Circles and my deep-seated psychiatric problems

Was my appointment with Woodfield Road, W9 a grotesque parody? On first impressions it was not good. An hour before the appointment I did a recce. The workmen were in and entry was troublesome. I retired to a café.

We started promptly at eleven. I was shown into interview room number 6 by two ABT workers. A man and a woman. The woman’s name-badge was the wrong-way-round, a common phenomenon for public sector workers and the man was badgeless. The interview starts, I interrupt by asking who’s who?, and introductions are made. The pic ‘n mix approach of W9 produced: Rohini, a Community Psychiatric Nurse and she is my first CPN since I entered psychiatric services eons ago and Aaron, a trainee social worker. This probably explains why he has no name-badge as trainee he may not have issued the requisite plastic. Aaron took notes. Rohini restarted by saying “she would not ask all the same old questions again” and in the course of the next hour she proceeds to ask all the same old questions. When I pointed out to Rohini her inconsistency she suffered a convenient attack of mutism.

If we accept the preparation before the interview was haphazard – they appear to consist of Rohini spending half-an-hour reading my computer records (which are erroneous) interspersed with talking to people who were involved in my care from over four years ago. The request for my paper records to be retrieved from storage was not processed.

Aaron the trainee took notes – I articulated my care needs and supplied cogent reasons – the majority of my speech went unrecorded and then Aaron – who, at all times, must be remembered is a trainee, supplied a solution. A solution that has failed in the past. There was some resistance from the ABT workers when I attempted to express why Aaron’s solution was a non-starter. I can’t say the meeting went well for I made the mistake of entering in the instance of ‘Unity Mitford’. My equilibrium was unsettled. It was not that Rohini and Aaron had no idea of the circumstances of the life and death of Unity Mitford that upset me, rather, it was a coarse and brunt interjection of Rohini’s which made me rattled: she demanded an instant answer; an instant answer that she could understand. By this stage Rohini was rushing through the standard (and to me, deeply offensive) questions on risk. She was determined to finish the assessment within sixty minutes. I would say to the pair – if you cause your patient to become rattled – then that is a sign of failure in your approach. The old rule of thumb used to be: you would not speak to a consultant psychiatrist like that, so, why speak to a patient of a consultant psychiatrist like that? I told Aaron off for passing notes in class. Looks like the mantra of ‘nothing about me without me’ is a million miles away in the approach of Woodfield Road, W9. On past experience I will probably never, ever meet these people again. If the appointment proves to a success it will depend on the verdict contained within the report the ABT workers write for Tuesday 27th May 2014.

Postscript:
As a precaution to today’s meeting at Woodfield Road, W9, independently, I arranged a supervision session with a psychoanalyst. Like a mental health profession who needs supervision for being around damaged people I need supervision being around mental health professionals.

On arrival my analyst said: “When I looked at your file before this meeting, a meeting which I was looking forward to, I noticed…” – and it was quite an insight! Why, oh why, oh why, can’t the NHS be this smooth?

However its comparing apples with oranges – would the pair of ABT workers hold down jobs in John Lewis Oxford Street? On today’s performance they would have to raise their game.

On learning that the BT of ABT stands for Brief Treatment my analyst declared: “You can’t give brief treatment to a man whose father burnt to death. It’s a contradiction in terms.” I resisted this type of analyst in the past but I can’t resist it anymore.

And on the disclosure that I attempted to introduce the Neural Diathesis-Stress Model to the assessment – a pointless task as it appeared to go over the heads of the ABT workers – and currently I score a 62 per cent chance of going psychotic – not a particularly high score on past performance but higher than Joe Public – my analyst despaired. In his opinion: it would be hard to tell who the CPN was and who was the patient.

As a patient you are entitled to be assertive on unsatisfactory answers. I think they were a bit shocked when I told Aaron off. A lot of hysteria was about from Aaron who offered to terminate the interview.

Overall, my psychoanalyst is not impressed. He asserts there is an actual fault in the procedure – and to use John Lewis as an illustration – normally the staff remain courteous at all times and a reasonable solution to a problem can be reached in a relatively short time. But then, when has a mental health professional ever admitted fault? Apples and Oranges.

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