ADMISSION 

Sunday – September 15, 2002

Admitted

Mathew did the intake.  I was give the trauma disclaimer, which I read, and I did not like the invalidation implied regarding the memories of survivors.  I thought I must be in the wrong place.

Group

This group focused on developmental issues of ‘need – cry – relief’ and onto object constancy by 3 years of age.

After group one peer said I was ‘scary’.  This sort of threw me since I wasn’t sure what she meant.  She went on to say that I was interesting to listen too and smart. 

Group

A peer asked if I was a Ph.D. or must be at least an MSW.  I must admit, with my poor self-esteem that was nice. 

I noticed that on the wall was this huge teal canvas with white letters validating survivors.  That was very cool. One of the peer's said she carried it with her on paper always.

Peer Visiting

A peer showed me her three life collages and we talked about her alters. She was pleasant, thoughtful and supportive.  Many times we had insightful conversations. 

10 PM – Late – Upset

I was going through the workbook given to me by a staff person and was asked to look it over and read it.  I found the Execution Boundary on page 39 and it jump right out at me.  Pretty much, 3 strikes and you’re out.  I was tense and tearful.  I asked to leave but the nurses talked to me and asked me to stay the night, and then suggested that I talk again about it in the morning. 

K – No, I want to go.  I don’t feel right being in a place that hangs the Execution Boundary over people’s heads.

S – Okay, if that is what you want to do.

K – It is. Thanks.

Staff gave me my empty bags so that I could pack.  After I was finished, I let them know that I was ready to go.  They wanted to wait and talk to the floor supervisor first.  When she arrived we went into a private room with her assistant.  As we talked I became upset. I was tearful and I wanted so badly to get out as quickly as possible.  I needed to get some fresh air.  I wanted to leave.  I felt the place was rejecting, conditional, and abandoning.  I felt that I needed to leave before they threw me out on a whim.

K – I hate this place.  Only an amateur would kick out a survivor.  I can understand letting violent people go, but a survivor???  Why don’t you call this club-med instead?  If you can’t deal with the hard cases, the black sheep, then how can you call this a hospital?  I don’t want to be treated by a rejecting agency.  

S – You seem very upset and are holdable.

K – No.

S – I can give you a choice, you can volunteer to stay on the program or I can place you on a 5150.

K – No, I don’t want to stay.

S – Then we will put your on a 5150 and we will have to transfer you to another unit.  (this unit was more acute and restrictive)

K – No, this is a choice being made under duress.

S – No, it’s not.

K – Yes it is.  This is a choice by cohesion.

S – No, it’s not.

K – Then I’m leaving

S – Okay, put her on a 5150 and transfer her to the other unit.

K – No, okay, I will stay voluntary.  Some choice – voluntary I stay in a better section on if involuntary I am transferred to a worst section.  Okay, under those circumstances I am voluntary.

Ten minutes later the floor supervisor said, “See, we do care about you, you are still here and not out in the street.”

45 minutes after midnight.

I’m still awake.  I took my medicine and went out on the patio and talk with a peer.  We talked about control issues and the Execution Boundary.  Peer was a sweet girl and here for an eating disorder.   

Monday – September 16, 2002

Group

I said my main issues are unresolved anger, rejection and abandonment.  I was then ‘booted’ by the group leader until I had orientation with Kristy’s group.

Orientation Group – Kristy

10:00 AM

She said that self-injury is not tolerated and Execution Boundary enforced.  I explained how I felt about that.  She also went over the drama trauma triangle briefly.

Group – Cognitive with Dr. Fridley

The focus centered on conflict resolution with alters.   Mainly for each alter to respect each other even though they may not approve.  The idea addresses that each alter did the best they good.  “I had my job and you had yours.”  Once respect begins to take shape, it is believed that a co-conscious may emerge. 

The group extremely therapeutic for me since it provided validation on the subject of DID through project material. 

Session with Dr. Beverley – Therapist

Intake and Questions

I brought up how the hospital policy on the Execution Boundary was disturbing to me.  Beverley said they didn’t mean it like that. 

Tuesday – September 17, 2002

Group Goals

8:00 AM

1. ‘lil Kathi has a right be here.

