Category Archives: Mental Health

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?

13 Things Mentally Strong People Don’t Do

Things Mentally Strong People Don’t Do


(posted on youbtube by Franque Michele)


Mentally strong people have healthy habits. They manage their emotions, thoughts, and behaviors in ways that set them up for success in life. Check out these things that mentally strong people don’t do so that you too can become more mentally strong.


  1. They Don’t Waste Time Feeling Sorry for Themselves. Mentally strong people don’t sit around feeling sorry about their circumstances or how others have treated them. Instead, they take responsibility for their role in life and understand that life isn’t always easy or fair.


  1. They Don’t Give Away Their Power. They don’t allow others to control them, and they don’t give someone else power over them. They don’t say things like, “My boss makes me feel bad,” because they understand that they are in control over their own emotions and they have a choice in how they respond.


  1. They Don’t Shy Away from Change. Mentally strong people don’t try to avoid change. Instead, they welcome positive change and are willing to be flexible. They understand that change is inevitable and believe in their abilities to adapt.


  1. They Don’t Waste Energy on Things They Can’t Control . You won’t hear a mentally strong person complaining over lost luggage or traffic jams. Instead, they focus on what they can control in their lives. They recognize that sometimes, the only thing they can control is their attitude.


  1. They Don’t Worry About Pleasing Everyone. Mentally strong people recognize that they don’t need to please everyone all the time. They’re not afraid to say no or speak up when necessary. They strive to be kind and fair, but can handle other people being upset if they didn’t make them happy.


  1. They Don’t Fear Taking Calculated Risks. They don’t take reckless or foolish risks, but don’t mind taking calculated risks. Mentally strong people spend time weighing the risks and benefits before making a big decision, and they’re fully informed of the potential downsides before they take action. You may be interested in this too:


14 Things Positive People Don’t Do


  1. They Don’t Dwell on the Past. Mentally strong people don’t waste time dwelling on the past and wishing things could be different. They acknowledge their past and can say what they’ve learned from it. However, they don’t constantly relive bad experiences or fantasize about the glory days. Instead, they live for the present and plan for the future.


  1. They Don’t Make the Same Mistakes Over and Over. Mentally strong people accept responsibility for their behavior and learn from their past mistakes. As a result, they don’t keep repeating those mistakes over and over. Instead, they move on and make better decisions in the future.


  1. They Don’t Resent Other People’s Success. Mentally strong people can appreciate and celebrate other people’s success in life. They don’t grow jealous or feel cheated when others surpass them. Instead, they recognize that success comes with hard work, and they are willing to work hard for their own chance at success.


  1. They Don’t Give Up After the First Failure. Mentally strong people don’t view failure as a reason to give up. Instead, they use failure as an opportunity to grow and improve. They are willing to keep trying until they get it right.


  1. They Don’t Fear Alone Time. Mentally strong people can tolerate being alone and they don’t fear silence. They aren’t afraid to be alone with their thoughts and they can use downtime to be productive. They enjoy their own company and aren’t dependent on others for companionship and entertainment all the time but instead can be happy alone.


  1. They Don’t Feel the World Owes Them Anything. Mentally strong people don’t feel entitled to things in life. They weren’t born with a mentality that others would take care of them or that the world must give them something. Instead, they look for opportunities based on their own merits.


  1. They Don’t Expect Immediate Results. Whether they are working on improving their health or getting a new business off the ground, mentally strong people don’t expect immediate results. Instead, they apply their skills and time to the best of their ability and understand that real change takes time



Now I want to share a website where you can find out more about YOU, and why you are the way you are. This website provides a test and a resulting personality profile, which will give you a clue about your ways of being and how and why your interact with others the way you do, as well as your preferences in life for being and doing. The test here is free and may be saved as long as you remember to register by putting in your email. The basic profile is free and you can pay for an indepth one but once you get your test results, which is four letter code, much info is available for free on the internet.


Another site, with the official Myers-Briggs test or MBTI, of which the 16 Personalities is a version, and gives much the same results, and this can be found here: then go to the Personality TYPE test.  Now, some of you may be fearful of being labelled but the thing about the MBTI is that it has nothing to do with labels being IMPOSED but any individual’s personal preferences leading to their type being discovered. I found it quite extraordinary, after taking the test a few times, and getting the same results each time, upon reading my profile with an open mind, just how predictive as well as descriptive of my behavior it was. The one thing it never is was prescriptive. It does not tell you what you HAVE to do only what you are likely to want to do or how you are likely to react in any given situation, given your personal preferences in life, and your personality style. Try it, if you don’t like it or don’t respond to it on a visceral level, disregard it!


Cheers, everyone!

Julie Mad Blogger Interview Recorded at Link Here…


New Book Launch Announcement!

LEARNING TO SEE IN THREE DIMENSIONS, BOOK LAUNCH INFO: JUNE 2. ARTWALK FRIDAY evening in Brattleboro Vermont. 6-7pm at the Hooker Dunham Theatre and Gallery. Or call the gallery for a privately arranged tour. Or contact pam for further information and a tour of the gallery. Any group of disabled individuals or those who cannot make it to the gallery for the show (it is not not not “accessible”) _ i will provide a reading/ talk and books for sale to any group who can get me there  to speak to them, providing  transportation to make it possible for me to meet with them. All entirely free of charge. 


