![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Shy_Girl on May 18, 2005, at 0:26:44
Lobotomies
Chemical Restraints
Physical Restraints
Loss of rights
PaternalismCan a person who has never committed any crime or broken any laws or regulations be locked up?
...unfortunately, YES
Such is the case in involuntary psychiatric assessments and committments.IMO this is unacceptable. Guess what I was told when I was in for an "assessment"?...."Sorry dear, you have no rights here."
What the f*ck! Some a-h*le pdoc can just waltz in, pretend to "listen" for a bit and then just freaking lock me up!...M'er f'er! bleep, bleep, bleep, @!#$@$%&%! Being treated like a f*cking
child...can't freaking step over the YELLOW and BLACK stripped line. I should've acted extra crazy in there, they expect that don't they? I should've freaking make a f*cking scene. Arrgh, I'm so freaking angry that they could treat me that way...stupid freaking paternalistic system.The fact is, there is nothing wrong with me. Did people forget that life situations can make people happy or sad?
I'm not going to be fooled anymore.
Posted by alexandra_k on May 18, 2005, at 1:00:46
In reply to History of psychiatry is disturbing *trigger*, posted by Shy_Girl on May 18, 2005, at 0:26:44
> Can a person who has never committed any crime or broken any laws or regulations be locked up?
> ...unfortunately, YES
> Such is the case in involuntary psychiatric assessments and committments.Yes.
Though...
I don't know how things are done in the US...
Over here if someone is sectioned under the mental health act for compulsory assessment and treatment for more than 14 days then they have to appear before a judge. They have the right to appeal the section. The judge can (and sometimes does) decide that the p-doc shouldn't have sectioned the client. There wasn't grounds to.My p-doc spent a lot of time in court defending his decisions. That is part of the process... It looks bad if too many of your decisions get reversed by the judge - so the safe-guards are actually pretty good.
> IMO this is unacceptable. Guess what I was told when I was in for an "assessment"?...."Sorry dear, you have no rights here."
Hmm.
You still have rights.
Did you ask anyone for information on your rights?
They should be able to give you info that tell you your rights in a way that is comprehensible to you...But sometimes nurses (especially) get f*cked off and say all sorts of crazy sh*t...
> I should've acted extra crazy in there, they expect that don't they? I should've freaking make a f*cking scene. Arrgh, I'm so freaking angry that they could treat me that way...stupid freaking paternalistic system.And that...
might just show them that you are at risk of making impulsive decisions...
might show them that you are in fact a danger to yourself...
might show them that you don't want their help.
I know it is hard...
I know that it can be hard...
But...
One has to try and make them *want* to help you
If you want their help.
Does that make sense?
> The fact is, there is nothing wrong with me. Did people forget that life situations can make people happy or sad?Sure.
But when things turn to custard...
Then you do ask for help.
Life situations do make people feel happy or sad
But typically...
Not suicidal.
> I'm not going to be fooled anymore.
Posted by Shy_Girl on May 18, 2005, at 21:25:13
In reply to Re: History of psychiatry is disturbing *trigger* » Shy_Girl, posted by alexandra_k on May 18, 2005, at 1:00:46
> I don't know how things are done in the US...
> Over here if someone is sectioned under the mental health act for compulsory assessment and treatment for more than 14 days then they have to appear before a judge. They have the right to appeal the section. The judge can (and sometimes does) decide that the p-doc shouldn't have sectioned the client. There wasn't grounds to.I actually live in Canada. I think a judge is needed to back-up the decision if the patient wants to challenge a stay of more than 3 days. In my case, I was only locked up for 3 days, so there was nothing I could do.
> My p-doc spent a lot of time in court defending his decisions. That is part of the process... It looks bad if too many of your decisions get reversed by the judge - so the safe-guards are actually pretty good.I'm sure my p-doc would never lock me up...she totally respects my decisions. The only reason why I was locked up was because no one bothered to call my p-doc about whether or not to lock me up. BTW, that is how I see it...being locked up, like in a jail.
> Hmm.
> You still have rights.
> Did you ask anyone for information on your rights?Yes I did. I asked nicely again and again and again for the nurse to let me see a copy of the mental health act. I also repeatedly asked to see a lawyer, but apparently it wouldn't have done a thing in my case. It was soooo fustrating in there. BTW, there IS discrimination there. I would never have been ignored that way out in the real world!
> But sometimes nurses (especially) get f*cked off and say all sorts of crazy sh*t...
Ya, it was only when I forced myself to be extra *nice* and *patient* that the nurses started to give me some attention. I wonder if it is some sort of behaviour modification thing...punish me by ignoring me when I'm "bad" and giving me attention when I'm "good"?
> > I should've acted extra crazy in there, they expect that don't they?
> And that...
> might just show them that you are at risk of making impulsive decisions...
> might show them that you are in fact a danger to yourself...
> might show them that you don't want their help.I did kind of have a little tantrum in there, after being ignored for so long. I was so angry that I moved a chair out pass the "Do not cross line" and sat there...staring at the guy at the nurse's station with a dirty look on my face. After a while a nurse made me go back to my room...then I was angry and decided to throw some M&Ms down the little hall pass the line that leads to the exit.
Then the nurse talked some sense into me...she said that the p-docs where looking to see if I had insight and if I was impulsive and that my throwing things wasn't helping me. I really wanted to get the h*ll outta there, so I had to suck it up and comply.
