The Hypocrite Oaf: First Establish Dominance Over Patient

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(This article is a cooperative authorship of jace cavacini (the patient), VictoryGrey and blogavoidant (members of my blog, my NowPublic.com profile and my ONLY support structure in this anti-society; there may be some shifting in perspective of who is telling the story)

Dr. Alex Thomas. PsyMD. Number five(?) in my experiences with sociopathic-like psychiatric doctors. Psychiatrists who seem to have god complexes… It's very common in this profession because they have the power to declare that anything they dislike about a patient is pathological. No one keeps these doctors in check, despite regulations requiring them to regularly attend their own psychiatric evaluations. Who watches the watchers? More of the same. It's like getting the government to start a legal battle for you against a government institution.

People wonder why i have PTSD, why it is so severe and why i dislike repeating myself to new doctors, offices and staff. This article is a particularly excellent example of why:

This was another of countless attempts to get me into a relationship with a new PsyMD since the loss of my prior, excellent Neuro-Psychiatrist Autism Specialist (he lost his privte practice because he could not financially maintain it as insurance companies refused to pay for "specialist" services). i need a new doctor for two very specific purposes:

1. Social Security Disability and Welfare seem to frown on providing services to "psychiatric needs persons" who do not have a psychiatrist. Obviously they assume we're in constant need of medication, therapy and other interference instead of healthy, stress-free and choice-filled living.

2. i am trying to discontinue the use of clonazepam, the benzodiazepine drug prescribed to me in order to mask the side-effects of another psychiatric drug (Effexor XR) i was coerced into taking (which i have since discontinued… a living hell that lasted months and the long term damages of four years of use are still unknown). i've been on clonazepam for about four years. It is physiologically addicting, is destroying my personality, impulse control, sex life and, most crucial: interfering with any future potential to "recover" from my toxic life experiences. Read my previous article about benzodiazepines for more information on the specific topic of benzodiazepines.

This article focuses on an occasion that was actually TWO appointments (TWO appointments to accomplish ONE first appointment with a doctor??). TWO occasions to waste precious tax payer money. TWO occasions to try the patience and the sanity of the patient seeking help.

The First appointment: an "intake interview," was on 10/30/09 at Friday, 2pm with Amy (last name unknown).

Appointment Location:

Haven House
1530 Hanover Ave
Allentown, PA 18109

(on the grounds of the State Mental Hospital, which freaked me out seeing as i have a fear of wrongful imprisonment, or any kind of restraint at all)

The Outpatient Director at Haven House is Allison Smith, who can be contacted at 610-433-6181, extension 119. Feel free to complain to her after you read this article. Hint hint, prod prod.

Preparations:

A note from blogavoidant to VictoryGrey and myself about the impending appointment:

"The appointment with the psychiatrist at Haven House is on Friday the 13th. (HAH!)  His name is Alex Thomas.  I intend to ask him questions before he asks anything of Jace.  Here are the questions I have planned so far.  Is there more or other information you think we should know about him?"

This were questions that were INTENDED to be asked OF Doctor Thomas, to screen him for potential toxicity to me (jace):

Proposed questions by my close companion and caretaker "blogavoidant:"

1. How familiar are you with high functioning autism?
2. How many people on the autism spectrum have you assisted?
3. How many of them were benzodiazepine users?
4. How many benzodiazepine users have you assisted?
5. How many were successful with minimal withdrawal effects?
6. How many benzodiazepine users have you lived with while they were withdrawing?
7. Are you familiar with the "Aston taper" method?
8. Have you assisted people using that method?
9. What other methods have you used?

My own additions:

10. will you listen to a patient who knows almost as much as you  do?

11. will you prescribe xyrem for sleep problems (details)? might  as well send yet another xyrem request to the fucks at the government from another doctor. every attempt must count in some database. narcolepsy variant.

12. will you treat your patient as a professional colleague  instead of an addict or child?

13. do you have problems giving technical explanations to  technical questions?

14. will you admit to not knowing answers and then do research for things you do not know or do you have problems being openly unfamiliar with topics or details if asked about them?

15. are you at all insecure or ever have problems with competitive behavior that might be triggered by dealing with an extremely knowledgeable and intelligent autistic person who has become an expert on many topics that average patients never would?

16. will you avoid attempting to prescribe any other drug beyond what your patient requests to be on? (nothing other than the required benzodiazepine and requested xyrem)."

i added the following to my list of questions:

"i don't even want to be in the building for this. the last time i was there answering questions, i had a total breakdown … a mental collapse. screen him for me please!!!!"