2. I can trust the treatment team and they have my best interest at heart.

3. I am Safe

Physically?   Tired

Emotionally?   Hopeful 

Spiritually?  Open

Goal?    Be attentive 

Introduction to Group

My introduction was sort of covert.  I had a hard time being open.  I read my introduction, received feedback.  Knowledgeable.

Role Play Group with Kristy – Facilitator

Upsetting

A sexual perpetrator was role-playing telling his abuser about being molested at a very young age.  He said that lead him to fondle relatives and siblings.  He said that he was mad at him.  And then said he wanted revenge but he can’t because he is dead now and that he ‘made’ him abuse others.

What? Made?? As survivors, we have a choice to stop the cycle.  He chooses to continue the cycle.  If he was so mad at his abuser, then why would choose to continue the sexual abuse that hurt him???

Yesterday I told Kirsty I did not want to be in any groups with sexual perpetrators because it would bring out rage in me.  And now, here I am in this group listening to a person that choose to do the same thing to others.  AT LEAST I ACTED IN AGAINST SELF AND NOT OTHERS!!!  Aggggggggggggg

I had to leave the group.  Feel like leaving the hospital – Not getting anything addressed or done.

Sexual Disorder Group

Video Tape Played – “Contrary to Love”

Cannot watch.  A child should not watch this type of material

Session with Dr. Beverley – Therapist

Intake and Questions – 9/17/02

Finished taking intake.  Talked about me leaving group due to sexual abuse toward other children from the person in role-play.  She said I should have expressed my feelings.  That is what the group is for.  No, I would hurt him more and he is here to get better.  She said he needs to know what it feels like from a victim’s point of view.  I said he expressed his hatred of it when it happened to him.  – Disclosed SRS under the condition she would keep it in confidence.  She promised, not to verbalize or chart it.  She said she is very perceptive and would have never guessed.  Good.  Talked about me feeling like a child.  And it is not age appropriate for a child to be in sexual disorder groups.

Cognitive Group with Kristy – Facilitator

This group revolved around a survivor  “playing the victim.”  In group I said that I thought it was an awful term.  She said that maybe it wasn’t the right term but continued to defend how survivors ‘play’ the part.  After group I felt invalidated hearing the phrase and I gave this to Kirsty after group:

She read it and handed it back.  I wanted to leave – talked to Kristy – discussion – okay to leave. It was a relief to make my own choice and have it respected. 

Later, peers asked me to stay.  They talked at length with me about staying.  They succeeded in getting me to understand and to have more tolerance.  It was a hard decision to stay.

That Evening…

Listening to a peer sing the songs she as written while she played her guitar.  Her songs are expressive and about mental health as well as love songs.  She is very animated and musical.  I can feel her spiritual grace and sweetness, and it comforts me.

Wednesday – September 18, 2002

Group – Core Issues Mixed with Sexual Disorders 9:30 AM

SOB!!!  I was put into group B for sexual disorders mixed with trauma survivors.  (Voiced I didn’t want to be in that type of group with Kristy)

I let Kristy know the group freaked me out.  She will remove me from group B and into group A immediately.  I told her since I viewed my developmental emotional level was as a child, that group is not age appropriate.  

Group – Contour Trace Drawings AM

Looked into a mirror and drew my face with my non-dominate hand, and, I wasn’t allowed to look down at the drawing until I finished it.  It was hard because it was like drawing blind.  Then after we were finished, our pictures were passed around to our peers for feedback. Interesting.

Lunch

Session with Dr. Beverley – Therapist

3^rd Session – 9/18/02

Talked about being in sexual disorder group.  I explained that it was not age appropriate for me.  And that it was not productive to put survivors of sexual abuse in that sort of group.  She defended there was good cause to put survivors in that type of environment. 

“Really?” I asked.  “Do you have any empirical evidence to back that up?”

She said she didn’t want to go there. “Lets not talk about the past, that is over and you got transferred.”

“Fine” I responded. “Lets not talk about anything in the past.  I see a plant, chair and etc.

She continued, “Let’s talk about your feelings.”

“Can’t” I said, They are feelings from things of the past.

She said, “Your feelings are how you experience things are what is important.”

