Had my next treatment plan discussion on Thursday, and it was horrible. There is a new ward psychiatrist, who knows nothing about me. Furthermore, the recreactional therapist neither the sports therapist were present. There was a nice nurse – not one of my primary care nurses, cause one is on vacation and the other didn’t work that day -, but that’s about it. The doctor started off glorifying the time-out policy, because I’d not freaked out majorly since it’d been introduced, and, hence, haven’t been in time-out so far. Hmmm, if I had been in time-out often, she’d likely have said that it was a useful tool.
The psychologist had a lot of questions that were poorly answered, said that there needed to come a functional behavior analysis, and wants me to live on another psych ward until I have enough control of my freaking out behavior. As for the FBA: I recommend it to parents of children with behavioral difficulties, when there is conflict or disagreement about which approach to use with the child. In itself, it is a useful tool. Mind you, the psychologist probably doesn’t know the difference, but I prefer a functional behavior assessment, which means that people around the person with the problem behavior observe carefully what occurs before, during and after the behavior, in order to determine its function. A really simple example is when a child (it’s usually about children) asks for a cookie, doesn’t get it, then tantrums and the mother gives them the cookie anyway. When this happens often, you might conclude that the function of the tantruming is to gain cookies. An actual functional behavior analysis is what I’d call “experiment around until you got what you want”, because it involves manipulating the environment to see what happens to the behavior. My main problem with having a functional assessment of my inappropriate behavior, besides the unlikelihood that it happens carefully on a busy ward, is that it’s a very passive process for the person with the problem behavior: I’m not supposed to participate actively in the process. And the doctor’s conclusions may’ve been right – as far as she could draw any conclusions about the cause/function of my behavior, I agreed with her -, but she never asked me.
And as for moving to another psych ward, it pretty much confirms the conclusion that I can only be in society provided that I meet other people’s standards of appropriate behavior. And if only it were about the actual dangers involved when I freak out – for example, that I might stand still in the middle of a busy road. But it’s not about that: it’s about screaming and door slamming. When I grunted at this to a nurse and the social worker today, they both asked whether I want to unlearn to scream and slam doors. Well, first, it depends on what the goal actually is: if it’s sismply that I stop screaming and slamming doors, no, but if it’s that I learn more appropriate alternatives to fulfill the function of my screaming and door slamming, absolutely yes. And second, even though I want to learn to change my behavior, this doesn’t necessarily mean that I need to be on a psychiatric ward as long as I display this behavior. By the way, after I qualify to move out of the psychiatric hospital, the psychologist wants me to live at Werkenrode. The reason is that he says I have a problem accepting my blindness and the people at Werkenrode can subtly handle that. Well, I have no problem accepting my blindness – yes, I’m laconic about it, but that doesn’t necessarily mean I have a problem accepting it -, and Werkenrode is an organization for the physically impaired.
There was a lot of debate about my possibly getting an UMTS card to connect to the Internet. That is very expensive, but the social worker says I can get funding for it because it’s an essential communication tool. Oh my, that sounds ridiculous! I told her that I won’t buy the card until I know where I can get funding.
The nurse was the only person who spoke directly to me – all the others spoke to each other. She actually had a pretty good contribution. Of course, quite a bit about the freaking out, standing on the road, pouring boiling water over my hand, etc., but she didn’t draw stupid conclusions. Then, my contribution was read to “the team”, but no-one commented and it seems no-one listened. There was some discussion about the fact – well, idea, it’s false – that I didn’t exhibit dangerous behavior (like the boiling water thing) before my last treatment plan discussion and did it now, about the accepting blindness stuff, and the new shrink asked why I was committed. My doctor used the simple word “danger” for it. Well, in the entire week of my crisis, there were only two dangerous acts of mine, and one, the doctor doesn’t even know about – the fact that I stood in the middle of a road on the afternoon of my commitment. The other is of course the fact that I made a suicidal threat, but my doctor used examples like my wandering – well, what’s dangerous about that? – or getting involved with the police – well, simply walking while blind can get you involved with them. The psychologist also asked why I was here, and got the standard answer that I’m just here to stay. Oh, and the doctor said that I thought I wasn’t doing well, but “the team” thought I was, thanks to the time-out.
At one point, I got my first nosebleed in ages and walked out crying. The reason was not just the treatment plan, but the fact that I’d half expected to finally be listened to at the discussion – after being very ill-involved with my treatment/stay here -, and I wasn’t. “The team” will have a new discussion about me sometime in February. I don’t want that – nothing about me without me -, but I likely have no choice.
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