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How's the interview go ? Are you destined to be another psy ward alumnus?
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Jun 26, 2014 17:16
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I found out today I've been short listed for the job, if I get it ill be working full time with Dave the serial killer! Thanks for the interest guys, I'm flattered you all like the stories so much. I'm just back from work in the old persons ward and shattered, was a long painful night there. Ill write up some of the new events after I get up again.
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Jun 26, 2014 22:04
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Congrats. Will this new job count as a promotion, demotion, or lateral transfer? Will you be working with other fine folks besides Dave, or is it a one-on-one, one-responsibility-only kind of thing?
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Jun 27, 2014 05:52
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I want to hear more about the "rage zombie" personally.
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Jun 28, 2014 04:18
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ExecuDork posted:Congrats. Will this new job count as a promotion, demotion, or lateral transfer? Will you be working with other fine folks besides Dave, or is it a one-on-one, one-responsibility-only kind of thing? I will be moving back to the ward i first worked on, a forensics unit, full of criminals. I started on this ward roughly a year ago and worked there for six months replacing a staff member that got fired. Unfortunately although i was expected to be kept on after my short term contract expired the budget fell out of the world and i wasn't renewed. Very recently one of my old workmates moved to another country so im trying to slip back in.. unfortunately my old boss quit the day after i left so i have very little experience working with the new boss, i spoke with him and he invited me to apply but also advised that the role is VERY highly sort after. Every staff member in my position is keen for a set roster that this position would provide. Ive really pushed the "been here done that" side of things on my application. The ward holds 12 patients day to day with 2 secure rooms that an out of control patient can be secluded in. Currently we are in a really bad situation as the wing of the hospital where we keep the very unwell people (normally the ones dropped in to us off the street) is closed for repair and redesign. What was meant to be a 1 - 2 week job has now become a 2 month job meaning that our secure rooms, along with the rooms in all the other wards, are being used 24/7 to hold the bad ones normally kept in the LSA ward (low stimulus area). The worry i have is that if any of the patients in the wards kick off, there is literally no where to put them. No one has an answer and short of taking them to the local police cells or literally holding them down 24/7 till the drugs kick in.
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Jun 28, 2014 16:33
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Morkyz posted:I want to hear more about the "rage zombie" personally. I don’t know a tremendous amount about her, I was there when they brought her in but all room entries were done with a full team of gorillas. Watching her through the glass im not ashamed to say I’m glad i didn’t have to go in, she was a ball of rage, almost bright red and hammering non stop at the walls. We could hear the steady pounding through the two security doors she was behind and those are solid as hell, 3 bolts on each. She was drugged at least twice and both times she raged till they overwhelmed her and ramped right back up the moment she regained consciousness. gently caress dealing with that.
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Jun 28, 2014 16:39
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Chupe Raho Aurat posted:Terry Pratchett Weird, I was going to ask if he'd read Pratchett. Would be interesting to know his thoughts on the characters of Sam Vimes and Moist von Lipwig. Both protagonists with either violent or manipulative personalities that are constantly having to be kept in check by their own moral center.
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Jun 28, 2014 17:20
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ApathyGifted posted:Weird, I was going to ask if he'd read Pratchett. He really loves the world building in the series, the fact you can trace the characters evolution over the last 15 odd years. Im going to be lending him some books shortly so ill see if he has read the Lipwig ones yet
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Jun 28, 2014 17:52
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Chupe Raho Aurat posted:the role is VERY highly sort after. Every staff member in my position is keen for a set roster that this position would provide. Ive really pushed the "been here done that" side of things on my application.
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Jun 28, 2014 19:02
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Consistent as in "you know what's coming" If your not a perminant staff member you are casual, which is basically part time (30 hours) but with no guarantee of days or even shift times. It's a right pain in the rear end, there used to be a fairly reliable timetable but it seems to have evaporated. I tend to get called on a day by day basis.. Which is awesome. Getting called daily at (my equivalent) to 3am to be told I'm wanted is great.. Hard to get back to sleep when your woken up mid afternoon. The worst part is sometimes the roster conflicts very very badly, a 0700 - 1500 shift one day and the following a 2300 - 0700. Meaning you go to bed at the normal time after day one, then you are awake all day and head to work at 2200 to work all night. Not fun.
