Wow, what a wild week or so it has been. A lot of anxiety with the build up and preparation for returning to the RCGP in person. Booking parking, workout out travel plans, preparing myself mentally to be around so many people again, and running through scenarios. All so much, after a long period of being fully in control of my surroundings and situations.
After some careful planning, I was lucky enough to find a parking spot, right on Euston Rd, just a few mins walk away from the RCGP, for a very reasonable £19 for the full day. I KNOW !! Bargain or what? Double the price of the train journey, but 1/10th the stress of the journey, and also enabled me to take things with me. In this case, running gear. Deciding to beat the traffic I aimed to arrive for 7am, get parked then head off to Regents Park for a morning run. Then head back to the car, grab a change of clothes, and get changed and freshened up at the RCGP. All went to plan thankfully, a nice 10k run helped me clear my mind of the usual pre session jitters.
Arriving at the RCGP and getting changed with minutes to spare was perfect for my mind. No time to wind myself up, just get my schedule, get my brain into gear, and away we go. Five morning sessions, five afternoon sessions, so quite taxing on the brain, but very little down time in between just keeps things flowing.
The first session or two went OK, the groups interacted well, some nice discussion after the scenario's were finished. A couple after that felt a little less enthusiastic, little engagement after the scenario, so felt a little bit clinical. With the last session of the morning done, I headed off to lunch, refuel, recharge and get my head back in the game. That said, exiting the RCGP onto Euston Rd, at lunch time is hardly the right setting to refocus. So I headed off to Coal Drops Yard.
What a little sanctuary that place is. In the middle of town, but a couple of streets back from the madness of Euston Rd. Sitting by the canal, taking in the sights, and chowing down on some unhealthy Burger King for lunch, I was at last at one with my thoughts again. Reflecting on the session for a moment, taking time to digest how each group had made me feel, (and writing this now) made me realise how important to me coming out of role at the end of each consult is. If I have sufficient conversation after the scenario, discussing my own mental health, I seem to disengage with the situation a bit better, and it feels a little less "real".
By that I mean, if you repeatedly go through a scenario, one which is a reflection of a real experience for you, eventually it begins to actually feel real, and current. For example, towards the end of the afternoon session I started to actually feel like I was having a proper consultation, and the answers to the question felt like I was speaking as if I was in a proper consultation regarding my concerns for my mental health. Coming away feeling as if I was about to take the first step of recovery all over again. Not a great place to be I have to say, especially when self induced.
Obviously, dealing with these things is par for the course, and like any other issue, you first have to identify it. So at least that part is done. Now I guess is how to deal with it. On speaking to a couple of the tutors on Friday, they are open to how the session runs, and I have some input on it. My thinking here is for me to somehow find a way to create an air gap between expert patient me, and roll play me. Just to give my mind a little time to balance itself, and help be keep a clear line of what is real, and what I am role playing. Something to think about for sure.
As ever, speaking to some of the students, it was nice to see how interested some are in psychology, and mental health in general, and also how naturally some of them dealt with the awkwardness and obstacles of a mental health consultation. I always find it interesting how the level of engagement can differ group to group, and indeed how this seems to be connected to their tutor for the day. Doing two circuits a day, I generally see 10 groups of students, with 5 tutors, so see each tutor twice per day. Within these sessions, I will tend to get similar levels of engagement from each of the groups with the same tutor. I shall explain, tutor 1 through to 5. If the groups with tutors 1, 3 and 4 are positive and engaging in the morning, the next groups with those tutors in the afternoon will be too. While 2 and 5 will be less so, both times. Does that make sense?? I feel like I am trying to explain my symptoms to a student now!
Hearing how the tutors explain things to their groups is also interesting, and gives an insight into how interactions with GP's in general can differ. Some deeply compassionate, speaking of engagement, and empowering the patient. Others keen to make sure all the safeguarding issues are checked off ASAP, but feeling less involved somehow. None feel terrible, but some certainly feel more empathetic than others, and obviously that in turn rubs off and shapes the up and coming students in a small way. I have grown far more confident these days is disagreeing "as a patient" with things that are said, and making sure I explain how my experiences don't always gel with what is taught as standard.