Silence

“Do you think you can help me?” I asked.

She answered, “It’s up to you. Tell me how.  Tell me your needs.”

Again I asked, “Do you think you can help me?”

She replied, “I like to think I can.”

I asked, “So you don’t know?”

She answered, “Yes, I can.”

“How?” I wondered.

“You have to help me connect to your feelings.  What I usually tell my clients is to write down their goals.”

“I have them all ready.  My goals are to find a new and positive experience to help me resolve this anger.  To work in this emptiness and lack of identity.  Have you heard of Bion – the Container and the Contained?”   

B – No. 

K – Have you heard of Winnicott?

B – Yes.

K – How about Gabbard?

B – No.

K – Have you heard of the Meinniger Clinic in Kansas?

B – Yes, I’ve heard of them.

I explained how I thought finding a new experience was possible through Projective Identification, Introjective Identification, to contain, detoxify and offer a new more manageable introject.  That is what I mean by hopefully feeling a new experience.

B – I feel like we are in a conflict.

K – According to the material I’ve read, the client plays out the internal drama into the external world.  So you are getting a taste of what is going on in my head.

B – It must be awful, this conflict.

K – Right, on that level, we have made a connection.

K – I don’t understand why I was put into the sexual disorder group when I made a caveat about this with Kirsty up front.  I was thought I made my self absolutely clear I could not handle that material. 

B – We have found that putting survivors in that kind of trauma group is helpful for them.

K – Helpful for who?  I can see how I would be helpful for a person that was a sexual perpetrator to be confronted by a survivor, and the pain they feel because of such an experience.  But I don’t see how it can help a person like me that has so much anger due to persons that acted out their impulsive desires.  

B – We need to move on.

K – The other thing that really bothered me was the cognitive group that claimed a person that revictimizes themselves are ‘playing’ the victim.  I felt like I needed to say something in the group to make a stand for the survivors in pain.  And it still bothers me that I was put into the sexual disorders group.  Kristy said I was put there because I was well-read.  So what, what about me and my feelings?

B – You should have confronted the perpetrator in the group about how you felt.

K – If I had done that, he would have retraumatized because I would have done it aggressively and you guys would have regretted putting me in that situation.

B – That would not have been appropriate in the group.

K – Right.  My point exactly – by putting me in there, I was exposed to his stuff and him exposed to my feelings and I would have traumatized him further.

Group

1. Lil Kathi has a right to be in the world.
Group response:  Yes she does.

2. It’s okay to be different, which is what makes me an individualist.
Group response:  Yes it is.

A thought about Role-Play

I was feeling desperate, my defenses were so strong and developed.  I had an idea.  I had shared with Kristy before that my defenses were strong, and that I have a hard time connecting to my feelings.  I was talking about this with my peers.  

K -- How about I take the role of the treater, and Kirsty takes the role of me.  I bet by now she knows me better then others as far as my strong defenses.  This way, I can try an reach myself by her role-playing me.  Do you think she will go for it?

P -- She might. Write it down, and I will slip it under her door. 

This sounded right, that is if she would go for it.  I needed to prepare.  She would be hard, that is if she were able to role-play me.

Thursday – September 19, 2002

Group – Cognitive with Dr. Fridley

Great group on cognitive ‘Feelings not Heard”, and ‘Emptiness” 

Lunch

While is was sitting and eating my lunch with peers, a staffer gave me another lunch pass as Kathleen aka Kathi.  This was very upsetting to me.  It was the 3^rd time.  The last time it happened I told staff that it was very triggering and staff promised to take care of it and resolve the problem.  Now this time I had in my hands an aka with my name Kathi in very small print above my old name Kathleen in large print.

When I felt the lunchroom I forgot to place my lunch tray in the tray holder.  I was asked by staff to go back into the lunchroom and take care of the tray.  As I was walking back, I thought how strange staff gave more attention to making sure the tray was put away but not the energy to stop this name thing. 

