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Confidentiality Struggles on Inpatient Psych Units

I’ve found that during my psychiatric hospitalizations working to maintain my confidentiality has been an issue.

I’ve never been hospitalized for non-psychiatric reasons, so I don’t have a perfect comparison. From observing while visiting family in the hospital I can tell that any hospitalization seems to result in some level of decreased confidentiality. When there’s a shared room it’s near impossible to keep everything private. You might not know details, but there is often at least a vague sense of what your roommate’s problem is. Family members who visit, often speak with the doctor without the presence of the patient, creating a risk that information will be communicated that the patient might have not wanted shared.

At my first hospitalization there was some posturing about confidentiality. Cameras including camera phones were banned and the lack of names on doors was emphasized.
I had a terrifying experience of 24 hours in the ER and was refusing to sign the form to be admitted. I wanted to go to a different hospital, but they wouldn’t let me. I asked if I could maybe see the unit first to see that it wasn’t scary. I was told I couldn’t have a tour because of confidentiality issues. This seemed reasonable. Eventually I gave in a signed the form.

A couple of years later I heard from a friend who was considering going inpatient at a different hospital for medication adjustments. He had been given a tour of the unit he would stay on before making his decision. So it appears this rule is not consistent between hospitals.

It seems the most significant confidentiality difference between general medical hospitalizations and psychiatric ones is that for psychiatric admissions patients are specifically encouraged to interact.
In fact, not interacting with other patients will likely be looked upon as a symptom.
Rather than staying in your room in bed all day there are common areas and group activities.

It might seem like that activity group is purely recreational, designed to break up an otherwise empty day. Wrong! In all of my records there are notes of my behavior during those types of activities.
One form for an arts activity group says simply that I attended and comments, “Very quiet- worked with no discussion with peers”. Never mind that I was focused and enjoying that I was doing. All that mattered as a record for that hour was my silence.

The problem of communicating with other patients is that all of a sudden your hospitalization is no longer just a relationship between you and medical professionals, now others are added into the mix. These others have no ethical responsibility to uphold confidentiality.
I know that sometimes outpatient group therapy groups discuss that what is said there should stay confidential, but I’ve never heard any sort of similar comment discussed in an inpatient setting.

Despite this, I have found the unstructured social time of inpatient settings to be one of the few helpful things I have gotten out of my hospitalizations.
I’m so secretive in general that it’s nice to be able to talk without the fear that I will be judged for my ‘crazy’.

But information besides what I choose to disclose also gets revealed. If I was in my room crying all morning, people know. There’s no hiding it. If I go back to one-on-one security, people know my suicide risk was deemed increased.

Sometimes check-in meetings with psychiatrists were conducted in the hallways where anyone could hear. I’d whisper everything and usually reveal less information as a result.

This makes visitors a very anxiety provoking experience. On the one hand it’s nice to get a visitor, on the other hand those visitors are generally my parents. I don’t tell my parents much of anything. They receive the most vague information possible. I worry about another patient blurting out something private about me in their presence.

At the first hospitalization visitors were let onto the unit and were allowed to all the same places I had access to. So much for that “No Tours” rule.
There was no private place to meet. They could go in my room, but I also had a roommate. I was on edge during all the visits, trying to steer them away from anyone I’d communicated with.

The second and third hospitalizations had rooms where visitors and patients could meet for more privacy. The second still allowed family access to the rest of the unit thus compromising confidentiality of anyone there. What if a visitor ran into someone they knew there besides the one they’d come to see? In a general medical hospitalization the chances of noticing someone you know are much less likely unless you were peeking your head into each room.
The third hospitalization restricted visitors movement more, only allowing them in that one room.

Some point in the middle of my first hospitalization my doctor asked me to list the top things bothering me at the moment. One of the top items on this list was the distress my hair pulling was causing me. I later learned that this had been relayed to my Dad. He didn’t understand why I was stressed about my hair (the part about pulling it out got lost it appears). I can’t imagine how that doctor believed that it was appropriate to share this information with my Dad. I was so visibly upset upon learning this that I worry my Dad held back telling me more he might know to keep me from getting further upset. I have no idea if he was told more.
I believe him when he says that he didn’t try to get information out of the doctor and that this was shared more spontaneously. The hospital only had my permission to talk about about logistics (such as arranging affordable outpatient care) with my Dad but still information gets shared that shouldn’t once a line of communication is opened.
My Mom is banned from speaking to any mental health professional of mine, because she tries to manipulate people into giving her information.
I banned her from visiting at all during my second hospitalization and unfortunately it wasn’t very effective because they kept allowing her on until I started to scream that she wasn’t allowed there.

