but is also a synonym for cloying, to a name that means “radiant light,” because it is only in the light of love that we humans can be seen for who we really are, children of God, the Source, the Force for Good in every human heart.

I no longer accept the world (or my past) of hurt and anger and the urge to revenge. It is gone, over and done with, a figment of my imagination, which is the only place it can live. Falter though I may, my body being only flesh and human, with this name change I hereby offer myself to Change itself, that is to the Infinite, which can be called space or The Void, but which I saw in a vision of beauty is nothing but Creative Love itself.

Remember that we are ALL of us beings of light and life, we are all God, and we all partake of and participate in That Which Creates, the Space or Void that loves everything into being. My name change is only to remind me of the Source from which I came, as did we all, and to which we all return.

5FDAEFBA-93EC-40E8-8782-7A715B7ED00A

(Photos in public domain)

Changing my name and email

This applies to this WAGblog as well. Please read!

Art Every Day 365

This has been my dream ever since 5th grade in England when my teacher was only given P as my first initial and asked me what it stood for. Having always hated the plosive P in Pam I thought quickly and decided that phoebe would be perfect, keeping the p but not the plosive. It took her a month to discover I was not tell)NG her the truth, and then of course she switched to the dread Pam.

So I am in the process of changing my name to Phoebe Sparrow Wagner, and will probably from this point on be calling myself exclusively Phoebe. It may be difficult for those who have known me as Pam a longtime to make the switch, but my Vermont friends are all trying .

bye bye Pamela

Hello, Phoebe Sparrow

phoebesparrowwagner@gmail.com

View original post

Just Saying: Restraints and Seclusion are ONLY used as punishment

My response four years ago to an article in CT papers about the use of restraints and seclusion in CT hospitals.

“As someone who has been subjected to more use seclusion and four-point restraints over the past “decade of change” than in the two decades previous it boggles my mind that anyone would even dare to state that things are improving in CT mental health care institutions. During my nearly month-long captivity in the winter of 2013, the Institute of Living in Hartford regularly restrained me to a bed for as long as 19 hours at a time, without ever releasing me for so much as a bathroom break — I had to defecate in my clothing. I was not even released to eat. When I was not in four point restraints “for not following directions, I was in seclusion, which they called the “Quiet Room” and not seclusion, but by CMS definitions, it was seclusion as I was separated from the rest of the patient population by force, and was not permitted to leave the room I was isolated in.

The one time I did actually saunter away, walk down the hall to look out the window, and return to my non-seclusion Quiet Room, I was punished with immediate use of four point restraints, into which I was placed without a struggle, hoping that would make it easier to win my freedom. Alas, for me, there was no way to earn freedom from restraints I never “deserved.” The entire point was discipline, and that would last as long as the staff wanted me to be in shackles to learn my lesson. There was literally nothing I could do, –stay calm, sleep, quietly ask for release — nothing, until they were finally satisfied that I was submissive enough to obey their orders, some 6-19 hours later. But I had to cry Uncle, and submit to a set of degrading humiliating “debriefing questions” that assured them that I took responsibility for my own being restrained and that my behavior would henceforth conform to their norms.

I was surprised to see Natchaug Hospital being given good ratings of any sort. One of their chief psychiatrists on the Adult Unit, a longtime presence their Chief Idiot Emeritus psychiatrist you might say, Paul Pentz MD was so insouciant about this job as to be nearly incompetent, but probably hard to fire even for negligence. HIs name I have mentioned . He routinely did drive-by visits with his patients– a wave in the hallway might not be a completely standard morning meeting, but it happened often enough that peatients knew that would be all of this doctor they would see for the day. He routinely discharged patients with GAF scores at or around 60, the highest “global assessment of functioning” that one can have and still be rated “disabled” — not because he knew this level of functioning to be the case, but because it made him and his psychiatric ministrations at Natchaug look good. After all, if person comes in with a GAF in the 20s, and barely able to function, and you discharge him or her a week or two and some drive-by counseling sessions later with a GAF of 60, you must be doing a terrific job, esp for a 75 year old doctor not too keen on using anything like trauma-informed or patient-centered care. I had never left a hospital before Natchaug with a GAF higher than 40, but suddenly I rated a 60….by a doctor with whom I never spoke.

Natchaug Hospital, when the nursing director was Sharon B Hinton, APRN, was a decent place, because she made certain that abuses like restraints and seclusion rarely to almost never happened under her watch. I know, because I was there about three times during her administration. I also knew her when she was Hartford Hospital’s psychiatric Head Nurse at CB-3, where she and her never failing humanity and respect for the dignity of every patient made all the difference in the world. I might have come from an abusive hospital in the early 90s, like University of Connecticut’s Dempsey Hospital, which in those days four-pointed people to an iron bedstead, by shackling them spreadeagled to the four corners of the bed, a stress position that is not just tantamount to but is in fact torture. But I would be rescued by someone finding me a bed at Hartford Hospital, where Sharon would discover me arriving there in tears and tell me, unfailingly,”Its not you, Pam, you did nothing wrong, It is the hospital that treats you badly…We don’t have any problem with you, because we treat you well and you respond to it. When they treat you with cruelty, you respond badly…That’s very normal.”

