Posted by BekkaH on January 15, 2003, at 12:57:08
In reply to emphasis on psychotherapy, posted by Pfinstegg on January 15, 2003, at 11:32:56
> However, I had been having some of the same concerns about the amount of distress Dinah had expressed over the holidays- the impulses to self-injure, as well as the suicidal ideation. I, also, had been thinking that primary attention to effective medication just then would have enabled her to continue learning and growing in her psychotherapy, as she has been doing, without having to endure such a painful period.
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> I got the impression that LostBoy had finally found medications which were really helping, and that his post was an effort to communicate that. It is really a challenge to allow freedom of expression without allowing posts which will discourage or put down other posters! I. personally, really value the freedom of expression a bit more- perhaps because I know I will learn more from it.> Pfinstegg
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Dr. Bob, I hope you read Pfinstegg's words above. I agree with them completely. Dinah has repeatedly communicated her wish to harm herself. Several months ago, she said she carried scissors around in her purse just in case she feels like cutting herself. I don't know of any psychiatrist in the entire world who wouldn't hospitalize a patient who is so intent on self-injury. Dinah didn't mention this impulse on just one occasion or casually. It is a PERSISTENT PATTERN with her and, frankly, I'm stunned that her therapist doesn't seem to take it seriously. I do hope that she communicates her intent to her psychiatrist as readily and as often as she communicates it to us. In another post, on PSB, she said she wanted her husband to tie her hands, ostensibly to prevent her from self-harm; however, one can also read into that and see some kind of sado-masochistic tendencies (i.e., wanting to be tied up, etc.). I do believe that, in his unique, inimitable way, LostBoy was simply voicing his concern for Dinah's CONSISTENT PATTERN OF SELF-INJURY or WISH FOR SELF-INJURY. You are a psychiatrist, and I think you must have the same concern. Of course, I'm sure there are some patients who TALK about self-injury as an attention-seeking behavior without ever really intending to act on it. There are others that read psychology books and then, either from hypochrondriasis or Munchhausen's Syndrome, manage to develop some of the disorders they read about, because they have not learned healthier ways of getting attention. While that is certainly a possibility, I think, at this point, a PB member who repeatedly speaks about cutting herself should be taken seriously. She should be in the care of a physician and/or hospital that can deal with her illness, and she should be properly treated/medicated. I believe that is what LostBoy was saying in his post. Whether you like him or not, LostBoy is a bright guy who does not "pussyfoot" around SERIOUS ISSUES. When a PB member wishes to harm herself or incessantly talks about harming herself, I would much rather read the words of someone who "tells it like it is."
poster:BekkaH
thread:8814
URL: http://www.dr-bob.org/babble/admin/20021128/msgs/8819.html