Art in Progress

I did this chair tonight with drawing  Vine charcoal I made in the grill. I peeled wild grape vine  then roasted the pieces in wired-together tin box pierced with a nail to let out the gases, for an hour..Inside after that was nice black vine charcoal!

Chair drawn with Homemade Vine Charcoal














The Second piece is my drawing in progress of which I will try to post a few stages..I have not come anywhere near to finishing it! Nor do Have any idea what it will look like when done!

#1 in Progress Art

In progress #2

Drawing in Progress#3






Robert Fritz Said Artists Can’t Use Art to Work Out Their Problems…


Aside from the fact that it is really stupid and cruel to say this to a student taking your course on creativity, and I was stupid enough to listen to him without objecting…Aside from all that, when Robert Fritz says artists can’t use art to work out their problems, I say, Balderdash! SAYS WHO? SAYS WHO?!!!

Can you imagine what the world would be like without artists who did NOT work out their problems in and through their art?  A world without the likes of, and I am just selecting a few very famous examples from all over the art world:

Edvard Munck’s numerous depictions…

Edvard Munch, "The Scream"
Edvard Munch, “The Scream”










Just in case you doubt that he was rendering his emotional turmoil in pastel and paint, he wrote these sentences on the frame of one of the four known original versions of  what the world now knows as
The Scream:

I was walking along the road with two friends – the sun was setting – suddenly the sky turned blood red – I paused, feeling exhausted, and leaned on the fence – there was blood and tongues of fire above the blue-black fjord and the city – my friends walked on, and I stood there trembling with anxiety – and I sensed an infinite scream passing through nature.[9]

And where would the world of poetry be without Sylvia Plath.  Surely it would be a milder and less rich place without her magnificent and moving poem, “Daddy”, which I will quote only in part below:

“You do not do, you do not do   
Any more, black shoe
In which I have lived like a foot   
For thirty years, poor and white,   
Barely daring to breathe or Achoo.
Daddy, I have had to kill you.   
You died before I had time——
Marble-heavy, a bag full of God,   
Ghastly statue with one gray toe   
Big as a Frisco seal
And a head in the freakish Atlantic   
Where it pours bean green over blue   
In the waters off beautiful Nauset.   
I used to pray to recover you.
Ach, du…
The poem continues for several more stanzas which are well worth reading before ending with the incredible punch of:
“…So daddy, I’m finally through.
The black telephone’s off at the root,   
The voices just can’t worm through.
If I’ve killed one man, I’ve killed two——
The vampire who said he was you   
And drank my blood for a year,
Seven years, if you want to know.
Daddy, you can lie back now.
There’s a stake in your fat black heart   
And the villagers never liked you.
They are dancing and stamping on you.   
They always knew it was you.
Daddy, daddy, you bastard, I’m through.


A contemporary poet who has for many years mined her life and traumas for art, is undeniably Sharon Olds. But one poet who made art out of exquisite spiritual agonies was the British Jesuit convert,
Gerard Manley Hopkins in the mid-1800s, who wrote what are now called The Terrible Sonnets, terrible because they portray with astonishing depth the  suffering and spiritual anguish he experienced as a parish priest going through the dark night  of the soul. I do not know of any poet, then or now, who has done it better.

This is one of my all-time favorites of Hopkins. But you really need to read it aloud…

Not, I’ll not, carrion comfort, Despair, not feast on thee;
Not untwist — slack they may be — these last strands of man
In me ór, most weary, cry I can no more. I can;
Can something, hope, wish day come, not choose not to be.
But ah, but O thou terrible, why wouldst thou rude on me
Thy wring-world right foot rock? lay a lionlimb against me? scan
With darksome devouring eyes my bruisèd bones? and fan,
O in turns of tempest, me heaped there; me frantic to avoid thee and flee?
   Why? That my chaff might fly; my grain lie, sheer and clear.
Nay in all that toil, that coil, since (seems) I kissed the rod,
Hand rather, my heart lo! lapped strength, stole joy, would laugh, chéer.
Cheer whom though? the hero whose heaven-handling flung me, fóot tród
Me? or me that fought him? O which one? is it each one? That night, that year
Of now done darkness I wretch lay wrestling with (my God!) my God.
Speaking of artists, does anyone else perhaps believe that Francisco Goya might have been working out something in this painting?
Francisco Goya, "Saturn Devouring his Son"
Francisco Goya, “Saturn Devouring his Son”


Francisco Goya Saturn Devouring Son

But as Robert Fritz said to me in class, and I stupidly took to heart, “ARTISTS CAN’T USE ART TO WORK OUT  PROBLEMS”…

Geee, they can’t? How dumb of me to think they can and do it, all the time.

Remember Franz Kafka? Why do I think he too might have been dealing with his authoritarian father in  such books as THE TRIAL, THE CASTLE, THE PENAL COLONY or a story like “The Hunger Artist”…No, that is impossible, right? After all, artists cannot and do not do such things, not real artists…Not according to Robert Fritz, who is the arbiter of all things art!

Songwriters are notorious for displaying their hearts on their sleeves, as most of us know. But VIc Chesnutt, who later committed suicide, did this in spades, with his song, “Coward.” This song is far too raw and painful to me to place it here as a sound file. But I will give you the lyrics and tell you to look for a version of Vic singing it, as no one can do it better.