But as to Natchaug…Bravo if they have done away with restraints completely. They had not done so when I was there last in 2012. Nor with seclusion, which was imposed in mostly a disciplinary and arbitrary fashion. Largely it was used to force medication on loud obstreperous patients or for angry fed-up senior nurses to take out their peeves on patients they didn’t particularly like (e.g. me). I still remember one APRN demanding that I be dragged to locked seclusion, and left there alone (despite all Sharon’s previous assurances that such would NEVER happen, that someone would ALWAYS remain in that room with me if I ever ended up there.. Alas, Sharon had left by then, so rogue nurses like D could have their way…) and when I peed on the floor in panic, and took off my clothes they rushed in to take them away from me, and inject me with punishment drugs, then made me stay for an hour alone on the pee-soaked mats, freezing cold, pretending to sleep and calm myself just to convince them I could leave and not bother anyone. I managed to do so, or at least the APRN D. got over her fit of pique and finally released me, but I was not really calm, and when they finally draped two johnnies over my naked body so I could decently traverse the distance to my room, I left, disrobing as I went…Who gave a damn about my flabby flat behind? I certainly did not. And it served them right if everyone got an eyeful…served them right..

Natchaug’s biggest problem was and probably still is a lack of staff cohesiveness and bad morale between the staff nurses and the well-educated techs/mental health workers who were all very dedicated college grads but were treated like grunts…The MHW’s did most of the important patient contact, but were not trusted to write patient notes, or the notes they wrote were never read, or accorded any import. This was not just despicable but very unfortunate in more than one instance during my stay, as the notes they took personally might have saved me from some terrible misunderstandings and outrageous misdiagnoses that harmed me terribly..

Most places use techs who are trained by shadowing for a day or two, which means, badly trained, if at all…

You have to take all such in-hospital diagnoses with such a heavy grain of salt, you know, even when they are labeled with the words, “THIS IS A LEGAL DOCUMENT.” Because they get so much of fact-checkable, factual material garbled that you cannot believe a word it says. And as for diagnosis, well it is all of it opinion, one, and two, it depends largely upon whether you are a likable patient or a disliked one, what they finally say about you on any given day. No one should have that sort of power over another human being, frankly. And the idea that they can brand one for life with certain psychiatric diagnoses just sickens me.

Be that as it may, my recent last experience was beyond the beyond, at Hospital of Central Connecticut, The old New Britain General…and I expect to go back to talk to someone there about it. I always do And I have much to say to them, after the pain and rawness have worn off a little. They considered it SOP to strip me naked and leave me alone in a freezing seclusion cell without any access to human contact, unless they chose to speak to me over a loudspeaker hidden in the ceiling. If not, I was utterly abandoned, no contact or even view of another human being for as long as they wanted to keep me secluded. They also restrained me, having male security guards four-point me stark naked to the bed, before they had the decency to cover me with a light sheet, even though I begged for a blanket for warmth. (A nurse manager came in and shivered, saying “Brrr its cold in here!” but did they relent and let me have a blanket…No, clearly I was not human, didn’t need warmth.)

This is just the tip of the SR iceberg in CT in the current years, Remember this is happening right now, not ten years ago, or before the so-called reforms. Nothing is getting better. Things are worse than ever, And when you are a patient in these hospitals, you have no help, no recourse, anything and everything can be done to you and you have no way to refuse or say “no”. No one will help you, or offer assistance. They can just grab you and seclude you or restrain you without your having the power to stop them or any recourse to make them pause and reconsider. You are powerless to stop anything…And so they get away with it every time. And once it is done, who will fight for you? What lawyer will take your case if the guards hurt your shoulder rotator cuff, or bruise you up, or degrade or humiliate you? No one….so you are deprived of your human and civil rights, completely, but the hospital knows that no one cares enough to fight for you, so they get away with it each and every time, and they know this when they do it. They have nothing to worry about,….You are just another mental patient, a nobody, a nothing.

That’s what you are if you are diagnosed with schizophrenia and hospitalized in CT hospitals in 2014. A nobody that the hospitals can abuse with impunity and will. Just wait and see if any of this changes…I doubt it highly. They have no motivation to change. They don’t think they are doing anything wrong now.”

