The New Business Model in Psychiatry

I checked myself yet again at the hospital. It became my full time job really.

Shame on me, I ain’t strong enough to survive outside more than a few weeks. But is it really my fault?

Not more than 24 hours later, yes you know it, I checked myself out. I wasn’t scared of the environment this time. I liked the room. I even met a couple of people with whom I could have a decent conversation – shout out to K, L, N and N!

My problem was the medical body. My sessions with them were more of open ended questions like in qualitative research. I felt time had no essence to them. Like progress cannot be measured daily.

When I went to London, and I am not being payed to say this – if you only knew how expensive it actually is to get treated there out of pocket – every single word I said was taken seriously. Every little side effect was looked at. I was seen as a person; a real person and not a spoiled brat complaining for no reason.

Secondly, the doctors would not dwell endlessly on what to do. They took calculated risks. Because if they agreed to the status quo then nothing would happen.

I was always reassured and never ever did anyone tell me this drug or this method works for 20% of the patients. I was given hope – in abundance and also had the opportunity to chat with other patients who are now truly healed.

While I was completely fitting the box of patients in the clinic, my individual voice and needs were immediately heard.

That is why I felt I was wasting time at the hospital and that is why I left 24 hours later instead of staying for a whole 10 days.

My business teachers at university always said a good product or service starts by answering a customer pain.

Very well, mental illness is filled with customer pain; be it the patient herself or her family members.

I have been treated and admitted to hospitals both in Paris and Cairo. Although the settings could be strikingly different; there are major similarities.

Patients have little control over the course of their treatment; unless they happen to well read – and still that could be interpreted as a personality disorder.

Here, business people, here is a business model for you to follow. Instead of keeping the one patient coming back for 10 years, you can have thousands of them and most likely very happy ones too. Am no mathematician but get your excel sheets out and do the works. It doesn’t need a genius to tell you where the money is; and coincidentally health too…

TBC

I am committed

I am committed to coming back to this very hospital

I am committed to receive every form of therapy there is under the sun

I am committed to doing whatever it takes to raise our children, see them graduate and organize their weddings

I am committed to loving and honoring my immediate and extended family in every possible way

Meanwhile I am finding my happy middle

It is a mirage

But I need to keep on looking

I will check out tonight if it is the last thing I do

I will come daily as an outpatient

I am committed to heal

I am committed to survive

I just checked myself in a few hours ago and now I want to run through the iron gates and never come back.

I cannot deal with my thinking, my needs, my wants, my moods.

Is this a magic spell?

Get me in here

Get me out of here

My patience is nonexistent and my insight is blurred with my tears.

End this torment for I am at the end of my rope

This song is on a loop and it won’t stop

TBC

Fighting demons

I left the hospital about a month ago.

I didn’t write earlier for many reasons. Initially, I was denied technology for the first 10 days of my hospitalization at the closed-up ward.

They took everything. I was allowed my bed and a few magazines. My luggage was searched. Chargers and electronics were sent home. Glass was separated from plastic. Belts were taken away from clothes. Everything else went into either a small closet to which the nurses held the key, or to the nurses’ office, access to which was upon their discretion. My cigarettes and lighter were locked up too. I got about 3 to 4 smoking breaks; always accompanied.

Interaction was limited. The idea was to spend time to heal without any distractions. Noises were rare – except for the TV that was on low volume. I remember watching Forest Gump while sitting (luckily) on one of the three recliners. Lights were dimmed.

I had visits from my family daily. I was eventually allowed to go down to the yard and cafeteria with them. I would have coffee and sometimes a kinder bueno. I slept 12 hours and ate together with the other five patients at the common table. My diet was mostly derived from the cabbage family. I think this was the cook’s punishment for vegetarians. I surely don’t have vitamin K1 deficiency.

We traded food as we complained about it. It was the highlight of our day. We also shared two bathrooms and a shower. They gave me a bedsheet instead of a towel. Sometimes people forgot to flush. I had to return my shampoo as soon as I finished. At night they sometimes did random searches of the rooms. They would put things back in the closet or their office. This period always reminded me of the Jungle Book song “The Bear Necessities”…

I had daily visits from either one of the doctors or the intern. They would ask all sorts of questions initially to establish my story, my case. It was intense in the beginning then it became more of a routine. I was weaned off my long list of drugs and little by little I had 3 instead of 8.

Without a mobile, we had access to a phone line from 2 to 8 pm. It was religious for me to call home at 7. I would then speak to the children. I would beg the little one to sing me a song.

