Agnieszka, age: 42
1. History
Agnieszka was sent to our Center from psychiatric
hospital after 6 months stay, with diagnosis of:
alcohol & drug addiction ( F 10.8, F 19.1 ),
alcoholic polyneuropathy, anemia. Originally she
was found lying on the ground in park.
She has lived for last 10 years in different towns,
with different men and finally ended up on the
street. Sometimes she supported herself with the
money from drug dealing or prostitution. Before that
she worked as an actress in TV & theatres. She has
MA degree.
Agnieszka has 7 years old daughter, living with her
ex-partner's parents. They don't have contact for
few years and she misses her. Also she hasn't seen
her parents for a long time.
At the time of admission she was a little
disoriented, depressed and had difficulty with
walking. Later she told me about hearing voices. She
didn't think it was important.
She seemed to be quied, helpless and exhausted.
2. Health
Soon her behaviour started to change. After she
clarified for herself that I'm her psychologist she
told me, she will ask me about everything concerning
herself. So she did, everyday. Usually she needed my
assurance, that we won't tell her to leave the
Center regardless her behaviour or we won't cut her
hair if she has lice or we won't punished her by
changing her room for worse accomodation. She
complained that other residents, especially women,
talked lies about her, plot. And because of it she
is going to drink again.
Her colleagues complained to us, that Agnieszka
disturbs their sleep: often uses the bathroom,
talks on the phone, reads books and insults them
vulgarly.
Agnieszka wasn't able to take part in food
preparation, because e.g. peeling the potatoes was
something totally new to her. The same was with
house cleaning chores. Other women didn't like it
and made fun of her. She complained about this to
all our staff, looking for understanding and
support, but it was never enough for her.
One day she asked me if it was important, that she
was diagnosed as a young women with borderline
personality dissorder.
3. Interventions
First appointment I've made for Agnieszka was with
the neurologist in a Clinic for Homeless People. The
doctor spent with us an hour and patiently explained
to Agnieszka all her symptoms. She was concerned
with her memory problems and pain in legs. She
wanted to return to acting one day. Unfortunately
the doctor couldn't promise her anything, as every
other specialist, and that upset her. He said, the
most important advice for Agnieszka was: Don't drink
again and have hope. The damage was done.
I also asked the neurologist for the referral to
physical therapy. He thought it could be better for
her mind than the body, and agreed.
Second appointment was with the psychiatrist ( one
of many ). I advised Agnieszka to choose and keep
one doctor. She suffers from side effects from every
prescribed drug and accuses doctors of not listening
to her.
Another visits were with the family doctor and these
Agnieszka makes often since she is also
hypochondriac. Sometimes he wants to send her to a
psychiatrist.
After half a year she agreed to see an addiction
therapist who accepted her choice only to talk, not
to write the stories. She had an addiction therapy
few years ago, but doesn't remember much of it.
Also she goes to an AA meetings.
After 8 months of being in our Center I see a
significant improvement in Agnieszka's health. She
walks with less pain, goes outside and is not afraid
of the outdoors, makes appointments by herself and
keeps them. The most important is that she feels
again and has memories, which are painful and
depressing but doesn't separate from them as before.
Agnieszka doesn't like to be that much alive, but
keeps going. She hasn't seen her daughter yet, but
has contact with her aunt.
4. Network
When Agnieszka came to us from the hospital with the
assistance of 2 social workers, I've asked them to
supply her with drugs for one month. They didn't
offer anything else, like contact with a doctor. But
slowly we established our own network of helping
Agnieszka. Very important was, that I accompanied
her at the first appointments and was her voice,
when she didn't have much to say. Also she had our
Center not only as a place to live, but as a
supporting her institution.
I've noticed that being a part of a network was a
new experience for specialists. The easiest was to
work with a family doctor, the most challenging with
mental health workers.
5. Possible proposals
When Agnieszka came to us, we organized very broad
network of people and institutions helping her. We
are in the beginning of this road, having in mind
that she is really sober for a short time, homeless,
jobless, lonely and having additional mental
problems. Nonetheless she has support of all our
workers even if she is pretty difficult with her
borderline personality.
I can also imagine perhaps easier script. She is
coming to us from the hospital to have an
accommodation and their outpatient center takes care
of her mental health and supports us in her recovery
and wellbeing.
Anna Boczkowska
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