Anyways, that place was horrible...no freedom to do anything. No freaking locks to the bathrooms! What the f*ck? G*d d*mn *t, if I ever, find myself back in that h*llh*le, I'll freaking show them...I'll f*cking hang myself...that'll show them how useful their "help" was.
> I know it is hard...
> I know that it can be hard...
> But...
> One has to try and make them *want* to help you
> If you want their help.I didn't *need* their help...all I needed was a little medical help for my nonlethal overdose...that was all.
> But when things turn to custard...
> Then you do ask for help.
> Life situations do make people feel happy or sad
> But typically...
> Not suicidal.I wasn't even suicidal when I was locked up. I *became* suicidal AFTER being locked up. They probably gave me PTSD...the m'er f'ers. And, so what if I'm suicidal...it's not like I'm homicidal...it is my own business what I want to do with *MY* life.
Thanks Alexandra for trying to help
Posted by Shy_Girl on May 18, 2005, at 21:50:06
In reply to Re: Lock up gave me PTSD *trigger* » alexandra_k, posted by Shy_Girl on May 18, 2005, at 21:25:13
Posted by alexandra_k on May 18, 2005, at 23:53:57
In reply to Re: Lock up gave me PTSD *trigger* » alexandra_k, posted by Shy_Girl on May 18, 2005, at 21:25:13
> I actually live in Canada. I think a judge is needed to back-up the decision if the patient wants to challenge a stay of more than 3 days. In my case, I was only locked up for 3 days, so there was nothing I could do.
Ok.
3 days so they could assess whether you were at risk of harming others or yourself.
> I'm sure my p-doc would never lock me up...she totally respects my decisions. The only reason why I was locked up was because no one bothered to call my p-doc about whether or not to lock me up.I dare say...
I dare say...
That your p-doc would involountarily hospitilise you if she felt that you were verrrrrrrrry likely to act on an urge to kill yourself. It would be unethical for her not to do this.>BTW, that is how I see it...being locked up, like in a jail.
A lot of people see jail as 'punishment' for offending.
Hospital, on the other hand isn't 'punishment' so much as 'prevention'. The aim is to prevent you from harming yourself or someone else.
IMO jail should be about prevention and not punishment as well... But thats another story...> Yes I did. I asked nicely again and again and again for the nurse to let me see a copy of the mental health act.
Ok. Sometimes nurses really are run off their feet. Sometimes nurses are lazy and go hide from the patients in the nurses station... But sometimes it is just a matter of them being rushed.
>I also repeatedly asked to see a lawyer, but apparently it wouldn't have done a thing in my case.
Yeah.
I suppose you are free to lodge a complaint - but what you would have to argue would be that they hospitalised you despite good grounds to think that you are not a risk to others or yourself. If there was doubt about your level of risk... Well, that sounds like that was precisely why you were hospitalised.From their perspective.
If they let you go home and you kill yourself your family could sue them. An intentional overdose is grounds to consider that you may be in danger of harming yourself.If you don't want to be hospitalised then typically you can get around that by promising that you won't harm yourself, and by promising that you will contact someone if you do have the urge to harm yourself again. If you keep what you have promised then you shouldn't have too much trouble remaining out of hosiptal if that is what you prefer.
But... Sometimes hospital can be the best place to be... I agree that sometimes the nurses can be judgemental and so forth. Typically... Typically... The most help you will find there is from the other patients. Just like how the Babblers are helpful, the patients can be most helpful too. If you try and make the best you can of the situation then the nurses tend to find more time to talk to you as well...
> it was only when I forced myself to be extra *nice* and *patient* that the nurses started to give me some attention. I wonder if it is some sort of behaviour modification thing...punish me by ignoring me when I'm "bad" and giving me attention when I'm "good"?
Yup.
Thats the one.
You have nailed it ;-)> Then the nurse talked some sense into me...she said that the p-docs where looking to see if I had insight and if I was impulsive and that my throwing things wasn't helping me. I really wanted to get the h*ll outta there, so I had to suck it up and comply.
Yup.
It isn't so much 'sucking up and complying'. It is more about not throwing tantrums... and being polite.. and patient...> Anyways, that place was horrible...no freedom to do anything. No freaking locks to the bathrooms!
Some people in hospital are at risk of harming themself.
Intentionally or unintentionally.
So the set-up bears that in mind...> I'll freaking show them...I'll f*cking hang myself...that'll show them how useful their "help" was.
And that sort of statement is the sort that is likely to keep you in there even longer... It shows that you are in danger of harming yourself as a matter of impulse.
What is most likely is that you will be found in time and then get put in seclusion.
Seclusion is no fun at all.
I can assure you of that.
> I didn't *need* their help...all I needed was a little medical help for my nonlethal overdose...that was all.Then you need to be able to guarantee your safety and give them some insurance that there won't be a repeat scenario. Because if they let you go home from the general ward and you kill yourself two days later then their necks will be on the line for having let you go without proper psych. evaluation. And if the p-doc lets you go home and you kill yourself a couple days later then he has to justify his decision to send you home. You can help the p-doc out there by guaranteeing safety - and sticking to safety contracts. Make sense???
