Fun and Games and Psychiatrists’ Names
I do not know what to make of my visit the psychiatrist(s) today. I am not even sure what the fuck to write about it.
I suppose it is worthy of mention that the appointment was in the building in which C used to be housed. He has been gone from there for several months now, and it was really strange being back there. His new office is better than his old one was, but the actual waiting area in his new building is a depressing shithole, which is funny given the nature of the clientèle. The waiting room of this morning is much more appealing, though I was as nervous as fuck and was actually rocking back and forth in front of the other mental freaks there waiting for their appointments. They kept looking at me, clearing believing that they must be sane in comparison to your humble narrator.
Anyway. After waiting for what seemed like ages – coffee is very important to medics, let’s not forget – I was finally greeted by a young woman. My initial reaction was, of course, one of annoyance; it seemed my fears that someone inexperienced would be treating me were realised. However, she introduced herself as Dr N – the senior house officer of Dr C, the consultant, with whom my appointment was scheduled. Dr N said that the way things worked was that she would take a case history, discuss it with Dr C, and that then I would meet her and Dr C both. So that was a bit better.
Having said that, I am sick and tired of providing mental health professionals with ‘case histories’. I have told it to C. I have told it to my GP. I have told it to previous NHS mental health fucks. Can’t they share this fucking information amongst themselves? Why don’t they ask questions about the here and now? Why does NHS bureaucracy not actually work?
I won’t go into great detail about the conversation with Dr N, as it would be to repeat a lot of stuff I’ve already detailed on this journal. Suffice to say I told her about V, about the sexual abuse and my worries about MW and the other generations, about school (which to my annoyance she kept calling a secondary school – it is actually a pretty prestigious grammar school, love), about my self-harm and suicide attempts, suicide ideation, how much school I missed, how long I could hold down any one job, etc etc etc. There was much more I wanted to say to her – I had listed all my symptoms on a sheet of paper specifically for the psychiatrists last night – but she didn’t give me the opportunity. Not that she was unpleasant; she was nice enough, and seemed understanding and empathetic. I half-relaxed during my time alone with her.
A couple of things piqued my interest; firstly, it seems that the referral with which she and Dr C are dealing is actually the one from C, rather than Lovely GP. I am now expecting to hear from some other psychiatrist on top of this, as NHS admin is clearly pathetic and will see it as two separate referrals, rather than two overlapping referrals for the one person. The second point of interest was that Dr N specifically asked me what I thought was wrong with me. I had already told that her my endless capacity and need to self-analyse and diagnose was pointless, but she said, no, I was the one who knew my symptoms best. So I told her that whilst it was very clear I do suffer from depression and anxiety, that I also wondered was it possible that I was borderline and bipolar, with elements of narcissistic personality disorder. She noted this, but made no remarks to refute or confirm my suspicions.
Then she went off to see Dr C, whilst I waited in the room. I was interested to observe that the daft cow had left several other patients’ files sitting on her desk; unsurprisingly all marked “confidential”. I could have sat and read them in some detail had I so wished, as she was gone about 10 minutes. I could be stalking the personnel concerned at their home addresses right now rather than be sitting here typing this spiel of cack.
In any case, eventually Dr N returned, and said that Dr C was ready to see me now. This meant I had to talk to both of them, which was not an appealing prospect.
I despised Dr C on sight. She oozed a complete lack of empathy and I felt that she was sneering at me. That’s probably paranoia, but really – I hated her. She is a hard-faced, hard-nosed, miserable looking old bitch.
She interrogated me as if I were some sort of criminal. She asked for anal detail about how I felt when I was manic, how I felt when I was depressed, how I felt when I was in one of my frenzied panics blah blah blah. This was not easy; it is hard to describe these things when you are experiencing them, so can they imagine how difficult it is when you are not experiencing them? In any case, to exemplify the frenzies, I detailed as much as I could recall from the incident at my cousin’s birthday party. She did say that these episodes are, in her view, probably just panic and do not necessarily represent psychosis. Is it strange that I am actually upset rather than pleased by this? Do I want to be mentally ill?! I think perhaps that what I was hoping was that she would come to all the issues of delusions, hallucinations etc but since she didn’t, I felt I had to convey some of the more serious aspects of my madness in response to what she did ask. Perhaps I simply didn’t put it eloquently enough, because that episode at my cousin’s was pretty hardcore in my view.
She asked what the worst part of it all was; I said, “dealing with people, though paradoxically I am terrified of being abandoned”. Dr C said, “so it’s about relationships? That is stronger than your depression?”
This annoyed me. One factor is not stronger than the other. I tried to articulate myself reasonably in response to her for a minute or two, then gave up and said, “I can’t say which is worse or more prevalent. There’s just so much.”
