Patient Name: ____________________________________________ Surgery Date: ____________________________________________ Operative Procedure: ______________________________________ ICD 9 Diagnostic Code: ____________________________________ Medical Clearance? No Yes, with __________________ PRE SURGICAL TESTING: MUST BE COMPLETED a minimum of 7-10 days before scheduled surgery
Microsoft word - veterans article for off our backsVeterans in an Unnamed War:
Hidden Abuse, Truth-telling, Resistance and Recovery
Laura Prescott is the president and founder of Sister Witness International Inc, a new organizationof formerly institutionalized women, girls, and their allies. She is also a recovering addict,psychiatric ex-patient, and survivor of childhood abuse. The following article is an edited version ofa keynote address given at the 2nd annual convention of the International Society of PsychiatricMental Health Nurses in Miami, Florida, on April 28, 2000. I frequently refer to survivors as “veterans in the unnamed war.” The reason I use this term is to drop the veil of semantic closure surrounding the naming of childhood abuse and adultrevictimization. Calling survivors veterans places the experiences of millions of women, children,and men in an established context, making their experiences real, immediate, relevant, andpowerful. I don’t think it’s a coincidence that many of my comrades who survived abuse andpoverty are locked inside psychiatric institutions.
It was here, behind the barred windows, that I heard the most moving stories of death as well as hope for life. Here I first saw the reflection of myself in others: alive, struggling for wholenessamidst the chaos and confusion. The women and men whom the world rendered “ill” spoke throughThorazine, Mellaril, Ativan, and Haldol, slurring and drooling as they talked. They were, and are,daring and brave, shaking not from fear but from the unameliorated side effects of medication andstaring with the unmistakable intensity of truth that pierces my chest. We talked about our lives inhushed tones, afraid we would be told to “be quiet,” “go to our rooms,” “focus on the positive,”“take our medications” and “stop triggering one another.” Against all odds we told our stories of war. Stories of what it was like to be battered, bruised, maimed, raped, sodomized, sexually and physically brutalized by someone we knew, someone welove or loved. We told the stories quietly, some of us holding our breath while swallowinghumiliation, shame, and rage. We whispered instead of shouting in loud, angry tones. And some ofus who were too tired to communicate were simply mute. Their muteness came out of long historiesof being contained, restrained, constricted, restricted, blamed, and shamed into silence.
Giving Pain a Voice: Self-Mutilation
I was in elementary school when my grandfather introduced me to wine. It was a nightly ritual after dinner and before bed. After the dishes were done and my grandmother retired, he reached forhis stash, kept like still glass soldiers under the counter. His broad muscular arms with thepermanent farmer’s tan soon surrounded my body. He was sloppy and crude. I had stoppedprotesting a long time ago, the words “no” and “please don’t” mocking me with theirridiculousness. The price for those words was high. My resistance made this ritual more intriguingto him. And instead of warding him off, he clamped down tighter on my body already suffocatingfrom lack of air. Survival in these circumstances required that I contain my feelings and thoughts,push them so far down and away that even I was at a loss to explain them. They disappeared intosome remote recess, a faraway pool where time stood still without reflection.
It was in this world of familial denial and destruction that I learned the language of secrecy, shame, silence, and self-mutilation. When I could no longer stand to utter one more word in theworld, I began to cut myself. Sometime around the age of 11 it occurred to me that it just didn’tmake sense to talk anymore. So cutting was my way of screaming, of validating the pain ofexperiences that couldn’t be articulated. It was the only way I knew to rage against the threat ofannihilation and to name that which was unnamable. It was a way to tell a story about deep Veterans in an Unnamed War:
Hidden Abuse, Truth-telling, Resistance and Recovery
emotional and spiritual crisis in a family that insisted on keeping its secrets. I raged against theviolations for which there were no words, for which there were no emotions and no witnesses.
