Psychiatry courses in my faculty were bad

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You, health students, are in the process of constructing in your mind the concepts of diseases, arranging them, understanding the ins and outs of them in order to ultimately know how to treat people. I find that you are not being guided clearly enough in this acquisition.

During my medical studies, in one of the most renowned faculties of France, schizophrenia was explained very badly, I think, giving the impression that schizophrenic patients have brains turned upside down! That the ideas they feel are not normal, that we should not try to understand them because it is foolish, that there must be something screwed up in their brain.

The courses at the university gave, I find, the impression that for schizophrenia and for psychiatric pathologies, that the patient's brain reacts in a totally aberrant way!

It seems to me that in the medical community the impressions, the ideas about schizophrenic patients are worse than in the general population because of the courses that explain very poorly. After having done an internship in a psychiatric department will usually help caregivers to better understand.

I was also afraid myself when I wasn't being treated that there was something really messed up in my brain, even though the idea of me being mistaken for someone foolish bothered me a lot too.

But as I said before, I think this way of seeing things is wrong and the basic functioning of the brain is good, but some functions are extremely exacerbated or diminished.

Here is another argument for this idea: if ever a somewhat disturbing idea came to mind, such as the fact that a plane would run into you and kill you, immediately you would relativize the risk, if the idea worried you for a moment, the next moment allowed you to tell yourself that the risk is very unlikely, and the idea of death even if it ever happens is not so serious.

On the other hand if 5 disturbing ideas came to your mind every moment, that I dread death because you imagine it as a cold and inhuman emptiness, that you fear the suffering causing death, that you do not have time to relativize these disturbing ideas that come to mind that already 5 new disturbing ideas have arrived to you, you would be psychotic, yet the ideas are no different from a normal mind but just more intense and more frequent than on a normal mind.

Also we should not look for noon to 2 pm, and we should not rely on the rumors that circulate about this or that pathology, for example for anorexics, although they can really suffer from many other symptoms alongside their anorexia, I guess they do not eat surely first because they are not hungry. I believe that there is a biological anomaly that causes this.

I think a mechanism is put in place and causes them to be as hungry as someone who has just finished a huge 800g meal, while they are hungry. That's why they are disgusted with food. What mechanism causes them not to go hungry? this is a real question to ask, I believe that scientists had put forward that bacteria in the intestine create a molecule close to the satiety hormone, it is for example an idea to explore, and that perhaps when bulimia is triggered, it is because there is an autoimmune reaction against these molecules that, in the end, block the satiety hormone and thus cause great hunger.

I believe that sometimes anorexic girls want to lose even more weight because they are too fat, be careful as a doctor not to generalize necessarily, all patients (and patients even if it is rarer for men) necessarily feel this, or at least, they may be aware that it is an exaggerated feeling and that it is dangerous for their lives.

I have already seen doctors be persuaded that these patients want to lose weight to be beautiful because rumor says that anorexics think so, while they themselves testify that this is not the case, and although I can not read the minds of patients, I think it was not. A friend of mine who had anorexia and was a doctor gave me the impression in her testimony that when she was hospitalized as a teenager for her anorexia, the doctors seemed convinced that she wanted to lose weight, while today she tells me that she did not want to lose weight but that she had a lot of difficulty eating… I believe that if we want to have the exact point of view of patients with certain diseases, we must look at the testimonies of these patients but when they are better, and not on the rumors that circulate in the medical community. We must not despise these patients and take them for idiots as I have already seen doctors do, or impose on them the idea that they have ideas that they do not have.

Indeed, understanding how patients feel is not easy at all. But just because it's not obvious doesn't mean you shouldn't try.

I think that the best way for doctors to understand the feelings of patients, if it is a subject that interests the doctor, is to base themselves on the testimonies of patients as well as on the word of peer helpers.

Be careful and try not to reveal any of the patient's thoughts that they are ashamed of. But I think it's important to try to understand the patient and communicate with him about his feelings, if he wants to and that the treatment he takes sufficiently reduces his delirium (which is the case for almost all schizophrenics on treatment).

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It can be difficult to understand the ideas that come to mind, to classify them, to describe them.

It is normal that it is difficult to understand patients because it is very hard to feel in someone else what you have never felt.

It is also difficult to understand patients, because, I believe, there is a kind of fear of the patient in a lot of pathology to say what he feels because he can be ashamed of his ideas, as for example when I was ashamed of being crazy.

Or he cannot explain to himself and therefore to others, what he feels, for lack of capacity for introspection or by a set of ideas that invade his mind and prevent him from understanding himself. As a result, it makes it difficult to understand what the patient feels.

For example, for me, I was afraid to say that I was paranoid to a doctor because I feared to be locked up, it was of course without treatment.

I was afraid to tell the details of my discomfort because I would have thought that my interlocutors would have ended up thinking that I was completely sick and dangerous, and the idea that they see me like that, would never have left me.

Also patients may have the impression that what they feel is obvious, that others must know well, that it shows. Yet not necessarily. So they will not testify to this feeling.

There are also the timid patients who lie in their testimony and who twist what they feel to hide from others and from oneself what they think, out of shame of these thoughts. This was my case before bactrim (a treatment I tried and which I find helped me a lot).

Also, patients should not be miscategorized by their pathology. Here's what I once wrote in a forum response, and that's how psychiatric terms should be used to better help people, not categorize them:

In the field of psychology we find in the majority of situations, types of feelings or ideas that other people have and make them suffer, we group it under a name of disease, term that can be hurtful, such as bipolar disorder or other. However, if the psychologist or doctor does his job well, this term should help to better understand his patient and not to identify him as someone not normal, whose people with the same pathology all have the same thoughts and the same behavior. Colleges should say in their course that we should not categorize people like that, but rather seek to understand them.

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