After I came back into the main building I went and knocked on Kristy’s office.  She was there.  I showed her the lunch card and she promised to take care of it ‘right’ away.  I wanted to explain to her why this was affecting me so much, because I felt such anger from not being heard.  She apologized and said she could not listen to my grievance right now because she had to facilitate an anger group in about three minutes. (sigh)

Anger Group with Kristy – Facilitator

Great group as she discussed the effects of anger and how to channel the energy positively.  She also discussed tools how to clear up distorted thinking from old defenses learned in childhood.

Agreed to Role-Play

Kristy agreed to role-play with me.  I had to prepare.  How would I approach myself?  This was not going to be easy.  I knew that Kristy would give me a run for my money to mirror how difficult I was.

From Alice Miller: "The stronger a prisoner is, the thicker the prison walls have to be, which impede or completely prevent later emotional growth."

Peer Infraction

After group a peer was being question by staff as to why she had an aerosol spray bottle on her possession. 

Staff – (taking to another staffer) Bye-the-way, she said that you give her (peer) permission to have that spray bottle.

Staff – Peer, I didn’t not give you permission to have that spray bottle. 

Peer – One staff gave it to me.

Staff – Who gave it to you?

Peer – This one staff person gave it to me then.

Staff checked with this other staff person and she also denied giving this peer permission.  Then the peer suggest that a different staffer had given her permission.  Staff then got on the phone and dialed several numbers on the phone to other staffers in an attempt to get to the bottom of this.  It was apparent staff thought this peer was lying and they were working hard to confront her. 

I couldn’t help but notice how much energy staff was putting toward this patient infraction.  Yet, staff infraction toward me got very little, if any attention.  It appeared to me staff was more concerned about controlling and confronting this patient rather then helping me as a patient from getting retraumatized.  This seemed to me as inconsistent or bias.

Session with Dr. Beverley – Therapist

4^th – Session

B – Today will be a real short session.

K – That’s okay, how long?  5 – 10 minutes?

B – About 20 minutes. [billed the insurance company for a full hour.]

K – That’s fine. Carrie said that we are to take up unresolved feelings from the group to our therapist and nowhere else.  And I tried to do that with you yesterday and you said it was over and to move on.

B – You fixed it.

K – Yeah, but the feelings were not resolved.  So I’m trying to be clear if you are, or,  if you are not going to listen to my feelings.

B – I don’t understand what you want from me.

K – Validation.

B – I don’t understand what it is that you want me to validate. 

K – ABC’s in psych – validation.  Since we are not doing so well in the abstract, lets try something more concrete.  For example, If I was a treater and you had come to me and said that as a survivor you were sexually abused and could not handle being around a predator and then was retraumatized in the group, I would said, “Beverley, I completely understand how frustrating that would feel for you.  I’m sorry that you had to go through that.  If it were I, I would not have done that to you.  I’m sorry that it happened.”   That is validation.  Maybe you are not a survivor, I don’t know, but the survivors I work with desperately need validation and I would have no problem what-so-ever giving it to them.

B – Are you saying that if I wasn’t a survivor that I can help them?

K – No, I’m saying that you would have a clear understating as to why validation is so important in the healing process and I wouldn’t have to explain this to you.

B – I’m still not sure what you want from me.  It feels like we are locked into an argument and we can’t connect. 

K – That is because a therapeutic alliance must be established to connect.  Trust is an issue.  If you cannot validate the mistake of me being placed in that sexual disorder group, then how do you expect us to connect?

B – You seem to be hung up on what happened rather then expressing your feelings about it.  And this is therapy interfering behavior. 

K – Okay, tell me then, what is the therapeutic framework?

B – To work on your goals.

K – I told you 3 of my goals yesterday and we are working on one of them right now.

B – No, we are not.

K – Then you must know what my goals are to say that.

B – I don’t remember.

K – Then how can you say we are not working on my goals then?

B – I think I remember one of you goals was about relationships.

K – No, that was not my goal.

B – Then tell me what your goals are because we were talking about a lot yesterday and I can’t recall.

K – One of my goals had to do with validation, and if I can’t get that, then it would be almost impossible to go further.

B – Maybe we are at an impasse then.

K – Maybe we are.

B – Well, think about it over the weekend if you still want me to work with you., because I enjoy working with you.

K – You’re kidding right?  I mean lets drop the hats for a moment.  I’m not the client and you are not the therapist, and we are hanging out at a dance club as friends dancing, and we reflect the last three days between us.  What was so enjoyable, if anything about that?

