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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 74 to 98 of 108. Go back in thread:
Posted by Dr. Bob on November 23, 2003, at 0:10:10
In reply to Re: offering help » Dr. Bob, posted by Larry Hoover on November 22, 2003, at 20:11:30
> > > One of the problems in this Babble environment is that I have no choice about continuing to interact....not really....because I can't do something as obvious as activating a killfile, or blocking the sender from appearing on my computer, or blocking threads once I identify them as troublesome.
> >
> > No, but you can not read their posts...
>
> I think your solution is demonstrably flawed. If it was that simple, there would be nobody hurt by any of this. Moreover, as I said, it spreads like ripples across a pond. We're like objects dangling from a mobile, each quite separate, yet attached. You can't move one object without all the objects moving. A big event cannot be ignored by simply turning one's head.Feeling hurt is one thing. Yes, events will cause ripples. But continuing to interact is another. Posters have some ability, unlike components of a mobile, to control how affected they are by ripples -- and to what extent they propagate them.
Bob
Posted by Larry Hoover on November 23, 2003, at 7:44:35
In reply to Re: offering help, posted by Dr. Bob on November 23, 2003, at 0:10:10
> Feeling hurt is one thing. Yes, events will cause ripples. But continuing to interact is another. Posters have some ability, unlike components of a mobile, to control how affected they are by ripples -- and to what extent they propagate them.
>
> BobIf matters were as simple as you imply, you wouldn't use blocks. They would be unnecessary.
Lar
Posted by Dr. Bob on November 23, 2003, at 17:08:05
In reply to Re: offering help » Dr. Bob, posted by Larry Hoover on November 23, 2003, at 7:44:35
> > Feeling hurt is one thing. Yes, events will cause ripples. But continuing to interact is another. Posters have some ability, unlike components of a mobile, to control how affected they are by ripples -- and to what extent they propagate them.
>
> If matters were as simple as you imply, you wouldn't use blocks. They would be unnecessary.I didn't mean to imply that it was simple...
Bob
Posted by ramsea on November 25, 2003, at 8:30:30
In reply to Re: parasuicidal threats and false reporting » Dinah, posted by Larry Hoover on November 22, 2003, at 11:45:08
Is this a question for everyone or just between you two? If it's meant to be more private, sorry for interrupting. I have known so-called borderline personality disorder diagnosed people, and am sad to say that three of them are no longer with us--while they did have parasuicide incidents, they were actually bent on going for the "real thing" too. BPD has a high successful suicide rate.
Sometimes a BPD person who parasuicides is considered to be practicing for the real thing. Sometimes they don't intend fatality at that point. They are often treated to great social castigation for their parasuicide behavior. Now, as a person who has know BPD diagnosed persons very well, I can agree Larry that it is VERY hard on the family/friend. It tries loved ones patientce and tolerance very deeply.
Like any other severe illness (and my mind believes they are ill, not bad), we can end up just wishing they'd never come into our lives, because it is so hard on us. And then that feeling just makes us feel horribly guilty. So it can be a lose/lose situation. I have tremendous empathy for relatives/friends of a BPD dx person who engages in parasuicidal acts.
It seems some pdocs believe that BPD is actually a form of both PTSD and bipolar II. If that is the case the person who "fakes" may be prepping for the real thing. On the other hand, such a person may have other difficulties. Overly dramatic, theatrical persons might do this, or a very bored, very unsatisfied person. The behavior may have nothing to do with a psychiatric problem.
Of course everyone in this thread is aware of these possibilities. But I am always hooked when people start mentioning borderline PD and a troublesome behavior in the same breath. Especially if the implication is that there is something fakey about the person and rather wickedly manipulative. In MHO BPD is a mistaken label. It covers too much ground. It's too female identified. If there is a problem with rapid cycling mood swings, sounds bipolar to me. If there are flashbacks, etc, of trauma/abuse in background, I agree with those pdocs who look to PTSD. If there's a lot of antisocial behavior going on, as in pretending to die and so forth, it seems we should call it antisocial and not "borderline", as it is possibly more descriptive? I mean, it strikes me as more of an antisocial thing than parasuicide, as a so-called parasuicide act usually involves dangerous, risky begavior that could maim, injure or kill the person even if they didn't want it. This particular incident reminds me of a friend of mine who told everyone she was dying of cancer and kept it up for awhile with dire consequences. Her "diagnosis" is antisocial PD. She was also abused most horrifcally in childhood (documented in court records).