Flynn Center Art Show for persons with disabilities

A670CDD22-181C-45E6-9817-6A62D0C6AA3B

 

E672E7AB-035F-4C12-B8F6-0807FD1C94A9

My picture NOT WAVING BUT DROWNING will be in this show. Click on link to see full color information

Continue reading Flynn Center Art Show for persons with disabilities

Difficult Decision: Will I or Wont I

 

 

 

 

 

 

I went off my psychiatric meds over the course of several months without a problem to speak of, until I was off them for a week, when two things happened. First off the withdrawal dyskinesia (see brief video above) was getting better, but I was beginning to feel, well, nothing, no motivation, no pleasure, no enjoyment in doing anything. I know that many people do not do well on Abilify and hate it, in which case I would say it does little good and to stop taking it. For me, ever since I started taking it in 2006 or so, I have had motivation to start doing and learning art in a way I never felt before. And each time I stop  it, no matter how  fast or slowly, I go down the hole into no motivation or pleasure in anything. I do not like this situation at all, because Abilify also causes me severe double vision, but but but, I must say that i helps me do things, to finish things, to enjoy the process. I do NOT have any idea why this is,  but it has always been so since I started the drug, and I can no longer bear being off it, despite the side effects and disapproval by others. Whatever the damage that years of first generation neuroleptics have done to me, this one drug seems to help me do what I want to do..

.Hate me or not as you will, I cannot bear not taking it. Without it I have no impulse to do art or write, and my life is shit. Is that really what I should be satisfied with?

Q and A, courtesy of Inkbiotic.com

Check out Inkbiotics WordPress blog for the origin of the questions I respond to below…

Now Tell Me About You…

1. Would you rather be beautiful, an astronaut or able to walk up any surface (ie up walls and along the ceiling)? Why?
Definitely I would love to be able to walk up any surface — it would provide such a “superpower” and afford me entirely new experiences.
2. Would you rather physically age, mentally age or visibly age?
At 65 I have been told I do not “look my age” to which my response is, this is was 65 looks like! That said, my mental and intellectual aging are of prime concern to me, and along with that is generally the requirement of good physical health. So if I had to choose for one of the three, I suppose I would opt for signs of visible aging.
3. What was the last good deed you did?
I hate to tell people what the good things are that I do in the world, it is boasting and so I keep these between “my concept of god” and me, where any accounting of good deeds belongs.
4. I’ve been watching the Good Place. It’s great. To give a spoiler-free description, it’s a comedy about a Heaven-like place, where you can live in your ideal house in a perfect village, eat all your favourite foods, and hang out with your soul-mate. What three things wwould you choose to have in your good place?
Good friends, good books, good memories.
5. You get a time machine watch that can only go up to an hour into the past or future. What would you use it for?
If such a machine existed, I would reserve its use personally for revisiting all the times that I have written and sent impulsively some email I should not have, or likewise, to repair words I spoke that might have caused immediate harm. I would not use it to visit the future, as that could tamper with the present big time and also I prefer the future to remain tantalizingly unknown and unknowable.
6. You’re such an awesome person, that the mayor of your town has asked you to come up with a national holiday, what would you want the holiday to be for (eg Tree Day, Festival of Dreams), and when would you want it?
Peace Day would be a national holiday of forgiveness where people are supposed to reconcile and make amends for past conflicts , both on the micro or personal scale and on the macro or international level, where this day is reserved for nations to think and act peaceably towards each other, and make attempts to end conflict.
7. What small something would you change right now?
I would start being able to speak again, having been mute since November 2017…
8. What are your plans for getting older? How do you want to spend your time when/if you stop working? Where do you want to be?
Having been on disability and not working all my adult life, retirement is meaningless, but I hope to be able to do art till the day I die.
9. You find out (probably from a magic floating wizard or by text or something) that nothing you do today will have consequences. What’s your itinerary for the day?
First of all, everything we do has consequences, absolutely everything, it is unavoidable, that is the beauty of what is called The Butterfly Effect. Small changes in a system can have enormous down stream consequences, like the butterfly that flaps its wings in Beijing and by a long series of directly traceable consequences and events eventually leads to a hurricane in the Atlantic. We all always affect others and the world in ways we can never perhaps predict or understand the full ramifications of. So given this, I cannot in any rational way answer this question.
10. When you die your ghost will be trapped in the place of your death, where do you want to die?
Sorry, but this question again leaves me bereft of an ability to answer. I do not believe in trapped ghosts. Energy exists, yes, and maybe we can “leave behind” personal energy that imbues a place, but I do not think one’s Life energy could get trapped in any place just because you died there. And frankly I think your “living ghost,” the life energy and intentionality you project and leave in your LIVING wake is far more important than where you die. We are trapped only insofar as we believe in traps. Ghosts or spirits or just human energy, life is where energy matters, as it warms the blood and invigorates the mind and body. I worry less about where I will die, and whether my “ghost” might be trapped, than that while living I am free in mind enough not to feel trapped or in a prison of someone else making. Freedom is a state of mind, an attitude. Where the body or the ghost is scarcely matters when your mind is truly free.

