Excellent article regarding a problem shared by many people.
Drawing boundaries is difficult for people that have People Pleaser Syndrome because we were never taught how to draw our own boundaries. Personal boundaries were constantly crossed by one or both parents.
People from abusive backgrounds were brought up to keep our feelings and opinions to ourselves and to cater to the feelings of others. If you have people pleaser syndrome then you have some (not necessarily all) of the following characteristics.
1. Difficulty saying no, especially when the other person does not want to accept “no” for an answer.
2. Extreme anxiety during any confrontations.
3. Extreme anxiety when people are disappointed in you, or they are not happy with your actions.
4. DIfficulty standing your ground, when you do not agree with someone.
5. Get taken advantage of easily or often.
6. Other people get more time to make their case during arguments. You get less floor time…
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The latest episode in my ongoing resistance to Kaiser’s efforts to snuff me out with lethal neglect comes courtesy of my stupid belief that Kaiser would actually give me basic psychiatric services without a struggle.
To understand my anger I should explain that I use words for clarity, not obfuscation; therefore, when I use the words Case Manager I have the following definitions in mind.
“A case manager helps you complete paperwork and get to appointments. Your case manager may meet with you at the mental health agency, in-patient facility, your home, or another community setting. Case management is usually covered by Medicaid or state funding.
Children’s case management is a similar service that works with parents and caregivers to support healthy growth and development for children.”
“Case managers help patients live as independently as possible by helping them apply for social services, advocating for them with public organizations, finding accommodations in supportive housing facilities and assisting them with paperwork. They may perform other duties as needed, and are often responsible for handling administrative tasks such as maintaining case files and other documentation.”
Every year in May, I must fill out and turn in paperwork for additional co-pay coverage.
I have deficits in memory and concentration and I usually need help with forms.
For the past three years, my case managers have filled out the forms with me and for me.
This year I decided that I wanted to do it on my own.
I called my “case manger” in April and said that if I needed his help I would call him.
Of course, I lost time and forgot.
I am constantly bumping into the wall of my denial and limitations.
I don’t blame the case manager for my lack of insight.
However, when patients with memory deficits fail to follow through on an important agreement that’s a clue that something is wrong.
I finally called the case manager at the urging of my therapist and left a message. I explained that I had lost time and that I felt too ashamed to call him earlier.
A few days later, I received a voice mail from him.
He said that he was going on vacation for two weeks.
He gave me the name of another case manager who would give me some forms to sign. His message was clear that she would process the papers while he was away.
I arrive at Kaiser’s Department of Psychiatry and at first, no one knows anything about it.
Then a receptionist calls the case manager whose name I mentioned and I was told to wait, she was on an important call.
When she finally emerged from the staff area, I overheard her tell a colleague that she had been on the phone for thirty minutes trying to get tickets to an A’s game.
She met briefly with another client, then looked for me to tell me she didn’t handle the letter G—that someone else does.
I waited for another thirty minutes and another woman found me and dumped the paperwork in my lap with the statement: “We don’t do this?”
Me: “You don’t do case management?”
She: We don’t do this. Maybe a family member can help you.
Me: (I’d had enough) Look. Everyone knows that Kaiser doesn’t want to work with the mentally ill.
She: That’s not true!
Me: I’m not an idiot. If you don’t do case management and you don’t do family therapy, and you don’t do intensive groups for trauma then by logical extension, you don’t do psychiatry. If I could do this alone or with family, I would have!
She walked over to reception, and then returned.
She: Why don’t you sign the forms and leave them at the front desk; your regular case manager will call you when he returns from vacation.
A couple of guards arrived in reception and glared at me.
I took the forms, signed them, and turned them over to reception under the menacing watch of the guards. I realized that these guys would hurt me badly to protect the staff of Kaiser’s department of ‘We Don’t Do That’ from angry patients.
I have never seen the degree of contempt for people with mental illnesses that I have seen at Kaiser’s Department of Psychiatry.
Whether it’s a call tree that repeatedly disconnects patients or the patronizing lies of the staff, I sense that psychiatric patients must “understand” that we will always be sacrificed for profit.
My experience of Kaiser’s department of psychiatry is one of pressuring its mental health patients to accept second-class status in the Kaiser system or leave.
How can it be otherwise, when according to The National Union of Healthcare Workers, “Kaiser’s failures are systematic and often purposeful? ”
“Indeed, the scope and specifics of these failures are sufficiently grave as to merit investigation by state and federal authorities as well as actions for recovery of funds by public and private payers, including individual Kaiser members.” Care Delayed, Care Denied: Executive Summary
Kaiser makes access to care difficult in order to force patients who need comprehensive psychiatric services either to leave the plan or to pay for outside services on their own.
My advice to Kaiser is stop bullshitting your patients.
Some of us know that you hate us.
Some of us know that you want us to leave.
Some of us also know that whatever it is you think you’re doing, it isn’t professional and it isn’t psychiatry.
However, the law says that you must give a reasonable public accommodation to patients with disabilities.
Since my request for help is also a request for reasonable public accommodation and since the action requested is a traditional function of psychiatric case management, Kaiser’s refusal to aid me is unreasonable and is in violation of State and Federal Law.