Ok, so I’m not ok with this

Warning: this is a long and rambling post.

Ever since my most recent visit to see General Psychiatrist, I’ve been bothered by what happened at the appointment.  It was almost 4 weeks ago (27 days to be precise), and it’s been something I’ve thought and puzzled about for most of that time.  4 weeks is a long time to sit on my fat arse doing nothing about it, I know.  To a certain extent, that’s been deliberate – I wanted to be sure my initial emotional reactions had settled down – but it’s also because thinking and writing about this whole thing is something I’ve been finding very difficult.  It is, I’ve decided, time to grasp the nettle, however.  To be honest, I’m not sure how much sense this post will make if you know nothing about the appointment itself – you can read my initial account of it here, which was written in the heat of my initial emotional reactions.

I guess my overwhelming feeling about the whole experience now is one of humiliation.  I felt belittled and patronised by what the General said, and how he said it.  The things I had told the General about in that appointment, and the one that preceded it, I had never told, in their entirety, to anyone.  It was a big deal for me to be so open.  I think in this blog I tend to come across as self-confident, and sarcastic, and articulate, but I’m really not like that at all in real life.  This persona I’ve created and given a name to – Aethelread – although he shares the same experiences and opinions and attitudes as me, isn’t really me, for all that.  He’s like me on those rare occasions when I’m at the top of my game and feeling great, but for most of the time I’m quiet, and withdrawn, and almost painfully inhibited, especially when it comes to talking about things like this.

Quite apart from anything else, it’s just embarrassing to sit under the staring eyes of a virtual stranger and own up in the cold light of day to things you know are more-or-less batshit crazy.  Psychiatric appointments are probably my least favourite experience in my life, ever.  I mean that quite seriously.  They’re embarrassing, and threatening, and infuriating, and socially awkward (why does he try to pretend like he’s my friend, for god’s sake?) and just awful.  I turn into a stammering, inarticulate idiot.  I become incapable of sitting still.  I fidget with my hands, and my knees twitch, and my voice shakes with the effort of forcing anything out into the open.  I can’t make eye contact, I look at my hands, at the door, at the clock, at the skirting board, at anything.  Sometimes I manage to pretend that I’m making eye contact by looking, not directly into his eyes, but at the epicanthic fold at the corner of one or other of his eyes.

It’s because of all of this that being told that I wasn’t mentally ill really was devastating.

I’m not sure he actually meant it.  After he’d told me, he asked a lot of questions about how I manage my depression, and told me with a big, beaming smile that I was ‘doing all the right things about that’, so I’m pretty certain he thinks I have depression.  He also told me that ‘you have that thing where you feel very anxious in social situations – you obviously get that a lot’.  So, all in all, it was pretty clear to me that what he meant was that I don’t have an exciting mental illness.  I just plug along with depression and anxiety.  There’s nothing ‘glamorous’ in my mentalism, like schizophrenia, or bipolar disorder.  (I know that in real life there’s nothing glamorous or cool or exciting about those illnesses – they’re just a different way to experience misery – but I’m talking about the impression I got from General Psychiatrist here, not my own attitudes and opinions.)

This was one of the things I found most humiliating – the implied assertion that, because I didn’t have a ‘sexy’ mental illness, I couldn’t be mentally ill, or at least, not mentally ill enough to be worth bothering with.  It seems to be a common attitude amongst people who work in MH services.  This is zarathustra from a little over a week ago:

My own opinion is that mental health services should always be focused on the people with severe, debilitating mental illnesses – schizophrenia, bipolar disorder, eating disorders etc.

Now, zarathustra was writing that in the context of an attempt to create controversy (and he’s been successful – 52 comments at the time I cut and pasted this excerpt), and also in the context of writing about a moderately idiotic proposal from the government to employ additional therapists to help people cope with the ‘depression’ they may feel on losing their jobs.  For what it’s worth, I agree with the assertion that depression is over-diagnosed, and that feeling bad when you lose your job isn’t a symptom of disease, and that it’s unhelpful to the patient to treat it as though it is.  But the underlying attitude still bothers me: if you don’t fit one of those severe labels, then how dare you waste the time of MH services?