> And, so what if I'm suicidal...it's not like I'm homicidal...it is my own business what I want to do with *MY* life.The point is that... You might kill yourself as a matter of impulse.
Whereas if you were prevented from killing yourself then two days or weeks or months or years down the track you might say 'jeepers, I'm glad I didn't kill myself back then'.Most times you think it would be better if you were dead.
I understand that.
I feel like that a fair bit.
Some times you say that you don't really want to die - you just want the pain to stop.
Some times you are happy to be alive.
The times you are happy will become more frequent and longer lasting as you get better.
The times you would prefer to be dead will become less frequent and won't last so long as you get better.The point: is to prevent you making a decision that you will later come to regret (paradox there - but you get what I mean).
It is just that sometimes you have faith that things are okay, and will get even better.
Whereas sometimes that black hole just seems to be too deep and the only way out seems to be suicide.
But it isn't.
And...
In your 'rational' moments I don't think you really want to die.
I just think that you (understandably) are just fed up with the pain etc and think that is the only way..
Posted by Shy_Girl on May 19, 2005, at 0:42:24
In reply to Re: Lock up gave me PTSD *trigger* » Shy_Girl, posted by alexandra_k on May 18, 2005, at 23:53:57
> I dare say...
> I dare say...
> That your p-doc would involountarily hospitilise you if she felt that you were verrrrrrrrry likely to act on an urge to kill yourself. It would be unethical for her not to do this.Hmmm...I have no idea what would be considered to be verrrrry likely then. I've always told her the truth and well, you know what goes on in my disturbed mind. :-) She's never even flinched. Maybe I'm not as suicidal as I think I am. I must admit that sometimes my threats are not so much based on wanting to die, but on wanting to make others understand me. A way of communicating maybe...a very disturbed way of communicating?
> The aim is to prevent you from harming yourself or someone else.
Sigh, yes, I understand on an intellectual level....emotional, that's another story.
> I suppose you are free to lodge a complaint - but what you would have to argue would be that they hospitalised you despite good grounds to think that you are not a risk to others or yourself. If there was doubt about your level of risk... Well, that sounds like that was precisely why you were hospitalised.
I tried to convince the p-doc really hard that I was not a threat to myself...I listed very concret reasons like I live with my parents, I didn't take a lethal dose, I only wanted to fake an illness, etc. etc....but he was intent on locking me up :-(
> From their perspective.
> If they let you go home and you kill yourself your family could sue them. An intentional overdose is grounds to consider that you may be in danger of harming yourself.Yes, that makes sense...I guess to people outside it does look kind of messed up to take so much aspirin just to fake an illness to get out of taking an exam.
> If you don't want to be hospitalised then typically you can get around that by promising that you won't harm yourself, and by promising that you will contact someone if you do have the urge to harm yourself again. If you keep what you have promised then you shouldn't have too much trouble remaining out of hosiptal if that is what you prefer.I tried that, it didn't work...I guess my actions spoke louder than any of my words.
> Typically... Typically... The most help you will find there is from the other patients.The patients there didn't talk much...plus I didn't want to talk much. It was so lonely and scary there...it was the weekend and there weren't any activities to fill the time. Not too many patients either...most went home on the weekends. It was real scary...a lot of "code whites" during the night...I even saw a nurse with leather restraints!!! In the middle of the night, I kept imagining that people where being wheeled off to get ECT or something...terrifying!
> Just like how the Babblers are helpful, the patients can be most helpful too. If you try and make the best you can of the situation then the nurses tend to find more time to talk to you as well...
Well, I don't ever intend on going to a hospital again, but thanks for the advice.
> Yup.
> It isn't so much 'sucking up and complying'. It is more about not throwing tantrums... and being polite.. and patient...I found it difficult not to throw a tantrum...I was so angry!
> And that sort of statement is the sort that is likely to keep you in there even longer... It shows that you are in danger of harming yourself as a matter of impulse.
Sigh, yes I know...it's just so frustrating...to have to be so "calm" when faced with such a situation. I did it somehow though, cuz they did let me out after 3 days :-)
> What is most likely is that you will be found in time and then get put in seclusion.
>
> Seclusion is no fun at all.
> I can assure you of that.What was seclusion like? I have no idea at all. Is it just a time-out room? Do you get locked in? That would sound very scary.
> You can help the p-doc out there by guaranteeing safety - and sticking to safety contracts. Make sense???I don't know about contracts...I've never had to really make one. I can't really see how they can really work, but if making one will keep me from being locked up again...I'll make it.
> Most times you think it would be better if you were dead.
> I understand that.
> I feel like that a fair bit.
> Some times you say that you don't really want to die - you just want the pain to stop.
> Some times you are happy to be alive.
> The times you are happy will become more frequent and longer lasting as you get better.
> The times you would prefer to be dead will become less frequent and won't last so long as you get better.I wish I could be happy/sad/angry/fearful whenever I wanted...instead of being controlled so much by my environment.
> In your 'rational' moments I don't think you really want to die.I'm just really confused right now. I don't know when I'm really "rational." I'm starting to question whether or not I really have insight into my problems.
Thank-you so much for the very thoughtful post Alexandra! It was very useful to me.