I began to cry after a few days. I missed my kids and although I could see my eldest in the garden, it was very impersonal and cold. My problem was my youngest. I was dying to hold him. He had never been away from me all that time and I had plenty of time on my hands. I obsessed about seeing him. I dreamt of him, heard him calling my name. I held his tiny blue car I had taken with me to the hospital. I looked at his picture most of the time. I was itching inside to see him.

Doctors had mercy eventually and I was moved to the open section. It basically meant that I could soon have the right to go out for a few hours. I was in a triple room though, I had absolutely no privacy. At the time it didn’t matter because all I cared about was holding my children tight.

My phone was given back to me but I could neither connect to social media, nor write. My stay at the closed ward influenced me to a degree I cannot explain. I thought it shall pass. I thought I will eventually answer calls or at least reply to messages. I am still in my bubble. This is where I feel safe. I still have dinner at 6 PM.

Eventually I was let out. I was on Prozac and lithium. After a few painful blood tests done by intern nurses, the doctors agreed that it is time to move to the real world. I could manage my nausea then. I hadn’t talked about this side effect to anyone. I feared they would change drugs again. I had had a few “mock” stays at home for 48 hours, and as these went well, they had no reason not to let me out.

I was extremely happy. Cured I thought. I was on a cloud. I savored my sheets, my coffee, my family. I felt liberated and free from the weight of all the previous drugs that left me with countless side effects.

I was managing my own medication. No suicidal thoughts. I could get dressed and go out for dinner. I didn’t fall asleep by the time the starter arrived. I did not snore or have awful nightmares. I didn’t wake up at 3 am to empty the fridge.

Yet, I could not write. It drove me crazy. It was as though my mind was emptied – literally. This caused me great pain. Little by little the cloud of happiness was disappearing. Gravity hit in fast and I was left with my initial illness of 2 years ago that hadn’t been treated till now. I felt all the personality changes that follow taking so much drugs. I look at the mirror and wonder who is looking back at me. I barely recognize myself, although I guess we keep the same values.

What keeps me afloat is my family. I cannot break my husband’s heart by falling again. I cannot imagine not seeing my baby boy. It is unthinkable to put my daughter through this one more time. And I honestly don’t know if my father can survive one more of my attacks.

You get the general feeling. I am scared. I also tremble. It is from the lithium. My hands are shaky and my face twitches sometimes.

I look like all color has been taken away from me. My world is black and white. I laugh sometimes, but it is momentarily. The thing I love doing the most is staying in bed alone, but my doctor says I shouldn’t.

My main concern is that this illness has taken over my brain, my life. It is the first thing I think of in the morning and the last thing I have on my mind at night.

I sleep poorly and have had some ugly panic attacks. My husband sits me through them and holds my hand to help me breath. He tries everything from rubbing my feet to aromatherapy. It eventually passes and leaves me incredibly tired as if I ran a marathon.

Now, I have to start therapy but I don’t feel like talking to a stranger. It has been three weeks since I had to take an appointment. I am scared of the slightest changes. When will I say I am me again? Oh dear, do I really want that?

TBC

The day before my hospitalization

As I smoke the day’s first cigarette, I wonder…

It has been decided yesterday that I will be hospitalized tomorrow.

Dread is all what comes to mind. A new place it is, specialized in mood disorders.

The ward I will be occupying will have 6 patients. Six individual rooms isolated from the outside of the hospital; from the outside world.

I worry about small details; will the room be warm enough? Will the charger reach my bed? Will they let me out to smoke?

I also worry about visitation rights. It is no prison I know, but there will be strict rules to follow.

How long will this stay be? When will I graduate to the open ward, where I will have access to the courtyard and the cafeteria? Will I get permissions to go out? When will I see my children again?

Soon enough all these mundane questions will be answered, and other ones will surface.

I will write as much as I can….

TBC

I don’t want to hurt myself

I don’t want to hurt myself. I do not want to end up in an emergency room.

My only weapon is my writing.

I have to fight myself as much as I have to fight the system. What on earth am I supposed to do not to end up in an emergency room? How can I control my impulses?

Could my pain make my heart explode? Is this physically possible? Will I let my children see me this way? What does the system offer to those in my position? Waiting and some more…

I wish I could feel numb like the last 48 hours. Today it hurts like an open wound. Will I keep on bleeding endlessly? will I hold this scream till the end of time? Will my tears ever dry? What can I do to protect my children from me? Leave? Go where? Die? They will be motherless just like me.

I have given all my strength in this fight. There is nothing left in me, not even pride. All what I ask is for is that it be quick. This separation that is tearing me apart, could it happen in the blink of an eye?

