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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 vwoolf on September 16, 2006, at 12:49:42
Many years ago I spent some time in a psychiatric hospital. I have felt very stigmatized by the experience ever since.
Recently I decided to apply for a copy of my records and wrote to the hospital. After keeping me waiting for a long time, they replied that they will not give me a copy of the records but that I can arrange an appointment during which a psychiatrist will provide me with supervised access to the contents of my folder. My t may accompany me.
I have decided that I still want to go ahead even though I am very scared. I really need to deal with this stuff. My t is very supportive of this need.
Has anyone else done anything like this? What was it like? More in general, have you ever had access to your records? Did you regret it or did you consider it helpful? Why? Was your t helpful in interpreting the information.
I'm also not sure whether to ask my t to come with me or not - I'm afraid she might be bored and sit and fidget and make me feel as if I need to finish quickly. I'm also afraid that I might feel that the two of them are colluding against me as authority figures. But I'm also scared that if I go without her I may misread things or forget them or be bullied by the psychiatrist. Sigh.
I would really appreciate any help or advice you can give me from your experience. I feel very panicky about this.
Posted by notfred on September 16, 2006, at 13:56:16
In reply to Psychiatric hospital records, posted by vwoolf on September 16, 2006, at 12:49:42
I have felt very stigmatized by the experience ever since.
So, how will reviewing your records help with this ?
Posted by Racer on September 16, 2006, at 13:58:22
In reply to Psychiatric hospital records, posted by vwoolf on September 16, 2006, at 12:49:42
I've got my records from the Agency From Hell. And I've talked to my T, telling her that I will eventually want to go through her records with her, too. She says that can be part of termination, and she will do it, although she does discourage it. (For good reasons...) In my case, she's said that she understands my reasons, and hopes that it will either not be an issue when the time comes, or that going through together will help strengthen the work we've done on my trust issues.
If you're going to do this -- more on that later -- I think it would be wise to take your T with you. And take a notebook, so you can take notes.
Why do I say "IF?" Well, it's not necessarily a good idea. My case was a little unusual, in that it involved a traumatic and abusive situation. Reading my records helped me see that it wasn't entirely that I was the worst person on earth, that it was only 98% that I was too sick to be helped in any way by anyone. OK, what it really did was prove to me that my perception that the people there had had a problem listening to me, or hearing me, was NOT a distortion. (They kept telling me that they were listening, that they were hearing, that they did understand -- and that I was the problem, because I couldn't see that. You ever seen the movie "Gaslight?") So, seeing the proof that they really hadn't heard what I was saying helped me. Again, though -- this was not a normal situation.
Unfortunately, seeing my records was also pretty devastating for me. It's been more than two years now since the last time I was seen there, and I am still experiencing a lot of problems from it that affect nearly every aspect of my life. Having read the records, and thus seeing what I wasn't aware of at the time, I feel impotent, helpless, ineffective, etc. Obviously, nothing I did made any positive difference for me. That's not a good feeling, and the records were uncomfortable for that reason. The information contained in there devastated my self-image, my self-esteem, and my self-confidence. If the situation had been any different -- if I had not been in such bad shape based on what happened there, I would not think it had been a good idea at all.
Here's the thing: I don't think it's a good idea to see psychiatric records unless there's a very compelling reason. What would be a compelling reason? Well, anything you could sue for malpractice over. If it's anything less serious than that, I don't think it's a good idea. What do I recommend? I recommend -- very strongly -- that you ask yourself what you're hoping to accomplish by examining those records? What do you think it will help you with? Depending on your answer(s) to that question, it might make sense NOT to see them.
If you do go to see them, I also recommend you take your T along. And I very strongly urge you to discuss with your T why you want to see them, AND whether your T thinks it's a good idea. Your T knows where you are, and can probably make a good guess about how damaging it might be for you at this time.
Another option, by the way, is to have a copy of your records sent to your T, who wouldn't be able to show them to you, but could check them out and talk to you about any issues you bring up related to them. If, for instance, you're wondering if your perception about the way you were treated there is accurate, your T could check the records, and see if they support your view or not, and then discuss it with you to help you resolve it. That, I think, is what I would have done if I had had a T I trusted. It's what I would recommend to anyone else who wanted to see their records.
I know it can seem as though The Big Question can be answered through something like this. But you know what? It's not going to resolve nearly as much as it's going to churn up. It can be DEVASTATING. If you go alone, I'd be afraid you'd break down over what you may see in there. Even if you're 99.9% mentally healthy with everything resolved when you read them -- I still think there's a good chance of it being very damaging.
I'm sorry to sound so discouraging. But I really hope you'll consider alternatives.