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Jun 28, 2014 19:30
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This is a great read, thanks Chupe! I'm curious about delusions. When I was psychotic (drug-"assisted", thank god, never had it before or since) I used to have really terrifying "mindscapes" where I believed I was dead or in a psych ward, but continued living in a hallucination of my former life, stuck in my apartment. Do any of your patients have really complex hallucinations/psychoses/schizophrenia, or (more likely) tell you about having it before they were institutionalized? Tias fucked around with this message at 12:02 on Jun 29, 2014 |
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Jun 29, 2014 12:00
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Hey OP, on the last page you used a slang term for a drug which I think is only used in one place. I could be wrong, but you might want to change it. Other than that, really enjoying the thread and interested to hear more. The Schwa fucked around with this message at 21:15 on Jun 30, 2014 |
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Jun 30, 2014 21:12
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The Schwa posted:Hey OP, on the last page you used a slang term for a drug which I think is only used in one place. I could be wrong, but you might want to change it. Thanks for pointing it out to everyone lol
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Jun 30, 2014 23:35
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Tias posted:This is a great read, thanks Chupe! From what I understand most of the guys just seem to see things, they will stare at a spot on the wall and react to it as if it was extremely funny, I've never had a patient see anything scary, but I have seen a few have loud screaming matches with "invisible family members" that accuse them of things. Dave the serial killer got leave! Damned if I know how but three times a week he can go for a 1/2 hour walk accompanied by two staff members. Apparently he could potentially get local town visits soon too. It has caused a lot of "reminders" on correct protocol when escorting patients. My final interview was today, I was interviewed by a panel that included the upper management member that cut the head off a relative. I believe it went very well but I've learned I'm up against another candidate that is hands down better than the rest of us, so it's pretty much practice for next time!
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Jul 3, 2014 01:50
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Chupe Raho Aurat posted:My final interview was today, I was interviewed by a panel that included the upper management member that cut the head off a relative. I believe it went very well but I've learned I'm up against another candidate that is hands down better than the rest of us, so it's pretty much practice for next time! The solution is clear. Cut off his or her head. 
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Jul 3, 2014 03:48
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Well I could, but he's a real good guy! Buggers act fast! Already heard the other guy got it, back to random wards.
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Jul 3, 2014 04:49
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The Schwa posted:Hey OP, on the last page you used a slang term for a drug which I think is only used in one place. I could be wrong, but you might want to change it. I also spotted that, but we use that term in my country too, and OP is definitely not from here.
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Jul 3, 2014 09:44
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Chupe Raho Aurat posted:From what I understand most of the guys just seem to see things, they will stare at a spot on the wall and react to it as if it was extremely funny, I've never had a patient see anything scary, but I have seen a few have loud screaming matches with "invisible family members" that accuse them of things. That's legit depressing  My cousin is paranoid schizophrenic, and will often hear the voice of our (dead) grandfather telling him to do things. He's medicated and well, but drat if it doesn't bother me :/
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Jul 3, 2014 12:16
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Tias posted:That's legit depressing Dead family members suggesting suicide seems a really common thing. A lot of my old patients seem to get voices saying obscene things to them, strangly wearing headphones so you can't hear the voices seems to really help the majority of patients.. No ideas why. Perhaps they don't like rap?
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Jul 3, 2014 13:37
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Chupe Raho Aurat posted:Dead family members suggesting suicide seems a really common thing. Well MY grandma certainly didn't.
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Jul 3, 2014 14:45
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Fortunately, a lot of sufferers appear to have some agency against it. Wesley Willis, noted paranoid music star, would write a lot of his most obscene and vulgar songs from the things he tells his voices. Allegedly, stuff that would "gross out" his demons made them go away and stop tormenting him.
