This new dovey is courtesy of Deb
Previously I have posted about the cold, callous, calculating consultant psychotherapist who psychologically abused Mrs Carr (here and here). I came across another example of sheer incompetence in dealing with a vulnerable youth and I have copied the entire post not because the psychiatrist's behaviour is particularly extreme but because his failing is so obvious and so basic. If a doctor is so uncaring or so lacking in people skills one wonders whether he is even safe to practice. I suspect that what follows happens over and over again throughout the UK. Certainly I have seen quite a few examples of this crass insensitivity.
"More on Emo by Zarathustra
Following on from my earlier post about emo, I think I’ve give a real-world clinical example, dealing with a self-harming emo kid.
A quick caveat before I do. Teenage self-harming is not an “emo thing”. We see plenty of cutters in CAMHS, and the bulk of them are not emos. Chavs cut themselves too. In fact, some kids cut themselves despite not being part of any fashion clique at all. It’s almost as if self-harm were a mental health issue rather than a fashion trend. Strange, that.
Anyway, let’s bring in our emo. He’s 15 years old, and in honour of My Chemical Romance, we’ll call him Gerard.
I’ve been doing a bit of individual counselling and CBT with Gerard following his referral to our service due to low mood, sleep problems and self-cutting - usually fairly superficial razor cuts on the legs and arms. He has suicidal thoughts, but doesn’t think he’ll act on them. He’s a pleasant, intelligent lad, and we get on pretty well during our sessions together. As a result we often wind up having a chat about music or art or whatever while doing the therapy.
A bit of background for you. Gerard’s early childhood was marked by marital breakdown and his witnessing of physical abuse by his now-estranged father against his mother. At the age of 11, Gerard was diagnosed with Developmental Coordination Disorder - poorly developed motor coordination. As with a lot of kids with DCD, his self-esteem plummetted and he became a target for bullying. Diagnosis at least meant he stopped getting berated as “bone idle” by his teachers for becoming frustrated with trying to write legibly, then giving up and staring out of the window in a daydream. It didn’t stop the other kids from taunting him for attempting to kick a ball on the football field and seeing it go in every direction except at the goal.
The reason I give the above bit of life history is to point out that Gerard did not become depressed as a “fashion trend”. The reasons can be found in his early life and upbringing.
Anyway, let’s cut back to the present, and Gerard is now a 15 year old emo. He’s got the spiky haircut with the fringe that looks a bit like Hitler. He’s got the My Chemical Romance hoodie. He’s got the black painted fingernails. He chats to other emos on Myspace and meets up with them at gigs, or just to hang around in a bedroom or in the park. He vastly prefers their company to the “ignorant, racist” kids in his class. Sometimes they get pissed on cider or smoke a bit of weed. This has led to a couple of occasions where, being a 15 year old who hasn’t yet mastered the art of pacing himself, Gerard has wound up collapsing drunk.
I’ve explored in sessions what Gerard feels he gets out of being an emo. His answers: a sense of identity, a feeling of mutual understanding with others, being accepted and valued in a way that he isn’t by the bullies at school who push his head down the toilet. All of which are things that have therapeutic value. The fact that he does booze and drugs with them isn’t so therapeutic, but underage drinking was certainly not invented by emo.
The consultant psychiatrist decides he’d like to review my progress. Given the high professional esteem with which I hold my consultant, we’ll call him Dr Cretin.
Dr Cretin is…shall we say…a little old-fashioned. Therefore I had a feeling things weren’t go to go well when Gerard turned up to the appointment wearing eyeliner.
Dr Cretin looks at him disapprovingly. “So….this emo cult that you’re involved in. Is that why you started cutting yourself?”
Emo cult? Oh Christ, please don’t tell me Dr Cretin read that bloody Daily Mail article.
Gerard looks at him blankly, “Er, no. I just started doing it because it made me feel calmer and stopped me from getting angry.”
“Really?” mutters Dr Cretin, “Anyway, you also need to keep away from alcohol. You’re probably doing more damage to yourself with that than you are by making a few cuts on your arms.”
“I just have a few drinks with my friends…” mumbles Gerard.
“Well then, you need to change your friends, don’t you? If you’re in with a crowd that’s getting drunk and using drugs, you need to move to a different crowd.”
Gerard looks like he’s trying to implode into his chair.
“So, then,” continues Dr Cretin, “Do you want some medication? Some antidepressants?”
“Very well, I’m going to prescribe you some fluoxetine. But it’s not going to do much good unless you cut out the drinking. Medication alone isn’t going to make the change. You’ve got to make the change yourself, young man. You’ve got to want to change.”
Brilliant move there from Dr Cretin, because getting 15 year olds to change by giving them a hectoring sermon has such a track record of success, doesn’t it?
He then makes the only helpful decision of the session by leaving the room while he goes to write out the prescription. By this point Gerard looks like he’s about to cry. Which is unsurprising, since he’s just been told his personal identity is a cult and he should get rid of all his friends. I decide to take the time alone to chat more with him about his interests so as to put him a bit more at ease. We gossip about bands and the quality of the local gig venues.
Dr Cretin eventually returns with the prescription and arranges for a review in 6 weeks. I also arrange to see Gerard myself for the following week. Partly to monitor medication compliance but mainly to make sure he hasn’t been completely scared off.
I finish off by saying, “So, you’ll be seeing me regularly for the talking therapies, and Dr Cretin occasionally to review the meds.” Hopefully he’ll realise that this is my coded way of saying, “Don’t worry, you won’t have to speak to him very often.”
I mean, honestly. You’d think that to be a consultant psychiatrist you’d consider it a priority to work on your people skills. (No disrespect to The Shrink or Cockroach Catcher, both of whom I’m sure are charm personified.)"
Does this seem familiar? YES!
Simple people skills missing and a life is at risk.
There must be cretins throughout the entire NHS.
There are cretins throughout the entire NHS.
We should stop them practicing because they are dangerous!