Something else I found profoundly humiliating was the General’s patronising attitude to a lot of what I said.  The most over-used phrase in the whole appointment was ‘I don’t do therapy,’ and it was wheeled out every time I showed any evidence of having thought something through for myself.  So when I told him about the fact that I try to work out whether something like being spied on is true, his reply was ‘I don’t do therapy’.  It had nothing to do with therapy, it had to do with me trying to tell him how I work out if I’m getting paranoid or not – in other words, it was pretty damn relevant to someone who had just, explicitly, asked me if I thought I was paranoid.  But – ‘I don’t do therapy.’

It was obvious he thought of me as a therapy casualty.  He tried to imply that I hadn’t ever really experienced any of the things I told him I had, but had just thought that I had under the ‘intensive pressure’ of therapy.  (Personally, I’m not quite clear on the distinction between real psychosis, where you think imaginary things are real, and pretend psychosis, where you think imaginary things are real, but there you go.)  He decided, despite the fact that I had told him the opposite, that I hadn’t been bothered by any of my symptoms before entering therapy, and that I was ‘one of those people who it would have been better if they’d never known.’  The implication here was that I used to skip happily about my business, exchanging pleasantries with my hallucinations, and that it’s only become a problem because my therapist said it might be, and now I’ve gone and got all anxious about it.

I’m doing a bad job of keeping my emotions out of this section aren’t I?  So, in keeping with my status as a therapy casualty, let’s acknowledge them explicitly.  I felt humiliated, and now, in reaction to the humiliation, I feel angry.  But I don’t think either of those feelings are inappropriate.  I don’t think I’m doing a bad thing by refusing to turn the feelings of humiliation and anger on myself, and criticise myself for being a bad person, for having done the things that the General seems to think I did.  I think it’s ok for me not to be ok about this.

Something else I think it’s ok for me not to be ok with is the overwhelming sense I have that I’m being played games with.  This is something it’s going to be very difficult for me ever to be sure about.  I have a tendency towards paranoia (and, btw, when I say that, I say it in the sense that a layman does – I’m not attempting self-diagnosis), and believing that the people you interact with are deliberately hiding things from you is getting pretty close to paranoid conspiracy theory.

But I can’t just dismiss the General’s comments about my being ‘odd’ and seeing the world ‘uniquely’ and having a set of problems I will very likely struggle with for the rest of my life.  Particularly that last part – how could the general say that unless he had some sense of what was causing those problems, and a sense that whatever it was, it was unlikely to ever change?  When I last wrote about this, I deliberately didn’t draw any conclusions about what the General might have meant, although I did have some ideas.  I wanted to leave it as open as I could, in the hopes that, if it suggested something to someone else, any responses they gave would be more objective.

As it happened, three people suggested the possibility that I might have been diagnosed with a personality disorder without being told about it.  This is what I had been wondering about myself.  As I said at the time, it just seems to make sense to me in terms of it being like a mental illness, but not actually a mental illness, and also incurable.  I was a bit more taken aback by the suggestion, which two people made, that my ‘incurable difficulties’ could be an indication that I might have an autistic spectrum disorder.

In a sense, the precise details of what the specific issue might be don’t matter too much to me at the moment (although, clearly, they’ll become important in the future).  What definitely does bother me is the suggestion that there might be something that is being kept from me.  Again, of course, I have to keep aware that this is starting to shade in the direction of paranoia – but the fact that several people have interpreted things in the same way does suggest that this may not only be a figment of my imagination.  And I do very strongly have the sense that I’m not being told the whole story, and have had for a while.  It’s why I asked to see the original referral letter, and the extremely anxious reaction by Yvonne definitely made me wonder why the thought of me seeing my notes might be so alarming.  I think the General’s assertion that I was the sort of person who is better off not knowing is also perhaps relevant: better off not knowing what?

Anyway, this is in danger of spiralling off into ‘potentially perhaps maybe could’ve been’ territory, and that’s not especially helpful, or interesting to read.  Trying to bring things back to some kind of focus, I think there are really three reasons why I’m not ok with what happened at the appointment:

  • the way General Psychiatrist acted and behaved;
  • the fact that all attempts at diagnosis and treatment seem to have been abandoned;
  • the possibility that there is something that has been decided about me that I’m not being told.

