Biadepsy

(If you missed Part 1, read it first!)

Back to my favourite psychiatrist. I was looking forward to it, believe it or not. I was looking forward to a chance to get help. (Seriously. I think Polyanna is my cousin or something.)

Back then, I had started Epilim and life was improving, and I was trying to deliberately be positive and motivated and take opportunities and change the unhealthy circuits in my brain that had accumulated over several years of broken life. So to a degree I was choosing to look forward to it, to be open-minded. But I was also just hoping to be looked after for once.

She was running late, so it was a perfect opportunity to make some small talk with the receptionist. I’ve never really known how to do that, so I was trying to practice. Getting past the social anxiety. Learning to enjoy it, learning not to overreact to awkwardness and how to handle it. And all that stuff that a lot of people seem to be naturally good at. I did fine.

The woman of the hour arrives and again invites me to sit in the unfashionable armchair. No “how’s it going?” or “how are you feeling?” of course. She doesn’t do that. Which is fine. It’s hard for most people to answer that question honestly anyway.

She asks me what I’ve been doing since I saw her last. I tell her that I’m trying to balance personal projects, meeting friends, and having down time, for instance playing games. But I also tell her that I prepared and gave a talk on my inhaled insulin, Afrezza, at a fantastic Sydney diabetes meetup, which was, for me, a massive achievement.

Nothing. No reaction. No engagement. If anything she seems unimpressed. Is it just me? Am I crazy, or is this really toxic behaviour for a mental health professional?

What’s her problem? Is it that I don’t have a job? Am I just another hypochondriac rich entitled white kid to her?

Then she asked me what I’d done that day. This was the best part of the whole appointment so I’ll save it for last.

Her whole style seems to be about dishing out “good old-fashioned common sense.” In a “kids these days! No common sense!” sort of way.

I watched a Judge Judy episode recently where a young man causes a car accident. She asks the kid to detail what happened and he said that he looked over his shoulder and saw that he had enough space, so he changed lanes. She said “well he hit you so obviously you didn’t have enough space.” Then she asked him what information he gave to the other driver after the accident. The young man was cagey and she asked “what did you physically give him?” He was still cagey but she forced him to admit it was a learner licence. So he was illegally driving on a learner licence. He justified that he was a good driver already. She prodded further until he admitted he had just failed a driving test. She found against him. In this case, I’m on Judge Judy’s side.

But that’s how the psychiatrist was treating me. I guess in her mind, I was treating my mental health the way that young man was treating driving.

She asked me how much exercise I’d done in the last week. I admitted that I hadn’t managed as much as I should. She threw medical conventional wisdom at me as though it were gospel. I need to get at least an hour every day blah blah blah.

She asked me how I was sleeping and I explained that diabetes interrupts my sleep regularly. “Well you should be getting at least 8 hours—[etc.]” Woman, don’t you think I know that? I don’t need a lecture. It was as if I told her I don’t sleep because I go out and party.

I don’t care that her tone was judgemental with a hint of condescending. (Although many in the T1D community would be shaking their fists purely for that.) Sometimes a bit of an old-school shakeup makes people wake up.

What I care about is the fact that the “common sense” was ignorant, close-minded and a few times, medically unsound or dangerous.

So here is the best bit. Make sure you sit down for this one.

“What did you eat for lunch?”

“Oh, I haven’t had lunch.”

“But it’s half past two!”

“Oh, well I didn’t feel hungry so I haven’t eaten yet.”

“You shouldn’t skip lunch.”

“Oh, I skip a meal if I’m not hungry. Sometimes I don’t have breakfast, sometimes I don’t have lunch. It makes diabetes easier to manage actually.”

“You can’t skip meals,” she said, very condescendingly.

“It’s what works with my lifestyle.”

“Having three meals a day isn’t a matter of lifestyle. It’s what everybody does!!”

I dropped it as another one of those “I can’t win this fight” things. We moved onto other things and it went out of my mind.

When it was over, I really didn’t want to go again. But, the receptionist asked me to make a booking so I did, partly due to social conformity and partly because I was being mature and letting my head cool down before I made a decision.

Then I walked onto the street and thought, “hang on... what was that three meals a day thing?” Now I could give it the outrage it deserved.

I’m reminded of those old black-and-white “how to be a good housewife” videos. Everyone (it is implied) has that nice family where the wife prepares breakfast and dinner and gives her husband a nice packed lunch. And irons his clothes. Some households are like that and that’s fine with me. But it’s 2019. How can people still have such a childishly simple view of the world where there is a model lifestyle and a person either strives for it, or is lost, sick, or deviant? And this isn’t some businessman or politician, we’re talking about, but a mental health professional!!

Seriously, she was shocked by my skipping meals, but merely displeased about my limited fish consumption.

Anyway, there I was on the street and suddenly it hit me.

“What if she told a gay person that being heterosexual was ‘what everbody does’??”

Not to mention that Muslims fast for Ramadan, Buddhists fast, and intermittent fasting was already popular at the time. To think I made her a few hundred dollars richer, for that.

Before the next appointment I got a call saying it would need to be postponed because she had a back injury.

Karma.

Also it got me out of having to call and cancel. 😀

Ah, I’ve been waiting to express my outrage about this one for over a year now. Here’s the story.

