The definition of self-mutilation as it pertains to my patient is severe cutting on her forearms and wrists. They vary in length from one to 5 inches- all involve stitches unless she tried to fix them up herself. Those she tended to are serious keloid scars, not just smaller scratches. Her hospitalization was due to a 2 week bout with spinal meninjitis where she was in a coma the first few days. Her parents say the outcome was in doubt, yet she recovered completely- physically. It was after this hospitalization that she supposedly changed completely...the nightmares, flashbacks, fears typical with PTSD. As for the "anorexia" she is 5'7 and weighs 109 pounds right now. Her mother says she (the patient) cries in the shower and when getting dressed in the morning because of how she perceives she looks. Her parents are trying to fill in some of the background, yet I am keeping what they say out of my sessions with my patient, simply because I don't know if any of what they're saying will match/be consistent with her "reality" and experiences. The last time I spoke to her she was consuming an orange and a piece of toast a day. I am concerned about her complaint of chest pains and shortness of breath. I referred her to a medical doctor to be checked out and she became extremely upset saying she wouldn't go and she felt fine. I tried to talk her through this and by the time we were done, she had curled up in a ball with her head down, exhausted from crying. But her final answer remains "no." I had her answer some questions for me on paper and I was surprised by how well she writes and how clearly she explains herself. She is very aware of what is going on around her and has been an advanced student all through high school. I'm still trying...it's just leaving me frusterated that I don't know for sure what the facts are- due to her limited communication.
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