Table 1 (cont'd)

The Major Time Periods of Anna's Life History

Major Verifiable Events
21yr 10mo-24yr
Sheppard Enoch
Pratt Hospital
Towson, MD

Private Insurance coverage reestablished; moved to Maryland private psychiatric hospital near mother; artwork published in hospital magazine; pregnancy; birth of child; release of child for adoption by St. Louis aunt and uncle and family of 7 children; self mutilation; first full disclosure to mother of sexual abuse by male babysitter at age 3 1/2-4 after discovering from other patients she was not the "only one in the world" with such experience; private insurance ends; Anna discharged.
24yr-26yr 1mo
Philidelphia State
Moved into a state hospital in Philadelphia close to mother; art exhibits and awards; drawing used on brochure cover for hospital APA conference; two nearly successful suicide attempts; self mutilation; disclosure to therapist of childhood sexual abuse; brief period of treatment for Post-Traumatic Stress Disorder; first agreement with diagnosis; witnessed staff violence to patients; secretly reported details to mother and advocates; led to investigation of State hospital and eventual closure; treatment team disintegration; flight from State hospital.
26yr 1mo-26yr 2mo
Philidelphia Comm.
Mental Health Sys.
Entered inner city community mental health system; 41 shifts in location within system during 39 day period of psychiatric crisis [see chart]- 1 shelter, 1 centralized intake unit, 4 psychiatric emergency rooms, 1 adult service agency, 2 community mental health centers, 1 rehabilitation residence, 2 day programs, 1 intensive case manager, 6 crisis specialist, 2 mobile emergency teams, 1 specialized crisis fascility, 3 community hospital acute inpatient wards; no treatment available related to childhood sexual abuse trauma; behavior observed by private therapist seen as indicating Multiple personality disorder.
26yr 2mo-26yr 8mo
Institute of Penn.Hosp.
Private insurance reestablished; moved to private hospital for MPD evaluation; Anna calls private (above) therapist asking her to come to see her at the hospital because "the baby wants to talk to you"; hospital physician denies therapist permission to respond to Anna's request ; MPD not
diagnosed; further disintegration; private insurance ends; Anna discharged.
26yr 8mo-30yr 6mo
Norristown State Hosp.
Moved to another State Hos[ital; no treatment available related to symptoms of childhood sexual abuse trauma; anerexia, bulimia.-weight loss to 87 pounds; 2 nearly successful suicide attempts, one jumping out of father's car into line of highway traffic, one overdose of antipsychotic medication; self mutilation; outside medical consultation and patient advocate intervention; change in treatment
(less meds, less restriction): does paid janitorial work at hospital; qualifies for new transitional residential program to prepare to move into community system in California close to mother, older sister, younger brother and sister; older brother moves to California; Creation of transitional program delayed. Anna saves money from janitor job and commissioned artwork, runs from hospital, purchases bus ticket and travels cross country to California
30yr 6mo-32yr
Napa State Hosp.
Anna is placed in the community mental health system in San Jose,CA; initial cliniciuans identify her condition as based in early childhood sexual abuse trauma and effects of long term institutionalization; no treatment to addrerss her condition could be found in system; maternal grandmother dies; Anna's mother informed by former housekeeper of male relative's sexual abuse of Anna at age 2 1/2- 3; Anna moved 5 times; several suicide attempts; her last residence was Napa State Hospital where she hung herself and died on October 24, 1992.