The courage of the coward
Is greater than all others
A scaredy-cat’ll scratch ‘im
If you back ‘im in a corner
But I ,I ,I, I am a coward
I, I, I am a coward
Courage born of despair and impotence
Submissive dogs can
Lash out in fear and be
Very, very dangerous
But I ,I ,I, I am a coward
I, I, I am a coward

Anyhow, I think I have made a case for stating that art — which can be used for a great many purposes,  in fact can be used in whatever fashion and for whatever use you want to employ it, because truly there are no rules — most certainly one can work out one’s problems in and through using art. What better way to do so in fact? Better than taking a load of guns and shooting up the nearest  _________! (fill in the blank with the most recent mass shooting locale.)

I welcome my readers to send me examples of artists who expressed themselves or used their problems to make art.  I will add them to the list, especially if you provide a link to an example of their work.

Much love to all,

Pamela Spiro Wagner

Oh, I plum forgot! Here is my own example of using art to deal with problems:

Chained, a colored pencil drawing 17 by 22 inches by pamwagg 2014
Chained Burka Liberty and the Pitbull, a colored pencil drawing 17 by 22 inches by pamwagg 2014


Center for Behavioral Health Statistics and Quality, Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health (2015). The range of conditions includes depression, which the CDC estimates will soon become the second leading cause of disability in the world

Folks, below this I post part of Hillary Clinton’s grand Mental Health Care plan, not because I believe in it, but because I want you all to see what our next president has in store for us. And because I hope you noted what the last thirty years have wrought in DAMAGES. Yes, after all the miracul0us advances of SSRI’s and SRI’s and adjunctive atypical anti-psychotics added to these so-called miracle anti-depressants. OOOooh, we have gotten so much healthier on our miracle pills.YES! We have gotten so much better that we now, get this, commit suicide at a rate 24% HIGHER than we did in 1999, In fact we kill ourselves at our highest rate in 30 years.

Well, I am sorry, people, but this is fucking BULLSHIT, just bullshit. You don’t believe me? Okay, i am used to that. No one ever believes me. So go ahead and read what dear Hillary posted in her Mental Health Care Plan below, from the National Institute of Mental Health. Those are not my numbers but right from the NIMH. So let’s go ahead, take our happy pills and tell ourselves we feel better, go right ahead, but what do we do when another buddy kills herself or himself despite the sweet help of his or her neighborhood pusher, er, psychiatrist???

Well, don’t tell me they did not warn us: ANTI- DEPRESSANTS DO NOT WORK THEY KILL. And it is posted very clearly right there, above.

Okay. Being forwarned is only part of the battle, we have to listen and we have to act.

Sorry for being so strident, I am really sorry.


Go ahead and discount me, I do not care. But look at the statistic I posted above and ignore the implications at your peril.




Federal Support for Suicide Prevention

Suicides, which are usually fueled by mental illness, are rising among numerous population groups, from adolescents and college students[11] to veterans[12] and older adults.[13] The overall rate of suicide increased by 24 percent between 1999 and 2014, and is now at its highest level in 30 years.[14] Over 40,000 Americans die of suicide every year, making it the tenth-leading cause of death nationally.[15] As the former director of NIMH, Dr. Tom Insel, often notes, suicides have 11 victims: the person who dies, and at least 10 people close to them who will never be the same. Hillary believes that suicide is a critical issue that she will prioritize as president. She will:

  • Create a national initiative around suicide prevention across the lifespan that is headed by the Surgeon General: As president, Hillary will move toward the goal of “Zero Suicide” that has been promoted by the Department of Health and Human Services. She will direct all relevant federal agencies, including HHS, the VA, and the Department of Education, to research and develop plans for suicide prevention in their respective settings, and create a cross-government initiative headed by the Surgeon General to coordinate these efforts. She will also launch a citizen input and feedback mechanism, to enable outside groups to comment on agency recommendations, and explore how we can harness technology to reach out to people who need support.
  • Encourage evidence-based suicide prevention and mental health programs in high schools. In 2013, a survey of high school students revealed that 17 percent considered attempting suicide in the last year, with 8 percent actually attempting it. The suicide rate among American Indian/Alaska Native adolescents is even higher, at 1.5 times the national average. There are effective ways to respond. It is critical that school districts emphasize evidence-based mental health education, so that students, teachers, and school nurses are aware of the warning signs and risk factors of mental illness and how to address them. The Model School District Policy on Suicide Prevention, released by four leading mental health organizations, includes concrete recommendations that school districts can follow. Hillary will direct the Department of Education to emphasize mental health literacy in middle and high schools and will work with regional and national PTA, school counselor associations, and associations of secondary school principals to encourage school districts to adopt this model policy.
  • Provide federal support for suicide prevention on college campuses. Hillary believes that every college campus should have a comprehensive strategy to prevent suicide, including counseling, training for personnel, and policies that enable students to take leave for mental health Such multi-layered approaches have a proven track record of decreasing suicides. For instance, the Air Force launched an initiative in 1996 that brought together multiple intervention programs and reduced the suicide rate among Air Force personnel by nearly a third in under a decade. Groups such as the Jed Foundation, American Foundation for Suicide Prevention, the Suicide Prevention Resource Center, and Active Minds have created frameworks around suicide prevention tailored for colleges and universities. Hillary will dramatically increase funding for campus suicide prevention, investing up to $50 million per year to provide a pathway for the country’s nearly 5,000 colleges – whether private or public, two-year or four-year – to implement these frameworks on behalf of students.
  • Partner with colleges and researchers to ensure that students of color and LGBT students are receiving adequate mental health coverage. Evidence suggests that the psychological needs of students of color are disproportionately unmet, impeding their ability to adapt to college life. LGBT students face added burdens as well, with gay youth being four times more likely than their straight peers to attempt suicide. Hillary will direct the Departments of Education and Health and Human Services to work with universities, researchers and community programs to determine how best to meet and respond to the challenges these students face and to provide specialized counseling.