Outside of serious personality disorde or mental illness, I suspect some people are troublesome, stressed out and gameplaying to an extreme and require serious therapy.
Posted by Larry Hoover on November 25, 2003, at 9:45:14
In reply to Re: parasuicidal threats and false reporting » Larry Hoover, posted by ramsea on November 25, 2003, at 8:30:30
> Is this a question for everyone or just between you two?
I was *so* hoping that more people would express themselves. Thank you.
> If it's meant to be more private, sorry for interrupting.
Not in the least. I hope you don't mind my editing your post to focus more closely on certain ideas.
> Now, as a person who has know BPD diagnosed persons very well, I can agree Larry that it is VERY hard on the family/friend. It tries loved ones patientce and tolerance very deeply.
Absolutely.
> Like any other severe illness (and my mind believes they are ill, not bad),
Ill, not malevolent. I have to assume that, even if I am wrong.
> Especially if the implication is that there is something fakey about the person and rather wickedly manipulative.
That's not what I meant by anything I said. It is a particular behaviour (the topic of this thread) that is excessively hurtful, though.
What I question is, how appropriate is it to seek "substantial" levels of support here, in these forums? Let me expand.
The need for support is not questioned (I hope). The behaviour is not malevolent (I hope).
The behaviour can be massively disruptive to other vulnerable people (we *are* a selected population). That is not in question (I hope).
Any support available here is probably inadequate, or at least, not substantial (my inference).It's a practise here to redirect on a topical basis.
It's a practise here to consider the impact of any posting on even hypothetical readers thereof.
It is a practise here to prevent posting by posters who ignore the feelings of others, *even if unintentional*.
Why would it not be a practise to redirect certain forms of posting to community-based supports? Is that feasible?
It is a practise on other similar boards to delete any such posts, and to report them to relevant authorities if the identity of the poster can be traced.
The deletion is to prevent any sense of rewarding the poster, and to minimize the the impact of the posting itself. The reporting is to provide the maximum level of community-based support that might be available. What more could anyone do, anyway?
Lar
Posted by Elle2021 on November 26, 2003, at 5:57:04
In reply to Re: parasuicidal threats and false reporting » ramsea, posted by Larry Hoover on November 25, 2003, at 9:45:14
Sorry Lar, you know your posts are just too tempting for me not to respond... :)
> "It is a practise on other similar boards to delete any such posts...
> The deletion is to prevent any sense of rewarding the poster, and to minimize the the impact of the posting itself."But, isn't deleting the post kind of a way of trying to escape the reality of things?
Elle
Posted by Elle2021 on November 26, 2003, at 6:00:51
In reply to Re: parasuicidal threats and false reporting » Larry Hoover, posted by ramsea on November 25, 2003, at 8:30:30
I wish everyone could be this understanding. :) Thank you for being so kind to the borderlines in your life.
Elle
Posted by Dinah on November 26, 2003, at 9:59:11
In reply to Re: parasuicidal threats and false reporting » ramsea, posted by Larry Hoover on November 25, 2003, at 9:45:14
So is the consensus that when someone is having suicidal urges, they shouldn't talk about it here because it might disturb other posters? I always thought here was a pretty good place because people here understood what it felt like to want to die.
Posted by Susan J on November 26, 2003, at 10:13:30
In reply to Re: parasuicidal threats and false reporting, posted by Dinah on November 26, 2003, at 9:59:11
> So is the consensus that when someone is having suicidal urges, they shouldn't talk about it here because it might disturb other posters? I always thought here was a pretty good place because people here understood what it felt like to want to die.
<<Hi, Dinah,
I don't agree with that myself. I'd never want to ban someone who has suicidal urges at all, and to whatever tiny extent I could help that person, I would.