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Jul 3, 2014 16:01
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Chupe Raho Aurat posted:Dead family members suggesting suicide seems a really common thing. I remember speaking to a therapist about hearing voices. He said something along the lines of them being less worrying if sticking your fingers in your ears DIDN'T stop them, as at least that showed your mind was aware the voices were internal. In schizophrenia, the voices seem to come from without and can be 'blocked' with headphones, etc.
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Jul 3, 2014 23:22
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Looking forward to more stories. By the way, please check your PM, OP.
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Jul 4, 2014 07:18
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Tias posted:Fortunately, a lot of sufferers appear to have some agency against it. Wesley Willis, noted paranoid music star, would write a lot of his most obscene and vulgar songs from the things he tells his voices. Allegedly, stuff that would "gross out" his demons made them go away and stop tormenting him. Whoa I had no idea. It's interesting and humanizing to get a little insight into the thought process behind a 400 lb man on the bus telling some invisible tormentor that he sucked Batman's dick
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Jul 5, 2014 23:01
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There's a lot of questions here about the psychological side of things. Would it be intrusive if I were to take a crack at answering a few of them? I'm a clinical psychologist and I've previously worked with dangerous sex offenders so I have some experience with psychopathy, personality disorders, and sexual pathologies. Thankfully, I've left that line of work and I'm working in private practice again as I return to university. There's a lot of misinformation about psychopathy on the last page Just one questions that really stood out from the last page: quote:Anyone know whether the triad was ever seriously used in diagnosis? I always get the impression it's more pop psychology than anything else. It wasn't pop psychology when the triad was first described but I would point out that it's overgeneralizing to say this triad predicts psychopathy; it was described specifically to highlight risk factors that predicted violence among psychopaths, particularly serial violence. The theory dominated psychological thought for a long time because it was embraced pretty thoroughly by the FBI criminal profiling unit who, through the 70's to 90's were prolific publishers of psychological literature. The problem is twofold, first, at this time, forensic psychology wasn't really a "thing"; psychological research in general was still pretty new and was mainly concerned with clinical psychology (I could write a book on why this is) and the FBI criminal behavioural units were the only outfit really producing any literature concerning the psychology of crime. The second problem is that the FBI really conducted a lot of shoddy research put out by people with backgrounds in law enforcement based on their own experiences rather than by people in psychology who formed opinions based on objective analysis. The McDonald's triad wasn't developed by the FBI but the FBI embraced it wholesale and it became part of the early psychological literature. The three factors are associated with a lot of things but tend to indicate situations of abuse or neglect in childhood (which is, itself, associated with future violent crime). The triad today is an artefact and really does a good job of demonstrating just how far research methods have come just in the last 20 years toward forming comprehensive models of criminal behaviour. It is notable that, among the triad, cruelty to animals in childhood is uniquely and directly associated with risk of violence as an adult so there is that. A lot of my research has been in firesetting and I'd argue that, in a lot of cases, childhood firesetting actually makes one <less> likely to demonstrate interpersonal aggression as an adult. Firesetting, in many cases, represents a form of passive aggression perpetrated by individuals who are otherwise, due to personality or circumstances, unable to air their grievance using direct means. This is most often due to failures of communication capacity or social skills but people like this tend not to be interpersonally directly aggressive. if the OP is okay with me answering a few questions, I'd be happy to answer a few from the psychology side of things...
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Jul 6, 2014 09:41
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Serrath posted:if the OP is okay with me answering a few questions, I'd be happy to answer a few from the psychology side of things... For sure! Maybe you can shed some light on the chaos I managed to spawn last night... I worked overnight in an acute ward full of particularly unwell people. During breakfast I sat with a male and a female, both of whom I have never met before. The male seems to have OCD as he would stand, hold 3 fingers up and mutter something to himself, the female would sit quietly and ignore me. As the woman took her plate to the sink she made eye contact with me so I asked if she had enjoyed breakfast, Cue the following loving disaster: Chupe: Good breakfast? Lady: why don't you have some? The toast is free Chupe: I'm ok, my breakfast is waiting at home Lady: why don't you want it? Is there something in it? Did you spike it? Chupe: why would I spike it? Man: YOU SPIKED THE TOAST!??!! Entire ward devolves into screaming crying madness. Good times.
