I might be dead.

[Snow White.]

Katie given you understand it a bit more than I am really interested in to what you think *would* be helpful for Carmen, if not the logic discussion.

I think Kims post, her final paragraph, is particularly important about needing help and needing someone who knows how to work with this type of thing to help you. Yes that might mean getting out of your comfort zone and talking about things you feel you can't for a bit.

Thinking of you.

[when.will.it.end]

I think maybe looking at the time this started and figuring out why & then grounding in the here and now and focusing on your senses. Sorry should have suggested this before!

Do you know when this started and what is triggering it now?

[Auror.]

thanks guys. it seems best if i just keep to myself.

[Snow White.]

I don't think that is what is best at all, things seem very difficult for you right now, to me it seems you need to be reaching out to people so you're not facing this alone.

[Auror.]

ahahaha

I got a certified letter (meaning I had to go to the post office and sign for it) from doctor lady saying I was being dismissed from their services and no longer able to use the clinic.

figured fuck it, they can't do anything to me at this point. so went in and demanded to see her for an explanation. was told i cussed out the reception staff- i did not. they tried to have me see a nurse and i replied, "I don't need to see a fucking nurse, I need to see doctor lady. She wrote the letter so would be the one who needs to explain. That's why I asked to see her directly." that is not cussing anyone out. it is using said language in general conversation. idiots.

saw doctor lady and got a bit of an explanation. still angry. she never responded to my last email even though she says she did. i am tempted to send it to her as proof. and then said she was surprised that i was surprised by the letter and that she was sorry i felt it was a shitty thing to do.

pretty much as expected but at least i told them it was a shitty way to handle the situation. feel bad for making her next person have to start their appointment late but i did tell her to apologise to them for me. i would have waited but they did not tell me to wait they told me to go back so.

it's super fun to be called high risk and be told that you engage in behaviours that are highly lethal and blah blah blah.

fuck all of this.

[Auror.]

oh and i told her it all felt like blackmail. her response was no it feels like help. no. no it feels like blackmail. that is completely different and makes zero sense and again pointed out that it was ridiculous to expect me to be there when i could not handle the financial burden of it as i had said multiple times before. she pointed out i did not used to have an issue with it and i told her that was true because i was working and now i am not - did not mention the new job because the amount of money i make now does not even cover my bills and my old job i had extra money left over each month.

i'm just pissed off.

[Morpheus]

I am not sure i understand. You didnt want to see her because you couldnt pay and couldnt show up regularly. You are discharged. Then you go in to complain about that when you know you cant see her for reasons you have given yourself because discharging you is a shitty things to do. But you said yourself you couldnt go and pay. You have also made clear you couldnt talk and do the therapy required. You turned away the offer for whatever reasons you may have, yet you complain when discharged. You have also complained about her repeatedly.

Its ridiculous to expect you to be there you say but discharging you is a shitty thing to do that made you very angry and cross. Im sorry to say im confused of what you actually want.

Can you not see how contradicting this behavior is?

[Auror.]

I am complaining about how they handled it because I thought it was handled poorly. Does that make it more clear?

[Auror.]

Also I had stated multiple times for months that it was an issue financially and I also think discharging someone for not being able to afford regular sessions is shitty. Hence why I wanted an explanation of why it was done. My complaint was that I did not appreciate how it was done and I was not given an explanation in the letter. That was why I went in. Lets attack me though fine.

[Dash]

I've just read this thread and it sounds like things are confusing and distressing for you.

I'm wondering, what would being dead mean to you?

I'm also wondering, how would you have hoped the situation with therapy had been handled?

[Auror.]

Being discharged is whatever. But I was told I would have the option to think about it if I got a letter, because the letter would be a warning. Not just being done. Doctor lady also did not respond to my email where I asked a legit question about my notes and she says she did respond. Hence my saying that it was not handled correctly. Either I was misinformed or misunderstood and sending someone a letter with no explanation IS shitty. I think the situation could have been handled better and I don't see how that is not a valid complaint.

[Auror.]

At least if I am already dead or were dead people would be safe and none of this would be actually happening. But it seems like I can't explain things clearly because it feels like everyone just wants to attack me. I'm not denying responsibility. I'm saying that if something isn't handled right it doesn't automatically make it my fault just because I'm mental.

[Dash]

I just asked two questions because I wanted to understand better. There was no attack, nor was there an implied attack or any language associated with that. I'm unclear why you felt those questions were an attack, especially when I empathised with how confusing and distressing things sounded. However, I do not wish to aggravate things further for you, and will respectfully step back from the thread. I hope you can find things become more tolerable for you soon. Take care.

[Snow White.]

I'm really sorry you felt it wasn't handled properly and it has caused you so much upset. It sounds like a rough day. I know maybe it's hard when you're feeling like this but I don't think people are attacking you, just trying to understand.

How are you feeling now?

[Auror.]

Sorry Dash, it wasn't directed towards your comments but more my frustration with comments from other people. I apologise, I was again unclear.

Thanks Aimee. Still angry. Trying not to do anything because I don't want anyone to say well you did this because of that when it would be untrue but i really don't even care. I just want people to understand but I seem really bad at explaining.

[sherlock holmes]

I'm sorry you feel attacked Carmen. That's not anyone's intention here. It's difficult to know how to support you in feeling like you're dead because when we try to use logic it feels to you like we think you're lying.