I am rambling, scared like a lost child in a forest. How can I be a mother when I am like that? God, if you exist help me… and if you don’t, then let me be…

Help me if you can

I packed my pyjamas, I packed my socks and leggings. I packed my sweethearts, tooth brush and lenses case.

I packed my nail polish, I packed my cotton buds. I packed my headphones and I packed my bathrobe.

I couldn’t pack my children, I just packed their picture. I packed a picture with both smiling, angelic as they are. I couldn’t pack their smell, though I packed their perfume.

I packed blue-tag to hang their picture on the wall. I just pray to god to hold strong till Tuesday. I have to wait Friday, Saturday, Sunday and Monday. How can I bring myself to wait for not seeing them?

How can I pack my husband’s hug? How can I pack the smile of my father? How can I pack humanity in a bag?

Anyone who has gone through this please help me. I can’t stay home, the hospital won’t take me for a few days. I am being torn up alive…. Help me

On waiting

I want to be readmitted to the hospital, but there is no place for me today. Maybe there will not be either till Monday. That means I have to keep my will to go for hospitalization alive till then. That means I have to give my family and specifically my babies the cold shoulder. Otherwise, I will change my mind again.

I know no one else understands the cyclical problem I am facing. Today is the last day before the weekend. This means today is the last day before total meltdown. I want to be safe before it. For others all days are the same. The dread of the weekend is creeping up on me like a thousand ants…

Will I have the will to go after the weekend? What will happen? I keep my drugs with my father. I will not go out alone. I do not even want to go out. I have to wait and waiting is what I hate the most about this whole process. If I could manage to sleep it through…

We have to wait for doctors’ appointments, for drugs to kick in, for drugs to taper off, for places in hospitals, for visits at the clinic, for permissions to go out, for the right moment to leave the kids when on perm, for the nurse to give you the pills, for the lunch tray, then dinner tray, for healing to occur, for convalescence to endure….

We have to wait to kiss our children goodbye, we have to wait to greet our children… We have to wait to explain over and over again what is wrong with us.

To hell with this waiting, yet we even have to wait for hell..

TBC

When your are dumped by your therapists…

Betrayal is the feeling of having been left alone, stabbed in the back, having someone take action behind your back or against your will.

Abandonment is the act of betraying a promise – written or otherwise for no logical or understandable reason to the person being abandoned.

Ethical Framework to the counseling professions is about Ethics (values, principles, and personal moral qualities) and it is also about Good Practice (putting clients first, working to professional standards, respect, integrity, accountability and candor, responding to ethical dilemmas and issues etc. )

I have been chewing on these few concepts since last night. I slept because I took a sleeping pill, which for once was quiet useful.

I would like to dwell today on values. I like the word values, it is tricky because it is personal. It is related to morality, because why would something be valued if it is or is not morally viable? hmmm

You might perhaps be wondering why I am asking or putting forward all these philosophical and linguistic babbling. Here it goes:

I was betrayed and abandoned by both my psychiatrist and psychologist agasint the ethical framework binding the helping professions. Ah, much better to say it in writing.

I am not interested in pointing fingers, or mentioning names. I like Jesus, this wise man decided to give the other cheek. I take to his way of doing things, though am neither religious nor wise. But you see, Jesus had a point. When you give the other cheek you force the person in front of you to start questioning their moral stand point. They start thinking of their actions and reactions. They question themselves. Maybe, if one is lucky, they discover that they could have acted differently.

The reason I am being denied treatment by both my helpers is that I refuse to be hospitalized. I prefer daily monitoring, while being close to my children. I am  in no danger to others and I have vowed not to pass to the act of self harm under any circumstances. I was not once offered an alternative solution to hospitalization, I was not once talked to about the benefits of being closed up. It was just decided, with a strong authoritarian approach  that no hospitalization equals no treatment.

Is there something called middle ground? Let’s try and find out in the dictionary. Yes! There is dear people something called middle ground,  and it means and I quote the Cambridge online English Dictionary: “a position between two opposite opinions in an argument, or between two descriptions.”

Very well, So if the argument of my therapists is that they wash their hands from the blood a potential suicidal person – whose suicide has now been established to be induced by anger – is valid. What does it actually mean? Here are a few options, you may add your own:

1- Protecting their “practice” is more important than protecting their patient: Self evident really. I wash my hand from thee blood on me chart of dead patients.

2- Protecting their “practice” is more valuable than the life of a borderline personality disorder (BPD) patient: By default a BPD fears, like seriously fears being left alone or behind. But again, thee blood is not on me finger (choice of finger left to you my dear reader)

3- Protecting their “practice” is a manipulative: Aha, yes let us tell the patient we shall not be responsible for you anymore and then wait behind the theater’s red curtain for the moment when the patient falls into the ground and starts begging them to control her life and take her back into the bliss of treatment.