The Appointment:

The appointment with Dr. Thomas was scheduled for 11/13/2009 6:30pm. After the intake interview was completed on 10/30/09, Amy, the intake interviewer, said she was "writing very detailed notes for the doctor," so i wouldn't have to repeat myself much, and to note that i was requesting someone who "wasn't arrogant; someone who does not have a god complex" (she claimed he did not). i want a doctor who will treat me like an equal. Not someone who thinks they are the only PsyMD in the world and have the compulsion to re-diagnose me from scratch. Again, Amy assured me that she was "writing a lot of notes" for the doctor…

Walking out on the doctor:

i walked out on Dr. Thomas twice to avoid becoming overly traumatized. It was too late. Walking out meant i was already traumatized.

The first time i walked out was a direct result of Thomas' refusal to allow my companions, with all of our collected documentation, knowledge and experience, to participate in what he called "the initial start of the session. i had already been through trauma like this before (isolated from witnesses who could corroborate my observations and help defend me).

i returned, that first time, because the Haven House Outpatient Director, Allison, told me that Thomas was "the best there was." She spoke gently and kindly; the total opposite of Dr. Thomas. i stood there looking at her, the exit and my feet. i considered my options: none. There were no other doctors lined up for possible help. My supply of clonazepam is dwindling and withdrawal is potentially deadly (it's at least horrific and suicide-influencing). i complied with Allison Smith's request to reconsider my desire to leave simply because she appealed to my respect for her gentle approach and her very simple status as a stranger to me. She seemed to care. i tried very hard to suppress my PTSD responses for the sake of Allison's supposed position of superior experience and knowledge. I COMPLIED, as ALWAYS, despite my instincts demanding me to run like hell.

So i returned to the sealed room, once more without my companions. Thomas claimed "my privacy" was the reason for wanting the "private session." We all told Thomas and Allison that there were no secrets between us - i have no secrets or issues of embarrassment in general, due to my personality, openness and autism. Thomas would not accept these facts from THREE people, including his own potential patient.

Again the repeat questions that had been covered by Amy in the intake interview. Not only did Dr. Thomas refuse to allow my companions into his office with me (something that, up to now, was unheard of in my doctor-visitation experiences), Dr. Thomas defeated the entire intake interview meeting:

i specifically complained that the doctor was asking questions that had already been answered in the paperwork we (myself and companions) had filled out and brought with us as well as the "extensive notes" Amy made a huge effort to create. Thomas placed his hand on the stack of papers and declared "i didn't read this."

What was the point of the intake interview, the note taking and the questions if the doctor will disregard it all, including a patient's previous doctors' records and diagnostics?

Who's In Charge, Anyway?

"Haven House" has four doctors. We were told Dr. Alex Thomas, who i would be seeing, was "the best." They declared Dr. Alex Thomas was certified in drug & alcohol abuse, has a history of working in prisons (which sets a scary scenario in my mind unknown to me at the time), is very compassionate…

My companions and i could find no indication that Dr. Thomas had ANY compassion or empathy; he demonstrated, through action and inaction, that he had no experience working with autism-spectrum persons, yet he claimed to know autism and (seemingly lied on the spot) that he had many patients who were autistic and several of them were high functioning). Thomas demanded i provide him with the exact symptoms that told me i was autistic (and quick quick quick!!). It was as if my last four years of research and doctoring meant nothing to Thomas. He was impatient, i was anxious and he was not willing to listen to me describe "why i think i'm autistic"

He gave us no opportunity to give him information in any way. He demanded his own private interrogation of me (jace) in his office, all alone with Thomas (since these kinds of sociopathic manipulative tricks have been used on me before, i have severe PTSD issues with them). i fought my best to maintain self control and respect to this stranger who was potentially supposed to help me.

Thomas had the room sealed with himself and i in it so he could control the situation; my companions were barred from the room. They had all the info that Thomas was demanding from me. Among those where "where do you come from" (which is in the records he indicated he did not read). Thomas demanded i tell him, in some precise manner, what amount of clonazepam i've been taking, which is not possible; we brought a full list of medications and side-effects (mental & physical) with us for him to examine. He did not even give us the chance to provide them. They were not examined… including a schedule of clonazepam use, which he demanded of me, verbally (i have autism and scheduling is an extreme weak point in my neurological makeup - very common among autistics, even high functioning autistics).

