Has Anyone Had An Assessment With A Forensic Psychiatrist?

[p-no]

I can really only do it on paper or to some degree over the phone. Once face to face with anyone who wants to poke into me I fold up and collapse. It starts in the waiting room where I am trapped and exposed, with all those competent people walking past me and the risk of encountering former colleagues who will see my abject failure.

By the time I've got into the room I can't think properly, can speak very little and I'm sure I don't really hear what they are saying. If I do manage to get it together, I end up in formal work mode and act/speak as if I'm in a meeting.

@stenni

Just an idea: Can you *now* (i.e. today, tomorrow, the day after...) write out a letter to those people that will be there later at the appointment and start off with what you wrote in the post I have quoted above?

Explain yourself, stenni. If it takes three pages, let it be three pages. Those people you can't talk to are not here now. But you can write to them now and later take that "letter" with you to the appointment. If you explain to people in the letter, in writing, in your own words, someone, whoever, can read it out to them on your behalf.

And if you explain what you have said in your post above, people will understand. Some here said it: you're not the only one shutting down/folding up and collapsing in such a difficult situation, so "experts" (i.e. the forensic psych etc.) will understand.

And they may well see this as a genuine sign of you trying to reach out and make yourself heard even without speaking any words.

Best wishes.

 

[KwanYingirl]

I had a forensic psych evaluation done when I applied for disability due to a chemical exposure I had at work. I lost my worker's comp case because the board of Labor decided that I was just crazy because I had a history of trauma. This in spite of an OSHA report condeming the hospital for the vast contamination of toxic chemicals in my workspace.

The report also documented the lung and brain damage this particular mix of chemicals causes. But, because I had a trauma history, they crapped out. This of course exacerbated my PTSD. Anyway, the exam was done in an office building that had very strong fumes from carpeting and I just got so sick from being in there, all I could do was cry during the interview. I was also trembling.

He was a compassionate person, and completed the interview in a short amount of time and before I knew it, my disability claim was approved. I have never been told if I was deemed disabled due to chemical brain damage or depression, but when they do a review, I always continue with my benefits.

I think it was my depression and PTSD symptoms. I've been diagnosed with Borderline Personality. I've read about it, and can identify with some, but not all, of the criteria. My therapist has a chart that has all the symptoms of trauma and how it overlaps with other disorders.

He's not that interested in labeling me. My biggest block with therapy is my avoidant coping style.

 

[Sandstone]

My plan for Friday currently is to take my panda with me as he's my best source of security and comfort. I've spoken to the newest Psych on the phone and told him I need to be able to see the door, that I struggle with being exposed in the waiting room, that the meeting room we are using used to be part the office I worked in so I can only see my failure when I'm in there. I also asked if the door could be left open, but once he'd realised I wasn't speaking figuratively, he said no because of confidentiality. I said I was more worried about the risk of ending up with the wrong label and treatment because I couldn't communicate then the chance of someone I don't now hearing a little bit of my business, but he didn't like the idea. I shall try for ajar.

I also plan to ask if we can wait outside, so the trapped thing doesn't have 15 minutes to build up in advance. I've asked my husband to get some marshmallows, my best portable comfort food. I've packed a hanky, so I know there's a backstop if I get emotional, and I plan to put Frankincense and Bergamot oils on it. ( Supposed to be for fear, panic and stress, and for anxiety, withdrawal of emotions and stress respectively)

Knowing that once pressure hits I won't be able to ask for what I need, I've written four flashcards, saying
"Can we take a break?"
"Please stop, I'm going to cry"
"Can I eat a marshmallow? Would you like one?"
"I need to get out now"

They seemed like a good idea,but now I have doubts. I'm afraid they will look self-indulgent and dramatising and make them angry with me.

 

[p-no]

stenni, I am really happy you have come up with some things that can help you through it. That is self-care in action! :)

Please don't settle for "ajar". Settle for: "door open". Let him be the one suggesting "ajar" if he does not hear your need for the door OPEN. My worry is that if you now opt for "ajar" they will not think you really truly meant that you really truly desperately need that door OPEN. If you need that door open, say so again. My therapist says to stick with saying what I really truly desperately need... so that the other person really truly gets that I'm serious.

I have a suggestion for you re the flash cards. Write on each of them, before the actual question or remark, why you are pulling out a card and why you do not speak. I could imagine a card reading this:

"I am very anxious now. When I am very anxious, I lose my ability to speak. This is why I am using this card right now. Can we take a break?"

All I wrote are things I noticed and ideas that could help you -- or not. Maybe you could talk to someone about them and see what they think (for example your husband or daughter)?

Good luck.

 

[KwanYingirl]

I think BPD will eventually phased out of the medical jargon. The more they learn what PTSD does to the brain I think it will be more encompassing. I was very anxious about my forensic evaluation but the psychiatrist was very kind and appropriate. I wish that I was as creative as you in expressing my needs. Good job!!!!

