You can divorce an abusive spouse. You can call it quits if your lover mistreats you. But what can you do if the source of your misery is your own parent?
Granted, no parent is perfect. And whining about parental failure, real or not, is practically an American pastime that keeps the therapeutic community dutifully employed.
But just as there are ordinary good-enough parents who mysteriously produce a difficult child, there are some decent people who have the misfortune of having a truly toxic parent.
A patient of mine, a lovely woman in her 60s whom I treated for depression, recently asked my advice about how to deal with her aging mother.
�She�s always been extremely abusive of me and my siblings,� she said, as I recall. �Once, on my birthday, she left me a message wishing that I get a disease. Can you believe it?�
Over the years, she had tried to have a relationship with her mother, but the encounters were always painful and upsetting; her mother remained harshly critical and demeaning.
Whether her mother was mentally ill, just plain mean or both was unclear, but there was no question that my patient had decided long ago that the only way to deal with her mother was to avoid her at all costs.
Now that her mother was approaching death, she was torn about yet another effort at reconciliation. �I feel I should try,� my patient told me, �but I know she�ll be awful to me.�
Should she visit and perhaps forgive her mother, or protect herself and live with a sense of guilt, however unjustified? Tough call, and clearly not mine to make.
But it did make me wonder about how therapists deal with adult patients who have toxic parents.
The topic gets little, if any, attention in standard textbooks or in the psychiatric literature, perhaps reflecting the common and mistaken notion that adults, unlike children and the elderly, are not vulnerable to such emotional abuse.
All too often, I think, therapists have a bias to salvage relationships, even those that might be harmful to a patient. Instead, it is crucial to be open-minded and to consider whether maintaining the relationship is really healthy and desirable.
Likewise, the assumption that parents are predisposed to love their children unconditionally and protect them from harm is not universally true. I remember one patient, a man in his mid-20s, who came to me for depression and rock-bottom self-esteem.
It didn�t take long to find out why. He had recently come out as gay to his devoutly religious parents, who responded by disowning him. It gets worse: at a subsequent family dinner, his father took him aside and told him it would have been better if he, rather than his younger brother, had died in a car accident several years earlier.
Though terribly hurt and angry, this young man still hoped he could get his parents to accept his sexuality and asked me to meet with the three of them.
The session did not go well. The parents insisted that his �lifestyle� was a grave sin, incompatible with their deeply held religious beliefs. When I tried to explain that the scientific consensus was that he had no more choice about his sexual orientation than the color of his eyes, they were unmoved. They simply could not accept him as he was.
I was stunned by their implacable hostility and convinced that they were a psychological menace to my patient. As such, I had to do something I have never contemplated before in treatment.
At the next session I suggested that for his psychological well-being he might consider, at least for now, forgoing a relationship with his parents.
I felt this was a drastic measure, akin to amputating a gangrenous limb to save a patient�s life. My patient could not escape all the negative feelings and thoughts about himself that he had internalized from his parents. But at least I could protect him from even more psychological harm.
Easier said than done. He accepted my suggestion with sad resignation, though he did make a few efforts to contact them over the next year. They never responded.
Of course, relationships are rarely all good or bad; even the most abusive parents can sometimes be loving, which is why severing a bond should be a tough, and rare, decision.
Dr. Judith Lewis Herman, a trauma expert who is a clinical professor of psychiatry at Harvard Medical School, said she tried to empower patients to take action to protect themselves without giving direct advice.
�Sometimes we consider a paradoxical intervention and say to a patient, �I really admire your loyalty to your parents � even at the expense of failing to protect yourself in any way from harm,� � Dr. Herman told me in an interview.
The hope is that patients come to see the psychological cost of a harmful relationship and act to change it.
Eventually, my patient made a full recovery from his depression and started dating, though his parents� absence in his life was never far from his thoughts.
No wonder. Research on early attachment, both in humans and in nonhuman primates, shows that we are hard-wired for bonding � even to those who aren�t very nice to us.
We also know that although prolonged childhood trauma can be toxic to the brain, adults retain the ability later in life to rewire their brains by new experience, including therapy and psychotropic medication.
For example, prolonged stress can kill cells in the hippocampus, a brain area critical for memory. The good news is that adults are able to grow new neurons in this area in the course of normal development. Also, antidepressants encourage the development of new cells in the hippocampus.
It is no stretch, then, to say that having a toxic parent may be harmful to a child�s brain, let alone his feelings. But that damage need not be written in stone.
Of course, we cannot undo history with therapy. But we can help mend brains and minds by removing or reducing stress.
Sometimes, as drastic as it sounds, that means letting go of a toxic parent.
Dr. Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.More Articles in Health � A version of this article appeared in print on October 20, 2009, on page D5 of the New York edition.
via nytimes.com
this ~IS~ personal, but it one of the things that disturbs me the most.