Family meetings seem to be encouraged, again creating the risk that something will be said that I wanted private.

My third hospitalization was the worst with regards to confidentiality. The central issue became my efforts to protect my privacy.

First they told me they were going to contact my school to let them know I was there. I strongly refused.
Anyone who’s been reading this blog regularly knows that letting my school know about my psychological issues is a touchy subject.
‘But it’s our policy’, they said. ‘We have an agreement with the local schools’
I called my lawyer and they called theirs.
After creating a huge amount of panic and stress for me they backed down realizing they had no leg to stand on.

While this was still being sorted out I noticed some student nurses were visiting the unit. I spotted a name tag. My college’s name was on it.
I fled the room. Had they seen me, had anyone recognized me?
Student nurses from my school came twice a week. No one had thought to mention this to me.
It happened too fast for me to spot any faces. Did I know any of them?
I spent the morning hiding in my room.
“Isn’t their being here putting my confidentiality at risk? I don’t want them to know I’m here. Can’t they leave?”
I go to a small school. People know each other.
No one seemed concerned.
I spoke to the apathetic Human Rights Officer.
I wasn’t allowed to ban them from the unit, but I could ban them from any activities I wanted to attend.
But I couldn’t attend the activities, I couldn’t walk down the hallway to get to the activities room without risking being seen.
The only way to prevent them from knowing I was there was to hide while they were on the unit.

When got out of the hospital I sent an anonymous email to the heads of the nursing department to let them know what had happened.

Here’s the email I sent:

“I am writing to inform you about an issue I had recently relating to the *college* nursing department. I do not believe that anyone at *college* was at fault in this problem, but I hope that by bringing this to your attention perhaps something can be done to fix it.
I am a student at *college* and I was recently a patient on the inpatient psychiatric unit at *hospital*.
My confidentiality is very important to me, as I have previously had my confidentiality broken and suffered discrimination as a result of this. I understand that not everyone will react the same way others have, but because of these problems, keeping my psychological issues separate from my education is very important to me.
One day while on the unit I spotted someone wearing an ID saying ‘*college*’. I bolted from the room to speak with a staff member and learned that a number of nursing students from *college* would be there that morning. The staff knew where I go to school, no one thought to warn me of their arrival. I didn’t want to be seen by them. The staff informed me that they couldn’t be kicked off the unit or restricted to a less central location and that my only option was to hide in my room(or the isolation room) all morning. So I was stuck doing that. The stress of hiding there and the isolation it involved were not things I needed piled on top of the reasons why I was already a patient there.
The staff I spoke with (including the human rights officer) were fairly apathetic towards this problem, citing that they have an agreement with the school to allow the students on the unit. I argued that allowing peers of mine to see that I am there is a breach of my confidentiality because them seeing me there involves receiving information that I don’t want disclosed.
I understand that the students themselves are sworn to confidentiality. (Though from my experience when people break confidentiality it is hard to prove and they end up getting away with it), Were I to run into one of these students in a social or academic situation at *college* the interaction would be colored by their knowledge, knowledge that I didn’t want them to have in the first place.
I feel that as a patient my needs, particularly my rights to privacy, should be taking priority over the educational needs of the nursing students, because there is the option for the school to find an alternate assignment for the students in this sort of situation, but I don’t have the option of being in an alternate psych ward for the morning.
I can’t imagine that I’m the first person to run into this problem. And I understand that having the students not be there when someone from their school is a patient there who objects may not be a reasonable option.
I understand that the teaching hospital is a very successful concept, but that doesn’t mean it can not be improved. The current way that it is being implemented at *hospital* is taking too casual of an attitude towards privacy. I do not know if this experience is representative of other hospitals.
At the very least, if you could help me out by giving me a list of all hospitals where *college* students are on the psychiatric units, I would appreciate it. So I can know to avoid them. Because at this point I feel that if I am in need of inpatient psych care I am unable to get it because I fear a confidentiality violation.
Thank you for taking the time to read this. ”

I now have a note behind my ID in my wallet listing 8 hospitals I can’t go to because my confidentiality would be at risk. Basically I would have to travel fairly far to get to a hospital free of my school’s nursing students. Even further if I wanted to get to a reputable hospital.