The difference for me is how it's worded. Saying, "hey, I feel like killing myself cuz I'm in so much pain, what can I do?" is a lot different than threatening to kill yourself just to get a reaction out of people on the board. Of course, I know it's difficult to figure out the difference sometimes, and impossible, probably, to make any sort of guideline about it.
And *faking* suicide or hospitalization, just to get sympathy, is really sad, too. I think there are so many people here who are sympathetic to people's pain, there's no reason to cry out in a deceitful manner for help. I think in those circumstances, the good of the many has to be considered over the good of the one.
I'm certainly not a therapist or anything close. But I *do* know reacting (positively *or* negatively) to any specific behavior reinforces it. I'd like to concentrate on reinforcing good, honest behavior, and try to ignore the deceitful type of behavior.
I think it's human nature to answer *honest* cries for help rather than deceitful, false ones. We reach out to people who need our help, not to people who hurt us. I know this point of view means I'm not the strongest most loving person in the world, but it's the best I can do right now.
Posted by NikkiT2 on November 26, 2003, at 10:18:19
In reply to Re: parasuicidal threats and false reporting, posted by Dinah on November 26, 2003, at 9:59:11
I don't understand it like that.. But my brain is a little dim at the moment.
I think.. people should be able to post that they feel suicidal, that they'd like to do it etc..
But, I do think posting that someone is dead, when they're not, is wrong...theres a big difference between feeling suicidal, or even threatening suicide, and actually saying that you've done it.
Just my thoughts
Nikki x
Posted by NikkiT2 on November 26, 2003, at 10:23:27
In reply to Re: parasuicidal threats and false reporting » Dinah, posted by Susan J on November 26, 2003, at 10:13:30
Hi Susan,
Re-enforcing bad behaviours is something I talk alot about when I do my sessions with Mental health students and psychs etc..
The services, here in the UK atleast, make me angry in that you ring them up and say "I want to commit suicide", or "I want to self harm" and they tell you to take a pill, go to sleep, come back another day.
But if you ring them up and say "I've taken an overdose" or "I've cut myself really really badly" then you get help straight away.
I think that reaction is wrong.. the people who are asking for help before acting out, or try to control those urges should be given equal treatment to those that ARE acting out. As the system works, people are more inclicned to act out before asking for help, as they know they'll get more help that way.When I was in hospital, I was virtually ignored as I was quiet and not acting out. Yet the loud scary ones, were given constant attention. My need was just as great, but because I didn't want to be seen as a pain, I was treated as if I wasn't ill.
Thats why if someone says to me "Help, I feel like doing x, y or z" I will offer help and support. But if someone says to me "I have done x, y or z" I am less likely to offer help, just advice on where else to go.
Sorry.. gone off on one there.. But just supporting what you said!!
Nikki x
Posted by Susan J on November 26, 2003, at 10:41:29
In reply to Re: parasuicidal threats and false reporting » Susan J, posted by NikkiT2 on November 26, 2003, at 10:23:27
Hi, Nikki,
>> But if you ring them up and say "I've taken an overdose" or "I've cut myself really really badly" then you get help straight away.
<<Yeah, I don't know if it's like that here in the States, but I wouldn't be surprised. There's real truth in that saying, "the squeaky wheel gets the grease."> When I was in hospital, I was virtually ignored as I was quiet and not acting out. Yet the loud scary ones, were given constant attention. My need was just as great, but because I didn't want to be seen as a pain, I was treated as if I wasn't ill.
<<That's not good at all. You are right. We (as a society) tend to reinforce bad behavior a lot, because we want the bad behavior to stop. We don't seem to concentrate enough on trying to *prevent* it....> Sorry.. gone off on one there.. But just supporting what you said!!