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Jul 6, 2014 10:05
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Chupe Raho Aurat posted:For sure! Good times indeed  I have little experience with actual psychosis; I worked for the prison system but within this system (Australia), we have a separate mental health court system so, if someone has severe pathology like this, they'd get shunted to a secure mental health care facility and I wouldn't have contact with them.That said, if someone who is actively psychotic enters any situation with a delusion on the go, they'll shape their information processing in a way to confirm that delusion. I don't know your patients and I don't know their story but if I had to hazard a guess, I'd suggest she probably had the thought that food spiking was a real possibility long before you sat down and your otherwise ambiguous response confirmed it for her. I enjoy likening psychosis to a disorder of infinite interconnectivity and egocentrism. To most people, the day passes on, you live in your world and everyone else lives in theirs and most people don't pay much of a mind to their world in favour of focusing on their own. A psychotic individual, however, will draw links from the rest of the world to their own; the world becomes an elaborate tapestry with threads all connecting to the observer. It's no coincidence that the most common delusion is paranoia; when the world inverts in a way so that everything is connected to you, it's difficult not to think that people must be monitoring you in order to respond to your internal world. I don't have a lot of experience with this sort of presentation but I have some; one individual I used to speak to believed that his thoughts could control the radio, that a station he listened to would select songs based on his mood, his thoughts and whatnot. His otherwise benign delusion gave way to a thought that the radio station was actively spying on him so he became obsessed with listening to this station, looking for them to give away some clue that they knew who he was or what he was thinking. He would start to interpret their normal DJ conversations to be references about him and he reasoned that, if they could see what he was thinking, they must be omniscient in some way and he started to interpret "messages" about him, commanding him to do things. As a related delusion, this person had a belief that people were following him around with tape recorders, trying to capture enough samples of his voice so that they could cut the pieces together and form an audio recording of him saying something that he wasn't. He thought someone was trying to call into the radio station as him to alert the radio station that he was aware of their plans for him. I mean, believing this stuff about the world is terrifying but it all stemmed from a belief that something unrelated to him involved him in some way. These delusions don't just "appear", they do follow some order of logic and I suspect that, if your breakfast guest could communicate their inner world enough and had the recognition to unravel what they're experiencing, you would find that this belief that the food is spiked stems from somewhere. As for everyone else in the eating area descending into screaming, crying madness, this is every acute ward I've ever seen It's a scary place because it's really hard, as someone with a severe pathology yourself, to follow why people are reacting the way they are. If someone starts screaming, it's easier to conclude that there must be a threat and scream and cry yourself then it is to try to unravel what's happening. But then again, this is just a guess on my part. I would have needed to be there to form an informed hypothesis
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Jul 6, 2014 11:26
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I think this thread http://forums.somethingawful.com/showthread.php?threadid=3636785 is a really good example of what you are talking about (meth induced psychosis) Completely unrelated, but one of the things that annoys me is a lack of communication between wards due to privacy.. three days ago while out walking i came across a patient hanging out in town. I know the patient has town leave and is quite close to getting out so i thought nothing of it, we chatted briefly and i carried on. This evening i learned he has gone AWOL from his ward and has been missing five days. Its very common for hospital staff to stumble across missing patients all over my city, but its only useful if you happen to know the patient, their case and wither or not they have leave.
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Jul 6, 2014 12:27
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swamp waste posted:Whoa I had no idea. It's interesting and humanizing to get a little insight into the thought process behind a 400 lb man on the bus telling some invisible tormentor that he sucked Batman's dick Yeah, when I was a teenager I remember pissing myself laughing at his music. Now I feel really bad because he was genuinely mentally ill and needed treatment. He died with like 400 bucks in the bank, it's pretty sad.