I got a couple of more sympathetic, “We’re taking this seriously” emails in reply, but basically the end result is still that I can’t go to those hospitals.

Confidentiality should not need be one of my primary worries when hospitalized, but it has to be because I have to protect myself.

It won’t go away

The 3 year anniversary of when I was kicked out of school is a bit over a month away.
It’s been so much, time but it is still an incredibly touchy subject.

I can speak about suicide, self-injury, hair pulling etc in a detached, emotionless voice. When talking about my forced medical leave I struggle to get out a sentence at a time without being interrupted by crying. When upset, my verbal ability plummets.

I spoke with a researcher who is studying people who have been forced out of their school or asked to leave due to mental health issues. I’m glad someone is working to get awareness for the issue. I don’t feel I did a good job of communicating the long term difficulties I have as a result of the forced leave, but at least I did something.

School is the most important thing to me. As you can see from this blog’s name my major is a important part of my identity. Before this mess I was a different major. I defined myself by that major too. I’ve lost a part of who I am. That old identity is tainted by these happenings. I try to push that old part of my identity away and people keep throwing it back at me.

I feel so isolated about it. There are support groups for so many things. Except this one thing I could really use a support group for. I need not only someone in the same situation, but someone who also has long term problems from it.

There’s a message board I’ve been going to for support of a more general nature for nearly 5 years. Using a message board for support is tough. I spend so much time trying to give background information that I don’t feel the ability to vent freely that I really need. What I really need is a best friend and I use the Internet as a poor substitute. My most recent thread, several weeks ago, related to ways this still impacts my life. I felt very misunderstood. Feeling misunderstood feels like an attack. I tried to put on a strong front in my replies, while alternating between tearful keystrokes and slicing open my leg. I wanted to clarify and understand how I can better explain myself. I am extremely touchy about this issue.
I don’t need people to tell me to move on from it. I know I’ve been hanging onto this a long amount of time. It’s easy to tell a person to get over it and not understand why the issue is still hanging around.

Let’s look at this through Compromise Formation Theory which admittedly I don’t know a ton about, but the little I know leads me to feel it is particularly applicable here. I wouldn’t be doing something if it didn’t provide some benefit.

The negative part of this compromise is that I am still hanging onto this thing that happened nearly 3 years ago and have incredible emotional sensitivity to it.

On the other hand, hanging on to this issue is the only way I know how to feel some security. Letting it go feels like opening myself up to the possibility of it happening again. I would be too vulnerable.

My hyper-vigilance is both damaging and protective.

Periodically I do a very stupid thing and google the therapist who got me kicked out.
He’s developing quite the web presence or so he appears to think.
Up until recently, he thought it was a good idea, and not at all reminiscent of tacky 1990s websites, to include a hit counter on his blog.
I’ve taken a lot of pleasure in knowing how small his web audience is.
Yes, it’s petty, but it helps me.

In my more recent googling I learned he is publishing a book, set to come out this year.
It has a cutesy name, the same as his blog, and is about taking a trendy psychology concept and adapting it for
a young urbanite audience.
A blog I can deal with, a book is a different issue. It has the ability to reach a large audience. The thought of all these people reading his book and possibly thinking he is a great guy upsets me.
I wish I were brave enough to publicly tell everything, write my own book, so people could know the rest of the story about him.

I have these horrible images in my head of spotting his book in one of my professor’s offices. I need to keep my old world separate from my new one. A book on the wrong bookshelf would signify an invasion. The fear is almost as bad as if it were to really happen.

In reaction to this I did the only thing I could. I used my Internet knowledge for a tiny piece of vengeance, while not violating any laws.
I reported his domains to ICANN. He had blatantly false Whois info (I highly doubt his phone number is (999) 999-9999).
I got one of his domains suspended for a few days.
Again, petty, I know, but it put a smile on my face for a little bit.

I wonder if he knows I did it. Probably not.

I’m sure I’m much less on his mind than he is on mine. This is part of the problem. It hurts to see him achieving any level of success, when I still have a day to day struggle over what he did.

Within the past week, a blog post of his was featured on the front page of a highly trafficked pop-psychology website. I wonder how many people I know read his article, having no clue about our association.

