[MRT6211]

In order to go back to school, as I am out on a mental health leave, the school is requiring me to do drug tests (even though I have no substance abuse diagnosis/history....). Whatever. I’ll deal with it. The problem is, they now want me to do supervised tests (yeah...they watch you pee...) and I just CAN’T bear the thought of having to do that. I have trauma/phobias in that area and every time I even think of doing this, it either makes me dissociate or I have a panic attack, or I just switch between the two for awhile.

T said the only way to help me with this if they won’t budge on this requirement (praying they will, but it doesn’t seem likely) is to do exposure therapy. I’ve never done it before and this kind of exposure therapy seems...awful...I don’t want T in the bathroom with me at all, let alone watching me pee. I feel like this would have the potential to really just make me so uncomfortable around her in the future and strain our relationship. But, on the other hand, would it be better to get desensitized to it with T there so that she can help me through things?

I hate this situation. I really need help.

[satsuma]

Oh wow, this situation seems incredible to me. Almost unbelievable - I mean I do believe you but it's such a ridiculous situation. Requiring somebody to be observed peeing, because they have had a mental health issue. I would even go so far as to say it's a human rights issue. My feeling is that there is no way in a million years I would do this, for a T or for a university or for anyone.
Is there any chance you can transfer to another place who would not have this crazy requirement? Or does that not seem like an option?

[LonesomeTonight]

Wow, that sounds really difficult. Maybe your T could write them a letter or something, to see if they might waive it?

Also, do you have difficulty using the bathroom if someone else is in there at all, or just watching you? If it's the former, maybe you could try just using public restrooms in a busy place, so you won't have to involve your T. Because I see where that could be really awkward.

[LabRat27]

Could you ask the university if you could do a blood test instead?

I can't pee when someone is watching me (or if someone is waiting for me or talking to me or if I'm on a plane or train) (called paruresis), but I found a breath holding technique that forces those muscles to relax and you pee anyway. It's certainly not pleasant because it requires elevating your blood CO2, but it's saved me in some really uncomfortable situations, like when I'm on a watch in the hospital and they won't let me use the bathroom unless they're next to the door which they keep ajar, and it's the only way I can pee no matter how much I need to go.

I know that doesn't solve the panic/dissociation issue, but it might help if you find you can eventually manage the panic/dissociation but still can't pee.

[Deejay14]

I think the blood test is the,way to go. They will tell you it's much more expensive. I was quoted a price of 400.00 . That amount was told to me by a nurse. If you only have to do this once then it is worth it. I would ask the lab they use how much they bill for. If it is a hospital lab you could easily go on a payment plan to make it easier to pay for.

[maybeblue]

I'd so much rather do a blood test. I can't even pee if someone is on the other side of the door and can hear me. As far as exposure therapy, I wouldn't want to do it with my regular therapist either. If I absolutely had to do it and there was no other way, I would find a therapist who specializes in exposure therapy and never, ever see her again after we were done.

[Taylor27]

I would never ever be able to pee infront of my therapist for a drug test that would freak me out even if it was exposure therapy.

[MRT6211]

Blood tests aren’t an option, I checked. It HAS to be urine tests. I tried everything I could to fight this. Also, I can’t switch schools, unfortunately. I’m in medical school and once you leave one US med school, no other US med school will accept you. So yes, they are violating my human rights, but no, there is nothing that I can do about it.

I feel like they trapped me into not being able to go back to school because they know I can’t do this, but if I don’t, I can’t go back. I wish it was just one of those things that was only just wildly uncomfortable, but if I try hard enough was still tolerable. Unfortunately...it’s not. And my trauma doesn’t even explain it that well why I’m like this...it’s more of the phobia piece. I have no idea what to do.

[growlycat]

Can you get a lawyer involved and see what your rights are??

[MRT6211]

Originally Posted by growlycat

Can you get a lawyer involved and see what your rights are??

I’m trying to exhaust all internal appeals methods first, but that’s the plan if I need to. It’s just so expensive.

I would second speaking with a lawyer.

This seems incredibly invasive. I would even perhaps characterize it as being done with malicious intent for them to suggest this knowing your difficulties, insisting this is the only way despite the fact that you've not had a history of substance abuse.

[nikon]

I've got no idea what the red tape is around your situation, but I know I would really not want to do exposure therapy with a therapist. that would feel like crossing some boundary and damaging a safe space. I've had to do a lot of drug tests with someone watching me pee or being in the room while i'm doing it, and at first i couldn't do it at all. i really struggled, like physically nothing would happen. the person was understanding and gave me time and a bit of space. after a while it got easier, and after a while i could (and was having to) do urine samples in a tiny bathroom literally squeezed up against the other person. i basically avoided eye contact and zoned out completely - went to another place in my head to avoid what was happening in the moment.
i've got a lot of anxiety about these things too, and have massive anxiety about being seen naked or semi-naked or anything like that, but it is do-able. it's a horrible thing and if you can avoid it, great, but if you can't, you are able to survive it.

[musinglizzy]

I have the same issue...and have spoken with my T about it. I don't know if your T has explained the "exposure therapy" to you, but my T has suggested this, but it has nothing to do with peeing in front of HER. I'd see if you could opt for a blood test also, but just know, I have the same issue....but my T would NOT be the one I would be doing exposure therapy with. Google "shy bladder," maybe you could learn some techniques on your own, without your T. This is a very common issue....