We Are Everywhere
As I walk through psychiatric institutions and jails today in the United States and overseas, I am reminded of how childhood physical and sexual abuse murders hope, how it chokes innocence untilit suffocates and gives way to despair. I am reminded of how the truth of those experiences arecarved into women’s bodies as wide-open mouthed screams with no sound—as wordless witness tolives unseen. I hear the echoes as women bang their heads until they pass out so they won’tremember, because they can’t forget. I am reminded of how they burn their flesh so it’s unattractive,how they binge and purge because they literally can’t take any more into their bodies.
itself, the battleground from which so many of us fled, is curiously, rarely mentioned as a reason forour behaviors and feelings. The war inside our homes, in which the majority of sexual abusehappens, is not viewed as pathological or sick. Those labels are applied only to the captives. So50% to 70% of the women in our psychiatric system today are survivors of this war for which thereis no name. Once someone bearing witness is labeled, her story becomes questionable. Weunwittingly undermine the evidence in front of use. I believe this is the beginning of how weobscure the evidence of child sexual abuse in this country. We make it unknowable bysystematically labeling those who live to tell the secret. In the mental health system, we are labeledclients, consumers, and patients. We are called schizophrenic, psychotic, personality disordered, andborderline. We are medicated with psychotropics so that our fears are not so “intrusive,”“pervasive,” “all consuming,” so we are “less needy,” “compulsive,” and “obsessive.” Untileventually we don’t act at all. In fact, we stop speaking about those terrible events with no name,and everyone is much happier because, after all, it is too much to bear. And so the war continuesunabated while those who have born witness to it are locked up and “treated” for a condition thatremains intact.
When I came into the psychiatric system 16 years ago, I was homeless and hearing voices. I needed a place to fit, to articulate the truth of my life and stop hiding. I needed a way to reconnectthe pieces of my past that had been torn apart. What I found was that my rage was medicated andmy flashbacks were relabeled “delusional.” Through the drugged haze, I listened to others tell thesame story I knew to be my own, each piece becoming a wider web of the truth that was obfuscatedas we each increasingly lived up to the labels we were given. The routine in these systems left a trailof terror behind, as we were often thrown to the ground during dissociative episodes in ways thatmirrored the violence of our past.
I asked for help creating a proactive program to assist me with my anger prior to onset of difficult times. I was told there was no place for my anger on inpatient units, that it would be tooupsetting for the milieu. If I was too overwhelmed, I should take a pill to calm me down, to de-escalate, to mask the symptoms rather than to heal the tragic gaping wounds. The concern for themilieu didn’t stop people from publicly rushing me in the hallways while huge men, staff, andsecurity guards bore down on top of my body and people looked on terrified and mute. It didn’t stopthem from injecting my body with drugs until my protestations became small, gulping whispers thatwafted down the corridor late at night.
Veterans in an Unnamed War:
Hidden Abuse, Truth-telling, Resistance and Recovery
A Final Shattering
One evening, in a local psychiatric hospital, I began pacing in my room, my heart slamming against my chest and the raw fury of being locked up clawing at my mind, tugging me in differentdirections. My mind was racing, the thoughts crowding each other out, the voices crashing into oneanother. I lay down on the bed, a thin mattress covered by state white sheets, and whispered abovethe din. “Help me, God help me.” I twisted the sheets under my chin and felt as though I wouldsuffocate from the pain. I couldn’t hang on, couldn’t find a place where the world wasn’t spinningon some crazy axis, couldn’t push the ache of old violation back down fast enough.
Then came the blackness, followed by a numbing calm, a floating distance, and time standing still. When I awoke, the bathroom walls were covered in blood, streaking in weird patterns I didn’tunderstand. I opened my eyes wider . . . glass, there was glass. . . shattered like my memory, shaved shards of myself sprinkled on the tile. The door flew openand people seemed to pile into the tiny space, taking up all the air, pushing and puling. “Don’t touchme,” I yelled into the oblivion. “No.” “Get away.” “Leave me alone.” “She’s doing this forattention,” I heard someone say in the distance as men rushed forward, grabbing my arms, andpinning them to a hard surface and people piled on top. I looked up at a gray-haired man, the sameage as my grandfather. “Just calm down, young lady,” he spit through a clenched jaw. It was like anautomatic response. I felt my body go limp as it had many years before, under the weight ofawareness of my own powerlessness. I vaguely remember floating somewhere far above, lookingdownward, listening to a chorus of voices talking about me: an object to be “pacified,” and“interruption” in their schedule, a “problem on the unit,” “treatment resistant,” “acting out,”“manipulative,” and I “liked what was happening to me anyway.” Intermittently, I’d hear a voice among the din. “Careful, be careful, you’re hurting her,” they said. Two nurses were pushing their way into the crowd, trying to peel off the men who had turnedme over and were pushing my face into the corner of the room. They were compassionate; aconfirmation that life existed in this atmosphere of destruction and violence. But they were sooncrowded out, the inside and outside noise colliding.
