Saturday, May 2, 2009

Visitation

Visitation


Every time I approach that hill, the one that leads to that monstrous fortress, the cold institution where those intakes caused my heart to pound, my palms to sweat in dread, the panic rises and I hold my breath. I hold my breath forgetting to breathe deeply. But, I had already reconciled myself to the fact that it was important to give feedback about the intake process, how everyone did their part, that the clinicians were excellent and caring, but that the communication on the team failed, and as a result, I was forced to retell and relive the trauma again and again without the tools necessary to do a little harm reduction as far as symptoms are concerned. I had to give the feedback because, like most of us, we believe that we are not allowed to actually participate in our own healthcare, whether it is physical or emotional. Doctors cure. I also know that doctors are constantly learning, and though their intentions are honorable, they are human. Researchers especially are cogs in the machine, so the fact that reports are produced, does not necessarily mean that they actually talk to each other about the patients, or treat each individual case uniquely.


I had already decided that I would probably drop out of this study after I had delivered my feedback to Dr. Marmar. For those who are not familiar with Dr. Marmar he is Vice Chair and Professor of Psychiatry at the University of California, San Francisco. He is also Associate Chief of Staff for Mental Health, San Francisco VA Medical Center. Dr. Marmar’s current studies include a five-year prospective study of posttraumatic stress. His research has been supported by the NIMH, Veterans Administration, and Upjohn, Solvay and Forest Pharmaceuticals. With the use of Cognitive Behavior Therapy, Dr. Marmar has had a high success rate in treating PTSD survivors since the mid seventies.


So, this man, this doctor, this amazing opportunity – was I going to give the feedback and just leave, knowing I had a great therapist who supports me, who thinks I am doing FABULOUSLY anyway? Or was I going to be open to the possibility. It is interesting how you think you have a plan, and yet you know you will try and be open for anything that might give you a way to get in or out. And that is what happened. Dr. Marmar told me that the intake process should have never occurred in the manner it did. There should have never been a seven hour intake. There was no reason to relive trauma three separate occasions, followed by a startle study that would produce said symptoms, before the actual treatment had even began. The feedback he said was useful, and I was assured that if I was willing to trust him, trust the process, to make associations that did to create pain and anxiety, with the help of tools, and techniques which would be given to me, and that if I did the homework each week, I would benefit from the treatment. If I received the medication or if I received the placebo, we would not know as it would be randomly assigned. But regardless, he would help. And so, I took a leap of faith, and decided to not give up just yet, and to do the best I could, and if it did not work, then I could make an informed decision. He also gave me the much needed self-esteem boost by telling me that he could tell I had already done my research that I was already working hard, and that I was well along my way as it was. So, I feel grateful, and I am shedding skin, and I am happier, because I am open. Being open. That is what it is about. And now I do not have to look up that hill and see the facility as something to be feared. I can look at it has a refuge, each time I visit.

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