Wednesday, October 17, 2007

I was ACTING, people!

Last night in my substance abuse treatment class, we all roleplayed a very disruptive support group for addicts and alcoholics. I pretended to be a brilliant neurologist hooked on painkillers and a person with borderline personality disorder, a heroin addiction, and a tendency to cut myself. The professor applauded me at the end of class. "Bravo, Ayelet -- very ham!" (Guess he doesn't know I keep kosher.)

Today in my clinical practice class two classmates were assigned to teach self-soothing skills (it's part of the manualized treatment of borderline personality disorder, and honestly, I'd rather learn it from the professor, but she wasn't in class today). We were supposed to fill out evaluation forms on the student presenters, and one of the categories was rating their ability to encourage and manage discussion in the group.

To make sure there was some discussion for them to manage, I asked one student an annoying question to see how she'd handle its impact. The other, my pal Jerry, I tried to flummox by telling him that the exercise he taught us made me feel empty and disconnected from myself -- i.e., instead of soothing me, it made me dissociate. Which is not something we want to induce in persons with borderline personality disorder.

Jerry knew I was kidding. I told the class I was kidding -- exaggerating. One of my classmates took me seriously, and I got this email from the professor:

Dear Ayelet,

At least one of your colleagues was concerned about you following the skills training portion of class today. The T.A., who led the class today in my absence, contacted me immediately after class. It was not her assessment that you were distressed after class by the content or how your response to the exercise was handled, but given your classmates' concern, I wanted to contact you as soon as possible. Could you please respond to this email and let me know what occurred? I have cc'd the dean of the school and of academic affairs on this as well; please respond to all.

Yiii-ii-ikes! I shot back, as quickly as I could:

Dear Prof. Worried:

I was acting!!! I'm so sorry if I disconcerted anyone. I was trying to challenge Jerry, who was teaching the self-soothing skill from the distress tolerance module, and kick up some discussion. I happened not to like his choice of self-soothing exercise, but I was *completely* exaggerating the effect it was having on me. I have never cut myself nor ever wanted to.

I hope you assure my classmate that I was absolutely fine, just acting to make the presentation more real -- if that makes sense? I was just in a role play last night for my alcohol/substance abuse treatment class, and I played a similar character in a recovery group we were simulating. The professor gave me a round of applause and thanked me for making things tougher on the student who was trying to moderate the group. I guess I was still kind of in "role-play" mode.

I apologize for obliging you to expend your valuable time on this matter -- Ayelet

I can't imagine who would be stupid enough to think that I meant what I was intimating... yes I can. There's an incredibly annoying woman in the class. Norma. Middle-aged, very pushy, talks as if she's the greatest expert on everything, which is highly annoying to us real experts. I'll probably never know who it was, but I'm inclined to think it was her. (So does Jerry -- he thinks she's got borderline.) Then again, I'm inclined to dislike her, so I might not be guessing entirely objectively.

Gevalt. Fortunately, I calmed Prof. Worried right down:

I am glad. Thank you for your reply. Will look forward to seeing you in class next week.
Copyright (c) "Ayelet Survivor"


  1. !!!

    i find your blog such an interesting window into this world.

    do you think you'd like to be in touch with dr. andrea lieber? you'd be such an interesting person/blogger to include.

  2. Given that you work in the mental health field, I'm quite concerned that you link imediately link dissociation with cutting oneself. While for some people, sometimes, there can be a link, it is not the majority - neither of those who cut themselves, nor of those who dissociate. Coming from the perspective of someone working in the clinical mental health field as well as one with years of severe treatment-resistant depression, and long experience with self-injury, I shudder to think that you might be bringing that perspective to your clients. You clearly have potential, but you have a lot more to learn, and I hope that you learn it before you work with either population.

  3. Actually, I was linking cutting and dissociation with borderline personality disorder, Anonymous. Fortunately, most of my clients don't suffer from that disorder. I appreciate your input, though.