As you may know, for many years I had no idea what was wrong with my head. I desperately tried option after option, consulting with no less than 12 mental/brain health professionals. Some of them I could immediately tell were wrong for me, while others I gave a chance and got nowhere.

As time wore on, Bianca and I began to question our strong gut feeling more and more often. Surely I couldn’t be right and 10 professionals be wrong? (As it turned out, they were failing me big time.) Not to mention the fact that I have a strong tendency to see the best in people and give them a chance. If I felt they were useless, they must be really useless.

Toward the end of that journey, at roughly number 11, still desperate for help but now with a much better understanding of what was wrong with me, I asked my GP to refer me to a psychiatrist. Unfortunately the only one that he knew well was retiring, so he had to take a stab at a new one.

At her offices, things felt sort of... 80s, you might say, which was kind of normal for the area the surgery was in. The psychiatrist was a thickset woman, reminiscent of an old-fashioned headmistress. Friendly, but with a no-nonsense undertone. I definitely don’t have a problem with any of that, but it fits with what followed.

She sat me in a dark brown corduroy armchair and took a seat behind a desk. As usual, I brought a small folder of notes I had printed out both as reference material and outlining what I wanted to discuss. As with every other mental health practitioner I’ve seen, she clearly tried to steer me away from my notes—as if my own self-assessment were invalid; as if she were better placed to figure out what I needed than I was.

At that point it was not a big issue, but in hindsight (and these are not words I say lightly): Fuck you.

There were the usual “tell me about yourself” and “why are you here?”

And as per usual, there was no understanding or attempt to understand what life was like for me and what I had been through. These people don’t know what type 1 diabetes is like, and don’t want to know. It’s like they think we’re whingers. I’m willing to bet that people with phobias or addictions or trauma don’t have their stories ignored in the same way.

But with her, it was worse. It was horrifying. I told her I had type 1 diabetes. She said “you must have eaten way too much sugar.” I said that no, it was type 2 diabetes where diet was a major factor. No, she said. She had a relative with Type 1 diabetes.

I started “I...” and shook my head nervously. “Generally speaking...” She was insistent. Very insistent. I tried one final “That’s... not true” but it was no use. It was just like being in a staring contest where the other person gives you a look that says “you can’t win.”

And you know they’re right.

Fair enough. Maybe she was ignorant and judgemental about diabetes but was very good at helping people with mental issues. No, wait, (I thought,) maybe it was some kind of test. Maybe she was trying to gauge my personality. Maybe she wanted to see how I reacted under pressure. Maybe telling me what she was doing would defeat the purpose of the test. (cf. secret plan.) Either way, I backed down and forgave her.

Then, “why are you here?” I made it perfectly clear why I was there. Some of my mental health problems were due to my epilepsy. Some clearly weren’t. Some were due to trauma, some to everyday events, some due to my medication, and some due to diabetes. It was really hard to figure out what was what, to unravel the tangled web of really weird, complicated and sometimes unnameable emotions and experiences.

halp plz.

Well that fell on deaf ears. As had been the case with many others, she acted like I had exceeded a word count that people go over when they are confused, when they are overcomplicating things. There was no “that’s a lot you’re grappling with, I’m very keen to help.” Nor was there “OK, there’s a lot to work on.” Nor was there “I’ve never dealt with this sort of thing before. I’m a little out of my depth.” Nor were there questions to try to understand better.

There was just an unspoken “ah... another one of those.”

There were some other procedural things, like what medications I was taking, family history, and so on. Then we got into her trying to “help” me. Am I eating enough fish a week? Am I eating enough vegetables? How much exercise am I getting?

Look, I appreciate it. A very common and very tangible cause of mental health problems is an unhealthy lifestyle. I may be arrogant that I’m already doing my best with everything, but I see the value in someone making me do a sanity check.

But then it got ridiculous. What kind of exercise do I like? I listed a few things including swimming. I explained that swimming is hard because of diabetes. I explained why. She tried to offer silly solutions like bringing a friend and having them hang on to my belongings, instead of actually addressing an issue that is really painful for me, namely the way diabetes gets in the way of things I enjoy. Solving practical issues is all well and good, but it will never change the fact that diabetes always has to be on my mind for safety reasons.

OK, she can’t be expected to know that about diabetes. Except I just told her about it. I literally just explained. Also, I had earlier explained why fruit is difficult to manage with T1D, but it went in one ear and out the other. I need to eat more fruit.

Then she spent at least 5 minutes umming and ahhing trying to think of local swimming pools. Oh, there’s this one, but you have to be a club member. Oh, there’s that one, no wait it closed down. Seriously, this went on for five minutes. I sat and smiled as she sat there wracking her brains for swimming pools.

I don’t pretend to smile. When I smile, it’s genuine. Being warm and patient and optimistic and trusting is just how I am. Unfortunately it doesn’t serve me very well when it comes to my health.

Time’s up, I leave, and think “that really sucked.” But then, as I do, I stopped myself and thought “OK, don’t give up after one visit. These things take time.” So I thought back to what was actually useful. Well, she seemed to know her way around medication, at least. Maybe she would be good in that sense.

Had fun? Read about my next visit here.