<<Nothing to be sorry about. I totally agree with you. It's actually been the story of my life....I'm quiet and don't ask for stuff, and get ignored. There's *got* to be a happy medium somewhere. Speak up with strength and honesty, but not in an angry, intimidating, deceiving, self-aggrandizing way. (hope I used that word properly, not totally sure what it means) :-)Take care,
Susan
Posted by NikkiT2 on November 26, 2003, at 11:52:58
In reply to Re: parasuicidal threats and false reporting » NikkiT2, posted by Susan J on November 26, 2003, at 10:41:29
Hi Susan,
I'm learning to speak up in a non-angry way.. The work I do for this charity is spilling out into not just personality Disorder stuff, but more general mental health. I know not everyone can do this kind if stuff, so I feel honoured to be invited to the thiings I'm involved in.. But too many people are quick to moan, but not do anything about it. I asked at the BPD group I'm a member of, for ideas on good / bad treatment (like I did here too), and not one single person answered - out of 122 members. many are very vocal on the list about how badly they are treated, but they were offered the chance to get their voice out there, via me, and not one person took it.
But, by practicing and getting good at this, I can get my message out there. And positive-reinforcement is one of the messages. Don't just ignore us quiet ones and give all your attention to the acting out ones! Isn't there something they tell you in first aid courses?? Something about at a major road crash, go see the quiet ones first, and leave the noisy ones for second, as the quiet ones are often the most seriously ill. Hmm.. I must remember that analogy (if thats the right word!!)
I'm so passionate about this at the moment.. I'm hoping to get my NHS trust to pay for me to do an advocacy course.. Its something I'm enjoying so much.
Nikki x
Posted by Susan J on November 26, 2003, at 12:18:01
In reply to Re: parasuicidal threats and false reporting » Susan J, posted by NikkiT2 on November 26, 2003, at 11:52:58
Nikki,
> But, by practicing and getting good at this, I can get my message out there. And positive-reinforcement is one of the messages. Don't just ignore us quiet ones and give all your attention to the acting out ones! Isn't there something they tell you in first aid courses??
<<I think that's really great! Anything that helps people think differently, and therefore see and understand more, is wonderful in my book.> I'm so passionate about this at the moment.. I'm hoping to get my NHS trust to pay for me to do an advocacy course.. Its something I'm enjoying so much.
<<That's very cool, too. I wish I could find something in life that I could be passionate about -- that would help other people. I don't think my movie habit does anyone much good but the movie theatre coffers.... :-)Susan
Posted by Elle2021 on November 27, 2003, at 6:21:56
In reply to Re: parasuicidal threats and false reporting, posted by Dinah on November 26, 2003, at 9:59:11
> So is the consensus that when someone is having suicidal urges, they shouldn't talk about it here because it might disturb other posters? I always thought here was a pretty good place because people here understood what it felt like to want to die.
I was also under the impression that this would be the appropriate place to discuss such thoughts.
Elle
Posted by Larry Hoover on November 27, 2003, at 7:00:08
In reply to Re: parasuicidal threats and false reporting » Dinah, posted by Elle2021 on November 27, 2003, at 6:21:56
> > So is the consensus that when someone is having suicidal urges, they shouldn't talk about it here because it might disturb other posters? I always thought here was a pretty good place because people here understood what it felt like to want to die.
>
> I was also under the impression that this would be the appropriate place to discuss such thoughts.
> ElleYes. I think that's an important and relevant topic of discussion.
I had hoped it was clear that I was discriminating between the thoughts (suicidal ideation), and the act itself.
And I don't think there's anything close to a consensus yet.
Lar
Posted by Elle2021 on November 28, 2003, at 1:37:00
In reply to Re: parasuicidal threats and false reporting » Elle2021, posted by Larry Hoover on November 27, 2003, at 7:00:08
> Yes. I think that's an important and relevant topic of discussion.
Me too.
>
> I had hoped it was clear that I was discriminating between the thoughts (suicidal ideation), and the act itself.You have made yourself clear now. :)
> And I don't think there's anything close to a consensus yet.
Right you are Lar! (that rhymes!)
Elle
Posted by ramsea on November 28, 2003, at 5:27:43
In reply to Re: parasuicidal threats and false reporting » Larry Hoover, posted by Elle2021 on November 28, 2003, at 1:37:00
Thanks for letting me into the discussion, guys. You've hit upon some important matters. I like the idea of a separate board for posters with difficulties like suicidal ideation, self-harm, and needing to vent, etc. Then Dr. Bob could stipulate the rules governing that site.