The first of these points I am, I think, going to have to just let go.  I’m annoyed about that, but I can’t see any way that I can raise or tackle the issue safely.  While there’s a chance, however remote, that I might have been labelled with a personality disorder, I think I need to be very careful about expressing anything that could be interpreted as emotional instability, or problems with handling interpersonal relationships.  It would make it far easier for them to dismiss what I say if they can pretend that I’m just ‘acting out’ because of an imagined personal grievance.  I’m going to be much harder to dismiss if I seem to be displaying a friendly, helpful, logical approach.  In practical terms, I think this means I’ll need to be careful to say things like ‘I didn’t understand what General Psychiatrist meant when he said…’ rather than ‘I felt insulted when he said…’.  It’s going to stick in my craw having to pretend to understand things less well than I actually do, but I think I have to do it.

There are, I think, three ways of dealing with the remaining points.  One possibility would be to try and make an appointment to see General Psych, and explain the problems I have, and give him a chance to set the record straight.  The problem with this is that I really don’t like the man, and, given the choice, I’d rather not spend any more time in his company.  I also don’t think there’s much chance of anything coming from it.  I’m pretty sure that, how ever I approach the issue, he’s going to interpret me questioning him as a personal attack.

Another possibility is to ask to see my notes.  This is, if I’m honest, the approach that appeals to me most, if only because it will give me direct access to what the various people who’ve met with me actually think, without it being wrapped around with all the ‘suitable for patients to understand’ bullshit.  But there are drawbacks.  For example, I think it’s likely to be viewed as a hostile, or maybe even belligerent, act.  That wouldn’t normally bother me – it is my legal right to see my notes, and they can take a running jump out the window if they don’t like it – but I have to bear in mind that I’m likely to be dealing with these same people for a very long time.  It would almost certainly be a mistake to alienate people I’m likely to be dependent on in the future.  It annoys the crap out of me that I have to think like this, but it would seem to me that I pretty much have to.

The other main drawback is that I’ve discovered that my legal rights are actually a lot less robust than I thought they were.  On checking, I’ve found that all or part of my notes can be withheld if there is reason to fear that allowing me to see them constitutes a ‘serious risk to my physical or mental health’.  There is, of course, no guidance as to what would be a ‘serious risk’, but, obviously, if they’ve already decided not to discuss something with me in person because it’s ‘not in my best interests’ to know, they’ll apply the same logic to the written record.  I have also seen some official documents online (they relate specifically to the Trust I would be dealing with, and I’m not linking to them so as not to give away where I live) which suggest that it would be considered acceptable (or, at least, not illegal) to create fabricated replacements for documents they don’t want me to see, in order to allay any suspicions I might have that I’m not being shown all my notes.  This situation seems pretty unfair to me – the people who diagnose and treat me are allowed to withhold from me the information that would enable me to discover whether or not I’m being diagnosed and treated correctly.  But all of that is pretty much academic – I need to face the fact that asking to see my notes might not actually get me anywhere, and is very likely to antagonise and alienate people who’s good will I’m likely to be dependent on in the future.

This seems to leave one final option, which would be to go and see my GP and have a chat with her about what has happened.  I would clearly be hoping that she would be more forthcoming, and might be willing to explain a bit more about what’s actually going on.  The disadvantages to this are that, firstly, I would feel awkward taking up an appointment for something that isn’t really a medical problem, and, more importantly, there’s no guarantee that General Psychiatrist will have written to her to let her know what the situation is.  Technically, I’m still under the General’s ‘care’, so my GP may well not know anything except that I have been referred to him.

In other words, there really isn’t an easy way out of this.  Deciding I wasn’t ok with what happened, or with allowing things to just drift on in the way they have been, was the easy part.  Deciding what to actually do about it is going to be far harder, I think.

As a final point, I have to say that all of this seems very unfair to me.  Why do I have to go through all this?  Why can’t I just have a straightforward, adult discussion about all the issues that there are, or seem to be?  It is, pretty much, what would have happened if I’d been referred to an outpatient clinic for a physical problem, after all.  There are times when I’m convinced that all of these things are power games played by the people who work in mental health just because they can.  I mean, the patients are loonies – who’d ever take any of their complaints seriously?

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15 Responses to Ok, so I’m not ok with this

  1. NiroZ says:

    Reminds me when my psychologist said that I was normal. If that was the case, then bloody hell I don’t want to be normal. I think, on some level, some people find being told that they don’t have a mental illness. But they need to be more careful who they say that to.

    My opinion. Write down your grievances, see the GP, and get a second opinion. Anyone who ‘doesn’t do therapy’ is an incompetent arse who just doesn’t have the guts to talk.

