- Joined
- Nov 5, 2014
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New patient who was originally diagnosed with panic disorder in college. Was on Klonopin daily and Ativan as needed, which the patient said was daily. Saw psychiatrist after college who added Prozac for OCD and switched the patient to exclusively Ativan, which is what the patient is currently on. The patient says her greatest problem is OCD, which she reports having since early childhood. Her manifestation of OCD for the last 10 years has been what she describes as “memory hoarding,” which I had not heard of before but I’ve since found some information on. She said it started because her medication regimen was so complicated that she worried she would take the wrong amount and she wrote down her doses and when she took them. She wrote more and more ideas down and became worried she would lose them. She claims to have lost entire years due to the Klonopin/Ativan and that she feels dissociated and “erased.” She became more and more obsessive about writing down everything that happened but it became debilitating. She thought that she would give herself a “break” by audio recording her narration of what was going on her life. She called it “analytic talk,” and from what I can tell it was her narrating everything that she thought or that was happening to her. She started video recording using a webcam. Her problem evolved more and more to the point that she now records herself on video 24 hours a day.
When she came into my office she was discretely recording herself with her cell phone. She records herself with security cameras in her home. I was very taken aback by it and it took me a while to understand her story. I asked her to turn off the recording on her phone, which she said she did. She wanted to make it very clear to me that the recording had nothing to do with me and that her only intention is to record herself. She says that she knows it is OCD but she believes it also caused by the fear of having more “blank erased years.” She said that she almost never reviews the recordings but feels comforted by knowing that they are there and that she thinks of them as the memory that a normal person would have if they didn’t have the amnesia she believes she has from the medications.
While I had never heard of anything like this before, I’m inclined to believe that she self-diagnosed fairly well. She’s never been tried on a maximum dose of Prozac so I’m working up to that and will later discuss a benzo taper. She seemed open to both. She is already seeing a therapist who knows about the recording.
Wondering if anyone else has ever come across this before? I told her I can continue seeing her as long as she agrees not to record in session and that I would have to terminate if I found out that she did. She told me that she was terminated before when she confided in a psychiatrist that she had been recording but hadn’t told him until after they had worked together for a year. I figure that it’s progress that she told me on the first visit and claims to not record in session. That was my on the spot assessment of how to handle it.
There are still surprises in this field.
When she came into my office she was discretely recording herself with her cell phone. She records herself with security cameras in her home. I was very taken aback by it and it took me a while to understand her story. I asked her to turn off the recording on her phone, which she said she did. She wanted to make it very clear to me that the recording had nothing to do with me and that her only intention is to record herself. She says that she knows it is OCD but she believes it also caused by the fear of having more “blank erased years.” She said that she almost never reviews the recordings but feels comforted by knowing that they are there and that she thinks of them as the memory that a normal person would have if they didn’t have the amnesia she believes she has from the medications.
While I had never heard of anything like this before, I’m inclined to believe that she self-diagnosed fairly well. She’s never been tried on a maximum dose of Prozac so I’m working up to that and will later discuss a benzo taper. She seemed open to both. She is already seeing a therapist who knows about the recording.
Wondering if anyone else has ever come across this before? I told her I can continue seeing her as long as she agrees not to record in session and that I would have to terminate if I found out that she did. She told me that she was terminated before when she confided in a psychiatrist that she had been recording but hadn’t told him until after they had worked together for a year. I figure that it’s progress that she told me on the first visit and claims to not record in session. That was my on the spot assessment of how to handle it.
There are still surprises in this field.