It could even be stated plainly that if anyone is discovered to be misusing the board through false claims or untrue cries for help, they will be banned--or whatever. That way posters who do need support in this way can be helped by other posters who are up for this (or they shouldn't use that board).
It might be useful to everyone if the site descriptions make it very very clear that a certain board is a ***spoiler***territory, and contains language and imagery that might be upsetting to some.
This problem could arise again, so being prepared for it, and having carefully thought put rules to deal with all eventualities, might be a way forward. I expect it would need to be clear that saying one is suicidal on the board could have repercussion in real space---so don't say it if you're not prepared for others to take actions.
Actually, I don't know anything about this on-board stuff, about legal matter related to board threats and claims, or whether someone saying they're suicidal means someone is morally or legally required to seek help for them. It's all tricky. But I do think a separate ***spoiler*** board might help.
Posted by Larry Hoover on November 28, 2003, at 5:58:06
In reply to Re: parasuicidal threats and false reporting, posted by ramsea on November 28, 2003, at 5:27:43
> Thanks for letting me into the discussion, guys. You've hit upon some important matters. I like the idea of a separate board for posters with difficulties like suicidal ideation, self-harm, and needing to vent, etc. Then Dr. Bob could stipulate the rules governing that site.
>
> It could even be stated plainly that if anyone is discovered to be misusing the board through false claims or untrue cries for help, they will be banned--or whatever. That way posters who do need support in this way can be helped by other posters who are up for this (or they shouldn't use that board).
>
> It might be useful to everyone if the site descriptions make it very very clear that a certain board is a ***spoiler***territory, and contains language and imagery that might be upsetting to some.
>
> This problem could arise again, so being prepared for it, and having carefully thought put rules to deal with all eventualities, might be a way forward. I expect it would need to be clear that saying one is suicidal on the board could have repercussion in real space---so don't say it if you're not prepared for others to take actions.
>
> Actually, I don't know anything about this on-board stuff, about legal matter related to board threats and claims, or whether someone saying they're suicidal means someone is morally or legally required to seek help for them. It's all tricky. But I do think a separate ***spoiler*** board might help.I'm less supportive of a separate board for suicidal ideation. I think the social and psychological boards are fine...either one, depending on where the individual has a greater level of existing support.
If the registration protocol was changed, if it was a non-negotiable term of policy, that an administrative decision might be made to notify local authorities if risk of harm was observed, then that would suit me.
If I understand correctly, Bob notifies the authorities if a criminal threat is made....for example.
There are degrees of suicidal ideation. I'd hate for someone to ever hesitate during such a time, and try to determine if they meet some criterion or another (like where can I post this, should I post this), at the very time their perception and cognition may be heavily biased and distorted.
And I don't like the word repercussions applied in this context.
Lar
Posted by Dinah on November 28, 2003, at 8:39:11
In reply to Re: suicidal ideatin » ramsea, posted by Larry Hoover on November 28, 2003, at 5:58:06
>
> I'm less supportive of a separate board for suicidal ideation. I think the social and psychological boards are fine...either one, depending on where the individual has a greater level of existing support.
>
I think that's a valid point, Lar. In fact I'd go so far as to say Dr. Bob should be a bit relaxed on the rules if a primarily meds board person was in trouble, since some meds board people don't seem to like a redirect, and that wouldn't seem to be the time to be strictly adhering to the rules. Babble is a part of our support network for a lot of us, myself included.> If the registration protocol was changed, if it was a non-negotiable term of policy, that an administrative decision might be made to notify local authorities if risk of harm was observed, then that would suit me.
>
I think the problem there would be expectations. Dr. Bob isn't always on board, and I'd doubt he'd want people to think they could rely on him to report anything, because they really can't rely on him to do anything quickly enough to prevent a tragedy. So I'm sure he wouldn't want it to be part of the registration process, except to say that he *couldn't*.> If I understand correctly, Bob notifies the authorities if a criminal threat is made....for example.
