Monthly Archives: July 2013

Some ideas for psychiatrists

Dear Psychiatrist,

It would be great if you refrained from judging your patients instead of giving them the feeling that you are judging them? Your job is to make your patient feel as safe and comfortable as possible and I am aware of the fact that this is not easy.

If you come on time for appointments in the hospital, it will show them that they do matter. It’s not as if you have to be called to the operating theater for emergency surgery.

It would be most helpful to take their phone calls or their parents’ calls when they are in trouble. In the hospital, I have seen how an orderly creeps up from behind and delivers a shot in the patient’s butt if the individual causes trouble. But what are we parents supposed to do at home? So we call the hospital for advice and it is imperative that someone picks up the phone at the other end.

Being in possession of a good sense of humor would be most useful too.

I know that at medical school psychiatrists are taught to keep their distance. Well, it does not work for the patient or for their parents. It makes your patient feel alone when he/she needs to be shown that you are human after all. Can you imagine what it must feel like to lose your  mind? I can’t.

If you have had a row with one of your children or your wife/partner, whatever; please don’t bring your irritation to the hospital. Your bad mood or personal issues should never influence your professional attitude. Easier said than done? Yes, I know that you are only human but because you chose this profession, it is par for the course.

If your patient is suicidal, I know that you give that person support, but as it is not that unusual an occurrence for you, it is easy to lack empathy when imparting this kind of information to the family. A parent goes through hell when their child has a mental illness and they do need some TLC.

It would be so helpful to mingle with your patients to create a safe and friendly environment while on duty at the hospital. Maybe sit with them and chat in a social context? Not for long, but it could change the atmosphere.

Please remember to inform your patient and his parents about any side effects that he/she might experience caused by taking medication. If your patient asks about the sexual side effects of the medication, please do not avoid the subject.

It might be a good idea to suggest that your patient get good dental care, hand out a pamphlet with the relevant information. The importance of exercise should be explained to him as well as the advantages of decreased smoking.

How about fighting the stigma of mental illness at every given opportunity? Most parents don’t have the emotional energy to do that.

And last, but not least, help your patient hang on to some hope. Nobody can live without hope.

To all psychiatrists who receive patients on a private basis. Try not to glance at your clock so often please.


Should having a mental illness make you feel guilty?

A psychiatrist asked a young woman in a psychiatric hospital; ‘Does having a mental illness make you feel guilty?’

‘Yes,’ was her surprising reply. ‘Because my schizophrenia has affected and even hurt my parents, my friends and my brothers. I feel terrible when I see my parents with that hurt look on their faces whenever they see me struggling with my voices.’

This woman has to figure out whether her guilt is appropriate or not. Her psychiatrist said; ‘Ask yourself whether you are truly responsible for your condition. The answer should be NO because nobody is responsible for having a mental illness. Neither are you responsible for other people’s reactions toward your illness. You have done nothing wrong. If you had diabetes or cancer, people would never think of blaming you, now would they? You need help in getting rid of your guilt feelings. Even if someone is born with, or develops a mental illness, it is not something he/she did purposefully. It would be wrong’ totally out of line, to take your parents’ money and blow it on drink, drugs or even frivolous items, but having an illness is not right or wrong.’

At the psychiatrist’s bidding, the young woman asked herself whether she had done everything she could possibly do to co-operate with her therapists and whether guilt serves any positive purpose.

It is preferable to get on with one’s life because negative, guilty feelings lead to inappropriate levels of shame and self-loathing. Nobody is perfect so there is no need to be so hard on herself. Her doctor suggested that she take part in positive activities.

A wish changes nothing

A decision changes everything.

The brick, the dent, and the Jaguar

black jag A young, successful executive was traveling down a neighborhood street and driving a bit too fast in his new Jaguar.  He was watching for kids darting out from between parked cars and slowed down when he thought he saw something.  As his car passed, no children appeared. Instead, a brick smashed into the Jag’s side door! He slammed on his brakes and backed the Jag back to the spot where the brick had been thrown. The angry driver then jumped out of the car, grabbed the nearest kid and pushed him up against a parked car shouting,

 ‘What was that all about and who are you? Just what the heck are you doing? That’s a new car and that brick you threw is going to cost me a lot of money. Why did you do it?’