There must be many more reasons, one of which is plain stupidity. Not once was I asked to find anther therapist, or helped in finding one. What about the period between ending your mighty help, and me finding someone else to help me? Lexomil, Dolipran, cutting my own veins?  What was going into your tiny minds, with your tiny neurons floating around in this state of reduced mental capacity for judgment?  I would seriously reconsider careers if I were you… But you are not that smart

You did me some favors though:

I learned that I alone own my destiny. 

I learned that I alone control what goes into my body and in my mind.

I learned that I alone decide whom I will share my life.

I refuse to learn that people are bad until they prove otherwise. 

TBC

 

4 reasons Why you should avoid going to CAC 6 in France

Yes I know I am sick as a dog, but if you read me out, you will understandably know why I hate this institution.

1- You might be refused help: I went with my own packed bag to the CAC* of the 6th arrondissement in Paris (emergency psychiatric center). I was seeking help, and mostly protection. I was refused by a psychiatric nurse CATHERINE – she told me to rely on my inner resources (smiley face) while I have suicidal thoughts )gesture with third finger and black dark pitch black ideas.

2- Mistreatment, under-treatment or non-treatment could be a nuisance: Next day, it started. I had my headphones on most all of the time to avoid any contact with the staff. I think it was the smartest thing I did. Next day, unfortunately there was still again no place at the private clinic to which I would be transferred to, so confrontation was a little less possible.

3- Spare yourself from unnecessary anger: Small things, like you cannot get access to your phone at 8:55 but at 9:00. That I have no visitation rights except for one hour. Small things like forcing you to take an ambulance to the other clinic while they have absolutely no right to do so. Small things that I could go home and have a proper shower (wearing same socks for two nights). Small things, like going home to pack my bags and kiss my children goodbye.

4- Food sucks: Just kidding, but unfortunately true!

Admission to CAC meant that I used my mind – a ruse – I managed to get admitted by waiting for the next shift of nurses to arrive, angels like FABIEN, MARTINE and BENJAMIN. They let me in, gave me something to sleep. I felt sad to be away again, but nothing weird – just the fact that I was not able to leave my husband and be away from home.

For a full review click here

*CAC: They are part of the 5 psychiatric institutions in Paris. They provide a hotline and psychiatric consultations. They welcome, treat, or offer short time hospitalization, but do not take charge of hospitalization without consent….Ils font partie de l’offre de soins des 5 établissements psychiatriques de Paris. Ils assurent une permanence téléphonique et des consultations psychiatriques. Ils accueillent, soignent, orientent ou hospitalisent pour une durée brève, mais ne prennent pas en charge les hospitalisations sans consentement.

Back from hell – for me not to ever forget what life means

I had no idea or no intention to write again. I though that’s it… The end.

Life decided differently, and now am alive. I had almost died 6 days ago. I overdosed again, but this time for a different reason.

Sunday it was, I knew there would be one pharmacy only opened. I went in and asked for 2 packs of paracetamol and one of aspirin.

I headed along Rue de Seine all the way to the river. I had even bought a large bottle of water at the pharmacy. What were they thinking I don’t know!

Glam, I was looking at the river and sipping one by one my pills. Families passing by, a child on his scooter, a group of American tourists on bikes. One pack gone, then I opened the second. I had managed to take 20 pills of paracetamol 1g each, and this is when I discovered that the aspirin needed to be dissolved in water.

Headed back towards the back streets of the 6th arrondissement, and found a nice coffee shop. I ordered their largest coffee and a glass of water. Little by little I had 18 pills of aspirin 350mg each.

It was 10:30 in the morning. I ordered a cab and decided to go to the psychiatric emergency center by my house CAC*. I had called my parents by then and they were waiting for me. Soon the ambulance came and I was taken to the reanimation room. My temperature was high.

CAC Entrance Paris 6

Tbey started inserting canulas and tubes all over me. I had one placed inside my nose and this was the worst part of the whole experience. They filled it with charcoal to make the paracetamol effect go away. They told us I would stay at least 5 days at the hospital.

I threw my guts out. It must have been that which saved my liver, or maybe it was God. I’d rather say the latter. I have to confess that I was scared. At some point I felt that was it. They then said that my blood results were good and that I could go home. A miracle by all means.

At Necker reanimation center

I wish the story ends here. It just begins. My husband had to take me to the famous psychiatric hospital of St. Anne. I had to have a psychiatric evaluation by a third party different from my own psychiatrist or that of the CAC.