B – You are honest, blunt and interesting, but it’s up to you.  Think about it.

K – (sigh)

Peer Suffocating 

The session was now over, and I felt frustrated that my feelings were not heard or honored.  Later I saw one of my peers sitting on a chair directly in front of the nurses station.  Something looked wrong with her.  She was gasping for breath. 

K – Hey girl, what’s going on?  You don’t look so good.

P – I can’t breathe.  I can’t get my breath and I asked staff for my inhaler but they said I needed to wait until after report.  Kathy the nurse, is in that room over there and no one will disturb her.  I can’t breathe, listen to my lungs, they sound like paper-thin cardboard.

It was true.  She did not look good at all and she was gasping for her breath.  It sounded like her air was blocked off and she was literally suffocating.  I turned around that tried to make eye contact with a staffer.  They were talking about their lives and work gossip.  It seemed to me they were very good at ignoring a patient at the desk.  I felt they knew I was there because I was making motions and verbal interventions to get their attention. It was like I didn’t exist.  They would glance toward me, and then blow me off, and then they went back to visiting each other.  I didn’t get it.  One of my peers needed immediate attention, and we were put on ignore.  

Another peer noticed that the sick peer was no longer responding.  She could not wake her and she was still gasping for breath.  I made a more direct, almost frantic gesture to get there attention.  They took notice and just kept visiting each other.  Finally, the other peer demanded that someone interrupt the report meeting and get her some help.  At this point, a staffer went into the report meeting, and it was still about another five minutes before the Kathi, the head nurse came out and directed a mental health worker to take her vitals.  They seemed put-off to help as we tried to revive her.  She ended up going to emergency for medical treatment. 

This was a bit much for me to take.  I was wondering by now exactly how much I could get from this place. 

That Evening...

Later that evening, a peer that had talked me into staying decided she had enough.  I tired to talk her out of it and to consider, and weigh out the good verses the bad.  She said the bad outweighed the good by a significant amount.  It was no use.  I could not talk her out of it.

K – How dare you leave after you and another peer talked me into staying.  If I have to stick it out, so do you.

P – I’m so sorry, please don’t be mad at me for leaving.  I just can’t handle it anymore.  I’m not being heard or acknowledged.  I got to get out of here.  I’m tired of it.

K – Are you sure?  Maybe you are just being impulsive.  Give it another 24 hours and see how you feel then.

P – I can’t.  I’m done with this place.  I came in here with a good attitude and to get some work done but staff is repeating the past all over again.  I can’t handle it any longer.  Please don’t be mad at me. 

I sat there and thought about it some more.  Trying to make sense out of the last 4 days, balancing it all out.  What I have learned in the groups verses the inattentiveness, neglect and invalidation.   About that time another peer can out to the patio and she was leaving the next day too.  She said she felt so apathetic and wasn’t getting very much from the program and that staff didn’t seem to take an interest in her recovery.  

The three of us talked about it at length on the patio in the evening air.  We exchanged our views and experiences with staff over the last few days.  We felt ignored, brushed away, a nuisance and that we were intruding into their lives.  I was getting more and more upset and wanted to leave right away.  Just to get out of the environment that saw us as intrusive.   

Decided to Leave

I asked the head nurse for release.  She advised against it because the doctor wasn’t there and she would have call him and go through a whole process.  It was hard for me to figure out if they cared about me leaving at night, or if I was imposing undesired paperwork for them.  Anyway, I agreed to spend the night, and perhaps I could see this in a different light the next day.  As objective as I am, it was still a challenge.

Sleep

Friday – September 20, 2002

Morning

I was sleeping when a mental health worker entered my room.

S – Kathleen, it’s morning.  Time to get up.

K – My name is not Kathleen, it’s Kathi.

S – I don’t know anything about that.  You will have to solve that at the nurses station.

