Katie had a rough morning.  She banged up her face pretty good.  I'm not sure what happened.  I've emailed her team leader because the staff who was explaining to me what happened has a very heavy accent and to be honest I'm not sure what he said.  I know Katie hurts herself.  She scratched her roommate while her roommate was still in bed this morning.  I know Katie feels a lot of remorse when she hurts people and I know that she will hurt herself when she's upset.

What I don't know is how to stop this.  It's not getting better, it just keep getting worse.  I know part of it is communication, or lack of it.  Part of it is her staff not knowing sign language.  Part of it is Katie not knowing how to express what she feels.  Her feelings usually come out in actions.  Part of it is anxiety.  Part of it is a fucking cape and wheelchair to protect the people around her.  Part of it is a brain that can't cope and is stuck in permanent fight or flight mode. 

I don't know how to help her and it breaks my heart.