I’m still here…

So sorry to every one for disappearing so unexpectedly. I was sent to Brattleboro Memorial Hospital Emergency Room on December 31, 2015, largely because MRR was short on staff, and there i was brutalized for 6 days before Rutland Regional Medical Center took me in, on their state hospital PICU unit.


In the ER not only did they restrain me as i have depicted, but they injected me with 15mg of Haldol and much more over the course of those 6 days, despite my advanced directive, signed by four people and notarized, that explicitly states that under no circumstances am i to be given Haldol!


The ER doctor admitted that he violated, knowingly, my advanced directive.  Due to facebook supporters calling the local newpaper in outrage, the newspaper called not the hospital–that would have violated my privacy, so they claimed, even though i had alerted the paper myself to their treatment of me! No, the newspaper, the Brattleboro Reformer, called my twin sister, Carolyn Spiro MD and asked her if this treatment of me, her sister, and her twin, was proper, and her amswer was, Absolutely!!!!


So you see where she stands on the issue of the torture of both psychiatric patients and her own twin sister! I have had nothing to do with her for years because of this.


Meanwhile, i have many many good words to say about the Rutland Regional Medical Center PICU but i don’t have enough time on my iPad tonight to say them all. So i will just end with this other artwork. I hope tomorrow i can tell you more about RRMC where they are trying, in a very small constricted place, to do things right, at least in terms of seclusion and restraints.



“Schizophrenia or Suggestibility ” by David

Sorry. Sorry! mea culpa!!! i meant to introduce this post with this: “David” wrote me with the following essay about his experience,which I promised to post for him on my blog. It follows: 

” I saw Lady Quixote’s story printed out at the Hearing Voices meeting in San Francisco.


“What struck me was how similar was the story she told to my story. When I was a small child I did self hypnosis as a hobby.  Later as a young teen I met a senior citizen from the Unity Church who provided me a lot of books about new-age psychic topics. She talked with me about automatic writing and spirits. I did many of these things in hopes of becoming psychic.


“Through my high-school years I continued to be interested in these things but only when the college experience overwhelmed me did I become preoccupied with the voices in my head.  I would look for guidance in things as simple as where to walk.  Since walking to class was a prerequisite to attending class, if I was guided instead to walk in the woods, I failed at college.


“In addition, throughout my psychic explorations there were instances where there were definite connections between my mind and the rest of the world.  Although the number of true experiences were far less frequent than the imagined ones, they reinforced my beliefs.


“After I returned to my parents’ home I had the typical delusional experience of believing that there was a direct connection between the universe and what I was thinking and hearing in my head.  Unfortunately what I was hearing was based on what I thought abut myself and as I spiraled downward, I was told that I had to kill myself.

“After getting out of the hospital and the halfway house with a diagnosis of schizophrenia, I returned to my parents’ home.  A few years went by with little change but I began to doubt the veracity of my voices and found that I could dismiss or ignore them.   They eventually faded away into the benign parade of inner thoughts.

“The thing that struck me after thinking about Lady Quixote and me is that there are some states of mind called schizophrenia that would better be described as suggestibility.  In the old days folks like us were seen as having been possessed by demons, and perhaps the exorcisms actually worked when the people believed strongly enough in prayer and calling on Jesus to drive the demons out.

“I think that it is a shame that this type of diagnosis has not been made by treaters because it would be helpful to folks to understand that they can be liberated from their troubles in a much more straightforward way, as  Lady Quixote was.

“Because, like her, I had some actual experiences that could be classified as psychic, having a diagnosis that labeled my inner thoughts as strictly delusional confounded matters.  The psychiatric community does not acknowledge that some of us have to deal with both real experiences and our overactive imaginations. They are trained in the practice of science, which is opposed to the various phenomena we call metaphysics.


“I am happy that my inexplicable experiences usually involve rather mild, not very intrusive thoughts, as opposed to noisy voices.  I try to practice good mental hygiene to keep the inner critic mostly at bay and avoid overstressing myself.  It has been about 40 years since I was troubled with my inner voices.



Two Poems

Audobon Field Guide Barred Owl
Audubon Field Guide Barred Owl


Dear R, you who have asked me,

via my Service Offer (“I write personal poems”),

to “create” you a poem, can’t know,

when my second late night email

fails to elicit a prompt response,

how my certainty of rejection hammers me

into old penances, and how I tinfoil walls

and barricades against my extruded poisons.

Then when your emails resume the next day

mentioning your little white house,

a she-owl who watches you with soulful eyes

and your growing “sense of despair”

I imagine a woman of mature years,

alone, though perhaps through choices

not always made freely. So to meet you

I navigate unfamiliar and unpaved roads

parking behind a half-built barn

and a muddy old green Subaru.

Younger than I expect, you’ve moved here

to escape precisely what we never discuss.

You reference only the need for peace of mind,

and a relief from startling triggers.

