Thursday, March 06, 2008

Even the nicest psychiatrists are wankers

We had a guest speaker in my clinical practice class, a psychiatrist who specializes in mood and anxiety disorders. He spoke about treatments for depression, and even though he had a ton of useful information to convey, and seemed like a very sympathetic clinician, I found him terribly condescending.

He struck me as having a very "us vs. them" mentality, "us" being the practitioners and "them" being the clients. He kept saying things like, "It's important to get a medication history from someone besides the patient, because patients won't remember how long they were taking a particular medication or what the dosage was -- they'll just remember it was a blue pill."

Excuse me -- but I've taken a lot of pills, and I've been able to keep or compile records of them. And I remember a lot more about them than the color and shape, including dosages, side effects, and what worked for me or didn't. So do many of my current clients, whose disorders are much more severe than mine. Not all "patients" are feckless wretches.

So he just rubbed me the wrong way, and I got very sharp and testy. To his credit, when I asked him questions in a challenging tone he responded politely and appropriately -- he's trained to deal with difficult people, and unlike some mental health professionals, he didn't get defensive when I contradicted or confronted him. But it was very hard to listen to him describe patients and their symptoms -- my symptoms -- and not be offended.

Part of the problem is that I'm experiencing some trouble right now controlling my own mood and symptoms. Including terminal insomnia -- it's 2 a.m. right now -- and use of my light therapy box. So when he was describing symptoms I'm troubled by, or medications I've taken, or strategies I've tried, it hit terribly close to home. But I still feel bad about being rude.

The class is taught by Professor Supportive, who participated in the panel discussion I organized last semester. So she knows I have bipolar. I sent her an apologetic email just now:

I'm sorry if I came across as sharp or disrespectful during Dr. Wanker's lecture. I'm struggling a lot right now managing my own symptoms, including terminal insomnia, medication changes, and when and how much I should be using my light box now that the days are getting longer. So focusing on depression treatment options brings up a lot of emotional responses in me.

Also, I kept feeling that, nice as he is, he's still got a very psychiatrist-like "us vs. them" mentality. I'm very sensitive to practitioners who don't really recognize or acknowledge their clients' strengths. Of course, psychiatrists aren't trained the way social workers are, and it might be better if they were, but he really rubbed me the wrong way.

Still, I shouldn't have been so testy. Please chalk it up to sleep deprivation and being reminded a little too much of my own current situation.


UPDATE: Professor Supportive wrote back.

Dear Ayelet, thanks for sending your apologies along with such a thoughtful message. I know how these things can happen, especially when the topic is sensitive, and you're dealing with issues close to home. Meanwhile, I hope you are okay -- I know trying to finish up this whole program is incredibly stressful under the best of circumstances. Please let me know if I can be of support.
Copyright (c) "Ayelet Survivor"

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