I want to scream out to the world ‘Hey look what he did!’, but I can’t because what he did left me too scared.

Stolen Therapy

Someone stole my therapy appointment today. I saw it happen.

I’ve been out of therapy since the beginning of August. I’ve been trying to get back in it since the beginning of September when I had my little freak out.

I had finally had an appointment scheduled for this morning. I dressed in a cute outfit, which is very much in contrast to my routine ‘stay inside doing homework outfit’ that is typical of my Thursdays.

I wasn’t at all familiar with the neighborhood his office is in (despite the location being close to my home) so I left early. And by early I mean I allowed an hour an a half for what turned out to be a 20 minute trip.

I have a thing about not entering therapist offices more than ten minutes early (earlier feels invasive on my part), so I walked in circles around the area and killed a lot of time in a coffee shop.

Finally, 10 minutes till the appointment I went into the waiting room and I sat down.
A few minutes later a man, probably late twenties early thirties, enters the waiting room.
‘Do we just wait here, or..?”, He asks

I shrugged and said ‘I assume so, it’s my first time here’
It was clearly his first time as well.

Then commenced the awkward situation of being in a small waiting room and attempting to avoid all conversation and eye contact. I stared intently at the generic waiting room art.

At Noon, my time for the appointment. A guy walks out of an office. ‘Is one of you here for Dr. X?’
The waitingroom man says, “Yes” and follows the guy into an office.

I have a auditory processing disorder. One of the things that means is that I have a lag time for understanding auditory info. So basically I didn’t understand the sound part of what happened until after both people were gone.

Dr. X was the doctor I was there to meet with.

I sat there for 10 minutes trying to figure out what happened. “Maybe they’re only meeting for a couple of minutes”, “Maybe he accidentally double booked”, “Maybe I was supposed to show up last week”, “Maybe my appointment is later today”, “Maybe I showed up at the wrong address and it happens to be the office of another psychiatrist who happens to have the same name in the same general area”

I felt  uncomfortable,like I shouldn’t be there, even though I knew my appointment time was correct. I’m very careful about these things. I check and recheck when writing it down. I read it back after writing it down as well. The probability of me writing the wrong time down is very small.
Ten minutes of this and I went into the hall and called my parents. I watched the door to see if this man would leave making my appointment available again. Twenty minutes past, against my parents advice that I should either phone the therapist or knock on his door, I left to go home.

I’m so busy. I’m juggling full time school, an internship, leadership roles in extra curricular activities and maintaining my ridiculous GPA standards. I hardly had time for this appointment. I especially I don’t have time to sit in an waiting room for an hour to wait for an appointment that isn’t happening.

I forced in into my schedule. Because I need it badly. My word repeating is at an all time worst. I’m terrified my neighbors can hear, because the volume is much too loud. Every night I pick apart my day and beat myself over every awkward imperfect interaction. There are a lot of them. One thing I am good at is creating awkward moments.
I don’t have time to sit in an waiting room for an hour to wait for an appointment that isn’t happening.

I cried my way home. Wow that’s a cliche sounding line. Sorry about that.

I didn’t feel comfortable calling the therapist. I considered not doing anything, just forgetting about this therapist so I could avoid the awkward interaction that would result from confronting him about this issue.

I whined to my Dad a lot on the phone and finally I agreed to let him call the therapist. I gave him permission just to gather facts, not to make a new appointment.

Here’s what happened:

-That man didn’t have an appointment at all. He’d just shown up. He wasn’t even already patient. He was just a person who showed up.

-The therapist hadn’t checked to see who his next appointment was with before going to fetch someone from the waiting room.

-When that man was able to react faster than me, he stole my appointment (Who does that!? Did he think therapy was just some sort of drop in thing?) and it took the therapist a significant part of the appointment to realize what had happened.

-Then the therapist went into the waiting room to look for me, but I was long gone.

I made an appointment for next week. I’m willing to give this guy another shot, though I’m not pleased about the whole situation. It threw off my homework schedule badly, because I was too upset to get work done. The only work I got done today was the work I did before I left to go to therapy.

In all my hypothetical situations I wondered about in that waiting room, the idea of someone stealing my therapy appointment wasn’t one that would have ever occurred to me.

24 hours

It’s scary how fast things change.

A month ago I was having a perfectly fine uneventful day. It was the last day of my week off before school started. I was feeling wonderfully relaxed.

