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Soon after this meeting, Amanda experienced another episode of feeling as if she were unreal and cut herself a number of times across her wrists with a soda can she had broken in half. The cuts were deep enough to draw blood but were not life threatening. In contrast to previous incident, she did not try to hide her injuries and several staff members therefore concluded that Amanda was exaggerating the severity of her problems to avoid discharge from the hospital. The members of Amanda’s treatment team then met to decide the best course of action.