What are/were the most significant barriers to your recovery from “mental illness”?

The biggest barrier to my recovery from what had always been diagnosed as schizophrenia or schizoaffective disorder was, I regret to say, the mental health system and psychiatry itself. Yes, for many decades I had been told I was ill and needed interventions like medications and the hospital for my “brittle psychosis”. I was told even that obvious brutalities, like 5-point restraints and seclusion in locked freezing cold cells, devoid of anything but a slab in the wall and a grate in the floor for drainage, were helpful treatments for my condition and not the torture and punishment that I felt them to be. No one or very few people treated me with kindness or any understanding or with the idea that there was hope for recovery, even though I had a genius level IQ and had shown some significant talents in many areas, and still did even when sick. They seemed bent on only one thing: coercion and control, and to prove that they were able to dominate me, and the other patients. If you dared to question their superiority or their information you would either be dismissed as delusional or worse, treated with more abuse.

 

Needless to say, I lived up to these expectations for many years, and i did not get better or even come near to recovering. In fact, before I took the drastic step of giving almost all I owned away and leaving my home, the state where I had lived for all my life and moving to another 100 miles away, by myself, knowing no one and nothing about it, I ended up again in the hospital and almost did not make it out. Not only did the guards there attempt to strangle me, but the doctor was convinced that I should be committed to the state’s one public facility that provided long term treatment…from which I might not leave for a long time.

Instead, I managed to play the game this sadistic doctor insisted on, and was finally discharged from a city hospital that had spent weeks doing nothing but torturing me, daily throwing me into their seclusion cell or shackling me in restraints …for no better reason than that I “disturbed the unit milieu”.

But discharged I was, with newly acquired PTSD from my treatment there, and within a week I was two states away, safe for the first time from these ministration that had inflicted on me nothing but damage.

It was here, in this northern state that I finally began to heal, with the help not of the mental health system but of a non-licensed therapist (she has a psychotherapist license from the UK) who taught me Marshall Rosenberg’s non-violent communication or NVC, and is the first person I felt sees me for who I really am, not “just another schizophrenic.” Even though I still take medications, I am slowly tapering off of them and doing well after decades on the massive doses I was told I absolutely could not survive without. Why? Because I’m proof of the fact that you can recover from life-long “mental illness” when given enough unconditional acceptance and understanding. When someone sees you and understands you and does not dismiss you, crazy as you might have been told you are, a lot of the craziness just falls away and you become another human being, no more and no less.

There is no normal, there is no abnormal. We are all just human beings trying to get along in society and often society is sicker than “we are” in its demands that we conform to some impossible standard. Maybe my experiences — hearing voices, thinking things that might be called delusions, etcetera — are not common but they are not outside the realm of human experience either. We should rejoice in our differences as in our similarities and look for common cause between us, not find reasons to fear what is Other in each other. Love really is what it’s all about. Maybe that sounds squishy and sentimental, but have you ever met someone diagnosed with schizophrenia who says they both love themselves and feel that they are adequately loved in the world by others?

Institute of Living, 2013, Torture and Illegal Confinement Part 2

Restrained at the Institute of Living 2013

Continued from previous post:

Here’s what SAMHSA the substance abuse and mental health services administration publication has to say on seclusion and trauma:

“Studies suggest that restraints and seclusion can be harmful and is often re-traumatizing for an individual who has suffered previous trauma…

“Further, there is a common misconception that seclusion and restraint are used only when absolutely necessary as crisis response techniques. In fact, seclusion and restraint are most commonly used to address loud, disruptive, noncompliant behavior and generally originate from a power struggle between consumer and staff. The decision to apply seclusion or restraint techniques is often arbitrary, idiosyncratic, and generally avoidable.

“Moreover, some studies indicate that seclusion and restraint use lead to an increase in the behaviors that staff members are attempting to control or eliminate.

I have been traumatized, and not just by hospitals. I was date-raped three times in my twenties and experienced traumatic domestic abuse. The cover sheet on the PAD made very clear that due to these trauma issues, I could not tolerate being secluded or restrained without severe consequences: regression and serious worsening of symptoms. Unfortunately, as soon as the staff saw fit to use physical methods of coercion and control on me, that is to say, punishment, from the first time a staff member grabbed me, all bets were off as to how I would behave. I certainly ceased improving, and my symptoms went downhill. Did they really think they were being kind and compassionate? Violence begets violence….

I tried to get help even when on the unit, at least I tried when I was free to make calls or leave my seclusion, err, forced-voluntary “time-out” two-week-long stay in the so-called side room” last winter. I do not know how many times I called  the patient advocate office, but the sole time anyone made contact was when she came to hand me some paperwork – I believe I was actually in 4 point restraints at the time – some papers I could not read about a forced medication hearing they would be holding. I needed her advocacy, but she never responded to my panicked called. I wanted her help, but she never came by to ask me what I needed. She was less than useful, the fact that I had to go through her, and her refusal to respond contributed to my ongoing panic and desperate feelings of aloneness and depression. No wonder Dr. Banerjee tried to force me into ECT (about which my feelings of horror and revulsion were stated clearly in my PAD).