Are there any other ways of getting therapy where you live for free or a very cheap price? I'm afraid I have no idea if that's possible etc as I'm from England.

[Auror.]

I just got a super long official sounding email from doctor lady that I don't even completely understand. I guess they are looking at funding options and seeing if my Medicaid would cover part of the fee so I may or may not be discharged? I am unsure. I don't even know if I would want to go back there at this point. Is that unreasonable?

She sent me a list of three places that do low cost but one I was told not to come back and the others are pretty far away and focus primarily on helping people with issues like drug addiction and homelessness. They don't really know a lot about much else and I will be the first to admit I am not easy to deal with. I am not saying those are not important issues or that people should not get help because they definitely should be helped, but it means the services they offer don't really apply to me if that makes sense.

[Snow White.]

That does make sense, and I understand why you'd be hesitant in going back and working with doctor lady. Because of your feelings of anger about how many things have been handled, (not judging it I'm just saying you've been angry with her) it would take a massive leap of trust to be able to work with her again and I'm not sure what would have to happen from your end for that trust to come back?? Might be worth thinking about it.

The fact she is looking into options for you to go back to her, alongside other options, is a sign of dedication on her part.

[Auror.]

I never trusted her in the first place. So. :P I mean I do not have anything against her as a person if that makes sense.

She said I could ask if I do not understand things but it seems pointless if I can't afford to be there anyways. She said my medicaid won't cover sessions so they would have to look into other funding options and she is unsure how long it will take. Plus all the things in the email seem to be things that I would have to do and none of them are things she would have to do and that seems not okay to me even from what I can understand of it. She said everyone has these same things but they seem rather strict and I cannot believe it applies to everyone.

I just don't understand why they want me to make a decision now. I'd rather have a few months to cool down and think about it but that doesn't seem to be an option.

At the same time I doubt things would be any better with another place or therapist or whatever because I don't trust doctors or mental health people or anyone really for that matter so I feel like I'd just run into the same issues.

I don't know. I've spent the past few days in bed and not gone to classes so things are not great. I just don't want people to think that situation is why I've done something.

[Auror.]

This was the email and I still don't see how it makes any sense. But there does not seem to be a point in asking if I am not going back.

The following content has been hidden - Reason : long. email from doctor lady.

As a follow up to our conversation yesterday, I have contacted the clinic administration to find out if there are resources available to provide financial support to students who cannot afford their copays. I found that we do have a student support fund, and we are identifying how to access that fund. The timeline for figuring that out is unclear, but we are actively working on it.

As the result of a recent change, we are also now a medicaid provider, so I have asked my clinic manager to help me identify what kind of medicaid plan you have and what, if any, out of pocket cost you might have if you used your medicaid benefits in our clinic. I don't have access to the part of our charting system that captures that information, which is why I have to have someone else look into it.

I just wanted to let you know that I am actively following up on your concern that finances would prevent you from meeting as frequently as is necessary for us to work together. I communicated to my clinic leadership that I continue to be willing to work with you in our clinic if finances are truly the only barrier to your participation in treatment. I will continue to follow up with you as I gather more information about how we might be able to work with the financial issue.

That being said, if we do agree to continue working together, we would have to be very clear about the terms and conditions of that work. Those conditions would be as follows:
1) Attend regularly scheduled appointments no less frequently than every other week, with the exception of the typical circumstances that may modify that schedule (emergencies, clinician out of office, client out of town, etc). If a longer or shorter time between appointments is agreed upon, it will not be considered a violation of this condition.
2) Agreement to prioritize personal safety and reduction of self-harm as an active treatment goal. This would involve active discussion about self-harm behaviors and patterns.
3) This will be your final chance to appropriately engage with treatment in this clinic. You will not be held to unreasonably high standards for improvement or engagement with treatment. However, you will have to show good faith efforts to engage in treatment according to these conditions.
4) If you do not comply with treatment recommendations to a reasonable degree (i.e. No attempt to engage in recommended interventions outside of session, no progress toward goals, frequently missing appointments), treatment can be ethically terminated and you will be discharged from care at this clinic.
5) If you prematurely, non-mutually terminate treatment on your own, she will be discharged from care at this clinic. This means that if you leave treatment by cancelling and declining to reschedule appointments, or otherwise ending your treatment without us agreeing to the end of your treatment, you will not be permitted to return to our care in this clinic. You have the right to decline further services. However,

If you disagree with these conditions or feel you cannot commit to the conditions as listed, we will not be able to continue our work together even if the financial situation is worked out. I would like you to know that all patients are held to the standards of complying with treatment and making progress toward goals. I am not expecting anything from you that I don't also expect from my other patients.

I will continue to follow up with you about the financial end of things as I get more information.

I replied to that email saying I read it but did not totally understand and got this response:

The following content has been hidden - Reason : second email. long.

Thank you for your response. I did get some additional information about your medicaid coverage. It seems it only covers prescriptions, so we would not be able to use that to reduce or eliminate your copays.

We are still working to identify how we might use the clinic's student support fund to pay for your co-pays.

I realize I have an incomplete sentence in Item #5. It meant to state: You have the right to decline further services. However, doing so against the advice of your provider will constitute treatment non-compliance and will result in dismissal from the clinic.

If you have specific questions about the conditions of treatment, please let me know. I understand that your return to treatment is dependent on reduced financial burden. It is also dependent on you being able to agree and participate in treatment, according to the 5 conditions contained in my previous e-mail.