JOURNAL ENTRY 4/6/2010: April 22, 2010. this i have no doubt in my mind that this will generate more questions since llegal aid and even people i thought were my "friends" have refused to accept one simple fact... that everyone is asing the WRONG question.
it does not matter WHO breaks the law. most people are murded or abused by some they knew... a family friend or relative. so i have aceepted the fact that i will go in a lone, as usual, an that any decision will ultimately be reversed within days... that record will likely "disappear" like all the rest. so yeah... parents can be toxic.
and if they can be toxic their own children, what does that say when they are in a position to be toxic to our culture, our history, our society.
so, yes, i'm prepared. i am prepared only because i have expections that anything sustancial change. because history and recent events and knowledge have shown me otherwise.
so i will be living on less than $600 per month for the rest of my life. and i can be at peace with that if i couldd trust that things would remain stable. but they change day to day {'myseriously" and no matter what i say or how loud i scream, nobody has stepped up to the plate legally to say, "this" [meaning, me, Elyssa] is a human being that is entitled to one basic human right. The right to be seen as human being rather than a human doing.
yes, i am sad. but i am resolved, and i resigned.
but my friends are virtual because aparently i inherited the toxicity from my parents so my life exists exclusively within these four walls. i have NO ineraction with anyone except from the occasional stranger or the neighbor i pass on my way to the store tweeting the whole way... for some eason,, the Twitter keeps me safe. The "community" remains silent.. My world is silent.
I am trapped.
i am very much in prison. and my tears are natural, and my anger justified. so please, give me this much... don't ask how i feel if you don't want to know the answer.
goodbye for now... my pain is physical, and i am hoping my tears may heal for just a few minutes and soothe my soul. [FOR WHAT IT IS WORTH, I WAS CORRECT]
VIDEO: Suspect's sister, lawyer say Trenton 7-year-old 'lied' and wasn't raped - The Trentonian News: Serving Trenton and surrounding communities. (trentonian.com)
Thursday, April 08, 2010, 2:25:48 PM
noreply@blogger.com (Elyssa D'Educrat)
via trentonian.com
Trenton, NJ. I had to cross the Delaware to go Hebew School. There were only two other times I had to go. To get a letter from a Rabbi to prove that I was a Jew before I could apply at the local Federation for Jewish whatever... it took six months before they would even mail me the appilcation. The second was when I was an editor of the school newspaper and I attended wrote a story about legislation pending regarding pro-choice for women unnder the age of 18. I was 16. So medical records? I recently had seven blood tests before they could find a "receiving hospital" patient dumping much? Tennessee? Jim Blumstein just gave a statement on federal law in Tennessee. He's an asshole. He cancelled class the same day HCA got busted for Medicare fraud. #WTF
Now, I need assistance from my Congressman to determine eligibility status for my "benefits" and he claims he has no oversight. I do believe US Rep Jim Cooper could take five minutes to set the record straight. I did after all pay $9000 [borrowed] just to meet with hiim once a week at Owen to learn all about this twisted system of care the are "buying into."
HealthCARE.... Is that what we are going to call it?
SEVEN BLOOD TESTS. Two different MR numbers. So they just gave me a code.
Dr: Nixon : Nurse: Les 69:36
March FORTH, March 7th . "Patient Safety Awareness Week"
Posted via web from ElyssaD's Posterous
~INSERT PATIENT SAFETY ALERT HERE~
http://www.associatedcontent.com/article/1577050/6044_dmht_and_the_tennessee_code_annotated.html?cat=17
http://www.associatedcontent.com/article/1577050/6044_dmht_and_the_tennessee_code_annotated.html?cat=17
Associated Content Home Business & Finance
Home » Business & Finance » Legal
6044: DMHT and the Tennessee Code Annotated Title 33, Chapter 6, Part 10
Adjust font-size: + – Published March 19, 2009 by:
Elyssa Durant
View Profile | Follow | Add to Favorites More: HIPPA Haldol Klonopin Celexa Coupon Code Taps
Wednesday, March 18, 2009
HIPPA Confidential Report: 6044
http://thepowersthatbeat.blogspot.com/2009/03/hippa-confidential-report-6044.html
Please confirm receipt of this email and note that I have made several requests for EOBs from AmeriChoice and have had more than one unauthorized disclosure of my medical records due to problems with TennCare when they transferred patients into AmeriChoice and AmeriGroup.
Please log all requests for medical information and do not release any information without my prior consent and HIPPA compliant medical release.
________________________________________________
RE: Confidential Report: 6044
state.tn.us/mental/legalCounsel/olc.html
________________________________________________
On March 7, I sought treatment at the emergency room and was asked to sign a blank release form for treatment. I refused to sign consent for treatment because they would not pull my primary care records that list allergy information.