And where did the ECT discussion come from at all? My PAD states that I would refuse ECT under any and every circumstance. My brother would be my conservator if Banerjee had sought to go down that road, and he would never have made any decision to counter my wishes on that subject. If Banerjee really read my PAD, he would have known that. He told me that “Dr Mucha and I have made the decision to force you to have ECT.” I recorded the conversation in my journal immediately  after it happened and Dr. Banerjee presented it as a two-man decision only, one that I had no choice in.

Regarding ECT and my so-called “depression,” Sanjay Banerjee MD had stopped my 75mg of the antidepressant Zoloft during the first or second week I was there. “Do you really need that?” he had asked, “You don’t seem depressed to me.” Obedient, and in any event glad to get off any medication at any time, I nodded my head, assenting to the change. At least, I thought, if things go haywire, it will not be due to self-fulfilling prophecy, a doctor looking for symptoms he expects to find and conveniently finding them. And at least he will know the reason.

A week later, instead of reinstating the Zoloft, Banerjee blamed my sudden “depression” on my refusal to take Lamictal, a drug I had not taken in 6-9 months. Now he was applying to force me to have ECT, something I was terrified of, convinced it caused deliberate brain damage.

It was this threat, and the brutality with which the decision was made, that started the downhill course of my IOL stay.

The very next day, all hell broke loose. When I entered the conference room, I pushed some important notes I needed Dr Banerjay and Laurie to read across the table in front of them. They refused, claiming that I threw the papers at them. Instead, Dr Banerjay proceeded to berate me, and told me how he had consulted with other hospitals and providers and had read my records against my instructions and Advance Directive, thus violating my HIPAA rights. Moreover, he threatened me with a behavioral treatment plan that would not permit me to do art or writing unless I “behaved.” I hit the roof, telling him I would sue the hospital and complain to JCAHO, then summarily left, slamming the door, an act that stemmed from feelings of utter impotence, because I couldn’t actually say in words anything more effective.

It could have ended there. I could have been left alone, to cool down and calm myself. But no, Dr. Banerjee had to write for stat meds again, and even though I was on the phone and trying to find someone to talk to, to calm myself, I had to be physically dragged off the chair I sat on, away from the phone and brought to the floor in a physical struggle (because they had attacked first, i.e. physically grabbed me, I defended myself, instinctually). They could have waited for me to finish the call. They could have waited to see if I calmed myself. I was not hurting anyone. I did not threaten anyone or myself with harm. ALL that I had done, in terms of physical threats was yell at the phone and refuse to take a pill. Furthermore, it was done and over with. I had left that area and gone to my room. I had then come back and now sat on the chair by the phone, speaking to my interlocutor on the other end. There was no need to pick a fight or encourage a struggle. A wait-and-see policy could have successfully guided things to a better resolution not only for the situation at hand but for my entire hospital stay. As a famous poem by Dylan Thomas ends: “After the first death, there is other.” Once the IOL staff decided to use restraints, there was no going back. The first time broke everything. So, they used them again, and again, and each time more freely and without justification but for convenience and punishment.

Some final points:

CMS regulations on use of Restraint and Seclusion

Restraint or seclusion may only be imposed to ensure the immediate physical safety of the patient, a staff member, or others and must be discontinued at the earliest possible time.

At no point in my stay was anyone ever in immediate physical danger except me, from the staff who were assaulting me…They may have claimed that I bit and fought and resisted, but this was always in response to their manhandling me first. Always. In fact, my medical records show they had restraints re-evaluated and approved while I was sleeping. They even discharged me from the hospital directly from restraints and seclusion, on a day when the usual attending physician happened to be out of town.

(ii) Seclusion is the involuntary confinement of a patient alone in a room or area from which the patient is physically prevented from leaving. Seclusion may only be used for the management of violent or self- destructive behavior. 

This means that IOL’s definition of seclusion as being “kept alone in a room to which the door is locked” is wrong. I protested that I had been secluded all along, for a good two weeks before they instituted formal seclusion. I was not violent or self-destructive, and certainly not imminently dangerous to self or others…Never was anyone in immediate physical danger.) Yet the IOL allowed staff to abuse me and seclude me because I was loud and made people uncomfortable…I was surely not the first person to be so treated and brutalized. It remains traumatizing to this day, and I know it is still happening to patients at the IOL even now, because no one can stop them if they don’t know it is happening. Due to this sort of brutal treatment, my PTSD escalated. I think about what happened there and I can’t stop trembling. I have nightmares every night that literally keep me from sleeping.