Then I checked my mail. I’d previously requested my records from a partial hospital program I had been to several years ago. They’d arrived. I wanted them more for my obsession with recording keeping and possessing anything anyone has ever  written about me and storing it in my filing cabinet than anything else. There was some curiosity about how they would write about the part where I was forced to take off my pants despite clearly refusing, but mostly I planed to skim through it and file it away.

First couple of pages, nothing too exciting.

Third page. “Hey! They got my age wrong. Typical.”

I read more. “Wait a second. I don’t have schizophrenia. ” I looked at the top of the page. It had someone else’s name on it. It wasn’t about me. There were 3 pages of someone else’s records in the middle of my stapled packet.

To say I was not pleased would be a major understatement.

Confidentiality is a major hot button issue for me. If they were careless with this person’s info maybe they were or will be careless with mine?

I work very hard to keep my privacy. I don’t have any close friends and especially not at school. I can’t trust anyone. If someone gets too close they might find out how crazy I am and somehow that will lead to my school finding out, because no one can keep a secret and that will lead to me getting kicked out of school again. I know it’s paranoid, but I have to protect myself. No one else will.

This reactivated and exacerbated all of my fears about my privacy being violated, anger towards health professionals who have been sloppy with confidentiality in the past, anger towards people who have used my personal information against me. I had just an overall sense of powerlessness, anger and feeling overwhelmed. I can’t put it into words that do it justice so I’m just going to stop trying. Point is I was extremely upset. I’m getting teary now a month later writing about it.

It took less than 24 hours for me to fall apart. The day after getting the letter I called the hospital. It took talking to 3 people at the hospital to get someone who understood what it meant when I said “HIPAA Violation”. One person said “Hippo Violation?” and tried to transfer me to security. No joke. Class act they’re running. They fed me a “We’re taking this seriously” line.

I was having cycling panic attacks. I’d taken my maximum daily dose of klonopin and it felt like I hadn’t taken a thing.

So what next? Clearly the logical step is to take a bunch of painkillers, right? Of course. So I did that.

And well I had a box of nicotine patches I’d been hanging onto for over a year just this sort of occasion. I’d thought about throwing them out before, lucky for me I still had them. I put all of them on from the previously unopened-box.

I lay down in my bed for awhile. I’m not sure how long, maybe an hour. I decided I’d made some bad decisions. I took off the patches and made myself vomit up as much as I could. I was extremely dizzy. I realized I had no mouthwash. I zig-zagged my way over to the store to buy some. Came back, vomited some more (this time without the help of fingers).

I felt significantly calmer once the dominant problem shifted from emotional to physical. I went to sleep for the night. I was still a mess for the following 2 weeks,but that first 24 hours was the worst part of it.

It is terrifying to look back and see how quickly things escalated. At the time it felt like much longer than a day. It’s scary to know that no matter no stable I am for how long these things can still happen out of nowhere. I’m always at risk that one day I could be fine the next I might kill myself.

—

This is the end of the post, but here’s some more writing anyway. I didn’t want to get bogged down with extraneous information that isn’t about the point of the post, but here some is.  I didn’t want this swept under the rug. I wanted to throw everything at them and not let them get away with it. I called more lawyers than I could keep count of and each kept referring me to another lawyer. I kept calling them until I reached one who never returned my call. A lot of this lawyer-calling was more related to my past school issues than my present issue. I was extremely lenient with my school. I could have been significantly more aggressive, but opted for gentler methods because I wanted to preserve my relationship with the school.

Ultimately it turned out that part of the other person’s file had been put in my folder my the social worker who had done both of our intakes. None of my pages were missing from the file (or so they tell me). They said they’d “talk” to the social worker. So wrist slapping, basically. I get it mistakes happen, but these mistakes can have big consequences.

Oh yes I should have gone to the hospital. Blah, blah, blah. Don’t anyone dare lecture me. I’d have gladly gone to get checked out physically  at the point where I’d vomited things up. But I didn’t want to be trapped there and risk messing up another semester of school. I know okay, priorities, maybe ours are not the same. School trumps physical health. And also wasn’t exactly feeling very trusting about hospital’s abilities to keep my confidentiality so no way was I going to risk telling them more information.

