In addition to last week’s post on patients (everything sort of revolves around patients, but nevermind). I thought a little back on my encounters with patients. Or second-hand encounters at any rate.
Another student treated a patient. She said she had made smalltalk. She had asked what he’d done over the weekend. She knew he had children and asked whether he’d spent any time with them.
The patient said, amongst other things, that he hadn’t. That it wasn’t his choice. And he said he didn’t want to talk about it.
I remember thinking, he is baiting. I don’t like being baited. Make up your mind, you wanna discuss this or not but don’t leave me hanging. I don’t like this sort of behaviour at all.
I said as much to her. I also told her I was convinced there was something about the relationship, a very young woman and a much older male patient, that made this sort of behaviour easy for him. I figured that he thought she wouldn’t challenge it. I also had the impression that he’d done this at least twice during concultation, baited her.
So I suggested she call him out to see what would happen. Make it clear, if he wants to discuss an impending seperation, it’s fine, but no baiting.
She was adamant she wouldn’t, other people were adamant this amounted to madness and that this was ok. It made me think of practitioner culture as well.
That’s it, really, except I still remember this and when I was baited similarly by my patient last week, I wondered what to do, ad hoc. I didn’t get the ‘I don’t want to discuss it’ line. I got a very provocative line and then nothing at all.
I tried to direct the conversation on to the abuse whilst doing some manual therapy on the side (yes! that’s what people come to us for!) but trying to be safe at the same time. Safe for the patient and safe for me. I’m not trained in the arts of psychological therapy, I consider it a tightrope act. The patient hadn’t come to me for that kind of trauma but she kept bringing it up.
I try to be proactive in these situations. She wasn’t being nasty, I was trying to remain neutral. But what is neutrality. Anyway, I don’t know how exciting it is to read a back-and-forth of these things. I asked my patient about when the abuse stopped. I asked her whether she’d received any therapeutical input.
I was trying to touch the trauma without putting pressure on it. The complication is of course that the person is another student and I will continue seinge her. as a student and potentially as a patient. This is a violation of … I’m not sure what.
I have often been told I’m very rule-bound. I consider some things absolutes. In a therapeutic setting there are absolutes such as the space and how to deal with seeing people outside of the space, can one still speak to them, interact with them etc. Is this ok?
I’m very aware of these things but also, I gather, pretty rigid. And my course isn’t designed to help me understand these dimension of dealing with patients. I agreed with my tutor then that I would like to point her towards other types of therapy to help her process the experience. And that the school would not be the most suitable space for this. And that it is also not something I would necessarily like to take on. All of which I will still have to wrap into appropriately sensitive words.
And so to bring this around a today a little, I managed to have an instructive conversation with a tutor today about the therapeutic space we provide. More on that later.