“The highest price of all is the price paid by the people who are restrained: their recovery is stalled by a practice that can disempower them, break their spirit, and reignite a sense of helplessness and hopelessness…” from Recovery Innovations

Worst of all, using restraints doesn’t work to make either the patient calmer and safer or the unit a calmer safer environment to work in for staff. In truth, things only go from bad to worse once you restrain an unruly patient…Violence only begets more violence…Moreover, when I was another hospital, I was told by one of their mental health workers that she had wanted to experience the process of being four-pointed so she could identify with patients. She was told no, because as the aide informed me, hospital administrators feared it would be too traumatizing.

Restraints are traumatizing, let’s face it, in order to restrain me the manifold times I have been brutally restrained, putting up no resistance whatsoever, even the most jaded and brutal should have felt a twinge of conscience and questioned why he or she was doing. Unless they had become so inured to cruelty that they no longer considered it degrading and obscene to spread-eagle a naked woman, shackling her legs to the bed posts, so hardened to sadism that they did not consider tying her wrists to the underside of the bed as torture, only a mild form of discipline,  meted out in order to teach her the lesson they had decided to teach her…

I hope you manage to read this letter and look at the supporting materials. You could learn a lot. You have more power than I do in this world, and could change things, if you know they are happening and are wrong. I beg you to think about what I have written to you. The IOL is not an isolated case. Brutality happens in nearly every psychiatric ward and hospital in Connecticut, and I believe this is the reason: As long as seclusion and restraints are permitted in any fashion, brutality and abuse will continue and at rates that are higher than where they are eschewed.

The problem is not that there may remain some exceptional cases who, it is claimed, will need to be restrained, but that someone somewhere will start finding such exceptions and boom, we’ll be right back where we started, with abuse and mistreatment of the most vulnerable. I believe the only way to stop the abuse of seclusion and restraints is to simply stop using them, period. Killing in self-defense is a good defense in law, and every decision to use restraints should be evaluated with similar strict thinking. Say No, we don’t go there, first, and then if done, know that it was a violation of the law and harmed the patient above all else, but under some conditions, this is the lesser evil compared to what might have eventuated without their use.

Now hospital workers are allowed to use restraints and seclusion as legitimate forms of “treatment. But when you permit staff to use violence against even one patient, it imbues their culture with an acceptance of violence as a treatment modality rather than something criminal. Restraints help no one. They are always retaliatory. Always discipline and punishment. Oh, in the short run the unit may seem quieter and easier to manage, but in the subsequent days, when the prisoner in restraints re-enters the community more chaos than ever may ensue.

Please help me. Do something about it today.

 

Institute of Living, Hartford CT, torture and illegal confinement in 2013

Part One

4-point restrained at the Institute of Living 2013 routinely for 19 hours or more.

Let me introduce myself. My name is Pamela S. Wagner, and I was for most of my 65 years a resident of Connecticut. I have a long history diagnosed with serious mental illness and have been on disability for many years because of it. Five years ago,  I was admitted to the Hartford Hospital’s Institute of Living on a 14-day PEC. I would like to tell you about some of the grotesque brutalities that transpired there and the egregious “treatment” that passes for care in that hospital.

Ever since I was discharged from the Institute of Living in February 2013, to which facility I had been committed as an involuntary patient under an order known as a Physicians Emergency Certificate. I have felt too terrified even to read the partial chart which the Connecticut Office of Protection and Advocacy obtained for me. Indeed, every time I recall what I am able to, or reread the brief nursing notes about what was done to me that winter at the IOL, my heart races unbearably, my body sweats and shakes and I start crying. Even so, because of trauma-induced amnesia, I remember the month I spent there only vaguely and in “snapshot” or flashbulb-like moments” of clarity. It is only now that I have acquired these few records, and learned some of the details of what happened that I’m finally able to put some of the pieces together.

Before I say anything further, I want to say that I believe that I was grievously injured by the “treatment” I received on Donnelly 2 South, and that what the staff did to me was not only unethical and cruel but that it crossed the line into illegality more than once.

I was admitted to Donnelly 2 South, and right from the first I made it clear that I wanted to witness their searching my knapsack. I wanted to know what they confiscated from me. They assured me that, Yes, of course, that is our policy, Don’t worry, Pam, you will have ample opportunity to watch us search your bags… I calmed a bit and followed a nurse to a closed room to do an intake interview. When she released me to the Day Area, I was shown to my room, where I found on my bed, my already searched knapsack and bags. Needless to say, this upset me greatly and I made my feelings known, which did not endear me to anyone. I let the charge nurse know that I felt violated and that she had openly broken a promise and my rights, posted prominently on the hospital wall.

