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Showing posts from April, 2019

Discharge

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One of the worst aspects of this year has been the sense of deja vu. Service user has been discharged before, and then about a week later, he tried to kill himself. Regardless of common sense or logic, the proximity of the memories to each other creates the illusion of connection. Sometimes it is as if everything is a replay, each place we visited with him on day trips is haunted by  ghost memories, shades and shadows of fear and struggling. I was fighting against myself, against my instincts almost all the time. I remember us walking along a narrow strip that led out to sea, the waves crashing against the walls, fierce and drowning and thinking - if he just jumps, I can't follow, I have to keep in mind where all the life rings are.... I know that memory is anchored to that wall and that sea...like the walks we took along a green and easy path, up a hill not far from here to sit among the trees. First time we went he was just out of hospital and limping, another time ...

Easter.

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Jaak describes seven innate systems or drives present in all of us: SEEKING (anticipation, desire) RAGE (frustration, indignation) FEAR (pain, threat, foreboding) PANIC/LOSS (separation distress, social loss, grief, loneliness) PLAY (carefree play, joy) MATING (sex—who and when) CARE (nurture) Though emotions are hardwired in the autonomic nervous system - see the work of Porges - these seven systems listed above (always written in capitals) describe more complexity. Panksepp describes SEEKING as the most important, the emotion that creates a sense of self, but anyway! The reason why all this intrigues me is the use of D2 blockers to block dopamine (at a set of receptors known as D2). Dopamine causes SEEKING, and SEEKING is all about interest, joy, finding, looking, engagement with the world. Too much of that, as in if you take various class one drugs....leads to psychosis in some people. So people with psychosis are proscribed dopamine blockers... Meanwhile, service ...

Home Visit Team.

It is Sunday, 10:30. Even though the original visiting psychiatrist has left the team, and even though it's probably only a couple of mental health nurses....I'm not getting involved at all. For the benefit of my sanity. Even speaking to a member of their  team on the phone on Friday was more than enough. The downturn tone of sympathy, the misalliance begins again. Sympathy and an attitude of ' yes, there is something wrong....' Makes me .... Oh, just been interrupted by service user, ' can they have your phone number just in case you want to phone them' hang on, one they phoned me on Friday, two I need their number if I want to phone them? The logic isn't worth thinking about. I wrote my number and handed the scrap of paper to service user. You may take from my tone that I'm far from pleased to have the Home Visit Team back. Especially if service user gets the Mindfulness lady again. She was instrumental in creating panic in service user, using sectioni...

Out of the sectioning..

The 28 days were up. We collected Service User for two days leave. A bittersweet experience....On the morning of the return day, after an extremely minimal conversation with the psychiatrist by phone, during which I was just asked if things were ok, I was told that that was it. Service User is discharged. We went to the shops and bought biscuits and chocolate for the staff, and returned at our usual time. Service User picked up his Respiridone, and we left! Home visit team due on Sunday. I was reassured to hear that the doctor who had threatened service user with sectioning - Dr Cho -  and who I regard as a part of why service user attempted suicide, has left...I was never clear in my own mind if I should push my complaint forward. Perhaps I should have, but I didn't...still, I made it clear to everyone what happened, and I'd like to think it had an effect.

Early Intervention...

The early intervention team are far from early, in fact they are running at least two hours late and so Service User is still in hospital, as they 'go through  his notes'. I'm hoping The Early Intervention Team isn't the same people as comprised  'The Home Treatment Team. A certain amount of distancing is essential for my mental health. I really don't want to know any more than I know now...

Informal patient.

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I was expecting to get Service User back today, but his doctor advised him to stay for the 'improv'...they want him for his musical skills. So we went round to the hospital coffee shop. As an informal patient he has the right to leave the locked doors of his ward and go for a walk. Service User is now officially an informal patient heading towards discharge  and today the devil turned up once more as a subject for conversation. Service User's 'diagnosis' seems to be 'religious paranoia' which is a description, and I've come to prefer it that way. From my point of view it is meaningless to describe someone as a schizophrenic, or bipolar because I'm sure his and everyone's transient chaos is an overwhelmed response to  something. In short I remain unconvinced of a disease model. The problem as I see it - the beliefs, emotions and actions - are a product of being overwhelmed. In madness, frantic and exciting organizing beliefs appear like ...

28 days later.

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The 28 days of sectioning end on Saturday. My head still feels as if it is full of foam. As if my brain just expanded into holes.  Decompression ...a sudden release from the intense need to partition my thoughts (to concentrate on writing) and to deal with the incipient smashing of objects. It would help if I thought medication could work. I find it ethically easier to talk with religious maniacs, rather than psychiatrists. Though religious fanatics get a bad press - Spanish Inquisition, witch burning...Psychiatry has its cabinet of horrors; and practices science in a maniacal religious way; magic words and faith required. Anyway, I'm not looking forwards to what comes next. As holidays are not on the cards, I bought a Vive. It would have been an Oculus Rift, only because they are cheaper and seem to have more games, but there were no Oculi to be had. Only one. solitary Vive with my name on it, waiting in the shop. As I sat at the edge of the virtual lift, looking out at th...