Posted by alexandra_k on May 19, 2005, at 3:16:11
In reply to Re: Lock up gave me PTSD *trigger* » alexandra_k, posted by Shy_Girl on May 19, 2005, at 0:42:24
> Hmmm...I have no idea what would be considered to be verrrrry likely then. I've always told her the truth and well, you know what goes on in my disturbed mind. :-) She's never even flinched.
Thats really terrific that you can be honest with her.
:-)>Maybe I'm not as suicidal as I think I am. I must admit that sometimes my threats are not so much based on wanting to die, but on wanting to make others understand me. A way of communicating maybe...a very disturbed way of communicating?
Yeah. Communicating. I understand that. Its a way of trying to say just how bad things feel. What they need to assess is how likely you are to ACT on your thoughts / urges. Especially if the thoughts / urges are frequent.
> I tried to convince the p-doc really hard that I was not a threat to myself...I listed very concrete reasons like I live with my parents, I didn't take a lethal dose, I only wanted to fake an illness, etc. etc....but he was intent on locking me up :-(
Sounds like you said the right sorts of things to me... I guess their thinking is 'better safe than sorry'.
> I guess to people outside it does look kind of messed up to take so much aspirin just to fake an illness to get out of taking an exam.It looks extreme. An extreme way to manage the situation.
>...I guess my actions spoke louder than any of my words.
Maybe you looked more upset / distressed than you realised... If they couldn't get hold of your p-doc and you haven't had prior contact with the service then it would make sense that they would have a 'better safe than sorry' attitude about it.
> The patients there didn't talk much...Yeah. I think the atmosphere can change quite significantly on the ward depending on the people in there. Sometimes the people are helpful, other times they are pretty sick and at other times they are best avoided...
>plus I didn't want to talk much. It was so lonely and scary there...it was the weekend and there weren't any activities to fill the time. Not too many patients either...most went home on the weekends.
Yeah. It was your first admission? I was pretty freaked out in my first admission. I can remember a bit of just how frightened and alone I felt. No fun at all... And it is typically the sickest people who don't get leave on weekends. So most of the patients who may have been helpful to talk to had probably gone home. It isn't a pleasant environment. I get that.
>It was real scary...a lot of "code whites" during the night...I even saw a nurse with leather restraints!!! In the middle of the night, I kept imagining that people where being wheeled off to get ECT or something...terrifying!
ECT tends to be done in the morning (need to have time with no food / fluids before the anasthetic). But I get what you mean. It is pretty scairey.
> Sigh, yes I know...it's just so frustrating...to have to be so "calm" when faced with such a situation. I did it somehow though, cuz they did let me out after 3 days :-):-)
> What was seclusion like? I have no idea at all. Is it just a time-out room? Do you get locked in? That would sound very scary.
****TRIGGER****Yeah you get locked in.
It is kind of like a prison cell...
Bare concrete walls.
Matress on the floor.
You might / might not get a blanket depending on your 'considered level of risk'.
There is a slot at the bottom of the door that they can slide your food through.
Paper plate.
Soft option.
Plastic spoon.
A tiny box of an opening in the door that they can open to look at you every 10 minutes.
You have to wear a hospital gown.
You get a toilet (sort of off to one side).
But they can see everything through the box in the door.
The toilet doesn't even have a seat.
Just a metal bowl really.The first time I went into seclusion I could hear one girl singing from one of the other rooms.
She would scream a lot.
And rave very loudly about her aunt.
I think she was having delusions about being persecuted by the nazi's.
She would rave about that a lot.The staff just observe you for a while...
Then talk to you a bit etc.
If they figure you are ok they will take you into the yard every hour or so for a cigarette.
If they figure you are ok they might let you sit on the couch and watch a bit of tv.The first time I was hospitalised I was 2 weeks in hospital before I tried to hang myself. One of the other clients found me and screamed out to the staff. They cut me down and I lost it. Screaming and kicking etc. Got an injection and got put in seclusion. I think I spent about a week in there. Till the chlorpromazine had me well and truely turned into a vegetable. I went from there to one of the more secure wards. On special obs (someone with me all the time). I was so out of it that someone had to walk me to the toilet. Walk me outside for a smoke. Walk me to the tv. Walk me to bed.
I don't know what happened to me there...
I don't know...
But I guess they were trying to keep me safe.
Then the ECT's...It is no fun at all.
Don't go that route.
Please.> I don't know about contracts...I've never had to really make one. I can't really see how they can really work, but if making one will keep me from being locked up again...I'll make it.
Thats the idea. If your p-doc gets too worried about your safety she might want you to contract just for a brief period. To promise not to do anything over a weekend or something like that.
> I wish I could be happy/sad/angry/fearful whenever I wanted...instead of being controlled so much by my environment.Yeah. I wish I could be happy all the time :-)
I think...
You have more control than you realise.
Well... Not now, because you don't have control if you don't know you have control... I just mean that I think that you can learn how to control them more. The environment certainly does play a role. But there are things we can do as well. That is the sort of thing I learned in DBT. About the sorts of things I could do to influence my mood. I really do think things will get to be better for you as you come to learn about the sorts of things you can do to influence your mood etc. So your emotions don't feel completely at the mercy of external forces...> I'm just really confused right now.
((((ShyGirl)))
>I don't know when I'm really "rational."
Me neither. Thats why it can be good to talk to other people as well. Get their take.
>I'm starting to question whether or not I really have insight into my problems.