  2. NiroZ says:

    Addendum. some people find being told that they don’t have a mental illness to be relieving.

  3. Zarathustra says:

    In all fairness, I wasn’t suggesting that people outside the severe mental illness bracket shouldn’t receive support. Just that people with transient problems such as a situational depression due to a job loss should be supported at a primary care level, with GPs offering a course of counselling or antidepressants, with the secondary-care services like the CMHT being more for people who are showing signs of having a more severe or enduring problem.

    I mentioned this within my own context of child and adolescent services, about how some of the kids currently seeing CAMHS could probably be better supported by in-school pastoral and counselling services rather than a psychiatric service.

    For what it’s worth, something that’s clear from your writing is that your depression isn’t simply a short-term reaction to a transient life crisis, and therefore I’d take the view that your referral to a CMHT would be entirely appropriate.

    There’s also a related issue of people who should be getting a secondary-care service but aren’t because the services simply don’t exist – personality disorders and eating disorders spring immediately to mind. But that’s another rant for another day.

  4. Lucy McGough says:

    NiroZ – not if they know that something is wrong, but nobody in the medical profession seems to be acknowledging the fact.

  5. Mandy says:

    Hi A

    You are not alone in finding meetings with psychiatrists daunting. Know that is obvious to those of us who either have to or wish to see the but that said it doesn’t make it any easier on an individual basis.

    The shrink/patient relationship has always been ‘difficult’ for the patient because of the hierarchy. the power that psychiatrists have (whether they choose to use it or not) over a person. Maybe it is the power someone lets them have but is not like we are in a really strong place to negotiate. I certainly don’t see a psychiatrist when I am feeling okay and the vulnerability makes it an unfair balance. They call the shots and, in most cases, they make that very clear.

    Also there is such a distance between the 2. Most people are lucky (or unlucky depending on relationship and outcomes of meetings for them) to see their psychiatrist 3 times a year. How can a psychiatrist know much of anything about that person’s life and how they are living it and it certainly can’t be gauged in a 20 minute appointment.

    Having one of the more sexy mental illnesses hasn’t done me any favours so the media can stick it’s view of bipolars as creative preciousnesses, as that is just as patronising as people thinking people with mental illness are useless articles fit only for the burner. All these mass produced ideas of what mental illness is do none of us any favours. Really, what I have to say about that is “Try it, you wouldn’t like it”.

    From my own experiences of the depressive side of my illness, I know that depression is foul. It is much more (in a negative sense of being) than that one word can express but it is foul. I think, the general view of depression..encouraged by government, the media and lack of understanding, all round ….is that it is a rather mild condition which with continual taking of the likes of Prozac is totally maintained and thus people will and should return to work forthwith. The reality is, as you will know yourself, rather different.

    I think the lack of understanding comes from the misapprehension that reactive and clinical depression are one and the same although clincical depression is definately worsened by traumas and stress (and therefore has a reactive element in addition to on-going state),

    anyway, am rambling and those in the know will already know the score.

    Perhaps it would have saved both you and the shrink’s time if they had just said to you “Well, you are still alive so you must be okay” because I think there are those professionals who use that as their gauge.

    ……and lucky me, am off to see psychiatrist today. Am under no illusion that it will be a constructive meeting with positive outcomes for me but am willing to give it a try.

  6. Mandy says:

    Hi A

    Apologies for assumption …as in I don’t know what you know yourself and my writing that was OTT.

    :>)

  7. bluesilk says:

    Hiya,

    it’s a tricky one. I don’t think asking to see your notes needs to be a big deal if you approach it breezily, like, “by the way, I’d quite like to see my medical notes out of interest. How do I arrange it?”.

    But if you’re not confident parts wouldn’t be witheld then I suppose it would defeat the object.

    I once had a psychotherapy evaluation, the results of which were sent to my psychologist at the time. She was reticent to let me see what had been written about me. I demanded and she relented but when I expressed upset about what had been written her response was “I shouldn’t have let you see them”. This made me FURIOUS. Of course she should have let me see them. The fact the stuff said was upsetting (most judgements from on high are) meant it was appropriate to help me through the emotions, not decide I shouldn’t have been allowed to read what had been written about me.

    Sorry, that’s my own irritation coming out but I feel pretty strongly about it. The psychiatrist/patient dynamic is inherently unbalanced in power terms. If the patient is expected to tell the psych stuff they wouldn’t even tell their partner then they need to, in turn, be open about what conclusions they are drawing and why.