At that point, I was escorted upstairs by upstairs two security officers who did not have any employee identification badge or ID number on their uniform.
Once inside the unit, I tried to call my sister, my medical proxy, and emergency contact person. I felt someone should know where I was and alert her that I was being held at the emergency room. They placed two wristbands on my right arm, the MR numbers (Medical Record Numbers) did not match.
Security would not allow me to make a phone call and used excessive force to grab me by the arm and take the cell phone out of my hand. Neither of the two ID bands listed or medical history or allergy alerts.
I tried to explain that I had a medical allergy; was intolerant to Haldol; and suffer from a degenerative condition concentrated on around T2-T3 on my thoracic spine, with cord damage from T1-T6. Because of the way I was being "handled" I told them over and over again that my physical health could be placed in further jeopardy due to the way the were forcing me into submission.
They refused to listen to my pleas, and escalated the situation by forcefully grabbing items out of my hands: my cell phone, my medical records, my disability papers including my treatment preferences and medical crisis plan that was developed with Ms. Nikki Freisinger-Chambless, a former employee of the Mental Health Cooperative in Nashville, Tennessee. Since the Mental Health Cooperative also houses the Mobile Crisis Unit (Respond) for middle Tennessee, I thought that they would certainly have a copy on record. I was wrong. In fact, several hours before I went to the Emergency Room, I was taken to Mobile Crisis, and they could not locate a simple glass of orange juice or chapstick to soothe my dehydrated state. They placed me in handcuffs, and treated me as if I had never been there before.
The Mental Health Coop is the very last place I would ever want to be in a crisis, and I say that as someone who has received "treatment" there, and participated in staff training and policy forums to address the needs of the persons with emotional disorders, mental illness, or other brain disorders.
After leaving the Mental Health Coop, I quickly realized that the years I spent as a patient advocate was not going to help me
research community verbal and written requests were completely disregarded at intake, assessment, and completely ignored by security. With the exception of a night Nurse named Monica, the night staff was condescending, dismissive, and inconsistent with rules and regulations we were expected to abide by.
They acted as if I was requesting special treatment to call my family members, all of whom are located outside of Tennessee. They refused to allow me to call my family, primary care provider, or anyone who may be able to verify my medical history and locate my treatment history and crisis plan.
They forcibly pulled the phone out of my hands and grabbed my left arm, pushed me into the ground face against the floor and forcefully held my arms behind my back.
I was then placed into a room with no emergency buttons, intercom, bathroom, fire alarms and forcibly pushed into a plastic mattress in the corner;
I was then forced down face first into a mattress on the floor, held down by two men who used excessive force twisting my arms behind my back.
With my head still pushed into the plastic mat, arms behind me into my back, with the weight of their bodies pressing into my back; when one of the men began to pull down the black leggings I was wearing, removed my underwear, and injected me with an unknown substance.
One of the men returned a few minutes later to taunt me through the observation window.
The man who injected me refused to give me his name, an employee ID number, or tell me what kind of medication they used to keep me safe. He told me he was "self employed" and taunted me about through the observation window. He threatened me, and laughed when I told him that I hope he remembers my face the next time he looks his own daughter in the face.
He thought this was hysterical, made physical gestures towards me, and kept moving towards me despite my repeated requests that to stand two feet away from my body. He kept making rapid threatening movements towards me and removed his identification badge, from his uniform, and told me that unless I sit down he would be forced to restrain me using whatever means necessary.
I have been trained TAPS (Therapeutic Assault Prevention System) and was certified on October 15, 2004 through the Tennessee Department of Children's Services. I can assure you that there was nothing "therapeutic" about the way I was treated.
I was placed on a 6044 hold (Two-Physician Commitment) under Title 33 of the Mental Health Hygiene Code, Title 33 of the Mental Health and Hygiene Code, involuntary from March 7 - March 13.
The medical personnel completely disregarded my medical wishes, and failed to recognize that any such plan had been developed shortly after I was hospitalized in New York City after the bombing of the World Trade Center.
www.tennessee.gov/mental/t33/compilation6-30-05.pdf
—dhmt—
It was my understanding that in filing such a plan, it becomes an official part of your medical record, but, again, I was wrong about that one too. The Declaration for Mental Health Treatment (DMHT) is a document I completed and updated annually through the State of Tennessee. I became quite familiar with that document since I have been both a consumer and a provider of mental health services in Tennessee.
I update it annually and have provided a link to that document below:
The DMHT is a comprehensive treatment plan that includes a crisis plan and allows consumers to take an active role in their treatment plan. The DMHT allows consumers to identify and plan for medical treatment, and identifies a medical proxy (decision maker) who can make appropriate medical decisions on their behalf in the event of a medical crisis.
The document helps the consumer identify symptoms and events leading up to a crisis; and is a helps consumers become more compliant and self-aware, active participants in their own recovery.