Nevertheless, I understand your need to know

that spirit-familiar, the barred she-owl, Strix varia,

roosting on a white pine bough

outside your window all winter,

less guardian than too starving to move away

or predate the small animals atop the ice layer

between her and proper voles held in safety beneath.

Only when deep-freeze breaks in early March

and a shadow swoops silently across your pane,

do you know who’s won the battle,

and cheer for a raptor’s kill that saves her life.

The world, after all, is all about killing or being eaten,

which is true even in the human world

where your neighbors stalk you with barking dogs,

and talk nights, beneath your bedroom window

of that woman next door, who is not like them,

with her window salad garden and that owl.

Fearful, blind, they believe that hoot owls

harbinger death. Instead you try to see

the way a mythical Owl might see,

through cold and black of night

for clarity, for lucency, for whatever it is

that warms the living embers

and rem-embers your mind to peace.


This next poem describes the present situation, which continues…with the following explanations.

In the Greek myth, Philomela is raped and has her tongue cut out by Tereus, the husband of her sister Procne. Rendered mute, Philomela weaves a tapestry detailing the crime to inform her sister, who, enraged, takes revenge on Tereus. At the end of the story, both Procne and Philomela are transformed into birds.  In some versions of this story, Philomela turns into a female nightingale, while in others she becomes a swallow. However, neither of these birds can sing.

Jerry Mahoney and Charlie McCarthy are two famous American ventriloquists’ dummies


I haven’t spoken out loud for many weeks,

bullied by “voices” to a frightened into myself silence.

Still, what does “speechless” mean

in these days of text-to-speech software,

with its choice of Vikki or Samantha or Victoria voices,

especially when I’m possessed of a blog and writing fluency

enough to speak my mind to my heart’s content?

Even so, being mute is not a manner of speaking.

Yet I tell you I can talk. Nothing physical impedes

my tongue, or locks my lips

except my brain’s hallucinated snarls,

Jerry Mahoney and Charlie McCarthy thrown

into surrounding shadows

ordering up this stoppage, blockage, blockade.

Now, like Stevens’ fire-fangled bird at the end of the mind

feathered unlucky, tarred, locked in golden cage

my voice remains only a memento

of everything

I wanted to say, but could not get out,

I couldn’t get it out, I could not get it out…

Don’t Worry, Be Happy, and Dance, Cry, Hum along!


If this doesn’t make you happy, I am very sorry…I myself despite a massive migraine and fears of vascular bleeds found mysefl directing a virtual orchestra in the midst of my pain and by the end, PooF! magically it was GONE! Miracle of miracles!


Sometimes it Takes a Village …to avoid the Hospital

Sometimes it takes a village...of caregivers
Sometimes it takes a village…of caregivers


I swore that after I left Hartford Hospital’s Institute of Living last January, 2013, having spent the better part of a month in seclusion and many many hours brutally and punitively four-point restrained, I swore I would never go anywhere that would treat me like such an animal again. But then, having twice been treated at Yale New Haven Psychiatric Hospital once in early 2013 and finally later on that same year, discharged with piriformis syndrome from having been forcibly held down and injected in the buttocks  over and over with 3 different drugs, Haldol, Ativan and Benadryl, I said that I would NEVER again permit such torture in the name of treatment anywhere, no matter what they called it. No not even at Yale.

Given the massive traumas I have experienced these past five to ten years in Connecticut mental hospitals, abusive practices that have only increased since my first hospital stays in the 70s, I decided last August, post Yale: never again. Never again  would I go to  ANY hospital whatsoever.


To that end, my family, my family of origin, since I never married and have no money of my own, has taken it upon themselves to hire for me (or let me arrange for myself the hiring of) several personal staff members to “come on board” for me in my apartment 24/7 starting in late December and if necessary work through January, if there is a crisis. I haven’t gotten through any January without a hospital stay in several years, so it is a good thing to be prepared, on the one hand. But the very fact that I need not fear the hospital now might also mean I can avert the worst of any crisis! Who can tell? All I know is that we are all talking about how to help me primarily stay safe from what the voices command me to do, and how to do so without panicking or calling 911.


One thing I insisted upon was NOT using any agency, because while they serve a function, I suppose, they also pay their workers shit. And someone who is paid $8 an hour is not going to want to do the same quality of job for me, while sitting with me in my tiny apartment as someone who is getting the entire $20/hour, if you get my drift. And why would they? I need people who are committed to keeping me safe from myself at the height of any craziness that might assert itself, and if the voices command me to grab a pencil and suddenly stab myself with it, as they frequently have, I NEED to know that the person I have hired will be right there with me, ready to grab it from me, not in the other room reading a book, or cooking, or yammering on the phone to a friend. For $20/hour I think it might not be too much to ask. At $8/hour it might be.


For $20 an hour, a person can stay awake all night and not need to work another job immediately upon going home, so I will know that if I wake up in my recliner and hear command hallucinations to set myself on fire, she or he will be right there to stop me. Because that is how it happens, has in fact happened just like that.


It is the only way to do it. Unless $20 somehow is not enough to cut it, pay wise, (and I cannot afford to pay more, over all) (the people I hired are also already not working other jobs either…) I think it is not a bad wage, is it? Honestly now, tell me. I am not asking for much else but for someone to sit with me, talk with me IF i feel like it, and watch me to make sure I stay safe. The worst thing would be boredom I imagine.  But I don’t usually bore people even when ill. THat is not often their problem.  The problems are other things, for me at any rate, and those are that the people that sit with me in hospitals have NOT done their jobs properly at all, and have ignored all the warning signs, even my open pleas to please please “do your jobs. I am on “one to one” for a reason!