When Thomas demanded i TELL him my "regular dosage," (still trapped with him in private), i pointed to the door, indicating that my companions had it all documented in a spreadsheet - the doses i've taken over the last two or three weeks.

Thomas didn't like that i was not complying with his inflexible demands. Thomas did no like that i wanted him to do his job like a professional and READ the documentation provided and offered. Because there were no witnesses, Thomas could say whatever he wanted about me i.e.: "he's too angry, I can't work with him," which he told my companions after i abandoned the building in disgust.

Thomas making such statements was his attempt to regain control over his "image" around his office coworkers, my companions and for him to maintain a feeling of control over the situation (since i challenged that "control" by walking out, TWICE)

So i ask: Who is in charge, Director Allison Smith or Dr. Alex Thomas?

Control:

i repeatedly told Dr. Thomas there was no risk of embarrassment among my companions & myself but he continued to refuse the concept, quite vehemently. Thomas seemed irritated that i even disagreed with anything he said (a common anti-social personality "clinical symptom"). Dr. Thomas knows nothing about me or my companions but he was completely inflexible to learn anything from us. It was clear that he wanted things his way or NO way.

About being the "best doctor…" no one is "the best" psychiatrist. Certainly no doctor with this kind of unprofessional behavior. Declaring being the best is an arrogant, grandiose statement. Very much clinical of anti-social personality disorders… such as the very exact statement that was also made by another PsyMD i encountered in my toxic experiences with "the health care system." That other doctor is named Dr. Duque, who was at St. Luke's Hospital, in Quakertown as a fill-in doctor to cover for vacationing doctors (when i was wrongfully imprisoned in hospital on an invalid 302). That's a story all of its own… but like Duque, Thomas demonstrated manipulative traits, need for control, bulldozing, questioning without demonstrating the receptiveness to the answers he apparently sought, a strong egotistical focus and possibly a problem of pathological lying. My opinion: i declare he is potentially sociopathic (at least dangerously close to it). It is clear to myself and my two companions who accompanied me that Dr. Alex Thomas wants control and will see to it that he has the control he wants or that he will refuse service (another sociopathic "trait" - "you can take my offering or get nothing").

i have a lot of experience with people who manipulate, push, and isolate their victims (they isolate the victims so there are no witnesses to their behavior, maintaining the upper hand on credibility and keeping control over the situation, despite the situation being unhealthy for the relationship or person they're dealing with). Thomas was not interested in me as a human being or a patient and gave a striking example of antipathy and a "clock punching" work ethic (if that's any ethic at all).

Walking Out AGAIN:

i was going to walk out on Dr. Thomas a second time because Thomas continued to refuse to work with me. It was Thomas' terms or no terms. He was not interested. He was impatient. Thomas argued with me over the simplest questions, demonstrating a critical distaste for my autism diagnosis. Thomas acted as though the work of other psychiatrists (even those who are autism specialists) was irrelevant. Thomas said "i'm a different psychiatrist from other psychiatrists"  (no kidding, pal, i'm glad you can handle that complex concept, but it doesn't mean you work in a vacuum!). "Different psychiatrist" is no reason to throw away years (yes years) of established information that has been backed and approved by research and experience (my own, that of my doctors' and countless specialists who have written books on the topics involving the autism spectrum).

After struggling to explain my diagnosis process to Thomas (first, my own discovery, which he attacked as "self diagnosis," which most specialists KNOW is the first step to adult autism awareness and secondly/thirdly: two doctors who are specialists in autism), Thomas changed topics rather abruptly; it seemed he didn't know how to regain the upper hand on the autism topic, so he returned to his aggressive questioning on irrelevant topics (such as "where are you from?" which was covered by intake-Amy's documentation).

By this point i'd had enough; i'd explained the importance of "relevancy of topics/information" and autism; i explained that i have PTSD (which Thomas and the environment were triggering). I made a physical gesture of frustration and a motion to get up from the chair and Thomas responded by jumping up and going for the door, announcing "This isn't going to work, I can't work with you." Thomas headed towards the door before i was able to, seemingly to "get there first," likely to maintain his feeling of controlling the situation. That action set me off: Thomas made it clear that he had to be the boss even at the cost of severely destabilizing his own patient.

What's the first rule and oath that MD's take? DO NO HARM. Thomas did great harm to serve his need for "control" over what he seems to think is HIS world. It is not his right to exercise control over other persons, nor is it "our" privilege to be controlled by said people. Point blank: He is NOT special, nor is he better than anyone else i've seen; he's one of the worst i've encountered (excepting Dr. Duque at Quakertown St. Luke's "Behavioral Health Ward," who's sociopathy traits are on par with or superior to Thomas').