The young boy was apologetic. ‘Please, mister…please, I’m sorry but I didn’t know what else to do,’ He pleaded. ‘I threw the brick because no one else would stop!’ With tears dripping down his face and off his chin, the youth pointed to a place just behind a parked car. ‘It’s my brother, ‘he said ‘He rolled off the curb and fell out of his wheelchair and I can’t lift him up.’ Sobbing openly, the boy asked the stunned executive; ‘Would you please help me get him back into his wheelchair? He’s hurt and he’s too heavy for me.’

Moved beyond words, the driver tried to swallow the rapidly swelling lump in his throat and moved to lift the handicapped boy back into the wheelchair, then took out a linen handkerchief and dabbed at the fresh scrapes and cuts. A quick look told him that they were minor. ‘Thank you, and may God bless you,’ the grateful child told the stranger. Too shaken for words, the man simply watched the boy push his wheelchair-bound brother down the sidewalk toward their home. Then he took a long, slow walk back to the Jaguar. The damage was very noticeable, but that driver never bothered to repair the dented door. He kept the dent there to remind him of this message:

‘Don’t go through life so fast that someone has to throw a brick at you to get your attention!’ God whispers in our souls and speaks to our hearts. Sometimes when we don’t have time to listen, He has to throw a brick at us. It’s our choice to listen or not.’

The above story, called ‘The Brick, The Dent and The Jaguar, was written on May 7, 1999, by Jeanne-Marie Fritts. 

I would like to add this quote that is well-worth bearing in mind:

Do unto others as you would have them do unto you.

We have committed this Golden Rule to memory.

Now, let’s commit it to our way of life .

                                                       by Edwin Markham

TED – Elyn Saks on her personal experience with schizophrenia

Elyn Saks comes out with the story of her schizophrenia and If every person with a mental illness could do what she has done, there would be NO MORE STIGMA.   I have never seen anything like this and I applaud her courage.

Thank you, Elyn. 

To see this clip, please click on the link below.

I didn’t say it was your fault, I said …….

The holidays never fail to come around year after year, and I sat back and watched others enjoy their holiday shopping; spending time choosing suitable gift wrapping and fantasizing about the upcoming festivities. All I could do was wonder what schizophrenia would hold in store for us and it always produced some drama. David always needed his psychiatrist during the holidays when the doctor was away.  He often became psychotic when there was a skeleton staff at the psychiatric hospital. We worried that he might hole himself up in his bedroom and refuse to join us for our festive meals; unable to process the noise levels, the groups of people and the odd snatches of conversation that he could hear. So, holidays meant nothing to him, and subsequently, to me too. Even today, so many years after David’s death, I am unable to enjoy any holiday without thinking back to the anguish and the disasters that befell our family due to schizophrenia. All we wanted was to enjoy one another’s company, laugh a bit, and maybe have friends over to visit. There were times when we were forced to call the police and other times when they knocked at our front door wihout being summoned. We lived a rollercoaster existence.

OF course my husband and I argued a lot as we had different ways of looking at the situation. I remember a time when we were arguing pretty loudly and on the spur of the moment, I said; ‘I didn’t say it was your fault. I said I was blaming you,” and that broke the ice and we hugged.

Can parents of someone with schizophrenia maintain a balanced life?

  • We listened to our son and were always there for him.
  • We were accepting and encouraging and tried to come up with new suggestions that David rejected.
  •  We always listened to him, sometimes for hours at a time until I felt physically battered.
  • We spoke to him with the utmost respect and tried to include him in our activities, but to no avail.
  • We tried never to be patronising.
  • We tried not to show him how upset we were.
  • We avoided arguing with him as much as possible as it never helped.
  • And more than anything else, we tried not to criticize but, as we were were only human, we did not always succeed. I was less successful than my late husband.
  • When David was psychotic, I was so tense that I sometimes felt as though I were walking barefoot on broken glass.

Were we able to lead balanced lives? Absolutely not. We had neither the time nor the energy and as most people plan social gatherings in advance, that was against us too. It all depenced on how David was feeling that moment. I also worried how my son would behave when people visited as the moment anyone asked him how he was, he launched into a long description of how bad things were for him and how we were ruining his life.

