I am smitten by my daughter’s new psychiatrist. He is text-book tall, dark and handsome, and has an accent that makes me weak at the knees. I could listen to him read out a list of psychiatric medication any day – and in fact, that is pretty much what he does read out in the meeting. But of course to my dismay, I have the curse of hayfever and appear with a luminous nose and eyes like fried eggs.
Over the years we have worked with many different psychiatrists, and each of them stands out as a very strong character – some charming, some stern, some repulsive. They have a powerful role, and of course they are aware of this – in the armies of mental health professionals, they are the generals, they alone have power to prescribe – and to section – and they are often in overall charge of their medical unit. Their influence over their patients, especially young patients, can be huge: they can be involved at every level of decision making, from where they live, their education, or whether they can learn to drive. They all develop their own particular way of handling this responsibility.
The patients, and of course the parents of young patients, confer on them almost god-like status. Because you want them to be god-like: you want there to be a cure. You want them to have the power to see inside the soul of your loved one, see what is lost and damaged, and use their powers of magical healing. This is almost always a mistake, and brings inevitable disappointment. Beware the charismatic psychiatrist, and beware prenouncements. “Julie is self-harming because… xyz” they may say, “If we do abc, then she will stop self-harming.” In the end it will turn out that they were wrong; sometimes “abc” was very painful to do, and caused damage of its own.
It must be tempting to speculate, it must be tempting to try and impose order on the chaos of your patients’ lives. They invite you to do it, they beg you to tell them if they are depressed or not, to tell them if the voices they think they hear are symptoms of psychosis or not, to decide whether their mood fluctuations are normal or not. All you have to go on is what they tell you, and not very much else, so you can make up pretty much any story you please. It is like making constellations out of stars: you can see the Big Dipper, or you can decide to draw yourself a whale in tights.
So far Julie’s new psychiatrist has avoided pronouncements, and seems wise. He speaks very little, looks carefully at the evidence, and draws conclusions that are boring but cannot be faulted. I don’t think he will do any harm to her, unlike some of the others. In the meantime, I am more than happy to attend any meetings he is pleased to call. And gaze adoringly.