No, in the hospital, the aides just turn their backs and stand in the doorway, facing outward, away from the room i am in, and gab with the other aides, completely  ignoring the person they are supposed to keep their eyes on at all times. It is crazy. I remember a woman named Jennifer deliberately turned her back to me no matter where I stood in the room, and if I went in to the bathroom, she left the outer room entirely…which was such a rule breaker. She knew what was happening, I think she was playing a game to see if I was truly dangerous to myself or not…Or really just didn’t give a damn.


Is it any wonder that at one point at one hospital, I  asked to get off that status. It was simple: I just told them I was safe and they were so glad to reduce their workload they stopped the one-to- one immediately. The next thing I knew the voices had me begging to use my makeup compact. the one with a small glass mirror in it.


“Sure, you can. Just make sure you bring it back to the nurses station in five minutes,” said the Nurses Secretary, handing me the little black plastic thing.


Well it took all of three seconds for me to stamp on it with a hard soled shoe, break the mirror and slice up my left wrist bad…


Of course, they punished me for that. Or they would have, I know. But I remember, I wrapped a huge wad of paper towels around all the blood and told no one for hours, so when I realized that I needed stitches and had to admit to what I had done, it was too late for them to respond with the punishment of 4-point restraints…


The point is, the aides weren’t evil. Not all of them, or at least their lackadaisical attitude was borne out of a lack of caring which itself was spawned by being paid little to nothing. Why should they care? It was just a job to most of them, and little better paid that flipping burgers at a restaurant. Worse than that, because they had no perks and no tips.


So when I hire someone to sit with me, talk with me, keep me safe both from myself and hospital abuse, I pay them $20 per hour (and even $30 per hour over time during snow storms etc), I expect them to be responsive and not lackadaisical. I do not think that is too much to ask or demand. My life and health and bodily integrity depend on it.

Open Letter to the Director of the Institute of Living, Dr Theodore Mucha, and Ms Ellen Blair, Director of Nursing

Dear Dr Mucha and Ms Blair,

Forgive me if I must read this instead of simply speaking extemporaneously, but while I may seem collected to you, inside I’m shaking. Indeed, every time I recall what I recall, or reread the nursing notes about what was done to me this past winter here at the IOL, I start crying. I need to stay in control in order to retain some credibility and so I have written this out in advance in order to make sure that happens.

Thank you for meeting with me today. Ever since I was discharged from the IOL in February, I have felt the need to come back here to speak to someone. Yet because of trauma-induced amnesia, it is only now that I have acquired my records and learned the details of what happened that I’m finally able to do so. But at the same time, I wonder why I bother, since it is not as if I expect you to do anything or say anything that will make a difference. You won’t. You can’t. No one ever does, not even when faced with the reality of the most egregious abuses.

 Before I say anything further, I want you to know that I believe that I have been harmed 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 told to assure you that I do not intend to sue or cause trouble. I do not, not at the moment. However, if I don’t feel that I have been properly heard at this meeting I may in fact file a formal complaint with the Department of Justice. For now, I just want you to listen carefully and hear what I have to say.  When I am through, if you are so inclined, perhaps we might discuss ways in which things might have gone differently and how they might change in the future, for others even if it is no longer possible for me.

Please understand that I know I was a difficult patient. I was loud and upset and hard for some staff to deal with. That is precisely why my Psychiatric Advance Directive was written out the way it was, and why I made my medical and psychiatric history online so available. When ill, I am frightened and paranoid, which makes me easily roused to irritability and hostility. I know this, from a distance as it were. But knowing this now does not mean i was in control of my behavior. I am by nature neither temperamental nor prone to temper eruptions or throwing things. In addition, I am extremely modest, hardly one to disrobe or urinate in public. My friends and family have at times variously labeled me  “stoic” and “peacemaker,” which should tell you a lot. But that I did all these things on Donnelly 2 South both horrifies me and concerns me because these behaviors point to something going on distinct from psychosis: they point to abuse and trauma.

Let me make it very clear that I have behaved in such outrageous ways before, yes, but only in response to extreme circumstances – as when i was subjected over and over to restraints and seclusion in a horrific and sadistic fashion at Manchester and Middlesex hospitals in 2009 and 2010. It is too bad that when Amy Taylor took it upon herself to violate my HIPPAA privacy rights and investigate my previous admissions, without asking my permission (which I never would have granted) she failed to make the connection between their abuse, and my subsequent behaviors there…It turns out all she drew as a conclusion was that if those hospitals could use restraints and seclusion ad libitum, well then, so could she. It didn’t seem to matter to her that in 2009 and 2010 those measures not only didn’t work, they made things worse when Dr Taylor followed their examples, the same results ensued, just as my PAD predicted.

I was admitted to Donnelly 2 South, and I came in with the very detailed Psychiatric Advanced Directiveas as I said. I made it very clear that my online electronic medical record  was available. It 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 who was also my psychiatrist from 2000-2009. Included as well was a letter she wrote to my present psychiatrist, Dr Angela Cappiello, explicitly stating her conviction that I do not have a personality disorder, borderline or otherwise, and never did.