In short, we had to be available. We had to be around for our daughters, particularly when their brother was psychotic. There were plenty incidents with the police and without. Of course, my husband had to go to work and so did I, but I tried to be available afternoons when the children were home from school. And, at night, we were so emotionally exhausted, that we barely managed to do more than read the newspaper or watch some television. What usually occured was that we fell asleep.

How should I speak to him?

This might sound unusual but I have found that most people dare not speak in a natural way to a person with a mental illness. They wonder for example, why he did not communicate with them when they once tried to make contact. But, speaking naturally is difficult for a person with a disorder like schizophrenia and there are people who feel embarrassed or actually fearful of holding a conversation or making contact with them – and they feel it.

I discovered how to do so, the hard way. It helped to speak slowly and clearly to our son and to keep my sentences short because the voices he was hearing in his head, drowned out parts of what I was tellihg him. There were times when he told me that he had trouble concentrating and often only absorbed half of what we were saying. If more than one person spoke to him or stood too close to him, he felt threatened. He preferred us to sit down when interacting with him. He needed a quiet place to chill out when necessary and that occurred often.

We tried to help him build some structure into his life as he did not like the unpredictable but we never succeeded. He spent his days sleeping till noon, walking for miles and miles and miles and wearing out a pair of sport shoes a month. He was unable to follow a schedule so we opted for trying to help him get into a routine, but, that did not work out either.

I learned never to approach my son while angry or upset and  tried to use phrases like:

‘It will make me sad if you …’

‘It will anger me if you …’

‘I would like you to …’

‘I would appreciate it if you ….’


Should caregivers set boundaries?

If you are in the position of caregiver for someone with a mental illness, you probably think that you have to do absolutely everything you can for as long as you can, for that individual. Why? Because he or she needs so much support and  care. That means that you still do whatever the person wants, whenever he/she wants it and for as long as he/she wants your help because that person is so very needy.

Now this sounds reasonable and even admirable, but it can create problems. A caregiver needs to set boundaries for his or her own good. I know that now, but I was unaware of it while my son was ill with paranoid schizophrenia, and no one pointed it out to me. My husband was even guiltier as he felt that the weakest link in the family needed the most care. As a result, he spent too little time with our other children. Friends? We had little time nor energy to instigate any arrangements and most of our friends shied away, unsure of how to handle the situation and maybe I was to blame because I was so difficult to be with at that stage. I know now that I didn’t have to be around as much because it was to my detriment. My son’s condition did not change whether I was at home listening to his pain for hours on end, or not,  and the result was that we suffered from burnout and utter exhaustion.

I realize now that by identifying too completely with David’s pain and fear, I was in danger of making them my own. I know now that I should have handled my feelings too, but I can’t help wondering whether I would listen to my own advice if I had to do it over again. Psychiatry is soul searching as well as very expensive business, and besides we seldom had the time, nor the energy to seek counseling for ourselves. Every cent went into helping David.

If we’d set limits to the amount of caregiving we could do, maybe other relatives and friends might have been prepared to share the burden with us, although I am not sure about that as the unknown is frightening and most people have their own problems.

Establishing boundaries would have been better for our son. We tried, and I managed better than my husband, who was totally involved with David’s pain and illness. He went to work and then gave his full attention to the problem at hand. He could not accept that David was not going to get better even though we had exhausted the current choice of medications available. In other words there was nothing to do except try one medication after the other. Unfortunately, David proved to be medication resistant.

We all need encouragement, don’t we?

It is so easy to talk down to people, to insult someone, never to praise a person for work well done, isn’t it? But, I think that we all need encouragement. I want to kick myself when I say something without thinking it through, but words cannot be retracted, can they? So, I have spent a great deal of time trying to put together all the positive words of encouragement that I could think of and here are some of them.

Some phrases that display confidence are:

I know you’ll be fine. You can handle it.

Phrases that recognize effort and improvement:

It took a lot of courage for you to follow through. I can see that.

You have achieved a great deal.

I can see that you put a lot of work into that.

Phrases that display acceptance”

I’m pleased that you are doing that course. It will help you.

You look so happy. I am pleased for you.

Phrases that acknowledge appreciation:

Thanks for helping. You made that work so much easier for me. I appreciate the effort you put into it.

By speaking this way to a person who is unsure of himself/herself, you boost their  morale and it can make a huge difference to their self image.