For example: Young Causasian (?) male, yellow skin, short yellow hair, orange T-shirt, blue shorts , poor self-care ( wearing same clothes for 10+ years), excessive psychomotor activity.
Might describe:
The other day I read one someone else had written. It said something like “30 year old female, short blonde hair, plastic glasses, unshaven legs.”
The woman in question had suffered a chronic mental illness for several years. The ‘unshaven legs’ was, apparently, a reference to her poor self-care, and, although the patient denied psychiatric symptoms, was perhaps a sign that all was not well.
We all judge on appearances all the time. It’s human nature. But it seems psychiatric patients are judged more harshly than others. If I had a friend with unshaven legs, I might think about it this way- it’s winter so she’s wearing trousers most of the time/she’s single so not bothered about anyone seeing them/she’s been busy and forgot/she thinks it conforms to a patriarchal view of what women should look like so doesn’t do it on principle/ all of the above, but uses the latter as her excuse.
But, said the writer in question, when I ask him about it later: it was written in the mental state examination, because it could be evidence of her mental state. She’s not shaving because she’s not taking her medications and is now becoming preoccupied by her hallucinations. She’s not shaving because she doesn’t want her body hair to fall into the hands of her persecutors (apparently this is quite a common reason for patients with schizophrenia not to shave). She’s not shaving because she’s suicidal and doesn’t see the point as she’s planning to kill herself next week.
At this point, I pull my skirt over my knees, so no-one can examine my own legs too closely.
1 comment:
In my (very brief) forray in to General Adult psychiatry, in my training, I followed the course of a 19 year old youth admitted in a manic state. On the day of admission he was then detained under the MHA 1983.
Every morning, as a zealous SHO, I'd review the nursing notes and see how he was faring.
When he sat alone he isolating himself, withdrawing from the ward and disengaged from social contact.
When he was letter writing he was "obsessive" with his mania causing him to "write excessively."
When not writing but instead reading he was "obsessed with fantasy worlds" and immersing himself in fictional text rather than dealing with his current situation.
He couldn't win.
He does nothing, that's evidence of psychopathology.
He's detained so can't hook up with friends so writes to them, that's evidence of psychopathology.
He's bored so reads, that's evidence of psychopathology.
It is all too easy to make judgements and to see what you want to see, or make the evidence fit the hypothesis.
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