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Jul 6, 2014 13:51
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Bad Roy posted:I remember speaking to a therapist about hearing voices. He said something along the lines of them being less worrying if sticking your fingers in your ears DIDN'T stop them, as at least that showed your mind was aware the voices were internal. In schizophrenia, the voices seem to come from without and can be 'blocked' with headphones, etc. I work as a "counselor" (and I use that term VERY loosely) at a group home for the mentally ill, and we have a resident, schizophrenic, who walks around a good majority of the day (and night, some of the meds that these people are on play absolute havoc on a normal sleep/wake cycle) with a mp3 player, earbuds in, with the volume so loud that you can pretty much clearly know what he is listening to 2 rooms away. We all theorize that he is doing it to drown out the voices, and to be fair, he has improved since I started working there, when he would be vocalizing the various voices that he hears in his head, but he is GOING to damage his hearing if he keeps this up, and we've told him that, and he keeps going. We're kind of afraid what might happen if he does wind up deafening himself.
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Jul 6, 2014 17:16
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Really interesting thread, OP! On the topic of listening to music to drown out auditory hallucinations, there is research demonstrating that while an auditory hallucination is happening, neural activation occurs in the primary auditory cortex (A1). That is the first part of the grey matter (cortex) to process any auditory signal, which should give you an idea of how "low-level" this is. Basically, auditory hallucinations look the same to the brain as a real sound does. It's quite literally like hearing voices, but the input to the auditory system isn't coming from the outside world. Blasting music over hallucinations may actually be "overwhelming" them on a neural level in some way by hijacking more of the cortex with the large amount stimulation (loud, complex sounds like music, especially with lyrics, since the brain has trouble handling more than one speech stream at a time). I'll see if I can find literature on it--this is pure speculation. (I did find this pilot study, if you're interested, but I'll have to look more to find something more substantive.)
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Jul 7, 2014 02:05
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The Scientist posted:Psychopaths are usually considered to be "untreatable" by medicine. In my own experience, it's considered entirely untreatable by medicine but "Basically untreatable" via therapy, which isn't usually tried because therapy can be a valuable asset for an ASPD person to learn how to manipulate people better. Basically, the theory is 'teaching' proper empathy, etc. to an ASPD individual. I don't know what it's like everywhere though, or even if it's correct in a more general sense. ASPD is basically the explanation for people who are "born evil", as far as I know. Maybe one day it'll be more reliably treatable but as it's like trying to treat a hardcore coke addict or the like. Still happens on occasion, though.
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Jul 7, 2014 08:52
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Anatharon posted:In my own experience, it's considered entirely untreatable by medicine but "Basically untreatable" via therapy, which isn't usually tried because therapy can be a valuable asset for an ASPD person to learn how to manipulate people better. Basically, the theory is 'teaching' proper empathy, etc. to an ASPD individual. I don't know what it's like everywhere though, or even if it's correct in a more general sense. No presentation is "untreatable", entirely or otherwise and you won't find many reputable mental health professionals who would ever argue otherwise. I think what you're trying to capture here is that, for some presentations, the prognosis may not be as good as for other presentations but that's tempered by a host of other factors, some of which are, themselves, amendable to treatment. When you see someone with ASPD, you're usually seeing them only after they've committed their crimes as those sorts of personalities don't usually present themselves for treatment so you don't tend to catch them early in their offence cycle. By then, they've accumulated a whole host of risk factors and trauma and they have therapy needs that extend well beyond "just" their diagnosis of ASPD. I don't think I've heard of any reputable therapy that purports to "teach" empathy to someone with severe deficits in empathy. Of course you need to