Image and Control:

Like most sociopaths, Thomas had to maintain the image of control by "getting there first." Thomas' seemed to proclaim that his patient was not abandoning him but that he was abandoning a patient not up to Thomas' standards. Thomas' behavior was aggressive and intolerant of my neurology, my sensitivities, my situation (which he had ample opportunity to investigate and become educated about but refused to under what seemed to be the fact that he felt it was irrelevant and beneath him). Thomas refused to acknowledge my autism at all. He demonstrates the opposite of what a "mental healthcare professional" should be.

Once you learn about, and experience, several sociopaths first-hand, you learn to quickly recognize the same pathology in the next sociopath you encounter. You're trained by exposure and the damage they do to you. It's almost unavoidable for many sociopaths to hide these "tells" and Thomas has many (the "less successful" a sociopath is, the quicker you can point out their pathological traits). Thomas has apparently found his stable "Peter Principal" floating point in "professional" society (unable to progress upward due to his personal deficiencies, but not likely to be taken down a rung by any other, more powerful, force). Clearly Thomas will milk it for all he can, getting his egotistical satisfaction by pushing and manipulating his patients (and his colleagues??). That's why i am publishing this; you can avoid this man and this facility.

(If you need a basic reference on sociopathy - the DSM-IV TR does not accept it as varying from any other anti-social personality disorder, though the previous edition DID delineate - get the rather inexpensive and accessible book by Martha Stout called "The Sociopath Next Door" - There are many other books and journals about sociopathy and the resulting diagnostic confusion regarding the lack of differentiation between sociopathy and other APDs)

The Damage Done:

i am not a child. i am an adult. i am not an addict. i was coerced onto medications toxic to me when i was naive enough to accept "advise" of people i used to trust. i am not unreasonable (as demonstrated by the fact that i went back after Haven House Director Allison Smith talked me into giving Thomas a chance, and by the fact that i WALKED OUT INSTEAD of creating a scene or acting out my rage; i CONTROLLED MYSELF, unlike Thomas - i even demonstrated an attempt to accommodate a foreign environment and new people by originally returning to Thomas' office, telling him it was nothing personal, shook his hand, and tried to explain that i have a great deal of personal trauma associated with doctors, authority figures and hospitals). i am a very reasonable person being driven to socially unacceptable behaviors by an unreasonable "healthcare system." i told Dr. Thomas i had no personal problem with him (just in case some idiot wanted to try throwing in the racism BS). Thomas made the situation personal by abusing his privileges to practice as a Medical Doctor and abusing the most easily abused and manipulated types of patients there are in "the system."

You cannot control autistics (especially high functioning autistics) with aggression and pushiness, especially when they have BPD (Borderline Personality Disorder) and/or PTSD.
Thomas was right that i was "angry" (which he declared to all who would hear him when he appeared to be sending me out of his office). He generated that anger. He triggered that anger. Dr. Thomas was the SOURCE of that anger.

i walked out of the building exceedingly angry. Angry that i'd been lied to, fooled by and manipulated by yet another "health care provider," and knowing there would likely be no repercussions for those guilty of misconduct.

(You people who fight "Left" and "Right" over health care reform have no clue what the real issues are; all you talk about is money & where it should come from- The real problem is the underlying system of the "provider" arrogance and the "coverage" domination over the providers and educators of said providers- your money arguments do not at all affect the situation i was in other than i was subjected to "good enough for government work"-quality of service, a colloquial expression meaning "if it's cheap, it's what we'll take, and give to our disabled citizens").

i was angry. Furious. Dangerous.

Angry that i was suffering new PTSD triggers by the very people who were supposed to help me. Dr. Thomas and the entire Haven House facility were a massive catalyst for an anger that lead me to desperate behavior and thinking. i was so desperate to escape the entire frightening campus that i walked, into the dark, down a hill and climbed over a fence twice my height (no exaggeration). i then walked 3/4 of the way home (about six or seven miles?). My feet are blistered. My legs, thighs, ankles, feet, etc burn with pain and weakness. Up till yesterday, i could barely walk. If not for my own sense of honor and respect for law, the rights of others and ethics, i would have assaulted people and objects on my "mad dash" from the source of trauma. Luckily, the stalking walk and climbing over a fence and the pain in my body were catalysts to remind me that i do not wish ANYONE to suffer BECAUSE i suffer and understand suffering. This reminded me that i was better than this so-called "best doctor." i have EMPATHY and ETHICS he clearly lacked an ability to demonstrate.