Posted by caraher on September 16, 2006, at 14:00:59
In reply to Re: Psychiatric hospital records, posted by notfred on September 16, 2006, at 13:56:16
If you do go, I think you should not bring your T if you'd feel rushed or nervous. You can discuss the records in therapy later if you find what you read disturbing, and possibly make another appointment to review the records, this time with your T.
Posted by alexandra_k on September 16, 2006, at 22:23:44
In reply to Psychiatric hospital records, posted by vwoolf on September 16, 2006, at 12:49:42
I've seen mine. Well... Most of them.
Usually I don't have a t at the time I request them. Requesting them is typically about... My trying to figure out why I got terminated and why they won't give me a t :-(
So they photocopy them and I go in to collect them. And I take them away with me. I've still got most of them. Stored back in NZ. I used to read them when I was feeling particularly massochistic.
It is hard reading them...
The quality of the notes can be quite atrocious in places. Judgemental. Sometimes it is clear that the person has confused me with someone else. There used to be another patient and my first name was her last name. I have chunks of her notes in my folder. I wonder if she has chunks of mine lol. Actually that is atrocious given privacy and co...
There are incidents I don't remember too. Write ups about attempts. Justifications for moves to seclusion and strip searches and... Anyway, I read them when I am feeling particularly massochistic, yeah.
Why?
Why do you want to read them?
I wanted them because I wanted to know what people really thought. I found out. It was not a pleasant experience. It gave me some pointers, though. I was better able to deal with new clinicians because I had some idea of the judgements they were likely to make. I was better able to get them to ASSESS rather than assume certain things about me. I wouldn't have thought to do that before reading my notes. I wouldn't have had any idea someone would have made those assumptions about me.
I wanted to remember... So much of it I couldn't remember. I thought there might be some key in there. About what was wrong with me. But there wasn't. I guess I didn't remember that stuff... For a jolly good reason. As I write this it half comes back... It is stored in NZ... I would read sometimes and it would send me into crying jags for days. It is still there... I'm sure I'll read it again...
But I do think it is a bit... Massochistic. I don't know. I know I was mistreated in hospital. All it did was... Get me reliving the trauma.
If your t goes with you...
I guess you have someone to process it with.
I never had that.
Maybe it would have helped...
Posted by vwoolf on September 17, 2006, at 14:15:42
In reply to Re: Psychiatric hospital records, posted by notfred on September 16, 2006, at 13:56:16
Hi notfred, I'm sorry to hear you have also felt so stigmatized. Can you say more about it?
I have felt I can't really trust my thoughts and the fact that I was hospitalized is the proof that I am crazy. It's been a huge secret in my life ever since.
I hope to change this by confronting my past. I started with my mother a few months ago.
I told her about the csa with my father which I had memories of from about the time I was 8 or 9. She reacted by telling me she had found him abusing me when I was two, which shocked me terribly. A few days later she told me she thought I had invented everything, i.e I was crazy, it was all in my head. I was able to keep cool and point out that she had already confirmed what I was saying, and this stopped her in her tracks.
Suddenly everything became very clear to me.
She has always covered up her own weaknesses by making out that I was mad, and I have taken on this role.I now want to clear up what happened in the mental hospital, because to some extent they propagated this view. I am not sure whether it will work or not. We'll see.
Have you tried to confront this stigmatization? I'd love to hear more. If you don't want to write on the board, use Babblemail.
Vee
> I have felt very stigmatized by the experience ever since.
>
> So, how will reviewing your records help with this ?
Posted by vwoolf on September 17, 2006, at 14:52:42
In reply to Re: Psychiatric hospital records, posted by alexandra_k on September 16, 2006, at 22:23:44
Hi Alexandra, good to see you here - thanks for your reply. It sounds like it wasn't great for you to get these records if you have used them to hurt yourself. I know there is a part of me that wants them to confirm how bad/mad I am, so I understand that well. Could you tell me more about the judgemental part? I have no idea what format these records will take even, so I don't know what to anticipate. Any details you can give me will help me to prepare.
Thanks.
Bestest
vee
Posted by vwoolf on September 17, 2006, at 14:56:17
In reply to Re: Psychiatric hospital records, posted by caraher on September 16, 2006, at 14:00:59
Hi caraher, thanks for that. I have read a lot of old Babble posts about asking for records, and it seems as if most of the advice is to have the support of a t. I'll talk to her about it and make sure that she doesn't do anything that will irritate me - at least anything I can think of in advance. Perhaps I'll take a magazine along for her just in case she gets bored .....
Posted by Racer on September 17, 2006, at 15:44:57
In reply to Re: Psychiatric hospital records » caraher, posted by vwoolf on September 17, 2006, at 14:56:17
> Hi caraher, thanks for that. I have read a lot of old Babble posts about asking for records, and it seems as if most of the advice is to have the support of a t. I'll talk to her about it and make sure that she doesn't do anything that will irritate me - at least anything I can think of in advance. Perhaps I'll take a magazine along for her just in case she gets bored .....
