Monday, February 26, 2007

quest for knowledge nosedive

Fear grips me - corners me and asks "surely you should know what to do?"
After studying for four years I certainly don't know it all - the old saying "the more you know the more you realise how little you know" is oh so painfully true. It wrecks havoc with my perfectionist character and is given life by my fear of asking.

I went to this seminar today presented by Dr Sally Hartley, here is a link to the Disability dialogue newsletter which highlights the focus of her work. Community-based rehabilitation utilises the existing knowledge/skills of the client/ community. i.e. the knowledge we have as professionals can only be relevant when integrated into the 'lived-experience'.

As I sat there listening my logic and self-knowledge integrated into a realisation that I don't need to know it all - just be open to learning.

Friday, February 23, 2007

"pushing bums around"

A client in the acute service was playing cards with me and a few other clients. He started externalising his thought processes regarding his dealings with women. When challenged about respecting women he replied: " I respect you - you come in here and sit with us, you're not like a doctor lady who pushes her bum around and makes me angry" Of course his anger and difficulty to control his feelings for women will need psychological intervention, however his statement draws the distinction between inforcing treatment authoritively and allowing opportunities for patients to express their needs in a therapeutic environment.
In a therapeutic environment the therapist does not simply illict/ observe behaviours for diagnostic purposes, he/she works with dialogue of the clients to make opportunities for in-action learning. For example answers to questions regarding insight are not simply recorded but insight training is done in all situations with the client.

Wednesday, February 21, 2007

psychiatry hoax or not?

This debate has been brewing in my mind for a while - I am still far from making an informed non-biased decision. Having recently discovered stumble video and the anti-psychiatry arguments that psychtruth portrays I am, I hope, closer to taking a stand point.
I work in the rehab frame of reference and have for a while felt the stifling and ineffective push that medicine has on the recovery process of a patient.
1) The patient is seen as having and illness
2) Decision to discharge a patient is made on 'stability' due to medication rather than resolution of stressors - this decision is made almost entirely by the psychiatrist
3) The patient is given very little information about his illness or the side effects of the medication and very rarely alternative therapies are suggested - if they are they are offered as a 'para-intervention' to medication.

I would like to here some pro-psychiatry arguments!
Might interview some Dr's myself and post later

Thursday, February 15, 2007

Still in psychiatry

Well.. I accepted a permanent post at another psychiatric hospital in Cape Town. I'll leave the name anonymous as I plan to blog about everything I experience there without shame.
I'm having a serious professional identity crisis at work!! I workas an occupational therapist in an acute male admissions i.e. high turn over of patients with little time for rehab. My role is not easily defined in this setting as it can be incredibly broad! The team is very excited about my arrival however I still need to do some job carving for myself! Eish... its really testing my ability to be assertive!!
I can surely say that I hardly have a dull day!!
One of our patients is convinced he will get sponsorship to host a huge musical event and donate a few of his millions to us. Nice hah? Now although there might be a slim chance that this is true in his current psychotic state there is very unlikely that he will be able to execute such an event.
As a rule we always check out the credibility of delusions with family members - one patient really is a millionaire (for what its worth).