Repercussions:

Thomas did damage. Haven House did damage; extreme distress of a long term variety. Thomas is toxic to people who have any sensitivities whatsoever. This experience will further compound difficulties in dealing with all future doctors and hospitals (here, Thomas did extremely serious damage). Thomas does not act like a service provider; Thomas acts like it's a patient's "privilege" to see him, as though the Doctor is a god who grants his sheep a casual glance now and then.

Wrong.

Thomas is a DOCTOR. A service provider. Thomas did not earn his pay. He has earned reprimanding or, preferably, dismissal due to the severity of his damage to a patient/client/customer. Haven House did not earn payment for the TWO agonizing appearances i was forced to make. Thomas should be charged for my psychological damage and dismissed. Thomas has no right (based on this behavior he demonstrates) to practice psychiatric 'medicine' and should have any license to practice medicine revoked.

Autism, BPD, PTSD… All of these diagnoses, explanations, and several other doctors' notes, were in the materials supposedly provided to Thomas by intake-Amy, sitting unread on Thomas' desk. Is this normal policy to ignore all the work of the interviewer and for the doctor to force the patient to relive toxic experiences by dredging them up again, aggressively, while the doctor does no work whatsoever on researching the patient prior to the first contact? Does Dr. Thomas view reading the notes as below him? Clerical? Or perhaps Dr. Thomas has some disabilities himself, such as reading comprehension, which leads to his refusal to deal with paperwork (a situation NOT uncommon in my observation). Why not investigate? i can't. THIS writing is all i can do. Complaints and writing and questioning "a lawyer friend" is all i can do. i am without resources of any kind except "word of mouth." Freedom of speech.

The Aftermath:

After i left the building, concerned about my well being, my companions, who were there to make sure none of this horrific stuff happened in the first place, followed me out of the building… but i was long gone. blogavoidant saw me climb over the 20 foot fence and i think that's about it. After i walked a little, trying to clear my head, i called them from my cell phone to inform them that Thomas told me he didn't read any of Amy's documentation. This motivated my companions to return to the Haven House office and complain about this issue. When attempting to return to the office and express their frustrations and observations, they found the place locked-up, the reception area light turned off and no response to the buzzer/intercom. That is highly UN-PROFESSIONAL of a medical establishment, especially in light of the OBVIOUS situation. The time between my departure and my companions' attempt to return to the office was at most 30 minutes. It appears like the guilty parties made a quick escape… or more likely… they were happy to be finished with the last office visit of the evening, all too eager to end and leave, regardless of the patient's needs. More ways to show "who is in control."

Well, it's not YOU, dear "health care system." No matter what you think, you will always be the service providers. One day you will suffer the consequences for the damage you have wrought.

As for me, i will never deal with Haven House again (the name is a cruel joke to me)… except maybe in the way you're reading now: to ensure that others know of my experience and do not patronize the facility. i will make as much of this situation public as possible until the Department of Public Welfare actively produces proof that they've corrected or terminated Dr. Alex Thomas as an employee, reprimanded Allison Smith for her complacency in allowing such a toxic "doctor" to do such damage as he has done. An offer of some just compensation for my enhanced suffering (which Haven House had been PRE-WARNED about, should the doctor behave as Thomas behaved) would be not just welcome but expected.

i was at Haven House because it was on the tiny list of welfare providers. i was there to get assistance to taper off of legally prescribed benzodiazepines which are harming me… yet the entire Haven House experience lead to self injury via walking home and taking a large dose of the benzodiazepine to cope with the inflicted toxic experience FROM Haven House's proclaimed "best doctor." i handled my damage without harming anyone or anything. Dr. Thomas harmed me with his pathological anti-social personality disorder, god-complex and general complacency and arrogance. Haven House did me a considerable amount of damage and dis-service: the opposite of its apparent purpose.  i will have extreme difficulty getting any rest [that night] if any.  This experience will linger with me for a very long time (as an autistic, i have eidetic memory) and the experience will interfere with future attempts at seeking help.

Thomas is unprofessional and dangerous. That makes Haven House the same.

i could continue, but by this point i already assume no one cares or, if employed at Haven House, they are afraid of Thomas' political power over his office mates and boss (like jefferson's control over his colleagues at KU) and will therefore do nothing about this clearly intolerable and unjust situation, and Thomas' inappropriate behavior.

-jace cavacini, blogavoidant and VictoryGrey of dysamoria.com