Mom’s Medical Fears

When I got my first period my Mom told me I might have Cancer. I was in a Disneyland bathroom, the one over by Adventure-land, near the Indiana Jones ride. I told her there was blood on my underwear. Panicky, she bought me a pad from the machine. Outside the bathroom there was frantic conversation between her and my Dad, with her saying it was too early for my period to start. ‘Do you think she has cancer? I think she has cancer! We have to bring her to a doctor!’ My Dad was able to placate her, something he used to be better at back then. I think he’s worn out now-a-days and doesn’t try as much anymore. I continued my day at Disney and did not have Cancer.

One time my Mom ordered salmon at a restaurant. She had eaten salmon many times before. That night she got food poisoning. She decided it wasn’t food poisoning and that she was allergic to salmon. Whenever she gets sick after eating something she says ‘oh it must have been cooked next to some salmon’.

One time my mom asked me if maybe adderall had made me gay.

In elementary school I bought a bar of handmade rose scented soap at a craft fair. I brought it home and showed my Mom. She said I couldn’t use it. “What if you’re allergic to it?” Instead, I could keep it as something decorative.

The bar of soap sat in my room at my parent’s house in the same spot up until a month ago. I had to pack everything up. They’re moving. I took the bar of soap with me to my new apartment. I washed my hands with it, even though I prefer liquid soap. I didn’t have an allergic reaction.

Searches

I swear I’ll write a post here again eventually. Therapy 3x a week was using up all of my desire to talk about myself. That’s over now though. I over-use the word though.

A quick question. I keep seeing in my blog stats people finding me by searching my user name. I don’t know of anywhere where my username would show up without a link back here. So I can only conclude that people had already found my blog and are googling me trying to find out more about me than what I’ve already written here. This freaks me out. This blog is anonymous for a reason. I don’t want you knowing more than I choose to share here. It makes me not want to write anything, feeling like people are trying to pry and access more info than I’d like to give, that maybe this isn’t a safe means of expressing myself. Not that I don’t google everyone, myself. It feels different when it’s towards me. I’m open to suggestions of less paranoid reasons why people might be googling me.

Oh and I’ve moved into an apartment with a buzzer. I guess I’ve become what I hate:P

Self-Injury

I was a freshman in high school. I sat in a bubble bath with the shower curtain pulled shut, adding an extra layer of protection added to the closed, but unlocked bathroom door. The lock didn’t work. Few of the locks in my parents’ house worked. At any moment my mother could rush into the bathroom unannounced.
At the time she was occupied screaming with my father about something, most likely related to my above average, but not up to her standards, academic performance.
I needed the shower curtain shut so she couldn’t see me with a shaving razor in my hand slicing open my leg, watching the blood mix with the bubbles.
The first dozen or so times I did this are mashed into one entity in my head. I want to know, what was different about that night that made me cut my leg open instead of just crying? At the time it didn’t seem at all significant. Now I wish I’d written something down.
I love having records of things. Without records I feel like maybe something didn’t happen. I want a physical representation of experience. I document. I write, I take photos and I make scars.
Scars leave records. A scar is easier to live with than remembering the details of why I have a scar. For this time period I have neither. The scars have faded and I wrote very little down.
Within weeks of the first injuries to my legs I began taking apart shaving razors. I didn’t want to keep all that plastic designed to “help” prevent me from cutting myself. Each shaver gave me three little blades. They were so tiny and seemed delicate. I hid them in a makeup compact.

It’s over 6 years later now. I still do it. Not as often as in the early days, but often enough that I identify as a “self-injurer”.

I don’t feel the same way many do about self-injury. I don’t think it is a bad thing. Don’t get me wrong, I don’t think it is a wonderful thing. It has flaws. In moderation, I think there is nothing wrong with self-injury. I don’t want to stop. I just want to stop the feeling that make me want to do it.

I used to be one of those people who mentally beats themselves up after self-injuring. No more. I’ve enough other things to mentally beat myself up over. I don’t need to add another.

I have never needed stitches. I have never lost a dangerous amount of blood. I have never gotten an infection. I am careful.

Much of my therapy has been a struggle. I want to not feel upset enough to want to cut. They want me to stop cutting, without fixing the underlying problem. The priorities are different.

Those same therapists will advocate the use of klonopin when I want to cut. I consider klonopin a worse way of dealing with stress than cutting. In my hierarchy of not-so-positive-ways to deal with stress klonopin rates worse than cutting. When I cut I can see the damage being done. With klonopin I can’t.