understand that empathy deficits exists along a spectrum; it's not on or off, some people will have more capacity than others and it's very situational. A person with difficulties in demonstrating empathy for their victims may have very strong relationships with their own children, their family, their dog... it's absurdly reductionist to view ASPD as just a lack of empathy, especially when you consider that a diagnosis of ASPD is generally made behaviourally anyway, after a crime or a pattern of behaviour is committed. The logic is that, if a series of crimes is horrific enough or demonstrates a pattern of behaviour where the personal feelings of others are overlooked, they <must> qualify for a diagnosis of ASPD because someone with empathy wouldn't be capable of the same crimes. That's why, as someone pointed out earlier, more than 30% of inmates in prison qualify for a diagnosis of ASPD; by committing the crimes that have placed them in prison in the first place, they have satisfied most of the diagnostic criteria for ASPD. Only when you can start seeing ASPD as being more of a label for their behaviour rather than an explanation can you start to work with this sort of population. If you see a client for the first time who has attracted a diagnosis, it does communicate some things about them, for example, it communicates that they have <acted> (usually repeatedly) in a manner that violates the rights and norms of others. But so many things can lead someone to acting in this way, empathy deficits for sure but histories of trauma, problems with communication or social skills, external locus of control, explosive temper, etc etc... these things are amendable to treatment and treatment follows a long and complex process of formulation and hypothesis testing. Concerning therapy teaching people how to manipulate better, that is a real problem; generally the prison system isn't that concerned with a prisoner learning how to manipulate people so much as learning how to manipulate health professionals sufficient that they can get extra consideration, be heard by a mental health court, get psychologists to testify on their behalf etc etc. Generally, though, among clients I've worked with at least, therapy is a process that lasts years, not weeks, and in situations where they <are> trying to manipulate, it is a herculean task to maintain the "act" for that length of time. Inevitably, the person I'm speaking to in session after 2 years is a very different person to the person I met mainly because a little manipulation at the beginning is the norm and you just have to work your way through that. In the end, while they may present with complex presentations that have contributed to a pattern of offending, they're still human and generally want the same things as other humans. When they have hope, when they have a plan for how to get their needs met in pro social ways and one day get released and get a job and get a relationship and just have the freedom to grow old quietly, you tend to find that even the most hardened psychopaths can bring to the table enough of themselves that they can show some real change. I saw people both in prison and on release orders and I was lucky enough to manage the transition to the community several people who were branded irredeemable sociopaths. To work with them, you just need to present this work as something that can work for their own benefit, where acting with respect to social norms has more benefit for them than not acting in this way.
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Jul 7, 2014 11:17
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Serrath posted:
OP do you have any experience with firebugs as well? Or people who put cans under their jumper, like muscles?
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Jul 8, 2014 01:33
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Serrath posted:stuff I found it really interesting in the Psychopath Whisperer book (from a few pages ago) how one mental health facility/prison (sorry can't remember exact details) invested great sums of money into rehabilitation & therapy systems for psychopaths, far greater than any other state was bothering to do.... And it really paid off, with re-offending rates far lower than in other states, and so far no murders committed by released clients (unlike other facilities) So although more money was spent by the state initially, it was saved in the long term by not having to further prosecute reoffenders and of course saved all the emotional costs to victims! So yes, there are effective treatment options. It kind of shows that investing in mental health, treatments, and prevention will reap greater benefits than the 'lock up as many people for as long as possible' model that many places (and people) seem to go for.