Same thing. It is good to talk to other people. I'm not so sure there is any such thing as 'insight' it is more that there are many 'insights' we can have along the way. Some of your obeservations seem very insightful to me :-) You aren't raving bonkers ;-)
I haven't worked out quite when to trust myself and when not to trust myself either.
That one is a hard one.
That is why it is nice to talk to other people too and get their take. If they agree with me then I think I am on to something. If some agree and some disagree then I think about it a bit more. If everyone disagrees with me then that tells me that I might want to think a bit more about their reasons and my reasons and then maybe rethink my opinion.
I don't know.
Take care.
Posted by Larry Hoover on May 19, 2005, at 7:42:42
In reply to Re: Lock up gave me PTSD *trigger* » alexandra_k, posted by Shy_Girl on May 18, 2005, at 21:25:13
> > I don't know how things are done in the US...
> > Over here if someone is sectioned under the mental health act for compulsory assessment and treatment for more than 14 days then they have to appear before a judge. They have the right to appeal the section. The judge can (and sometimes does) decide that the p-doc shouldn't have sectioned the client. There wasn't grounds to.
>
> I actually live in Canada. I think a judge is needed to back-up the decision if the patient wants to challenge a stay of more than 3 days. In my case, I was only locked up for 3 days, so there was nothing I could do.Because of the way federal and provincial responsibilities are split up in Canada, health care and perforce mental health fall under provincial jurisdiction. Jenny, I strongly recommend you read the relevant statute, the Mental Health Act. http://www.e-laws.gov.on.ca/DBLaws/Statutes/English/90m07_e.htm
The 72 hour assessment is not subject to judicial review. If the results of that assessment were that they wanted to involuntarily detain you for extended treamtment, you get the right to appeal that. The law provides that not only must you be provided with a copy of the order, but that hospital must immediately counsel you on how to appeal it, and how to obtain timely legal assistance. Once they've held you for 90 days, an appeal is automatically held.
> > My p-doc spent a lot of time in court defending his decisions. That is part of the process... It looks bad if too many of your decisions get reversed by the judge - so the safe-guards are actually pretty good.
>
> I'm sure my p-doc would never lock me up...she totally respects my decisions. The only reason why I was locked up was because no one bothered to call my p-doc about whether or not to lock me up. BTW, that is how I see it...being locked up, like in a jail.I'm sorry jenny, but it's all explained in the Mental Health Act. A doctor must act if any of the criteria are met. Any of the criteria. There are some things doctors are compelled by law to decide on the basis of their own assessments, and those assessments alone.
> > Hmm.
> > You still have rights.
> > Did you ask anyone for information on your rights?
>
> Yes I did. I asked nicely again and again and again for the nurse to let me see a copy of the mental health act. I also repeatedly asked to see a lawyer, but apparently it wouldn't have done a thing in my case. It was soooo fustrating in there. BTW, there IS discrimination there. I would never have been ignored that way out in the real world!You know what? This is another aspect of planning for those situations that make your life really difficult. The suicidal urges might get you back on another 72-hour assessment. You'll know, from reading the act, just to ride it out. There is no possible appeal to authority on a 72-hour hold.
The nurses answered your questions, and then you kept asking. You're being assessed on those behaviours too.
I'm going to ask you a totally tangential question. What would you give to never have another suicidal episode, and never end up on another 72-hour hold?
Possible answers include medication and counselling.
> > But sometimes nurses (especially) get f*cked off and say all sorts of crazy sh*t...
>
> Ya, it was only when I forced myself to be extra *nice* and *patient* that the nurses started to give me some attention. I wonder if it is some sort of behaviour modification thing...punish me by ignoring me when I'm "bad" and giving me attention when I'm "good"?Of course it is! These nurses are very specially trained. You don't think the other patients weren't observing what was going on?
> > > I should've acted extra crazy in there, they expect that don't they?
>
> > And that...
> > might just show them that you are at risk of making impulsive decisions...
> > might show them that you are in fact a danger to yourself...
> > might show them that you don't want their help.
>
> I did kind of have a little tantrum in there, after being ignored for so long. I was so angry that I moved a chair out pass the "Do not cross line" and sat there...staring at the guy at the nurse's station with a dirty look on my face. After a while a nurse made me go back to my room...then I was angry and decided to throw some M&Ms down the little hall pass the line that leads to the exit.They very likely cut you extra slack because you're a first-timer. Don't expect similar leeway if you return for another "visit". I'm serious. You don't want to end up in the rubber room (protective isolation facility, heh heh), with depo-Haldol i.m.
> Then the nurse talked some sense into me...she said that the p-docs where looking to see if I had insight and if I was impulsive and that my throwing things wasn't helping me. I really wanted to get the h*ll outta there, so I had to suck it up and comply.If you had pushed one little bit more, I am pretty sure you'd have found out what it means to be committed for involuntary psychiatric care, the formal process that involves lawyers et al.
> Anyways, that place was horrible...no freedom to do anything. No freaking locks to the bathrooms! What the f*ck? G*d d*mn *t, if I ever, find myself back in that h*llh*le, I'll freaking show them...I'll f*cking hang myself...that'll show them how useful their "help" was.That would show them what, exactly? And, what of the effect on the other patients? I know you're angry, but the patients on the ward are subject to twenty four hour observation. It is as safe an environment as can reasonably be maintained, given that some patients are voluntary, and most (if not all) can still receive visitors.