As the Donnelly 2 staff learned, I had arrived prepared with a detailed Psychiatric Advanced Directive and I made it very clear that my online electronic medical record was accessible from any computer. I made the Read-Only access code available to the doctor and nurses. That included documents such as my narcolepsy diagnostic consult and special documentation proving my need for a higher than usual dosage of Ritalin, written by my former sleep specialist (also my psychiatrist from 2000-2009.) Included as well was a letter she wrote to my present psychiatrist, Dr.  C, explicitly stating her conviction that I do not, and never did have a personality disorder, borderline or otherwise, a conviction that Dr C also held.

According to Dr. Sanjay Banerjee, the doctor who first took over my care, he read every page of these and all the other documents that I brought with me. That is what he told me. Moreover, when he spoke with Dr. C, my outside psychiatrist, he brushed off my concerns about anyone misperceiving me as having a personality disorder. My brother, P, himself a psychiatrist, brought the same matter to the fore again when in discussion with Laurie Denenberg, LCSW. Again, her response was much the same: “Personality disorders are not a part of the picture here. We intend to honor her PAD. We are glad that she has had the foresight to prepare such a document.”

Nevertheless, Amy Taylor, MD, the doctor who took over my care after Jan 27th decided to summarize my psychiatric history from this stay in words such as these: “long psychiatric history of schizophrenia, paranoid type, PTSD, and personality disorder NOS with borderline traits.” I was treated for four weeks for an active psychotic disorder. No one could know – especially with the significant additional diagnosis of PTSD, whether or not I had any personality disorder, given the two Axis I diagnoses already present. I believe she decided to use this diagnosis as a way to “justify” the brutality that she had ordered to be used to punish me during the hospitalization I write about.

As I said, I was on the Donnelly 2 unit for almost a month. But I was admitted on January 10, 2013, right into to seclusion because of putative “blepharitis.” They called it “infection precautions” but never took a culture of my swollen eyelids to determine if there truly was any infection present. They simply said it had to be blepharitis – as if saying so meant that it was so (but the fact is that blepharitis generally speaking is a benign non-infectious condition, and one that doesn’t produce massive swelling in the entire facial region). There were other factors however that accounted for my swollen face: prime among them the self -inflicted second degree burn on my forehead the size of a half dollar. Knowing this, the fact that my face had swelled to 1½ its size should not have surprised anyone. Blepharitis? The doctor was looking for zebras instead of seeing the common nag right in front of her…

I know I was a difficult patient. I was loud and paranoid and hard for some staff to deal with. That is precisely why I wrote out my Psychiatric Advance Directive the way I did, with explicit and detailed instructions for how best to deal with me when I was upset… When ill, I am frightened, paranoid, and hostile, which makes me easily roused to irritability. I know this, from a distance as it were. But knowing this now does not mean I was in full control of my behavior at the time.

On Feb 5th, I was being held incommunicado in the so-called “side room”, which, when I called it seclusion, the staff insisted it was not so. That afternoon, I simply walked away from it. I had had enough of them saying it was not seclusion, then preventing me bodily from leaving it. So, when I could do so without someone actually wanting to fight me, I walked away.

I proceeded to enter the unit and walk down the hall to the end and looked out the window. I took a deep breath, heard  staff behind me, and sauntered back to the proper end of the hall, the “lost end” where they kept anyone from seeing me or knowing what they were doing to me. Once I got there, they descended upon me, some staff I knew, but most I did not. I did not bother to look at who was doing what to me. I simply lay passively on the bed and put my arms where they could do what I knew they would do. Tightly, they shackled my wrists out past my hips so there was no play in the restraints and I could not turn on my side or do anything but lie stiffly on my back. At the same time, others jerked my feet apart and just as tightly shackled my ankles to the lower corners of bed. Then came the coup de grace. They twisted me over onto my side somehow, pulled down my pants, and injected me with three drugs: Haldol 5mg, Ativan 2mg, and Benadryl 50mg. Why, except as punishment I do not know. I had, just a half hour before, been doped up on involuntary Zyprexa 10mg. Then they walked out, leaving someone just outside the door for the usual monitor, and did not release me for 19 hours, despite the fact that I was sleeping much of that time.

Of course, this was punishment. The very fact that they told me it was “not punishment” only “what your behavior brings on every time, Pamela,” proves my point. At first and usually they only said, it was because I “didn’t follow directions” so if they were not punishing me, what were they doing? They most certainly were not following Centers for Medicare and Medicaid regulations for the use of Restraints and Seclusion only in cases where a person is in imminent danger of harming her self or others. Indeed, the best they could do, when I protested, passively, saying just those words, was to respond, “You are not safe” as if that proved somehow that I was in danger or posed any imminent threat to the safety of anyone.

