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wow room #2

Thanks Lynne!
Man your fingers are getting a work out typing tonight! :-)

thank you for the gallerys on met state its my favriot kirkbride building ever it warms my heart and soul (like campells chicken noddle soup)

Surely, Shirley. ;-)

I personally feel a good therapist should have enough empathy to be able to get at least a faint sensation of what their people are going through to be any good at what they do. That way they can answer the questions that the person may be unable to articulate. The majority of folks I currently work with are nonverbal. so you REALLY have to try to figure out what they are doing, thinking, and feeling so you can best assist them in increasing their independence.

A lot of other therapists (probably ones who are much better than I am, to be honest) believe that you need to build up a pretty stiff wall between yourself and the people you see. That is the case for many patient populations, but that's why I love working with folks with intellectual disabilities. I don't have to be all formal and business-like and fake - I can be myself and they can be themselves and we all slob around and get dirty together, but we have a good time. We are on each others' level and it's a lot more truthful. They don't like something you did, they hit you in the face. Lesson quickly learned - don't do it that way next time. They do something you think is fantastic, you give them plenty of attention and reinforcement and pretty soon you'll each be members of the others' "biggest fan" club.

Best job in the world, and they actually pay me money to do it! :-)

i love this photo to my grave

lynne you keep educating me, and for this i say thank you..

The majority of cases of schizophrenia are first seen when people are teenagers/young adults. It is very rare that someone exhibits any signs of schizophrenia in middle age or later if they haven't already done so when younger. If someone starts to look "psychotic" anywhere after 30 or so and with NO history of psychosis, you have to rule out other factors, like brain trauma, medication, tumor, alcoholism, electrolyte imbalance, etc.

But again, the pattern of signs and symptoms of schizophrenia are fairly consistent, and even if someone faked it as a younger person, a good clinician should be able to tease it out, especially if there were good reasons why the person would have wanted to malinger.

As far as being unnerved, I'll have to think about it. I've done this so long and seen so many things that I can't think of any specific time I was particularly unnerved, but that may be due to the fact that after all this time the events seem natural, like having lived through a natural disaster makes you forget that rough times aren't necessarily part and parcel of everyone else's world.

yes sure tourture sessions

lynne, you truley know.... to understand dont you have to emphasise....

That ceiling fan looks sad and lonely :-(

Thanks Lynne,
Thanks for your reply, I'm siting here reading all your comments, they are really fascinating. I love how you described how to handle people with loss of reality control. Like starting with the day and stuff, I'm getting really into learning about all this! :-)
Your job sounds hard but you seem to love it. I think passion has a lot to do with how good you are at your work.
My uncle claimed that the younger someone is when they pull an insanity stunt the better it works, I suppose that does make sense since if something is wrong with the brain it would show up young.
Has a patient ever managed to do something so disturbing that deep down you were a bit unnerved?
Sorry for all the questions but I find it so fasniating to hear the opinions of those who work with and care for the mentally ill.
Sorry about my spelling. :)

Dang, surly girl, do you know me or what? :-)

However, it IS true that we are always "madder" than the people with whom we work. :-)

Sorry - surveyors are in town and we've been working early and staying late last week and this.

It's possible, but it's difficult. There are a lot of tests that are specifically designed to detect "malingering," as it is called. There are a lot of things you do naturally if you have depression, bipolar disorder, schizophrenia, etc., many of them involuntary, and there needs to be a consistent pattern before someone gets the diagnosis. A good mental health expert should be able to detect the fakes most of the time. However, I am sure there are a handful of people out there who have gotten away with it, probably under the circumstances in which the person is exceptionally good at faking PLUS the mental "expert" isn't that good.

If you have lots of time to observe someone (months) it would be very, very, very difficult for someone with any skills NOT to figure it out. Ironically, with the way insurance is going these days they try to make you prove 1,000 times over the person has a true problem or they won't pay you and/or the courts won't allow the person to remain in a mental health facility.