You don't want to find out what other, more secure, facilities are like.
> > I know it is hard...
> > I know that it can be hard...
> > But...
> > One has to try and make them *want* to help you
> > If you want their help.
>
> I didn't *need* their help...all I needed was a little medical help for my nonlethal overdose...that was all.That's all you think you needed. An objective medical professional thought that your decisions were unsafe.
I urge you to reconsider this whole timeline in terms of your own decisions.
> > But when things turn to custard...
> > Then you do ask for help.
> > Life situations do make people feel happy or sad
> > But typically...
> > Not suicidal.
>
> I wasn't even suicidal when I was locked up. I *became* suicidal AFTER being locked up. They probably gave me PTSD...the m'er f'ers. And, so what if I'm suicidal...it's not like I'm homicidal...it is my own business what I want to do with *MY* life.To a point. There are both legal and medical limits on that issue of competency.
Can we summarize a bit? It's clear you don't like the involuntary psych procedures. What behavioural choices are open to you to minimize or prevent their occurrence?
In your states of remission from suicidality, I again strongly urge you to push for and establish a self-treatment and management plan.
Medication can be a cornerstone for such a plan. Techniques learned in cognitive therapy can be solid foundations. Finding someone specific to call in an emergency could be another resource.
Lar
Posted by Larry Hoover on May 19, 2005, at 8:15:45
In reply to Re: Lock up gave me PTSD *trigger* » alexandra_k, posted by Shy_Girl on May 19, 2005, at 0:42:24
> Hmmm...I have no idea what would be considered to be verrrrry likely then. I've always told her the truth and well, you know what goes on in my disturbed mind. :-) She's never even flinched.
You need to discriminate between suicidal ideation (talking about the thoughts related to suicidal impulses), and suicidal or para-suicidal acts.
> Maybe I'm not as suicidal as I think I am.
Frankly, I think you are worse than you think you are. That's why I keep urging you to copy off your "black" posts. I think you are in denial about how bad it can get for you.
> I must admit that sometimes my threats are not so much based on wanting to die, but on wanting to make others understand me. A way of communicating maybe...a very disturbed way of communicating?
You can learn new ways of communicating that. And, the new ways of communicating also change yourself. Acting differently changes you.
> > The aim is to prevent you from harming yourself or someone else.
>
> Sigh, yes, I understand on an intellectual level....emotional, that's another story.You've nailed the problem there. Have you, though, done all you can do in the cognitive realm? I'm sure you can see that you have not.
> > I suppose you are free to lodge a complaint - but what you would have to argue would be that they hospitalised you despite good grounds to think that you are not a risk to others or yourself. If there was doubt about your level of risk... Well, that sounds like that was precisely why you were hospitalised.
>
> I tried to convince the p-doc really hard that I was not a threat to myself...I listed very concret reasons like I live with my parents, I didn't take a lethal dose, I only wanted to fake an illness, etc. etc....but he was intent on locking me up :-(Think also in terms of consequences. Could this be a warning, "Don't go there" ?
> > From their perspective.
> > If they let you go home and you kill yourself your family could sue them. An intentional overdose is grounds to consider that you may be in danger of harming yourself.
>
> Yes, that makes sense...I guess to people outside it does look kind of messed up to take so much aspirin just to fake an illness to get out of taking an exam.Right.
> > If you don't want to be hospitalised then typically you can get around that by promising that you won't harm yourself, and by promising that you will contact someone if you do have the urge to harm yourself again. If you keep what you have promised then you shouldn't have too much trouble remaining out of hosiptal if that is what you prefer.
>
> I tried that, it didn't work...I guess my actions spoke louder than any of my words.Actions always trump words, in this context.
> > Seclusion is no fun at all.
> > I can assure you of that.
>
> What was seclusion like? I have no idea at all. Is it just a time-out room? Do you get locked in? That would sound very scary.Alex gave a lovely insight into the process. It is about total disempowerment. It is not where you want to ever go.
> > You can help the p-doc out there by guaranteeing safety - and sticking to safety contracts. Make sense???
>
> I don't know about contracts...I've never had to really make one. I can't really see how they can really work, but if making one will keep me from being locked up again...I'll make it.That's what I'm talking about. A management plan is sometimes formulated into a contract, often between a psychiatrist and a patient. It can contain anything, really, and it isn't binding in a court of law. The idea is that it addresses the cognitive commitment of the patient. A formal declaration that the patient recognizes some preplanned mechanisms to minimize or prevent future occurrences. It is purely a cognitive tool, in hopes the cognitive realm can guide behaviour in critical moments.
It takes time to set one up. They're individualized. I'm hoping you'll push to create a management plan.
> I wish I could be happy/sad/angry/fearful whenever I wanted...instead of being controlled so much by my environment.
Yes, but.....To a greater or lesser extent, your decisions alter your environment. You can avoid certain situations, if you learn how to do it. You can even come to see your own thoughts as being part of your mental environment, in real time. You can learn to self-observe, and to guide your thoughts towards a safer mental environment. You can learn to invoke your management plan. That takes training, received in cognitive-behavioural counselling.
> > In your 'rational' moments I don't think you really want to die.