To be fair to her, Dr C accepted that and changed tactics by asking what “work” I was doing with “Dr J”. This infuriated me. C is not Dr J. He is C. He doesn’t call himself Dr J, he calls himself C. I call him C. Dr C also called herself Dr C and her colleague Dr N. Fucking bitch. Does she think they are worthy of a pedestal status, sitting up there in their ivory towers, hiding behind their titles? ‘Dr’ C and ‘Dr’ N are almost certainly not real doctors anyway; C is the only real doctor amongst the three. He has a doctorate in psychology. They have MBs or BAOs or whatever and almost certainly no ‘D’ after their names, so the old bag should shut the fuck up (American readers: medical doctors in the UK are not required to undertake MDs or PhDs or whatever doctoral study here. Most of them have Bachelors degrees and call themselves ‘doctor’ only by convention). After two hours between Dr N and Dr C, I still don’t know what either of their first names are. It feels like being back at school. In fact, it’s worse, as in sixth form at least I was actually on first name terms with two of my teachers.
In answer to her question, anyway, I said that my “work” with C had been largely of a psychodynamic bent hitherto, but that he now wanted to try DBT as well.. I’m not sure whether I brought it up or whether it was her sensing my cynicism but in any case this led on to a discussion of how I felt the DBT material was patronising. I did tell her that I felt there was some useful stuff, but that it just seemed to me to be CBT in disguise and that that had not in any way worked for me.
I was quite annoyed, as she seemed amused by my annoyance at this type of therapy. She has the most punchable face I’ve seen outside of TV in many years.
Basically, the long and the short of the meeting ended up being that they want to discuss my case in full with “Dr J” because at present they only have a brief referral letter from him. In the meantime, Dr C has suggested cutting my dose of Citalopram from 40mg to 20mg. This seemed odd to me, but to be fair her rationale was reasonable: if it is really not helping as I believe, reducing it will mean that I will see no marked deterioration in my condition when I next see her (in three or four weeks, apparently). If I am mistaken and that it actually does do something, then I will feel even worse. I agreed to do this, and for her part she will go off and talk to C and, between the three of them, they will “see if they can do something to help”. At this point she finally smiled, and I think it was genuine.
I still hadn’t had the chance to show either of them the list of symptoms I’d spent so much time on yesterday so I made sure to give it to Dr C before I left. She accepted it with thanks and did acknowledge that it can be hard to articulate oneself verbally, especially in unfamiliar and/or formally conscribed situations. Then she actually volunteered the view that the sheet could be “very useful” and said she would peruse it in detail. Then Dr N showed me out, saying that I would get a letter regarding the next appointment probably within the next week, after they have spoken to “Dr J” (this was annoying as Dr N had called him C, not Dr J, whilst we were alone and until Dr bloody C got involved. Why couldn’t she have kept it that way?).
All in all as I write this, it doesn’t seem as if it was that bad and I think that I really should be grateful that at least they are willing to progress my “case”. Dr C doesn’t seem, on (electronic) paper, as bad as I felt she was. Perhaps detailing it here is cathartic because I feel a bit more positive about it now. But I left the place with a very heavy heart. As I was driving back to A’s along the motorway, I toyed with the idea of driving into one of the huge pillars that holds up one of the many bridges along the route, or even into the articulated lorry in front of me. I quite deliberately broke the speed limit several times with this intention in mind. As ever the only thing that stopped me was the horror I felt at the potential of having Disraeli, my car, written off. My car is more important to me than my life.
As Twitter readers will know, after perusing the DBT material from C last night I reacted with some anger. There are some fair points in it, but a lot of it is condescending rubbish, particularly the authors’ need to always exemplify their points. I am not brain dead. I understand the concept, fuckheads. Really, I get it. You do not need to explain it by telling me how fucking Sandra or cunting Ronnie, who don’t even exist, behaved or reacted. I have annotated the sheets to this effect and will have no problem showing the remarks to C. But then this makes me feel guilty and sad. I don’t want to dampen C’s enthusiasm and I don’t want him to abandon me. He knows me better now than to suggest something so apparently wholly inappropriate, doesn’t he? He must really feel it’s worthwhile. Perhaps I should just put my scepticism to one side and give it all a go, just like he told me to do. As I told Dr C today, things have got to the stage where I’m willing to try anything. If something doesn’t work soon, I’m either going to top myself or get sectioned. So I will try and approach this DBT with as positive an attitude as possible, I suppose. It’s just that everything is so hard and it’s all getting on top of me. My new worry is seeing C on Thursday after the shrinks have spoken to him. Will they tell him some of the more bizarre stuff, such as the shapes? How will he respond? More importantly, why the sodding hell do I care?
Meh. I don’t get myself at all.
This entry was posted on Friday, 29 May, 2009 at 4:09 pm and is filed under Mental Health Diagnoses, Moods, Psychotherapy with tags anger, anxiety, bipolar disorder, borderline personality disorder, bpd, clinical depression, cutting, dbt, delusions, depression, Dialectical Behaviour Therapy, Dialectical Behavioural Therapy, hallucinating, hallucinations, insanity, insomnia, madness, major depressive disorder, mania, manic depression, mental health, mentalhealth, mindfulness, panic, panic attack, psychiatry, psychodynamic psychotherapy, psychology, Psychotherapy, sadness, self harm, social anxiety, suicidal thoughts, suicide, suicide ideation, therapy. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.