[feileacan]

I suppose that something so absurd can only happen in US ...

[toomanycats]

Personally, I would rather go through it just once than to go through it a bunch of times in the name of exposure therapy.

I would schedule a therapy appt for immediately after the test and a phone call right before or maybe therapy the day before and the day of right after the test.

[MRT6211]

My T said she could have one of the other T’s (who I know) at my treatment program do the actual exposure part with me and then she could help me process my feelings afterwards. That made me feel a little better.

And I have to do the tests not once, but 16 times...4 times per month for 4 months...

[LabRat27]

Would taking a strong benzo help with just getting it over with? Like would that be enough to be able to do it without panicking?
(If you have a prescription for it from a doc then the drug testing service usually has a medical review office that will contact you and then report the test as negative for that substance, but it depends on the company and what the test is for so you'd want to verify this ahead of time. I'm on Adderall so I have this issue with testing positive for amphetamines).

I mean obviously it's not ideal, but if it would work...

[velcro003]

this seems absolutely insane that this school is forcing you to do supervised urine samples because you left for mental health reasons?! Even worse that you have no substance abuse issues. OMG. I don't even have a phobia of this, but i hatteeeee peeing in a public restroom with another person there. No way I could do that.

Ugh, I am so angry for you!

[satsuma]

Originally Posted by velcro003

this seems absolutely insane that this school is forcing you to do supervised urine samples because you left for mental health reasons?! Even worse that you have no substance abuse issues. OMG. I don't even have a phobia of this, but i hatteeeee peeing in a public restroom with another person there. No way I could do that.

Ugh, I am so angry for you!

Me too! It is such a horrible way to discriminate against anyone who has dared to say publicly that they have mental health issues. And in a medical school of all places. What a thing to teach to new doctors! It seems like they are punishing them, in the most invasive way, for having experienced issues with mental health!

MRT6211, I was trying to imagine finding myself in such a situation, and I think if I did and I had already tried every route to appeal against this requirement, I would seriously consider going to the press/the local news media with my story. I think at least in this country that if this story were made public it might cause a public outcry and embarrass and shame the university into backing down.

[maybeblue]

I'm sure if you worked at it enough with exposure therapy you could get so you could do it. It is possible to get past most phobias if you work at it enough, but what a dumb thing to have to spend your therapy time on.

What about a hair sample? My understanding is that blood samples aren't as accurate as urine samples because the drugs pass out of the blood faster than the urine. But hair samples are supposed to be more accurate because they can detect drugs people have used weeks ago in hair. If you were willing to pay the extra processing cost I wonder if they would go for it.

[Anne2.0]

Unfortunately academic institutions, like all institutions, have much power to require those who seek to return after some fallout to do pretty much anything in exchange for readmission. My advice is for you to see this as a hoop you have to jump through and yes sir you can do it. The more you dig in and try to get them to change their minds the more they are going to dig in and see you as weak because you're unwilling to do what they ask. Trying to get them to change their minds just gives them more ammunition to use against you later.

You can do this. I say this not because I know it to be true, but because I believe that very specific phobia/fears like this can be worked on and overcome. It's a very specific thing you want to be able to accomplish and you have a really powerful reason for wanting to accomplish it. I have my own versions of this, including a medical exam situation, that a few sessions took care of. It's an enormously empowering thing to be able to overcome a fear and do what needs to be done. You can do this. You could probably do it even without therapy sessions around it, because the worst part of fear is the build up to the thing, that's where all the worries and anxieties and terrors join up together, like rivers dumping in to the ocean.

If you have a date where you need to do the thing, you can build a plan with your T that takes you there. I'm not saying it's going to be easy, just that I think you can do it, and the idea of you swaggering in there with a "no problem" attitude and showing those *&^%D that you are so ready to be back in school and get on with your life is inspiring to me.

[LonesomeTonight]

If a benzo would affect test results, could something like Benadryl help with the anxiety (it's helped me before) without being a flag?

[MRT6211]

Thank you so much for the support, everyone!
Unfortunately I can’t take a benzo, because part of the thing is that the day before I went into the hospital (the event that caused me to go on leave), I had a script for Ativan and I took twice what I was supposed to because I was trying to sleep so I didn’t harm myself. They see that as evidence that I am a drug abuser. *heavy eye roll* My Treatment team sees it as a sign of psychiatric crisis...which it was...there was no pattern of use or anything, and diagnostically if doesn’t even come close to being substance abuse. But nonetheless...here I am...
I wish I could do hair tests, but they denied me that.
Anne2.0, you’re very right. They basically can do whatever they want to me. And I just have to sit here and take it, or else they label me as still being psychiatrically unstable because I’m fighting them. So I’m trying to practice some radical acceptance here and make it through. I only have to do this 16 times. Or so they say. And then hopefully I’ll be free.

[unaluna]

Plus, you will want to remember these days when you could NOT pee as desired, when the days come when you can NOT NOT pee as desired. :Oldladyblues:

[MRT6211]

Originally Posted by unaluna

Plus, you will want to remember these days when you could NOT pee as desired, when the days come when you can NOT NOT pee as desired. :Oldladyblues:

Omg thank you. Maybe keeping that in mind will help me get through this. Ahaha.