I'm in the US so I can't speak for the systems in place where you live. A lot of doctors do forensic work on the side. In my case the insurance companies 'experts' totally lied about my medical diagnosis and I never allowed him to examine me without a nurse in the room and I wanted it taped.

He refused so all he testified about was trauma this and trauma that. What an ass he was. My disability claim was handled by the Social Security Administration. It took two years and I was desperate to get some financial aid. They were very nice to me. So, point is, in America if it's an insurance case you get screwed. If it is Social Security they rely on your providers. Take whatever you can think of for comfort.

What do you think about audio taping it so you can process it later with your support system? My anxiety sure makes it hard to remember details. Or perhaps someone could take notes for you. Good luck!! I'll be sending positive thoughts in your direction.

 

[Laura 2]

@p-no - great suggestions on stenni's great self-care strategies.

I can see myself finding them all useful. Thank you both.

 

[Laura 2]

I think BPD will eventually phased out of the medical jargon.

So, point is, in America if it's an insurance case you get screwed. If it is Social Security they rely on your providers. Take whatever you can think of for comfort.

What do you think about audio taping it so you can process it later with your support system? My anxiety sure makes it hard to remember details.

I agree with all your comments in that post - spot on.

Don't know anything much about BPD but it just sounds to me like one of those cop-out dxes that doctors whip out when they can't think of anything else.

I'm sorry you got screwed, really I am. Makes you thoroughly understand how corrupt the system is, doesn't it? In my case, I got screwed by a doctor giving false/untrue evidence and an 'independent' expert witness who was just so far hooked into the system (hey, who pays her the most?!) but it was the INSURANCE lawyer (i.e. the defendant's lawyer!) who was completely on my side as soon as he'd seen/heard all the evidence!

I mention the 'heard' bit as it is entirely relevant to your last point about audio recording. That was what clinched my success in litigation, even though the recordings had been accidental.

I've said this before on this forum, I always voice record meetings/appts with such as therapists and all doctors etc.

Call me paranoid but:
a) not all professionals are professional and actually frequently demolish boundaries they should be upholding.
b) A voice record (or its transcript) is the ONLY way you can both protect yourself and prove any subsequent allegation of malfeasance.
c) I too have a poor working memory, can get easily sidetracked and/or triggered and can get lost after only a few minutes of an important conversation. It is extremely helpful to be able to listen back to the verbatim later.

It's a fine line whether or not you tell them you're recording the meeting and seek their permission. Certainly in British jurisdictions it is not unlawful to secretly record conversations, in which case the recordings are accepted into evidence as 'hearsay evidence' rather than the slightly stronger (in this instance) material evidence.

 

[Ladyghosthunter]

I took a forensic psychology class in college and it was like digging into a grave just to see what the body looked like decomposed. When taking such a class, it will hit nerves like it did me. It talked about things that just struck my own psyche ....

 

[Sandstone]

Not Borderline. After a week of chasing the psychologist rang back this morning. Initially she said she couldn't tell me anything, as they wanted to feed back to me properly at an appointment to be made some time in the future.

I said that indicated they'd decided I was Borderline, as they knew how anxious I was about it and if they could have put my mind at rest they would. She said that was an unfounded formulation, but went on to say that I hadn't scored the 5 of 8 traits needed to diagnose Borderline. In fact there was only one trait where I showed any indication of meeting the criteria, and that not fully. The reports they had taken from my husband and daughter confirmed these findings. Huge relief is in order, and if I wasn't currently in a state of panic and terror over something else I'd probably be celebrating.

 

[Laura 2]

@stenni - I've been thinking about you a lot and really hoping that things went well.
Good to hear that the worrisome BPD thing is out of the way - yes, a great weight of your mind there. (Plus, like e.g. autism, everyone has some sort of trait in the list!) I hope they really got the depth and breadth of your anguish and were compassionate.

I'm so sorry to hear that you're in a terror sweat about something else. (Not connected I trust.) It really does seem that once you're in the pit, more and more crappy things come at you relentlessly... Is there no wiggle room at all for a couple of hours' of sheer pheeeeeewww!! with only a smile on your face and an unwrinkled brow?

 

[Sandstone]

So I ran away. Even with my panda, my husaband, all the other stuff I'd put in place I was still too much of a coward and I ran. Couldn't deal with it being 9am at my former place of work so everyone was driving by or not yet settled to work and seeing me outside their windows.

Couldn't deal with the fear. He'd say why did you do it I 'd say I don't know and we'd move on to the punishment. Even it was just community service I wouldn't be able to deal with other people and I can't always manage to go out so I'd miss sessions and get into more trouble. I kept saying before that I couldn't do the appt. and no-one believed me even when it was 27 degrees and I was shivering and my teeth chattering. I knew I couldn't I said I wanted to walk away from the whole thing and no-one believed it and now I have so I'll be dealing with it all alone from now on.

 

[Laura 2]

@stenni - Oh, I so know that 'can't deal with the fear'....when you can't, you just can't and no one seems to understand, oh poor you...

Most important - are you safe, somewhere safe you can relax a little?