Well, four hours later into the waiting room, we were finally able to sign the most importantly binding paper of my life. It said that I can get out of the hospital against all medical opinion and under my own responsibility. My husband of course had to sign it as well. We had talked hard and long about the danger of such an act. It basically meant that he will be psychologically guilty should I decide to be in danger to myself or others. That night I promised him that this will never happen again. I would never forget the look in his eyes..

The deal may sound naive. Yet we have a good system in place to avoid further crises. The CAC is my panic button. I will tell my family immediately that my rage is coming up and I would immediately go there. At the center they talk to you, they give you medication, well they do what it takes to stop you before committing the act. I also have biweekly meetings with the team to discuss any important developments.

Lesson learnt the hard way. Life is precious. By doing this I was not only hurting myself, but my whole family; my husband, my children and my father. Do not commit the act. Talk to someone first, try it. Maybe it works, maybe it saves your life and makes you grateful for what you have never lost…

Tips and tricks for those in Paris

*CAC Garenciere: A centre for psychiatric emergency. These centers around Paris are places made to welcome and orient or even be a place of hospitalization for a short period of time.

Leaving the clinic today

Well, I’m quite excited about today. You see, today I leave behind 41 long days of hospitalization. I have been waiting for this day for so long, it seems almost a dream come true.

Yet, I am afraid or rather apprehensive that today I leave the cocoon and safety of the hospital. I know I want nothing more than being with my family, with my husband, with my beautiful children, my ever so giving father and my loving mother in law.

My apprehension comes more from expectations outside. I need to get back to my role as a mother. My children miss me, but I miss them even more. I know that my husband is waiting for me patiently. I also know that my immediate family would like to have the house come back to normal, this was mainly my duty – I am a stay at home mother…

I also know that everyone understands my condition. They understand that now I am in a state of convalescence.

So since the last few entries that I posted on the blog, I like to leave you with some tips and tricks which I hope might be useful should you find yourself in a similar situation.

Here it goes…

Don’t get too comfortable in your hospital stay: I think from my experience you have to know that everything is temporary. Getting used to the safety of the clinic is not something that you should really get used to. What I mean is you always have to know that there is a real world waiting for you outside. This real world is where you will spend the rest of your days. Please know that no matter how long the hospitalization is you will eventually get around and you have to be ready. This is basically a primary psychological preparation.

Prepare your exit so that it easiest for everyone: Knowing that you’re not going to be at your full capacity once you are out makes expectations more real. You will need help. I am speaking as a mother of two beautiful children who require plenty of energy; energy that I do not have right now. Even if your budget is limited try to find help through family, maybe hiring a cleaner or a nanny, or maybe even relying on some good friends. Basic tasks could be haunting In the beginning, and I am certain that people around would be willing to land you a hand.

Continue seeing your therapists and psychiatrist: I cannot stress the importance of this. Professional support outside of the safety of the clinic is essential for your well-being. You will adjust your medication according to the development of your case. You also should make sure that your therapist is there for you, ensuring that you are on the road to healing.

Don’t pretend to be stronger than who you really are: We get carried away, thinking that we are better, thinking there could be no harm in taking more tasks than we should. Remember, one step at a time. Do not take more on your plate. You have a long way to heal even if it doesn’t look it to others.

If you are a parenttalk to your children love them though as a mom or dad you might not have your full energy yet: You would be amazed at what can children understand. Just by maybe saying that mom or dad are yes at home, they will help little by little and take care of you slowly but surely. Ask for their patience, more important and more efficient than melt downs. I cannot stress enough the importance of one day at a time.

Routine is your best friend: My doctors told me to try and keep a routine even though it could be difficult at the beginning. For example try to wake up early and have breakfast every day at the same time. Maybe we can go to the market, pick up the stuff that you would be eating the same day. I personally find that my muscles have weakened so much over the past months. Morning walks will keep you sane and will get you into an exercise routine slowly but surely.

You need to rest: Again my doctors told me that I need to rest everyday. Even talking too much can drain you. He recommended naps but not more than 45 minutes a day.

Be patient: Rome was not built in a day. Stay in tune with your body and don’t over do it. Little by little you will find your old self emerging; or better still your improved self coming to surprise you.

Take supplements: read about taking supplements because this is very important for your overall health. Read about the importance of vitamin D, magnesium, omega-3 as well as a variety of other vitamins and minerals, they can benefit your wellbeing more than you can imagine.

Congratulate yourself: Yes, you made it! Give yourself a big pat on the back. Be grateful you made it. They wouldn’t have let you out if you were not ready. And remember, you did most of the work! Be proud for your achievements: )

TBC