>
> I'm just really confused right now. I don't know when I'm really "rational." I'm starting to question whether or not I really have insight into my problems.Read those "black" posts again.
Sorry for barging in. I'm hopeful that you can gain insight by answering some tough questions.
Lar
Posted by Susan47 on May 19, 2005, at 9:23:35
In reply to Re: Lock up gave me PTSD *trigger* » alexandra_k, posted by Shy_Girl on May 18, 2005, at 21:25:13
I work on a behaviour stabilization unit, Shygirl, and I know the type of behaviour you were displaying is reinforcing that your behaviour wasn't stable, and it isn't fair to blame the system. My thoughts are that you were in there for good reason; our healthcare system is grossly overtaxed, and you wouldn't have been in there without the triage system. If you don't want to be back there, you have to work on being stable. People are trying to take care of you. The nurses have to put up with a great deal from patients, as do all the workers in the hospital system, and it won't hurt you to appreciate that in general they're very kind and tolerant.
Posted by Shy_Girl on May 19, 2005, at 13:57:57
In reply to Re: Lock up gave me PTSD *trigger* » Shy_Girl, posted by alexandra_k on May 19, 2005, at 3:16:11
> Yeah. Communicating. I understand that. Its a way of trying to say just how bad things feel. What they need to assess is how likely you are to ACT on your thoughts / urges. Especially if the thoughts / urges are frequent.
Hmmm...maybe it's not always about communicating...because a lot of times there isn't anyone I want to tell. Am I communicating to myself? Maybe in a perverse way I like to make myself suffer. I can't predict how likely I am to act on my thoughts...it's probably not very likely though.
> Sounds like you said the right sorts of things to me... I guess their thinking is 'better safe than sorry'.
Yep, I overheard the p-doc say to two residents, "...But she's never had an assessment." Anyways, I couldn't have been that crazy in there, cuz they only give me a dx of adjustment disorder.
> Yeah. It was your first admission?
Yes. I'd never ever been admitted/treated in any hospital ever (well, except for when I was born).
>I was pretty freaked out in my first admission. I can remember a bit of just how frightened and alone I felt.
Yep, very scary...not to mention embarrassing for my family. My parents, esp. my Mom didn't want me to stay in the hospital. Thank goodness I was let out the day before Chinese NewYear...apparently, it is extremely bad luck to not have the household present on NewYear's Day. Someone from my family came to see me everyday, but it was still extremely boring and scary.
> ECT tends to be done in the morning (need to have time with no food / fluids before the anasthetic). But I get what you mean. It is pretty scairey.The thought of people getting ECT scares me to death! I know it is very different from the "olden" days, but still...I can't get over the fact that it is basically like electrocution! Super Yikes! The thought of people being restrained also scares the cr*p out of me. Did I mention that I thought psychiatry can sometimes seem barbaric? Shiver me timbers...eeekkk.
> > What was seclusion like? I have no idea at all. Is it just a time-out room? Do you get locked in? That would sound very scary.
> ****TRIGGER****
>
> Yeah you get locked in.....etc. etc.OMG, that sounds horrible! I'm so sorry you had to go through that. Do you think going through that experience helped you in the long run?
You mentioned you only wear the hospital gown in seclusion? That's odd, I had to wear one the whole time I was there...stupid oversized gown...no shoes either...guess they knew I was a flight risk.
> The staff just observe you for a while...
>
> Then talk to you a bit etc.
> If they figure you are ok they will take you into the yard every hour or so for a cigarette.Hmmm...I don't smoke, does explain why I wasn't let outside?
> The first time I was hospitalised I was 2 weeks in hospital before I tried to hang myself.
I'm so sorry about what happened to you. I'm glad you made it out alive.
> It is no fun at all.
> Don't go that route.
> Please.Mental note taken and re-taken...done and done...no going that route for me. It's either all the way or no way at all for me.
> I really do think things will get to be better for you as you come to learn about the sorts of things you can do to influence your mood etc. So your emotions don't feel completely at the mercy of external forces...
Looking forward to learning. :-)
> Some of your obeservations seem very insightful to me :-) You aren't raving bonkers ;-)
Hehe...glad I'm not bonkers. :-P
thanks again Alexandra...your experiences are really going to help me
Thank-you so much for sharing that...it's quite the wake up call.
jenny
Posted by Shy_Girl on May 19, 2005, at 14:21:48
In reply to Re: Lock up gave me PTSD *trigger* » Shy_Girl, posted by Larry Hoover on May 19, 2005, at 7:42:42
Thank-you so much Larry for the important info and for taking the time to respond to my post. Your help is always very much appreciated. I hold your opinions in high regard.
> The nurses answered your questions, and then you kept asking. You're being assessed on those behaviours too.
Yikes...everything I did was recorded? That's freaky.
> I'm going to ask you a totally tangential question. What would you give to never have another suicidal episode,
Hmmm...tough one, like I mentioned once or twice, I actually *LIKE* being suicidal sometimes. I guess to avoid an unpleasant suicidal episode I would give all the money in the world (sorry about the cliche).
> and never end up on another 72-hour hold?
...this one is easy...MY LIFE
> Possible answers include medication and counselling.
Oops...answers not what people are looking for eh? I dunno, I'm weary of "pscyhiatry" right now. Counselling is ok though...that's just talking. My p-doc is ok too, she mainly talks to me. I think I can counsel myself though...it shouldn't be too hard.