Do you not trust her? See, if you don't trust her enough to be support for you while doing this, maybe it would be a better idea to find a better fit with a T before viewing these records?
If the records are from so long ago, they'll still be there in another few years...
Posted by alexandra_k on September 17, 2006, at 21:01:07
In reply to Re: Psychiatric hospital records » alexandra_k, posted by vwoolf on September 17, 2006, at 14:52:42
Mostly I read them because I was trying to figure what was wrong with me and I figured the 'experts' would have some kind of special insight into that and it would be there in my file. I wanted to know THE TRUTH. But... It isn't like that... There are just things written there... And some of them are immensely hurtful. And I'd get into this cycle of 'but I'm not like that' and 'they misunderstood' and 'but they are the experts they must know what they are talking about' and 'I must be in denial' and 'they list denial as one of my coping strategies so that must be it' and... It hurt. A lot.
> Could you tell me more about the judgemental part?
I'm from NZ. I don't know if there is a standard format for notes or whether it varies by country.
They are chronological.
There are entries from p-docs there are entries from nursing staff there are entries from psychologists. Both inpatient and outpatient all there every visit recorded in chronological order.
So my admission assessment.
Have you seen a psych assessment.
There is stuff like 'patient presented as a 18 year old european female. Dress was tidy casual and appropriate. Flattened affect Minimal eye contact. Good rapport was established. Patient said that she had been feeling depressed for several weeks..'
Lots of technical terms and fairly by the book.
Then there are the 'interpretations' which can come across as judgemental. I had to look up 'La Belle Indifferent' (however you spell that) and one p-doc noted that I had carefully manicured nails which is extremely surprising to me since I've eaten my nails to the quick ever since I was a child.
There are the ward notes. Ranging from 'patient attended ward meeting and PMR. Was observed chatting with other patients. No problems this shift'.
There are psychology notes.
There are medication notes at the back.
The facts are okayish for the most part.
The interpretations can be judgemental.I don't want to go back there... I'm sorry.
Um...
I guess I was depressed for a long time...
They were fairly sympathetic and I thought things were going okay. Then... It was like they changed. I didn't know why they changed and started saying horrible things to me.
I can track that in my notes. Things like:
'patient was observed laughing and chatting with other patients on the ward. Mood is reactive even though the patient complains of feeling depressed'.
[Innocuous enough perhaps...]
'CAT call recorded at 8.15pm. Patient complained of feeling 'bad' and 'upset'. Patient was told to practice her skills and was informed that she would not be admitted'.
Those aren't judgements.
Just facts.
'Facts'
Interpretation filters through...
Even the neutral stuff can be hurtful...The judgements... So much worse...
Posted by alexandra_k on September 17, 2006, at 21:26:30
In reply to Re: Psychiatric hospital records, posted by alexandra_k on September 17, 2006, at 21:01:07
Doctors 'observations' can be interesting.
They are supposed to write their 'observations' but oftentimes those are theory laden. You can read between the lines on assessments when they switch from 'patient was ____' to 'patient says that'. It if fairly clear whether they think that their observations match what they report the patient says. And sometimes they don't hear too good with respect to what they say the patient says though I think they are supposed to quote. I guess their... Clinical judgement shines through...
> 'La Belle Indifferent'Is a term that shouldn't be used. Like hysterical and neurotic.
> One p-doc noted that I had carefully manicured nails which is extremely surprising to me since I've eaten my nails to the quick ever since I was a child.
And that is an example of how their theory can infect their observations. Sometimes (oftentimes, mosttimes) clinicians read your file before seeing you for the first time. The 'observation' of my nails was supposed to support the previous clinicians 'judgement' of La Belle Indifferent I guess...
I noticed a substantial difference between clinicians seeing me for the first time when they had not managed to locate my files. And clinicians seeing me for the first time after either a cursury look through or a substantial reading. The latter were much more theory laden in their observations, judgmental in their interactions with me etc etc. That was why I wanted to read it. I wanted to know why I deserved such treatment. What on earth was in there?
> 'patient was observed laughing and chatting with other patients on the ward. Mood is reactive even though the patient complains of feeling depressed'.