>He has, he also has reported serious suicide threats. But he can only do it if he becomes aware of it.
Posted by ramsea on November 28, 2003, at 13:40:12
In reply to Re: suicidal ideatin, posted by Dinah on November 28, 2003, at 8:39:11
Good points. Thanks Lar for the info. I only use the word "repurcussions" in a limited way, i.e., I agree the word should not be used to inform posters of anything. It does sound punitive.
I do believe posters need clear statements of what can happen when using the boards. Dr. Bob does state that posters need to be aware of their situation as posters--I was glad to see his advisements. I was just wondering if it could be more clear when it comes to issues like discussing suicide.
I've come across some seriously upset net users who have had, well---repurcussions. They stated suicidal ideas in one of the mental health groups and then some group member or other apparently has gone to some trouble to secure emergency services for them. In the 3 or 4 cases I've come across through the years of surfing websites, the posters were very distressed about having been "turned in". They hadn't expected anything like that to happen.
It's no excuse I know, but some of us tend to forget how public the boards and sites really are. One super aspect about Dr. Bob's approach is that he constantly reminds group members that this is a very public place. Still, it's pretty easy to get lured into private discussions. We may think we're just expressing ourselves as people might in a rural bar after a few too many beers, and say stupid, out of character things, or act overdramatically.
It's frighteningly easy to make a major mistake that could have serious effects on our lives. Like drawing several police cars and ambulances at the door, or being hospitalized against our will. All of this when really the person was only momentarily out of it, as most people do get from time to time.
Whether the group has a separate board for suicidal problems or not is really not important to me. I would leave that to those of you who know more about how this site functions. I do think it should be very clear what may happen--or not---to posters who cry out for help.
Posted by noa on November 28, 2003, at 17:51:00
In reply to Re: offering help » Dr. Bob, posted by Larry Hoover on November 22, 2003, at 20:11:30
Larry, I agree with you that it isn't possible to completely block out troublesome posts or threads.
I know it takes a lot of effort and determination to do this, but given the limitations of the board that you mention, I think it is possible (and I find it necessary) to choose to not open certain posts that I know or suspect will be problematic for me.
And it's true, there are times when I open a post that seems benign enough and only then discover that it is something I wish I hadn't opened. But then I choose to close it and move on.
It isn't easy, I admit. It has gotten much easier over time, though--I guess with practice. It's not a perfect solution. And I hope it doesn't seem like I'm minimizing the impact of detrimental posts.
Perhaps another solution will be found by this group. For now, this is what I offer, fwiw.
Posted by noa on November 28, 2003, at 17:55:52
In reply to Re: parasuicidal threats and false reporting, posted by Dinah on November 26, 2003, at 9:59:11
> So is the consensus that when someone is having suicidal urges, they shouldn't talk about it here because it might disturb other posters?
I hope not, Dinah. But I think there are different ways that these feelings get talked about. I don't have much difficulty with people talking about their suicidal feelings, but threats and repeated help-rejecting I do find extremely difficult.
Posted by noa on November 28, 2003, at 17:59:26
In reply to Re: parasuicidal threats and false reporting » Susan J, posted by NikkiT2 on November 26, 2003, at 10:23:27
You're right. Here in the states, as funding for MH services have shriveled away, and managed cost health insurance has prevailed, you can't get proper services pretty much unless you have the knife to your wrist or something. It is just awful that resources are not there to help people prevent crises and learn to cope before it gets that bad.
Posted by noa on November 28, 2003, at 18:05:40
In reply to Re: parasuicidal threats and false reporting » NikkiT2, posted by Susan J on November 26, 2003, at 10:41:29
>It's actually been the story of my life....I'm quiet and don't ask for stuff, and get ignored.
I am reminded of that great scene in "Terms of Endearment" -- Debra Winger's character is quietly suffering excruciating cancer pain as her medicine has worn off, so Shirley MacLaine, who plays her mother throws a huge screaming fit at the nurses' station because the nurses are slow to get the next dose in.
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