What I learned in these moments was to stop hoping for anything different. Each time I was restrained I learned to drive the memories deeper into myself, to close down and fragment a little bitmore. A part of me is gone; a part that was left behind in those restraints and cannot be recovered. Iam leery now, even as I travel around the world to meet people; I wait with anticipation to be let offthe unit, quietly holding my breath waiting for the hard click to let me know I am free.
Rather than deterring anything, these episodes perpetuated a vicious cycle. The more I was restrained, the more humiliation I felt. The more shame and humiliation I felt, the more Idissociated, self-injured, and was restrained. The level of containment is not only traumatizing, butit is also a costly proposition. Research shows a correlation between the use of restraints andincreased length of stay in a facility. This disruption to the milieu could have been avoided hadpeople been willing to take some risks well in advance, assisting expression and witnessing pain.
Working Collaboratively to Co-Create Healing Environments
I believe it is time to heal, time to shift our focus form the deficit-based behavioral and biological models toward the strength-based, interactive, and relational approaches known to reducethe level of traumatization and improve the overall quality of care . It is time to decrease costs ofexpensive hospitalizations and recidivism, reduce the injury to clients and staff by implementingconcrete, creative, and compassionate alternatives to the policies of containment. Psychiatric Veterans in an Unnamed War:
Hidden Abuse, Truth-telling, Resistance and Recovery
facilities have accomplished drastic reduction and elimination of seclusion and restraint whenadministrators, policy makers, clinicians, clients and advocates work collaboratively to implementinnovative measures toward that end. By enacting principles of least restriction in the developmentof all practices and standards governing clinical interventions, we can change the current cultures ofcoercion to environments that support dignity and empowerment.
Vaclav Havel wrote that “the salvation of the world lies in the human heart.” And I believe that precisely this exploration of our hearts will lead us back into recognition: back into awareness ofwho we really are from across the great divides that seem to separate us. Therefore, I encourage youto begin this exploration by telling your own stories, even when they are called anecdotal. Tell themto one another. Stories are the oral tradition of history. They remind us of who we are in an eramarked by increasing separation, isolation, and dehumanization. bell hooks, a black feminist author,notes that the power people have even when they are marginalized, poor and disenfranchised is toname who they are in essence to tell their stories. It seems a simple act. When the story is told toone other person it becomes an act of rebellion, an act of resistance, an act of bearing witness. Intelling the truth about our lives, the story is transformed. The references are no longer individual butplural. The “I” becomes “we,” and the exchange becomes its own story. We are no longer alone.
All too often we are encouraged to turn away and say, “it’s too much,” missing opportunities to bear witness to another, their lives, stories, and struggles for dignity and language. We becomediminished in a world that demands our time and tells us to hurry up and make assessments, tells usthat a person has “schizophrenia” or “psychosis” or “paralysis,” so they “don’t make any senseanyway.” I believe it is time to take a deeper look at the meaning we assign to life. We must beginto see people as whole human beings with complex lives rather than simply viewing them throughthe labels they are assigned.
My hope is that one day we can break through the barriers of silence and create language that has meaning, that matches the experiences of those who have been abused and bring it into focus.
We need to look at the rage instead of trying to contain it, look at the confusion and utter chaos thatfollows loss on a very deep level—the confusion at having trusted and been betrayed, having lovedand been raped, having cared and been punished for getting too close.
Violence only teaches violence and indifference; it never teaches kindness and compassion. It is the antithesis of healing and true recovery. I believe that recovery is only possible in the absence ofattack, force, and coercion, that health happens when the greatest dignity and respect is afforded toeach human life. When these elements are present, people can be assisted in deep and meaningfulreconnection with themselves. We need to commit to treating all people the way we would insist onbeing treated when angry, despairing, afraid and confused. We must come together because everylife that is diminished, diminishes us all.
This article was previously published in Perspectives in Psychiatric Care, Vol. 36, Number 3 (July-September 2000), pp. 95-100 and reprinted in the feminist news journal, Off Our Backs, Vol.
XXXIII, nos. 7 & 8 (July-August 2003), pp. 47-51. For more information contact Laura Prescott at: or call, 413-774-3233.
LifeTalk February 24, 2004 ANNOUNCER: From the headquarters of Life Dynamics in Denton, Texas, it’s time for Life Talk. Now, here’s your host — he’s pro-life without compromise, without exception and without apology — the president of Life Dynamics, Mark Crutcher. MARK CRUTCHER: Hello and welcome to the show. We’ve got a lot of really interesting information to talk about tod