According to Dr Sanjay Banerjee he read every page of documents that I brought with me. That is what he told me. Moreover, when he spoke with Dr Cappiello, he brushed off my concerns about anyone misperceiving me as having a personality disorder. My brother, Philip Spiro, MD, himself a psychiatrist brought the same matter to the fore again when in discussion with Laurie Denenberg, but 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 an document. If this was so, then how did it come to pass that Amy Taylor wrote on my discharge summary that I have a “long history of Borderline personality disorder” and herself diagnosed “Personality disorder NOS with borderline traits”? I was being treated for four weeks for an active psychotic disorder. She would have no way of knowing whether or not I had any personality disorder, given the axis I diagnosis and you know it. She did too.

Dr Mucha and Ms Blair, you were not there on the unit or in the quiet room with me, so were you even aware of what happened half the time? Did you know for example, that on Februrary 6, I walked away from the quiet room, strolled down the hall, looked out the window and slowly retraced my steps back to the quiet room. But when I arrived I I was confronted by a cohort of staff who proceeded to 4-point me, even though I was quiet and put up no resistance? Not wanting to give them any reason or justification, I passively lay down on the bed and placed my own limbs out for the restraint cuffs, saying, (I quote my journal entry made later that evening): “For shame. You ought to be ashamed of yourselves. I am not and never was a danger to myself or others.” Their response was “ You refuse to follow directions so we do not know what you will do. This is not punishment, Pamela, this is what your behavior brings on every time.”

Were you aware that they always restrained me, spread-eagled, so tightly I couldnt move a muscle? That they never permitted bathroom breaks or even let my hands free to eat? That I would fall asleep rapidly after three injections  –whether calm or not, it was a routine punishment needle in the buttocks: Haldol, Ativan and Benadryland they would invent reasons to maintain me in restraints even after asleep for hours? Or when I woke, groggy and hardly dangerous to anyone, they would grill me with questions that I could not answer, and they would use my inability to respond as reason not to release me?

Later in the evening on Jan 6th, for the second time that day, they restrained me, for throwing half a graham cracker at the wall. Then, as usual, they left me like that for six 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 earn my way into them in the first place. They always refused to release me, ALWAYS, until I literally cried, “Uncle” when they told me to.


As to those vaunted shows of force what did you expect? Presented with a cohort of threatening staff personnel I saw 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? 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 death!


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 me, knowing that one of the admission diagnoses I came in with was PTSD, how you  Dr Mucha, could possibly approve in advance, the emergency abrogation of my PAD and a “just in case they are needed” use of restraints and seclusion. Why not counsel the person asking for this advance “right to restrain” to do all in his power NOT to restrain me and to work with the PAD instead?


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 leads 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 by a long-term roommate. The cover sheet on the PAD made very clear that due to these trauma issues, I could not tolerate being secluded or restrained without serious 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, read 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 quiet room last winter. I made I do not know how many, but many, calls to the patient advocate office, but the sole time anyone made contact was when Carmen Diaz came to hand me some paperwork – I believe I was actually in 4 point restraints at the time — papers  I could not read about the forced medication hearing. I needed her advocacy, but she never responded to my panicked calls in any way that was helpful to me. 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.


And where did the ECT discussion come from? My PAD states in no uncertain terms 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, and you too. Because he implicated you, you know. He told me that “Dr Mucha and I have made the decision to force me to have ECT.” Oh, I know, the chart talks about having “discussed the possibility of ECT with me” but that is not how it went down. I recorded the conversation in my journal directly after it happened and Dr Banerjee presented it as a discussion that you and he had, and a decision that you and he had come to, not one that I was privy to. And he presented it as one that I had no choice in.

Nevertheless, let me ask you this: regarding ECT and my so-called depression, were you fully cognizant that Banerjee 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 shook my head, assenting to the change. I remembered having trouble getting down even to 50mg quickly at Natchaug the summer before, I dared not mention this and frankly believed it had been a fluke, the opposite of the placebo effect in a sense…So I went along with Banerjee’s decision to summarily cut the Zoloft and hoped for the best. 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 of Lamictal, a drug I had not taken in months. Now he was applying to force me to take ECT, something I was terrified of, and to have calculated brain damage.

It was this threat, and the brutality with which the decision was handed down, 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 B and Laurie to read across the table in front of them. They refused, claiming that I threw the papers at them. Instead, Dr B 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 HIPPAA 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, ie 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 or even threatening anyone or myself  with harm. ALL that I had done, in terms of physical threats, was to throw a lightweight chair at the wall. And that, it was clear to everyone, was intended not as a threat to anyone. 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 the situation to a better resolution not only for the situation at hand but for the entire hospital stay. As the poem by Dylan Thomas goes: “After the first death, there is other.” Once they decided to use restraints, there was no going back. The first time broke everything, So they used them again, and again and more and more freely and without justification but for convenience and punishment.

Back to Feb 6, after sleeping for six hours, I was taken out of restraints just in time for a visit from Dr Cappiello. Observed by my 1:1 staff member, I could barely whisper and dared not tell my outside psychiatrist the full extent of the abuse that had been happening. Nevertheless, she took one look at Dr Taylor’s behavioral treatment plan posted on my wall, and told me that it would be impossible for anyone, even someone who was well, to follow it to the T. She was so worried about me, and about my ability to complete the requirements, even for a “mere 24 hours,” that she intervened. The next day was the single day that Dr Taylor planned to be out of town, so Dr Cappiello asked Dr Mehendru to evaluate me for discharge, telling her that she feared a power struggle had been set up that I could never win.