That put more weight on my decision to leave.  It happened again with the name thing.  I went up and asked a staffer to please get my papers ready because I wanted to leave.  She said that was fine but I needed to speak to the doctor first.  I sat around about another hour.  I asked again for my release.  I asked my Doctor and he agreed right away for the release.  I went back and took my seat still waiting for the paperwork.  Jill, a nurse motioned me up to the front to sign the paperwork.  It was then that I noticed all the forms were written for a patient named Kathleen.  I felt I needed to stand up for myself and asked her to rewrite all the forms as Kathi.  After all, that is how I admitted myself in the paperwork, and also how I introduced myself to the hospital administration and staff.

K  -- I can’t sign these papers like this.  The wrong name is on there again.

S – Just ignore it Kathi because it will take too much time to redo the papers.

K – No, I won’t do it.

S – Go then, get out of here!

I turned and walked down the hall.  I felt like I was a pain all along, and because I had advocated for myself, I had become the black sheep.  I would imagine that staff was all too happy I was leaving.  I was objectively trying to sort it out.  I went into the lobby and waited for my ride.  While I was waiting, I decided that perhaps if I talked to the manager of administration, perhaps someone would be able to get it right. 

Meeting with the Assistant Administrator

I explained the situation to Howard the assistant administrator.  He got the file – verified all the administration papers were filled out as Kathi.  My social security card was Kathi along with my Drivers License.  My insurance card had Kathleen on it.  Yet, all other ID and paperwork was Kathi.  Upon admission I had told the intake person how important it was that I was known as Kathi since I had gone to court and legally changed my name.   Howard had no knowledge of this.  

K – So, it’s more important for you guys to get paid then to stop me from getting retraumatized?

H – No, of course not.

K – Then how do you explain why staff kept referring to me as Kathleen? 

H – I can’t.  Did you explain it to them?

K – Yes, I did.  On the second day when it happened, I told them the effect it had on me and they said they would take care of it, but they didn’t.  When it happened again and I told Kristy about it,  she promised it wouldn’t happen again and that she would take care of it – done.  Then the next morning, today, I was woke up by staff calling me Kathleen.  I told her I wasn’t Kathleen, and the name was Kathi. She said that if I had a problem with that, to take it up with the nurse.

Then I explained to Howard what happened to me before in another hospital and why it was so traumatizing for me  And the reason I came here was to resolve this anger and experience something new.  (crying at this point).

H – And you didn’t get a new experience and instead it verified what happened to you in the past.

K – Yes and that is what hurts so much.  Here in the lobby is a sign that says ‘We Care’ and to me it didn’t feel like care at all.  Sorry – don’t mean to cry.

H – No, it’s okay.

K – And just now when I left, I was supposed to sign out, and the discharge papers had Kathleen written all over them.  And when I told Jill I won’t sign the papers with that name, she got mad and raised her voice and said, “Go then, get out of here!”

H – I understand Kathi.  Are you safe?

K – At the moment I am but I don’t know about later on because I am worst now then when I came in.  But it’s all over now.  Howard, you are the only one that took the time to listen and validated me.  Thanks.

Sunday – September 22, 2002

11:45 PM

I just finished typing the journal notes. I’ve had two days to reflect on the past events.  I tried to weigh out what happened and it’s value overall.  What stood out is that the program itself seemed to be 80% on target.  The team that wrote the program presented a carefully thought-out framework.  What appeared to be deficient was the force that worked in that framework with the patients.  Except for participation in leading groups, the treatment team seemed preoccupied with much more then the paperwork.  The tone that came across was they were ‘put out’ with the idea that some patients needed attention.  It was oblivious with most of the treatment team there was a sort of distance that came off as though the patients were second-class citizens.  

A Neutral Therapist and Conflict of Interest

In reflection, I wondered why my inpatient therapist came across so ‘neutral’ and invalidating when I talked about staff infractions.  She seemed uncomfortable whenever I was upset with the treatment team.  As though any validation from her would get her into trouble with the management.  Then it seemed oblivious there was a conflict of interest going on.  She was contracted by the hospital to work as a therapist.  It seemed like an easy way to get clients.  All she had to do was show up and listen, and conduct therapy as long as the management was priority over any validation to the patient regarding staff infractions.  After all, it would be disturbing and disruptive for staff if a patient actually got some validation because of staff transgressions.  I may be off, but I doubt it.  It goes back to if management is unhappy with validated patients, then her contract may be in jeopardy when up for renewal.  Food for thought. 