    Hope you find a resolution anyway :)

  8. aethelreadtheunread says:

    Thanks for all the comments. For some reason, NiroZ’s original comment at 02:43 got trapped in the spam filter, and didn’t appear until i approved it just before this appeared. It follows that Lucy McGough’s comment made at 08:54 was made having only seen NiroZ’s second comment at 02:47, which may (or may not, of course!) have made a difference to what Lucy wanted to say. :o)

    NiroZ – thanks for the advice. I’m not sure going to my GP with a list of grievances will neccesarily be helpful – i think i probably need to approach this in an ‘exploring difficulties/ confusion (my own)’ sort of way. It’s not what i actually think, of course, but i think this is probably the game that i have to play. I’m also not sure of the likelihood of receiving a second opinion – it’s hard enough to see one psychiatrist on the NHS, let alone two.

    On the being told you don’t have a mental illness issue, i’d agree with you when you say that they need to be careful who they say that to – in that they should only say it to people who don’t, in fact, have a mental illness. Saying it, even as a therapeutic strategy, to someone who does have a mental illness is just, in my opinion, wrong.

    Zarathustra – sorry if i misrepresented you. I would be entirely willing to concede that this is a bit of a ‘hot button’ issue for me at the moment, and that may well have led me to draw conclusions that i shouldn’t have. I am in a rather ‘me versus the medical establishment’ mode at the moment, i’m afraid. :o)

    Lucy McGough – thanks for commenting. :o)

    Mandy – I hope your appointment with your psch went/ goes well. Just becuase mine seems to have certain chocolate teapot tendencies doesn’t mean they all do!

    I agree with everything you say, i think, so you don’t need to worry about what you said. :o) It’s one of my biggest bugbears that depression isn’t treated seriously by the media and society. I guess that bugs me because it affects me personally, but i’m sure it must be just as annoying and soul-destroying having to cope with an illness that people think makes you ‘interesting’ and ‘artistic’. I don’t agree with any of that nonsense, so i hope it didn’t come across like i do!

    bluesilk – i’m basing my expectations of how people are likely to react to me wanting to see my notes on the reaction i got before, which was barely concealed panic. I think that, for whatever reason, medical people, and MH people in particular, just really, really hate the idea that a patient might be able to see what’s been written about them. But that may, of course, not be the situation everywhere.

    I agree with you entirely about your psychologist having got her response wrong, and i’d have been furious if i was in your shoes, too. I guess it might have been appropriate for her to do some ‘how would you feel if what you read is negative?’ type probing to get you acclimatised to the idea that it might be upsetting before showing it to you, and have been ready to talk through the issues afterwards, but the idea that you should have been prevented from seeing them is just maddening.

    Thank you for your kind wishes – i hope i get a resolution too! :o)

  9. beetrootsoup says:

    Hmm, I have to say he sounds like a bit of an asshole. What did he mean by saying ‘I don’t do therapy?’ It’s neither here nor there, as you point out. Is he grinding some sort of anti-therapy axe I wonder?

    The best scenario one can hope for with a psych is to have some level of continuity with one, so that they get to know you. Mutual respect is absolutely crucial if you are to work together. All too often this is absent.

    The relationship is always going to be somewhat fraught with need and expectation (not to mention power imbalance), unless you are one of the lucky ones who is more or less in control of the condition. It’s best to approach it with low expectations if at all possible.

    I know your situation is different though. You are simply trying to get your mental health needs recognised and validated so that you can access whatever treatment you need as well as get the necessary benefits etc. This is not an uncommon scenario.

    It is a tough one A. I really feel for you. Is there anyone you know who could attend appointments with you as a kind of advocate? I can see you finding that idea abhorrent, but I do think dealing with this all on your own must create so much anxiety for you, and you have no witness of what was said to corroborate (or not) your experience. Take care. Love Zoe xxx

  10. Alex says:

    I don’t think anyone would expect you to be OK with this kind of thing. Apart from General, but fuck him (and I mean that as a dismissal, not a suggestion ;) ). I don’t know why some mental health professionals take it upon themselves to try and be your best mate. My CPN calls me ‘mate’ often enough that I’m beginning to suspect he’s forgotten my name.
    I think you’re right in suspecting that raising the issue with him directly would probably end badly. To my (hugely unqualified) eye, the best option looks like asking to see your notes.
    Mental illness is hugely unfair. I wouldn’t wish this kind of depression on my worst enemy, and all of the people I’ve encountered in the MH blogosphere have been lovely people who deserve long happy lives without having to worry about CMHTs or SSRIs.
    But what do I know? I don’t do therapy.
    Take care.