They always restrained me in an X, spread-eagled so tightly I couldn’t move a muscle. They never permitted bathroom breaks or even let my hands free to eat, so several times I had to pee and even defecate in my clothing. I would fall asleep rapidly after those three injections–whether I was restrained while calm or not, it was routine: punishment needles in the buttocks of Haldol 10mg, Ativan (up to 5mg at one time) and Benadryl 50mg—and then they would invent reasons to maintain me in restraints even after I was asleep for hours. When I woke, hardly dangerous to anyone, they would grill me with questions that I was too groggy to answer, and they would use my inability to respond as reason not to release me.

Later in the evening on Jan 5 or 6thth, for the second time that day, they restrained me, this time for throwing half a graham cracker at the wall. Then they left me like that for hours, even after I fell asleep. In point of fact, I could never earn my way to release from restraints by good behavior or quietly, calmly asking for release. Of course not, because I hadn’t done anything to “deserve” them in the first place. They always refused to release me,  always, until I cried, “Uncle” when they told me to.

As to those vaunted “shows of force” what does anyone expect? Presented with a cohort of threatening staff personnel I saw only one thing: an impending assault.  I know they anticipated my panic; it said as much in my chart. Isn’t that the point of a planned “show of force” – to induce fear and panic? (which when you think about it is grotesque…What sort of person wants to induce fear and more panic in someone who is by definition already terrified?) But why else do it? So why should it be any surprise, when I defended myself as they grabbed me? When they stuffed me into a body bag and were trying to tighten the straps, surely you can understand why anyone would bite the hand of an attacker whose digits came near. It was a matter of life and survival instinct…

But none of it should have happened. My PAD explained in exquisite detail exactly what to do and what I respond to better than fear tactics and force. In fact, it is beyond comprehension, knowing that one of the admission diagnoses I came in with was PTSD, how the director of patient care at the time pre-approved on paper the emergency abrogation of my PAD and a “just in case they are needed” use of restraints and seclusion. Why didn’t he counsel the person asking for this advance “right to restrain” to do instead all in his power not to restrain me and to work with the PAD instead?

TO BE CONTINUED… SEE NEXT ENTRY.

Please let me be (Ushering in the New Year with a call for inclusion and empathy )

An amazing poem with a stunning opener line for the new year. By my friend Marie Abanga in Cameroon.

Marie Abanga's Blog

Please let me be

for the world

Please let me be queer

let me be queer it’s my life

be all the regular I don’t care

Please let me be a misfit

I am done trying to fit

You can do all the fit in I don’t care

I come from a broken home

I now lead a broken home

keep your fixed home

He cries mama

she teased my papa is gay

And so what I ask?

gay means happy

why be any judge?

and then go to church?

sing unconditional love

and love so conditionally?

They call me a rascal because I love pascal

he is such a friend

we trust each other so

sinners you say?

who did HE come for?

Winners they who followed HIM

Shabby may be the dress code

merry the constant mode

you can care for your body

I’ll care for my mind

View original post 15 more words

New Poem by Pamela Spiro Wagner

FIXING YOU – A REWRITTEN POEM

Recalling my month-long “treatment” at New Britain Hospital a.k.a Hospital of Central Connecticut on Grand Street, in May 2014, under the supervision of Dr. Michael E. Balkunas

 

Naked in restraints in New Britain Hospital 2014

 

 

 

 

 

 

 

 

 

Only nine days after that last adders-pit hospital —

You still wear sunshades to protect others from you

though no one out here believes they are in peril.

 

Nevertheless, the staff there described you

as “assaultive,” dangerous to self and others,

unfit for company or visitors.

Neither accurate nor truthful

they wrote lies for the sake of their convenience.

 

Now you are a week from making new friends

in far northeastern Vermont,

in a place magically named the Kingdom

and it’s a move your bruised mind

requires, still unable to let go of

the half-nelson grip of hospital guards

bent on eliciting pain, who, when told to strip you

then four-pointed you naked to a mattress,

replaying their favorite rape scene,

yanking each limb apart to expose and humiliate, knowing

that the nurses’ own official policy was hands-off

and would protect their asses.

 

You want truth, you wish for reconciliation

but how, you wonder, does any Truth or Reconciliation proceed

when so many refuse to acknowledge

that hospital staff broke every rule,

stopping short of murder only

because you submitted nick of time,

your terror strangled in a towel they wound

around your head and face,

before they injected punishment drugs into your buttocks,

then muted the intercom and sealed the door

 

No one was ever there to bear witness.

That was always the point,

from your father to the hairdresser

and all the hospital staffs in-between.

They’ve made a religion of secrecy

and no one Outside wanted to know

what they didn’t want to know…

 

Call this, “our family business,”

call it, “a private shampoo,”

call it, “necessary treatment.”

they could always do what they wanted to you.

 

And when it broke you, as it eventually would,

when your sudden screams split the night,

and no one could explain what drove you

to empty your lungs,

ripping the air to shreds,

they stood aside and declared you

just “one of the family” now,

no better and no different than anyone else,

now that they’d finally fixed you for good.