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The Royal College of Psychiatrists Improving the lives of people with mental illness

 

A perceptive and supportive iron hand in a velvet glove


Well, I should say that when I was asked if I would write an account of the psychiatrist who treated me I had no hesitation in immediately saying that I would be pleased to do so.  Why such a positive, immediate response?  After all, it would mean a bit of work and time.  I suppose it’s because my psychiatrist changed my life – it’s that Diane and Mallysimple.  This person slowly helped me through difficult physical and mental stages to the point where I could again function and, hopefully, once again contribute to society.

 

I should say that I saw this psychiatrist because I was absolutely in the grip of the addiction I had.  I should actually say “have” – recovery is not finite and I shall always be potentially addicted, although hopefully I can now cope with it and the fall out on a daily basis.  When one is in the throes of an addiction, it takes over your whole life and nothing else is remotely important.

 

Let’s go back a bit (skipping over the fact that medically I had other, probably related, problems). I was sent by my GP to an alcohol treatment centre where I met, amongst other fantastic staff, the psychiatrist who was going to treat me.  To be honest, I can’t remember much about my initial sessions (such is the effect of alcoholism) but I do recall that when I first met my psychiatrist I was, possibly unwillingly, impressed.  He spoke to me and he listened.  He listened – I can’t tell you how important that was and what an impact it had. 

 

Of course, as the sessions progressed the whole experience wasn’t easy and we were not always in agreement but, most importantly, I was never forced into doing anything I didn’t want to do.  Instead, I was given information and guided with patience.  Mind you, come to think of it, my psychiatrist wasn’t always totally patient with me, but then I could at times be extremely stubborn and annoying. 

You see, alcoholics can be very manipulative and I was no exception.  However, at some point I realised that my devious arguments, my coaxing and pleading, were not actually having the desired effect.  I’m sure I wasn’t an easy client, being very determined to get my own way and my point of view across whatever it took.  And, do you know, I was actually pleased that he saw through me and I admired/ respected him for it.  Don’t get me wrong – I was treated with kindness and respect too, but it wasn’t the easy ride that I thought it was going to be when “all” I had to do was convince this person that I knew best what to do.

 

The whole contention really came down to the fact that whereas I realised that I had to do “something” about my drinking (which was totally out of control and causing huge dramas and misery, not to mention numerous accidents), what I wanted was to be given a “magic spell” which would control my drinking and then all would be fine. 

 

The notion of stopping drinking altogether was totally abhorrent to me and not an option.  So, against strong advice, I was allowed to go for controlled drinking (remember you can’t force a patient to do anything they don’t want to do) and eventually through help reached the stage where my alcohol intake was greatly reduced to something acceptable and then, of my own volition, I left the alcohol treatment service very grateful for everything  ...  I’d done it!  That psychiatrist was wrong – I could control it!  He wasn’t correct after all when he said that he did not think that controlled drinking was the answer to my problem, that in his view, the only feasible option in my case was abstinence but that it had to be me who decided to go down that path ... He was wrong and I was right!

Unfortunately, however, it soon turned out that my psychiatrist was right ... My controlled drinking lasted for about three months and then I was back to my old drinking ways, but much worse than ever before.  Let’s gloss over the next few years which were not my finest. Suffice it to say that I eventually reached the end of the road.

 

It took five further long alcohol-filled years after leaving the treatment centre for the first time to have the courage to go back to my GP and ask to be sent back to the same NHS centre.  I knew that I was going to tell them that I had to somehow become abstinent.  I was going to ask them to help me achieve this. Luckily, I was sent back to same alcohol treatment centre.  It was incredible that the same psychiatrist was still there.  Yes, he did help me – and without any hint of “I told you so”. 

I vividly remember his saying that I had so much to offer and why was I wasting what I had.  Being at rock-bottom, my self-image was absolutely zero.  It wasn’t just him, of course – there were other wonderful staff who also helped me enormously. However, I have to say at the end of the day, throughout this horribly difficult journey, that my psychiatrist was the central pivot, the stability, at times the reason I kept going.

 

I can’t tell you a failsafe blueprint for a “good psychiatrist”, but I can tell you what I very much valued.  Still value.  Very much. 

 

Here are, in my view, a few personal do’s and don’t’s for a psychiatrist:

  • Listen to what the person has to say.  Make them feel they are important, that what they say is important and that they are being heard.
  • Use your skills to sum up your patient. All patients need handling differently and some can take, or may need, a tougher line than others.
  • Help the person to restore their self-image. Point out what they have to offer.
  • Remain professional however emotional the case may make you feel.  But remain human and approachable.
  • Remember how vulnerable your patient is.  Their outward show of strength, aggression even, may hide what’s inside.
  • Remember that however many meetings you may have, whatever time of day it is, this one is the patient’s special appointment and is hugely important to them.  They have probably been psyching themselves up for this meeting with you.
  • Never try and force a patient to do what they don’t want to do – it will end in tears and you’ll be back at square one.

I’m sure there are many more points to mention, but those above will do for a start.

 

I was lucky to see the psychiatrist I did.  I shall never forget him nor what he did for me.  I gave him my trust and respect and he didn’t let me down. 

 

Oh, even now my life isn’t a bed of roses of course.  Recovery isn’t easy and it’s a battle some days more than others.  However, my psychiatrist changed my life, helped me change my life, and enabled me to put myself back into society.

 

I’m eternally grateful.

 

Diane Goslar

October 2011

 

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