  11. loopykate says:

    Aethel – I looked back to your previous related post and noticed in my comment that I’d guffawed somewhat then. Please believe me that i wasn’t laughing at you or your predicament – far from it – I was laughing at the amusing, wry way you’d reported the situation. The situation is indeed very troubling and I completely understand your frustration and angst.
    It sounds to me as if you’ve pulled a short straw and got some dick-head of a shrink who, for one reason or another, is dismissing you because you don’t easily fit his criteria.
    You have a right to see your medical records and these SHOULD NOT BE CONFABULATED on any grounds (who, what, where said they could?). There is a blogger who undertakes work helping patients access their records. I suspect you know who this is. Perhaps they might have some advise for you on this issue.
    I’m currently training as an advise worker for the Citizens Advise Mental Health team. I haven’t been there long enough to feel confident in doling out informal advise. Challenging Psychiatric decisions (or non-decisions)and gaining acess to notes is obviously something that crops up alot and is one of the most difficult type of cases for the bureaux given the power structures involved. I am going to bear this post and the issues it raises in mind.
    K.x

  12. No Other Medicine says:

    I’d say that if you GP is of the helpful/supporting variety they’d be a good place to start. Don’t feel guilty about taking up appointments, that is what they’re there for too. They can go to the General and be regarded from a professional and sensible position, where as anything you say can be taken as further example of what a nutter you are. Maybe the GP can get the notes for you?

    On the subject of interesting illnesses I think I was treated better when they thought I just had situational depression, because that can be fixed. One dose of tablets and one course of therapy and you’re cured, box ticked, quotas met. Now I’m diagnosed with bipolar there is no getting rid of me, no cure, so no interest in helping me because they know I’ll just be back a week, month or year later.

  13. aethelreadtheunread says:

    Thanks for the extra comments.

    beetrootsoup – wow, you must have hit ‘submit comment’ just seconds after i did… ;o)

    I think you’re absolutely right to say that he’s grinding an anti-therapy axe – it practically radiated off him. I do, at least, have continuity with him – he’s the only psychiatrist i’ve ever seen, and i must have been having appointments with him, off and on, for getting on for 3 years now. Mutual respect isn’t really on the cards, i think, and from his side as much as mine.

    I really don’t know anyone who i could ask to advocate for me, and, as you say, it’s not something i’d really want to do anyway. I think my few remaining tatters of self-respect would just flutter away if i thought i couldn’t even fight my own battles anymore…

    Alex – thank you for the support! Oh, and don’t worry, there’s absolutely no chance of me taking ‘fuck him’ as a suggestion – defensively heterosexual power-crazed pricks don’t really do it for me… ;o)

    If someone i was seeing in a MH context called me mate, i don’t think i’d take that well at all. In fact i think i’d probably get all prissy and say something cringingly embarassing like ‘I’m not your mate, i’m your patient’. But perhaps CAMHS try to maintain a more informal approach, no matter how cringingly embarassing it may be to be on the receiving end of?

    The ‘lovely people’ thing also applies to you, btw. I hope your own difficulties recede soon. :o)

    loopykate – don’t worry about your previous comment – as i said at the time, laughter is an entirely justifiable response. :o) I don’t actually know who the blogger you’re talking about is – but it’s also academic at the moment as i haven’t quite decided if i want to go down the asking to see my notes route yet. Thanks for the tip-off about the CAB too. It hadn’t occurred to me, but of course they are a potential source of help if i do seem to be having difficulties accessing all of my notes. Still, let’s hope it doesn’t come to that!

    Good luck with your training – i’m sure it will be challenging but still very worthwhile work. :o)

    No Other Medicine – i think my GP is likely to be supportive, but i wouldn’t actually be 100% sure she’d still be there – she was obviously a fairly elderly lady when i last saw her a couple of years ago, and she may well have retired since then.

    I’m sorry for the bad experiences you’re having. It does seem sometimes as though psychiatrists are prone to giving up on their patients who don’t just get better when they think they should.

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