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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by smokeymadison on January 13, 2005, at 13:39:13
i thought that you might find this interesting. while i was in this last hospital, my roommate developed the Cotard delusion.
when i first got to the hospital, the woman was very confused and had trouble membering things that happened hours earlier. then one morning she said that she was saved by God and no longer needed her meds. Then a day later she no longer needed to eat, because God had told her that she didn't need to. She was completely obsessed with having been saved by God,
I kept talking with her all through this and i and the others tried to get her to eat at least.
then the day before i left she i woke up and she was sitting in the chair by the end of her bed staring at the floor. She told me that she was dead.
the nurses got involved in trying to get her to drink something and she threw it at them. she kept screaming that she was dead. they locked her in the seclusion room and i didn't see her again.
any thoughts? this didn't seem to be an utterance of metaphorical weight or anything. she truely believed that she was dead. i know that they had her on Xanax and Risperdal, but of course i don't know the doses.
by the way, i wish i were back in the hospital. i am waiting until my car gets fixed to do intensive outpatient therapy. in the meantime, i miss the structure of the environment. here at home i just feel out of sorts. but of course, the pdoc know i was becoming reliant on the hospital--that is way i was only there for 3 days.
SM
Posted by alexandra_k on January 13, 2005, at 19:24:40
In reply to alexandra_k: live example of the Cotard D, posted by smokeymadison on January 13, 2005, at 13:39:13
That reminds me of another case I have read about. One woman claimed she was dead. She made her family put on mourning clothes and wore them herself. She made them go and buy her a coffin. She used to lie in the coffin with her arms folded in front of her. This seems more than metaphoric. She never asked them to bury or cremate her though!
> any thoughts? this didn't seem to be an utterance of metaphorical weight or anything. she truely believed that she was dead.
Yeah. I don't know what to say... Only that in these cases 'emotional death' might not quite cut it. But then 'biological death' doesn't quite seem to cut it either (presumably she would have admitted to feeling her heart beat).
That is the problem of delusions I suppose... :-)
Hey, you didn't happen to have a pic of the Muller Lyer illusion with you did ya?
> by the way, i wish i were back in the hospital. i am waiting until my car gets fixed to do intensive outpatient therapy. in the meantime, i miss the structure of the environment. here at home i just feel out of sorts. but of course, the pdoc know i was becoming reliant on the hospital--that is way i was only there for 3 days.Yeah, thats why they don't like putting me there either. I get on 'too well' with the patients. I get on 'too well' with the structure and with some of the people who are kind and accepting (typically the patients). I have a fondness for the 'most crazy' ones. Trying to understand what it is like to be them via empathy. This is probably a misquote but I'll have a go.
'the psychiatrist Elvin Semrad could make any psychotic patient sane. Semrad got into the minds of his patients by radical empathy. He succeeded in drawing them out of their delusional world'.
If only we could systematise this skill. Make it comprehensible to everyone else (if it was true that he was indeed able to do that). Don't know if it is possible or not..
It is hard adjusting to being out. It is hard to know whether being there is good for one or not. Good to get one through a really hard patch. I read somewhere that it was optimal (though cost prohibitive) to have intensive inpatient treatment for a year and then continue intensive treatment in the community for peoples with BPD. Just not practically possible I suppose. Who knows what the optimal treatment would be if cost wasn't an issue. Who knows. Probably not the same for everyone.
I hope you get your car fixed soon.
Thanks.
Posted by thinkfast on January 14, 2005, at 15:53:51
In reply to Re: alexandra_k: live example of the Cotard D, posted by alexandra_k on January 13, 2005, at 19:24:40
Sounds like a perfect world...everyone is there to help and, for the most part, most there would be extremely understanding. I'd stay permanantly if it were possible. Of my own accord, of course. Take about a year off and live every day there listening to people and trying to help them out wherever possible. It does a lot for people to just have an understanding ear to talk too. At the same time you could share parts of your own problems which in itself would be theraputic. I might just commit myself! Interesting stories though! I've only stayed for three days and they told me to go home....
Posted by alexandra_k on January 14, 2005, at 17:30:51
In reply to Re: alexandra_k: live example of the Cotard D, posted by thinkfast on January 14, 2005, at 15:53:51
> Sounds like a perfect world...everyone is there to help and, for the most part, most there would be extremely understanding.
Wellllllll. Some of the staff can be judgemental and cold and harsh and overworked etc... Depends on how many staff to how many clients I suppose. It is not all beer and skittles. It is not.
>I'd stay permanantly if it were possible. Of my own accord, of course. Take about a year off and live every day there listening to people and trying to help them out wherever possible. It does a lot for people to just have an understanding ear to talk too. At the same time you could share parts of your own problems which in itself would be theraputic. I might just commit myself! Interesting stories though! I've only stayed for three days and they told me to go home....
Yeah. 'Institutionalisation' I think they call it :-)
I have been there.
It is better on the outside.
Harder.
But better.
Posted by thinkfast on January 15, 2005, at 4:06:21
In reply to Re: alexandra_k: live example of the Cotard D » thinkfast, posted by alexandra_k on January 14, 2005, at 17:30:51
maybe just a job there???
Posted by alexandra_k on January 15, 2005, at 19:09:33
In reply to Re: alexandra_k: live example of the Cotard D, posted by thinkfast on January 15, 2005, at 4:06:21
I don't think I would like to work in a psych hospital...
Public ones are too underfunded. Not enough time to spend quality time with all the patients you are responsible for.
Private ones would be better.
I don't know that I would be capable of doing it without becoming to personally involved / attached. That would wear me down eventually.
I don't know that I would be capable of putting my own stuff aside to be focused on helping other people. I can manage this at times. But my sh*t can absorb everything at other times...
Would you like to work in one?
Posted by thinkfast on January 15, 2005, at 19:51:14
In reply to Re: alexandra_k: live example of the Cotard D » thinkfast, posted by alexandra_k on January 15, 2005, at 19:09:33
Dunno, think I'm pretty good at helping other people...can't help myself, so why not? You're right though, it would get pretty rough sometimes...You have to deal with the violent people too, and that would suck! There was a BP chic that heard voices when I had my stay, and she was kind of unstable/violent and was generally scary. Might get used to that after a while, but I usually steer clear of violence.
Posted by smokeymadison on January 15, 2005, at 20:29:01
In reply to Re: alexandra_k: live example of the Cotard D, posted by thinkfast on January 15, 2005, at 19:51:14
i actually applied to work as a tech on a psych unit one time. i think that i could handle it in say, five years. i just need some time to get my own crap out of the way so i can focus on other people. that is what i want to do eventually. in the meantime i plan to stick to less challanging career choices.
Posted by alexandra_k on January 15, 2005, at 20:36:36
In reply to Re: alexandra_k: live example of the Cotard D, posted by smokeymadison on January 15, 2005, at 20:29:01
Yeah. I thought about working in supported accomodation, but, well, I don't know...
I don't deal with violence or loudness / threats either.
But yeah, helping is good.
A reason for living :-)
This is the end of the thread.
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