When Dr Mehendru came to see me, at first I was angry, as the chart indicates, thinking she was just another Taylor flunky, preparing to use more restraints and seclusion, But when she asked if I would like to go home, I took one look at her, saw sincerity in her eyes, and burst into a smile, ready to say yes to anything. Miraculously “cured,” I left the IOL that very same day, less than 12 hours after being released from 4-point restraints and not 4 hours out of seclusion.


However, I was not well.  And within two weeks time, I was back in the hospital, this time to be admitted to Yale New Haven Psychiatric Hospital, via their emergency room. Over the next 3 weeks I experienced an entirely different kind of care. At Yale I did not find a staff ready to fight or try to seclude or restrain me. This staff did not need their day to be hassle-free with drugged and cowed patients. Instead, they were trained to remain tolerant, calm and compassionate in the face of sometimes very trying circumstances. It worked. Even when I screamed and yelled and swore, they countered with compassion, and lo, I calmed, no brutality needed, not even IM medication. They had no need or use for cruelty at YNHPH. I felt they sincerely wanted only to understand and help me heal.


Appreciating the shock and trauma of my IOL stay, each staff member I dealt with did everything in his or her power to prove that hospitals do not have to be brutal or abusive. At the IOL they pretend to use “best practices” but in truth it consists only of coercion and control. Treatment at Yale was in fact the “best practice” possible, and it consisted mostly of being consistent. Consistent in being patient-centered, trauma-informed care, consistent in being not cruel and uncaring, consistent in being humane to each and every patient, consistent in extending a compassionate hand and heart to every patient and reacting in a different and more constructive fashion than did the staff at the IOL (or at Middlesex or Manchester etc).

And you know, though I was still the same person with the same problems, loud and angry at times, even “violent” to property in my frustration, and still psychotic, they never responded with a show of force. Why would they? At Yale it would be absolutely anathema to deliberately frighten a patient. What would be the purpose in that, they would think….  They also never showed up at my door with forced medication or pushed me into a seclusion room or strapped me down in punitive 4-point restraints, or any of the other ill-advised responses that my PAD  explains are the worst things to do to anyone who is struggling, scared and paranoid. In point of fact, Yale Psychiatric Hospital’s Washington Square unit does not have a seclusion room. They also have a “restraints-free” policy, so they didn’t use those at all either.

The IOL on the other hand with its “We only use restraints and seclusion if we have to policy, restrained me countless times, and for many more hours than was even legal. When I woke up that last morning I spent there, the room opposite me was occupied by yet another person in restraints! That is because, you know, once you allow a staff to use restraints a little, it only takes a little to use them a lot.  And once you sanction the use of restraints and seclusion at all, it is only time before someone abuses them and abuse becomes the norm.


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.


(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 IOLs 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 you allowed them to abuse me and seclude me because I was loud and made people uncomfortable…Instead of dealing with me, you let them torture and punish me. WHY? WHY? Why? I want an answer to this question.

“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 at Natchaug Hospital, i was told by one of their mental health workers that she had wanted to experience the process of being four-pointed herself so she could identify with patients. She was told no, because as the aide informed me, hospital administrators feared it would be too traumatizing.


Where do we go from here? Well, I will never return to the IOL; inflexible IOL policies have no safeguards in place to properly protect patients. I came prepared, Dr Banerjee said so. And yet it did me no good, because all the preparations and advance directives in the world do me no good when staff is given carte blanche by their own director to ignore them.

So where we go from here is largely up to you. You can simply ignore what I have written, tear these sheets up, justify all staff behaviors and throw away my complaint as meaningless information. After all, Dr Mucha, you are retiring in a few days, so you can leave all this behind without a care in the world. Ms Blair, even you don’t need to believe my words, you can simply trust the superficial, documented words on the chart, and if necessary, the lies of staff as to what happened. What you don’t know won’t hurt you. But lies they are, and lies they always were, even as they told me what they were going to write in order to get away with restraining me as punishment. The problem is that not everyone was so clever as to cover her footprints, so once or twice the truth was written down and not corrected later. I will show you those pages if you wish to see the evidence I have.

The problem for you is not that I am going to sue you for malpractice, No lawyer is going to take my case on a contingency basis. No one in this country or anywhere in the world cares about a mental patient who was tortured in an abusive hospital situation but didn’t die. I would be worth money dead, yes, but not alive…Your staff knew this and that is why they knew they could get away with it…No, the problem for you is strictly moral, one of conscience. But if you can live with it, then I cannot change a thing.

The IOL could change, it could adopt a philosophy of patient-centered, trauma-informed care, as Yale has done, but that would require changes that would involve every aspect the unit. I doubt IOL administration has the ethical or moral fiber or the political will to do it.  I think you choose to remain a brutal, backwards and controlling institution because it feels easier and you believe it is cheaper, though both notions are mistaken. Sometimes it just feels easier to think mistaken thoughts than to challenge them and learn to think in new ways, absorb new paradigms. This is unfortunate because in the end the IOL would save money and patients would heal with less trauma, if you implemented changes that actually worked rather than resorting to the old ways of cruelty, coercion and abuse.

That is all I have the time and energy to say, for now.