Conclusion

• Most of the groups addressed the cognitive, and processing elements.  A good source for building the cognitive toolbox for handling stress and life strategies.  The downfall was the hype that a survivor ‘plays’ the victim role and most staff seemed to interact with patients on that basis. 
   

• Little, if any psychodynamic psychotherapy was available. 
   

• Validation from staff did not seem to be a chief concern when it came to experiences inpatient, or memories from the past.  Some of the printed material was validating as were some of the group theories.
   

• Most of the staff seemed inattentive and burned out and viewed most patients that acted out their drama as attention seeking. 
   

• Patients in deep distress and crying were often ignored.
   

• Psychical problems from a patient did not receive prompted attention but rather were ignored from what I had witnessed.
    

• Corrective action requested by the patient was ineffective and ignored in favor of using that time disciplining patients for infractions. 
    

• Overall it came across that it was a privilege to be helped.  I had witnessed on many occasions that the Execution Boundary was threatened and some patients became despondent, frightened and more desperate. 
    

•  It seemed that the only advantage of being hospitalized would be that it provided a convenience for the patient by not having to sleep at a motel.  The desired functions of nurturing and positive regard for the patient appeared to be severally lacking from most of the treatment staff.  For this reason, day treatment may be a better choice to prevent the concrete beliefs of the patient that the world is bad.  The trauma of treatment is a concern when inpatient here.
    

• A daily group (group A), the men's issues of sexual disorders were mixed with the women's issues of sexual trauma from child abuse.  To me, it seemed inappropriate to mix a sexually abused child with sexual offenders.  
    

• A favorable point that did come across as validating was the stance that DID what a legitimate defense.
    

•  The milieu was structured with a flux of activities. 
    

•  The cognitive groups had some good information.
    

• The creative groups provided personal reflection.

Last, the preponderance of feedback and conflict resolution came from peer support and not from staff.  The extent of staff involvement was from the groups, after that the patients were pretty much on their own, unless a patient was facing the threat of the probation or the execution boundary.

Friday – September 20, 2002

Arrived home

After thinking about this some more on the way home, I decided to fax the hospital a letter on my feelings about my admission. 

Attention: Hospital Administration

I was hurt by treatment staff and the issue was never resolved, so I decided to leave the hospital.  I saw this in your lobby and decided to write it down because most times, I did not experience this.

I talked to Howard about this just before I left.

This is in the Lobby of your hospital under:

State of Principles

Compassion   We will never lose site of the fact that we provide care and comfort to people in need.  The patients and families that rely upon us are fellow human beings, and they will receive respectful and dignified treatment from all of our people at all times.

It seemed no one there was interested in helping me resolve this or even cared about what happened to me.  I write this because I had asked no less then 5 times for some sort of Corrective Action, but no use, it still continued.

I have decided to write about my experience and about the polices of your hospital, and how the problems(s) did not get resolved.  To think no one cared to correct the matter needs to be addressed.  Least I can do is warn others before they check in your hospital.

Kathi Stringer

Who knows, maybe someone will take notice?

Monday – September 23, 2002

Phone call from Kristy

4:15 PM

Kristy, the trauma unit coordinator called.  She thought that we had connected on some level.  I explained to her the previous trauma that I had experienced because of the name thing. She did validate my experience with the name problem and she said that she had talked to administration about it.  I shared how my experience along with peer experience, mirrored back -- was that we felt like second-class citizens.  She understood that was my perception of it, and it is an problem that they are currently addressing in training.  I let her know that I was going to be as objective as possible when writing this...to consider the good with the bad.  And she said it seemed to her that I would write the truth as to how I perceived it and that my writing is part of the process. She also said it was okay to do what I needed to do, to process this and the door is still open. 

After the phone conversation, I felt better.  I felt heard.  I felt that I mattered.  I only wish this type of call was imbued within the emotional and nurturing framework in the attitudes of treating staff.  

What has kept me from acting in, self-harm and suicide from this overwhelming anger, is that I'm writing about it and sharing this with others.  Take it for what's it worth.  For me, it has been therapeutic to share my experience, and my observations.

In support,

Kathi Stringer