For any one out there who has ever felt on the verge of "losing it," I would strongly encourage you to read this document even if only to become more self aware of your own mental well-being.
For those who wish to fill out the document, I would suggest that you do so in the presence of another person so that your wishes do not exist in a vacuum.
Much like a living will, the DMHT allows consumers to think about their own emotional health so they can monitor themselves before someone else does it for them.
Most of us are tend to know how to soothe ourselves, albeit through music, art, exercise, or even a nice cold drink or a hot bath.
No one solution works all of the time. However, given several options, it is easy to take responsibility for your own behaviors before you are locked up as I was last week.
By identifying treatment modalities that have worked well in the past; one can also identify those that have not and avoid treatments that may have caused adverse reactions or complications in the past.
The most important thing to consider is that people are not all cut from the same cloth. Just because one medication works well for one patient, we cannot assume that it will work well for all patients.
Many time-tested medications have been found to cause long-term t may cause another patient adverse reactions or life threatening events in others.
And just as one medication may work well for one person, the same is true of medical interventions procedures and interventions including but not limited to holistic medicine, meditation, and yes, even prayer.
DHMT form developed byThe Tennessee Department of Mental Health and Developmental Disabilities.
Tennessee Code Annotated Title 33, Chapter 6, Part 10.
TITLE 4 Chapter 3, Part 16 Creation of Department of Mental Health and Developmental Disabilities
TITLE 33 MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES LAWS
I have cuts bruises and injuries that were not treated or evaluated medically during my stay, given multiple injections, and discharged without meds. They refused to acknowledge that I have an allergy / intolerance to Haldol.
I had a 4-day supply of Geodon, Klonopin that I paid out of pocket. Trazodone was covered. The Geodon cost $243.19 for an 18-day supply, so I could only get a 5-day supply with a manufacturer's coupon they gave me when I left the hospital.
In addition, I have up to seven puncture wounds from multiple injections, multiple cuts and bruises and abrasions that were not medically treated or evaluated during my stay.
They are unable to locate the record for the second injection that I was given while unconscious face down on the plastic mat.
I am waiting for my Celexa to be approved at the pharmacy, since Effexor was not covered.
I have a primary care appt scheduled for Wednesday, and must file more appeals. I have no fax machine and I am running low on gasoline. I am writing this email from my cell phone that is rather inefficient at best.
Kindly take note of this complaint and I will follow up when I have better access to a computer.
In short, I need Geodon preauthorization, med transport to pharmacy and to a medical appt on Wednesday at 10am Effexor prior authorization, a copy of my medical records from the psych unit, and do not feel I should have to pay $2/pg for a copy.
I had to pay $54 in cash for parking, and this is all I can type for right now.
Thank you for your efforts to improve patient care and safety.
Sincerely yours,
Elyssa Durant
Cell: 6154248810
ed70@columbia.edu
Sent via BlackBerry from T-Mobile
http://www.associatedcontent.com/article/1577050/6044_dmht_and_the_tennessee_code_annotated.html?singlepage=true&cat=17 <~ clean feed today
HTTP 404 Not Found -- http://wikileaks.org/file/us-intel-wikileaks.pdf gee.... what a surprise
Thursday, April 08, 2010, 8:34:35 AM
noreply@blogger.com (Elyssa D'Educrat)
This error (HTTP 404 Not Found) means that Internet Explorer was able to connect to the website, but the page you wanted was not found. It's possible that the webpage is temporarily unavailable. Alternatively, the website might have changed or removed the webpage.
For more information about HTTP errors, see Help.
via ieframe.dll
http://wikileaks.org/file/us-intel-wikileaks.pdf.%3C/p
Still blocked from my own IRS medical finacial and Scoial Security records. Pretty much everything else important in the becoming a self-sufficient adult with internal locus of contol and self-efficacy.
blocked from #wikleaks but at least i know that they are still there! so i'm not going to worry about that right now. and i'm not worry about my hearing next week... i might freak out a bite over taxes and MDHA deadline that always sends up a red flag... so i think that i can stay in my apartment since i paid the rent...
Yet my mind has an image of those two characters "I can't pay the... you MUST pay the rent!"
The moral of THIS story "footnote" is:
http://thepowersthatbeat.blogspot.com/2009/03/hippa-confidential-report-6044.html
SAVE YOUR FUCKING WORK BEFORE YOU LOSE THE INTERNET CONNECTION.
GODDAMIT! iWANT iNTERNET
SAVE YOUR FUCKING WORK BEFORE YOU LOSE THE INTERNET CONNECTION.
GODDAMIT! iWANT iNTERNET
Elyssa: It hurts for me to see you going through this. I wish I could take all your pain away. But all I can do is be here for you when you need someone to talk to,scream at or if you need a shoulder to cry on. I Love You Elyssa! Mike
ReplyDelete