I was depressed. I WAS. Maybe not depressed exactly... In a way I think my depression became more intermittent. The couple of hours to a couple of days variety. But I always FELT bad. Even when I was laughing and joking and chatting with the other patients. There was an intense sadness behind the happy face. And there were periods (of a couple hours to a couple days) of INTENSE distress. And I didn't understand what was wrong with me. I felt bad. They started saying to me (in 'frank chats' that psych nurses can excel in) that I was winding myself up, creating my own distress, that I was institutionalised, that their was nothing they could do for me, that they couldn't help me if I wouldn't help myself etc etc. Those things... Infected the way they wrote their notes. Doctor writes that patient is admitted complaining of depression and nursing staff are careful to note all their observations of laughing and chatting and are careful to make no mention of the time spent crying... Of the episodes of distress... I'm sorry, this is hard for me.
> 'CAT call recorded at 8.15pm. Patient complained of feeling 'bad' and 'upset'. Patient was told to practice her skills and was informed that she would not be admitted'.
I just needed someone to be a bit reassuring. To listen for a while. But they say 'what do you expect us to do'? And if I say 'I feel so bad I feel like killing myself' they write me up as threatening suicide. I never asked to be admitted... Though to be fair... Sometimes I thought that was what I needed. But what I really needed was for someone to spend some time talking to me.
But CAT are busy and overworked etc.
It hurts.
Posted by alexandra_k on September 18, 2006, at 2:00:10
In reply to Re: Psychiatric hospital records, posted by alexandra_k on September 17, 2006, at 21:01:07
And then there are the incident reports...
I think the hardest thing of all is that when you read what they have written...
It is like they are talking about someone else.
A someone else who isn't even a person.I think...
What sort of person would I expect to meet after reading these notes?
Would I expect to like this person?No...
I would not.
I would not like to meet that person.
But it is me. Only it is not me. But it is what they think of me. It is the way they see me. Not meant to be what they think of me because it is meant to be objective and clinical. But what they see... Infects their judgement and shines through.
Admittedly, it helped a little when I started looking up the precise meaning of the terms and saw that I thought there was judgement in a lot of instances when there was not. But then I got to reading a little more... Theories of symptoms etc and then I realised that there was judgement in a lot of instances when I thought there was not.
Don't look to your notes to try and figure out who you are...
I guess that is all I'm trying to warn you off...
But then if someone had told me all this I'd probably still want to see...
Some kind of morbid fascination.
Reading the incidents... Sometimes I remember... And I match my memory to their incident reports... And I'm fairly horrified. It brings back the feelings you see. When I read about the incidents... I get flashbacks of them I get flashbacks of the feelings the distress the panic the inability to communicate the horror the fear...
That can be hard...
Posted by vwoolf on September 18, 2006, at 11:15:00
In reply to Re: Psychiatric hospital records, posted by alexandra_k on September 18, 2006, at 2:00:10
Thanks so much for all of this Alexandra. It sounds very painful. I'm sorry it hurt you so much.
I suppose a lot of the pain is because of the cold, almost brutal judgement of others who are "experts" and should be able to see the "truth" about us - even though a lot of what they write seems to be very superficial and not very useful.
I think what my journey entails at the moment is taking back my sanity and power to take charge of my life. I have started by confronting my mother and husband. The next step is the hospital, which might be a bit harder. But I don't think I can stop now. I have spoken to my therapist and we have agreed that she will accompany me. Tomorrow I will call and make an appointment.
I am not going there to try and find out who I am. I am going to debunk the idea that I am incompetent.
Posted by vwoolf on September 18, 2006, at 11:21:40
In reply to Re: Psychiatric hospital records » vwoolf, posted by Racer on September 17, 2006, at 15:44:57
Hi Racer, I have discussed it with her, including all my reservations. I do trust her - more than anyone else I have ever known. Of course it's not 100% trust, she isn't me so it can't be.
But I feel I must go ahead. I feel my journey to wholeness will not be complete unless I face what happened. The good and the bad. It is like facing the csa and then confronting my mother. It is taking back what was mine.
Posted by alexandra_k on September 18, 2006, at 20:50:27
In reply to Re: Psychiatric hospital records » alexandra_k, posted by vwoolf on September 18, 2006, at 11:15:00
> I think what my journey entails at the moment is taking back my sanity and power to take charge of my life. I have started by confronting my mother and husband. The next step is the hospital, which might be a bit harder.So it is about looking through your file for evidence of mistreatment / incompetence so you have ammunition with which to confront them?
Posted by alexandra_k on September 19, 2006, at 7:21:11
In reply to Re: Psychiatric hospital records » vwoolf, posted by alexandra_k on September 18, 2006, at 20:50:27
Sorry.
I guess I'm just having a hard time understanding the rationalle.
And...
I'm concerned for you. That it will hurt you more than help you.
But that being said... Even if someone said to me what I've said to you I would still have wanted to see them.
And I'm glad I have them.
I probably will read them again...
But...
I don't know why.
I think there is a name (for me)
Repetition compulsion.
I think that is it...
This is the end of the thread.
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