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Jul 8, 2014 02:37
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katlington posted:Tell us more about firebugs! Are you saying they tend to be more subdued and light fires because they can't act out in other ways because of a sort of shyness? Do they try to sneak things in to burn or start fires when in hospital too? Are they pyromaniacs or is that something else? Are they into little fires as well? Like if patient X was having a tough day, would watching the flame of a lighter calm them down or does it have to be something big to work? Does fite actually calm them at all or does it give them something else? Also finally do they want to burn themselves, other people, buildings or just things? How do they choose targets? Firebugs is one of those things that I tell people I study and people are really really interested but the study of arson comprises my PhD and the topic just bores me to tears. In the spectrum of crime, it tends to be among the least sophisticated crimes committed by some of the least sophisticated people and I can only presume that this is why it's so under-researched compared to other forensic areas. Anyway, the clearance rate (rate of crimes "resolved" as in they know who did it and it was proven in a court of law regardless of the sentence) is less than 15% of suspicious fires in general because it's a very easy crime to get away with so, in the <study> of arson, you're generally only dealing with those criminals who were unable to get away with the crime, leading to maybe a bias on the "more impaired" side of the criminal spectrum. Anyway, firesetting is committed for a whole host of reasons and this is also why it's so hard to study... a person setting fire to a car to conceal evidence after a crime spree is a very different "kind" of criminal than someone setting a fire to their partner's belongings after a bad breakup or someone setting fires because they sincerely like watching fires burn. In general, the most recent models suggest that there are four key risk factors that tend to underlie firesetting offending: communication impairments, impairments in social and emotional regulation, inappropriate interest in fire, and offensive supportive cognitions (the "thoughts" we have that make a crime okay such as "it's not a big deal to do this" or "I'm not hurting anyone"). Not everyone presents with all risk factors; they exist on a spectrum so a firesetter who is a member of a gang and sets fires to rival clubhouses may score highly in offensive supportive cognitions while a firesetter who sets fire to communicate anger and hostility may score higher in emotional and social regulation deficits. Anyway, the above is just a really long way of saying that firesetting spans a whole variety of behaviours committed for a variety of reasons; it's possible to chart these reasons and map them to an aetiological framework for offending but because there is such a wide spectrum, talking about firesetting "in general" doesn't really capture the spectrum of behaviours. Instead, we talk about "a" firesetter, or a "group" of firesetters who share features in common. quote:Are you saying they tend to be more subdued and light fires because they can't act out in other ways because of a sort of shyness? Tons, and this feeds into what I said above about communication deficits and emotional regulation issues being paramount for a lot of firesetters. It's a bit more complex then this but the simple version is that a childhood of neglect or abuse, where a child may learn that their needs cannot be met using normal methods of communication may turn to fire as a way to act out. It's power fulfilment; in a situation where someone feels dis-empowered, something as vibrant and dramatic as fire becomes a method to send an authoritative message and, in a situation where deficits in normal communication persist into adulthood, it becomes the <only> way some people have to communicate aggression, hostility, or even anguish. I'm reminded of one female I talked to; in an abusive home where her needs were continuously unmet by her parents, she accidentally lit a fire at the age of 16 by hiding her smoking. When the fire caught, she alerts authorities and was praised by the firemen for her quick thinking in the situation and this, sadly, was one of her first experiences of real social recognition or acknowledgement. As an adult, she progressed into a pattern of behaviour where she would set secretive fires and then alert authorities which became a real problem in the assisted living facility she lived in. She lit these fires when she had emotional needs, when she was upset or depressed and the response tended to calm her down... In her case it wasn't shyness, it was an entrenched belief that persisted in childhood that, unless she acted out in a way that was dramatic and consummate to her often raging emotions, she wouldn't have her needs met. quote:Do they try to sneak things in to burn or start fires when in hospital too? Yes, but I don't end up seeing them. I should clarify, my work was mainly in the prisons; my research is concerned with developing a treatment plan to address firesetting that can be administered in prison so I speak to prison based offenders and psychiatrically disturbed offenders end up being processed through the mental health court and don't end up in my therapy room. But yes, there is a subset of firesetters who either set fires for that emotional release (see above) or because they have a sincere interest in fires. interestingly, serial firesetters tend to be of the latter, fire-interested category and, in spite of having multiple offences, their fires tend to be the least destructive. For them, the fire isn't instrumental for some other goal (getting revenge, destroying something), fire itself is the goal so the fires tend to be small, out of the way, and outdoors. the difficulty is that I live in Australia where bushfires are a real problem; most of my funding comes from a commonwealth supported fund set up after the Victorian black saturday bushfire disasters of which as much as 60% of the fires were deliberately lit. They caught one guy who fits the profile of