>>>> I wonder if it is some sort of behaviour modification thing...punish me by ignoring me when I'm "bad" and giving me attention when I'm "good"?
>
> Of course it is! These nurses are very specially trained. You don't think the other patients weren't observing what was going on?Hehe, I guess I was a "bad" influence.
> They very likely cut you extra slack because you're a first-timer. Don't expect similar leeway if you return for another "visit". I'm serious. You don't want to end up in the rubber room (protective isolation facility, heh heh), with depo-Haldol i.m.
OMG, no, never again! I'll rather die than end up in a rubber room!!! Now I'm serious. Geez, not all suicidal people are "crazy" and need to be locked up!
> If you had pushed one little bit more, I am pretty sure you'd have found out what it means to be committed for involuntary psychiatric care, the formal process that involves lawyers et al.
Eeekk...now you're really scaring me! I better read up on the laws etc., gotta learn to be my own advocate!
> I urge you to reconsider this whole timeline in terms of your own decisions.I shall try. :-)
> Can we summarize a bit? It's clear you don't like the involuntary psych procedures. What behavioural choices are open to you to minimize or prevent their occurrence?
Hmmm...never ever do a stupid thing like take an overdose and then tell a doctor about it. Never ever make suicial gestures...it's either all the way or no way at all. Try to live a happy life and not complain too much?
> In your states of remission from suicidality, I again strongly urge you to push for and establish a self-treatment and management plan.Yep, my plan is to phone the distress centre and have someone listen to me and make me feel better.
> Medication can be a cornerstone for such a plan. Techniques learned in cognitive therapy can be solid foundations. Finding someone specific to call in an emergency could be another resource.Thanks Lar, I will go read some CBT self help books.
Posted by sunny10 on May 19, 2005, at 15:15:53
In reply to Re: Lock up gave me PTSD *trigger* » Larry Hoover, posted by Shy_Girl on May 19, 2005, at 14:21:48
yes, in most parts of the world, you are not thought to be sane if you think about killing yourself.
I'm not saying I agree, but that's the prevailing feeling the world's current population has about anyone who would choose life over death.
It appears to me that most people are afraid of death. Therefore, in their minds, the fact that you would joyfully embrace something that scares THEM must mean you're crazy....
Personally, I am inconsistent and waffle on whether I would have "the right" to take my own life... but then, I am a mother and you are not.
I'm not saying that you should kill yourself because you're not a mother, I'm simply explaining the only reason I waffle about this "have a right to" issue...
For me, the key is trying to figure out WHY I cannot see the joys in life that other people see. WHY is it that what freaks me out, anxiety-wise, is barely a blip on someone else's radar.
WHY do I have such a hard time finding happiness that others merely take for granted on a daily basis.
If I can figure out and mend myself accordingly, maybe I wouldn't even waffle... I'd be too busy enjoying my life to think about ending it...
Posted by Shy_Girl on May 19, 2005, at 16:16:37
In reply to Re: Lock up gave me PTSD *trigger* » Shy_Girl, posted by Larry Hoover on May 19, 2005, at 7:42:42
> Possible answers include medication and counselling.
> Medication can be a cornerstone for such a plan.
I'm afraid of drugs now. My lips, my arm and even trunk sometimes "twitches" involuntarily because of taking the Celexa. People don't even know what exactly it does to the brain. I think I should stop taking it. I was perfectly fine and very productive for a whole semester and was 100% drug free.
>Techniques learned in cognitive therapy can be solid foundations.
My p-doc told me to think: "What would Dr. X (my p-doc) say?" I must have all the answers I need within myself.
> Finding someone specific to call in an emergency could be another resource.
Yes, I will call the Distress Centre.
Posted by Shy_Girl on May 19, 2005, at 16:18:24
In reply to Re: Drugs are scary, posted by Shy_Girl on May 19, 2005, at 16:16:37
Posted by Larry Hoover on May 20, 2005, at 12:12:13
In reply to Re: Drugs are scary, posted by Shy_Girl on May 19, 2005, at 16:16:37
> > Possible answers include medication and counselling.
>
> > Medication can be a cornerstone for such a plan.
>
> I'm afraid of drugs now. My lips, my arm and even trunk sometimes "twitches" involuntarily because of taking the Celexa. People don't even know what exactly it does to the brain. I think I should stop taking it. I was perfectly fine and very productive for a whole semester and was 100% drug free.One trial of one drug does not give you enough information to decide about other trials of other drugs. Celexa is one drug of many in its class, and there are many classes of drugs.
The twitching might be related to other matters entirely, like electrolyte disturbances, or mineral deficiencies. Drugs aren't perfect. In any case, which would you choose.....muscular twitches, or suicidal impulses?
Earlier in this thread, a poster mentioned that drugs had relieved her of suicidal impulses.
It's an option.
> >Techniques learned in cognitive therapy can be solid foundations.
>
> My p-doc told me to think: "What would Dr. X (my p-doc) say?" I must have all the answers I need within myself.You need to learn the answers. The voice of your instructor (your pdoc, in this case) is part of your memory of what was being learned. You can learn how to do this for yourself.
> > Finding someone specific to call in an emergency could be another resource.
>
> Yes, I will call the Distress Centre.Good.
:-)
Lar
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