Lisa's Agenda

Different patients have different goals when they are admitted to a psychiatric hospital. They go like this:

(1) those who sincerely want to get better; (2) those who are persuaded by their family to come in - they often eventually gain insight and appreciation;

(3) those who can’t wait another second to get out; these patients are oftentimes admitted against their will.  They consistently have no desire to engage in meaningful treatment.

And then there is the unfortunate but inevitable 4th category:

(4) those who have a self-serving agenda, like economic gain or a desire for ‘disability’.

Enter Lisa….

Lisa was an attractive woman who dressed the part. She was a flirt.  It was easy to see that the male patients were highly distracted and couldn’t take their eyes off her.  She milked this, loved the attention.  When I made my room rounds and she asked me why a (female) nurse had to accompany me, I recognized that Betty was a probable danger zone.

The next day my suspicions were confirmed: Lisa reported that a particular male patient had entered her room during the night and had taken advantage of her sexually. She said that she would pursue legal counsel and sue the hospital for not protecting her. 

Certainly, it is always the hospital’s responsibility to protect each patient. And that’s why every psychiatric hospital has ‘mental health aides’ to watch over all that goes on, day and night.

There are also cameras throughout our particular psych ward and so, after hours of reviewing the video tape, Betty’s claims were deemed a total fabrication.

Amazingly but not surprisingly, the next day Lisa announced that she felt better and was no longer harboring “suicidal thoughts”.  We made sure this was consistent and so a couple of days later she was discharged.

In short, Lisa was what we call a malingerer, someone who pretends to be ill in order to achieve other gains.  In my mind, Lisa's malingering was a reflection of her own internal pain and needs, which led to navigating the world as her personal playground of manipulation and self-interest.

I tried to talk to Lisa about this, but she was not interested.  Sad.  She was simply unable to look at herself.  Diagnostically, this pattern falls into the categories of narcissism and sociopathy….almost impossible to cure.

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Two weeks later, a male patient, Jim, came to my office.  Jim had been in the psychiatric hospital while Lisa was there. He told me that he desired her and they had exchanged numbers: “She was so pretty, doctor”, Jim told me, “and she said she wanted to meet me at my place.  I couldn’t believe my luck!…”

But as fate would have it, Lisa came to Jim’s place and, within short order, she robbed him of a good sum of money. “What a fool I am”, Jim cried to me.

Lisa. 

Lisa’s agenda.

The truth is that Betty, like all of us, has a soul within her, a soul that is a piece of Divinity, a soul that is pure and good, a soul that is who she truly is.  But, sadly, her soul has been muffled and covered over.

To uncover that grime is the challenge, each on our own level, that we all face.