fire interest who was lighting pieces of paper and throwing them out his car window, not because he wanted to set a big massive fire but because he was just interested in fire and didn't have the cognitive capacity to really think through his actions from lighting the paper to the fire danger present. The fires he set were individually responsible for (I think) 16 deaths and he was done up for homicide. If your followup question is how an interest in fire itself can develop, there's a complex framework underlying it which I can talk for hours on but summarized, we (as human beings) have a custodial relationship with fire, fire is something that most people enjoy, we have fireplaces, outdoor campfires, we watch fireworks and fire has been instrumental to our survival since we crawled out of caves. There is a subset of people who take what amounts to a normal human fascination with fire to an extreme. Add to this an attraction to what we call the "trappings" of fire; the bright lights of the firetrucks, the excitement as people clear their houses to watch them put it out, the noise and the lights and whatnot... some people are attracted to the sensory stimulation of both the fire and the aftermath of fire and will set fires to satiate that need. quote:Like if patient X was having a tough day, would watching the flame of a lighter calm them down or does it have to be something big to work? Does fite actually calm them at all or does it give them something else? It depends what need the fire serves for them but yes, for a lot of offenders fire becomes a means to calm down. It can represent a focus or something to relax to and if that sounds weird, consider how relaxing a normal fire is in a fireplace at the end of a long hard day. Now just take that normal human experience, exaggerate it and you're one step closer to understanding how some firesetters can use fire for normal emotional regulation  quote:How do they choose targets? Not to sound simplistic but targets are chosen based on the purpose of the fire. Someone using fire for revenge will pick targets of emotional significance to them or targets which can send a message. I talked to one guy who set a dog carrier carrying his wife's dog on fire; his design was to hurt her and she loved that dog (the dog was okay, don't worry!) Compulsive firesetters or ones setting fires to help regulate their emotions tend to drift toward targets of opportunity... bushes which may lie in their path on the way home, an empty warehouse next to their work etc. Actual damage related to these fires tends to be a function more of placement of the fire rather than any real intent on the part of the offender. quote:So yes, there are effective treatment options. It kind of shows that investing in mental health, treatments, and prevention will reap greater benefits than the 'lock up as many people for as long as possible' model that many places (and people) seem to go for. Couldn't agree with this more. I have never had one of my "intensive" offenders (sessions 1 or more times per week over years) recommit a crime and these are some of the "worst" offenders within the prison system. Dangerous sex offender legislation in Australia refers to extra safeguards placed around sexual offenders who have completed their sentence but are deemed to be such a risk to the community that extra precautions must be placed around them. Part of these precautions is mandated intensive therapy and, among DSOs who have been released in my state, not a single one has gone on to commit a further sexual offence. And this is in spite of the fact that these offenders represent the aggregate of all offenders who are classified in the worst category of reoffence risk.
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Jul 8, 2014 05:32
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Hi, I've been in and out of mental hospitals for most of my adolescence.(I'm 20 now) I've only been in low security wards and mostly for ED, but also for severe anxiety. So I've got some experience from the patient end of the American mental health system. Also had to ask, have you been in low security wards and have you dealt with ED patients?
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Jul 8, 2014 07:53
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freypies posted:Hi, I've been in and out of mental hospitals for most of my adolescence.(I'm 20 now) How did you find being around other patients? Did they lump you in with unpredictable or aggressive people? Were you ever worried for your safety?
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Jul 8, 2014 23:19
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More stories about Dave.
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Jul 9, 2014 08:51
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Hoplosternum posted:How did you find being around other patients? Did they lump you in with unpredictable or aggressive people? Were you ever worried for your safety? I spent most of my time in the open wards as they are called. When I was around other teenagers I was mostly around ED patients, and they were all pretty chill. When I went in as an adult though we had an incident with one dude who had at least two nurses near him at all times and he wasn't supposed to interact with the other patients. It turned out though that he just had an ace bandage and they were worried someone was going to take it and like try to suffocate themselves or something. Also in the adult ward you tend to be in with people that are much older than I am and that was a little strange. When they tried to put me in groups with people my own age it was mostly addicts so there were some interesting experiences there. Like we had a kid who was severely OCD but was coming off meth, which just blew my mind because I would have thought that would be the last drug you'd want to be on with that disorder. A bunch of things like that, people getting into drugs that just did not jive well with their disorders. I'm trying to think of other things, and I'm sorry if this isn't terribly coherent.
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Jul 9, 2014 21:13
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