I wouldn’t advocate it to others. I realize there are negatives. I have scars. I deal with the pain the following days. I consider these negatives to be acceptable for me. I realize most people dosn’t feel this way.

I also realize that most people who self-injure consider it a struggle. For me the struggle is what leads up to the self-injury, not the self-injury. But I do support those who feel differently.

Self-injury helps me stay alive. I can short curcuit negative thoughts spiraling downward. I can prevent my mental state from further deteriorating.

In my first hospitalization the doctor drew a picture of my cuts. It’s in my records It amused me quite a bit that going to med school resulted in her drawing a picture of my cuts.

scanscarrealcropped01

I believe on the right is supposed to be a drawing of the bruise that was on my hand from punching the floor.

The tic-tac-toe one is my 2nd favorite, the first being the skull. The tic-tac-toe one has some faux symbolism that’s so corny I can’t even say it with a straight face. “The X’s represent life. They won before I could make a move” See it started out one day I decided to do a tic-tac-toe board. No particular symbolism or anything. It’s hard to make curves with the knife so I just made Xs, no Os. I cut over the same spots many times. Eventually I gave that meaning to it, despite the original purpose being visual, not symbolic.

Visuals are important for me with self-injury. I have to see what I’m doing. If I punch a wall I need to see the bruise. Otherwise it is not as effective.

I like the skull because I think it is cute. One the left leg cuts must be parallel (the skull is the exception). The right leg allows chaotic criss-crossing cuts.

I’m rambling now so I guess I’ll stop. I’ll just end things by saying that for me self-injury is helpful. Often times mental health professionals ignore its adaptive function and try to eliminate it without fixing the problem or understanding it. I fight them every step of the way. And then I get labeled as difficult. They worry excessivly about the risks, not realizing that I am careful. If they paid closer attention they’d realize that my anxious, obsessive traits carry over into my self-injury. I’m much more likly to panic and over react thinking a cut is far worse than it is than I am to underreact.

Grades Obsession

I need to get out of this mindset where I think an A- is a bad grade.
I wasn’t like this before.
My first semester of college I got a mix of As and Bs and I felt quite good.
My second semester I got all As I was thrilled.
My third semester, again I got all As.
By my 4th semester I was thinking ‘wow It’d be neat if I kept this all As thing going, and again all As
Now it’s my 5th semester. It’s no longer just an neat thing, I feel I have to do it.

Right now my GPA is being pulled down by an A- (the Bs from that first semester transferred to my new school and don’t factor into GPA).
This pattern started because I was enjoying classes and putting a lot of time into them as a result. Now this pressure is destroying my ability to enjoy the learning.

I just want so badly to watch my GPA to creep up closer to a 4.0, undoing the damage of the A-. I want to discover if there’s a point where a 3.99999999 can be rounded up to a pretty 4.0. How many decimal places are needed?

I need to keep telling myself ‘You don’t have to go to an Ivy League school for grad school.’
I’m not even sure the particular Ivy league school I’m thinking of has the type of program I want.
I guess as long as I get into grad school it’s okay?
No. I need my little bit of elitism. As long as it’s not a state school (No. <3 you Emi. Do you even read this? We can go to state school together. Future Alumni of Generic State School ftw?)

I’ve had a series of academic disappointments this week. When school is your life that makes them bigger
-The student I tutor got a D+ on her test. Which makes me feel awful, since it’s my job to try to keep that from happening. We’re going over it tomorrow to see what happened. I feel really bad, especially because I though she had a good sense of the material.
-I didn’t get into a really interesting class I wanted to take.
-I got an A- on a paper. I realize that isn’t awful. I just can’t consider it good. I lost some points because I didn’t italicize the volume number in my APA citation. It’s worse when it’s something that preventable.
-I had two peer writing workshops that were useless. I’d been looking forward to them, because I’m excited about my paper and wanted feedback. I don’t feel like my classmates took it seriously. The only constructive criticism was spotting a few typos. Rip my paper to shreds please? I can handle it I promise. As long as it’s not a bad grade, I’ll find it helpful.

I hate that I’ve become one of ‘those people’. I wasn’t one of them in high school. They say if you graduate high school without doing drugs it’s unlikely you’ll start after. I guess the same doesn’t apply to being obsessed with grades.