Time and time again we cover the stigma of certain topics, and I share my take on them, which of course is not the same for everyone. Mental health in itself has the biggest stigma attached to it, or at least it did have. Now it has another issue, but I will come back to that in a moment. The other stigma seems to be around asking patients certain questions, and how they are tip toed around. The main two being "do you use any recreational drugs" and "have you considered harming yourself or others". In the given situation, neither question should really be an issue these days.
Recreational drugs are more prevalent in todays society than ever before. People openly use certain drugs, talk about them and ever seem to promote them in certain situations. Cannabis for example being popular to help with depression as well as other things. So being asked in a confidential environment if you have used anything like that really doesn't cause much embarrassment for many these days I would not have thought.
As for self harm, well.... Suicide is no longer something people are not aware of, or believe only affects a few people. It is common knowledge now that certain groups of vulnerable people in society are at much greater risk from thoughts of suicide. The word is used on TV, billboards, magazine and online advertising etc. It is not a forbidden word anymore, and should not be treated as one. I asked a number of the groups in post scenario conversation, could they ask their friends in general conversation if they had ever considered self harm. Most said they didn't see why not... To which I replied, "what's the difference then". Sure, you have a mentally vulnerable person in front of you, and you are trying to help them, but mentioning suicide is not going to encourage them to consider it, put ideas in their mind, or make it any more likely. If the thought is there, they may or may not tell you. I would think some would be relieved to tell someone that they are thinking that way. Someone who is finally listening and asking those questions.
Coming back around full circle, mental health has another issue these days, and it's not stigma anymore, it's "popularity". Once upon a time people didn't like to talk about anxiety and depression. Mothers coped with it in silence, fathers drank themselves under the table, and any other stereotypical coping mechanism story you can think of. Then of course there were the Prozac mums, around the 90's (guessing here) it seemed that it was the done thing to pop some pills, forget about your worries, and life in some cases. But now we have moved on a bit, and people actually identify having mental struggles, and seek help over it. In more recent times A-list celebs have also started to talk about their battles, and I think that is almost where the problem starts.
At times, I really do believe that certain conditions, especially mental health and brain related, can be fashionable. Of course a rise in awareness will help some identify with certain conditions, however I get the feeling that some identify with the sense of belonging, more than the actual condition. Now I am in no position to tell anyone they are not struggling in any way. I have only my own experiences to guide me on my understanding of anxiety and depression. A couple of weeks ago I was privy to a session hearing about other conditions, and have to say I was somewhat humbled at hearing what others go through. So I am no expert on mental health at all.
That said, sometimes when speaking to people, you get the "I know how you feel" line, or the "oh me too", followed by a story of a very basic negative experience, which somehow left them feeling a little bit let down. Nothing much more, and the conclusion of the story will probably confirm that later that evening, all was well again. A far cry from a simple experience triggering a few weeks of isolation, self loathing, and feeling of complete and utter rejection and failure.
Of course, we are all individuals, and experience things differently, so one persons bump in the road is a catastrophic car crash of the mind for others. So I try not to judge. But sometimes, you just can't help but feel that there is SO much of a certain condition, just a short while after it became popular. Which in turn puts a massive load on the system, and drains resources away from those who need it the most.
Every time I speak to a friend who has experienced the true lows of life and the mind first hand, I have a little more of a feeling of normality, and it is always nice to reflect with someone in the know, and compare experiences, to learn a little more, and gain a greater understanding of the whole situation. Being able to understand, and then take that back to groups such as the RCGP, and help others understand, just feels like some sort of validation for me.
So.... as you can see, a quick 8 hour session at the RCGP gave me a lot to think about, and truly mentally exhausted me. Thankfully I had the foresight to book Monday off work also, so I would have a little more time and space to reset. Heading to the coast on Saturday, to let the wind howl in the hollow between my ears, and a long bike ride on Sunday just to get back into the rhythm of things. For my day off on Monday I decided to go for a nice half marathon distance run along the Thames Path. Switch off for a bit, and exhaust myself physically. It certainly seems to have done the trick.
After a short bike ride with a friend yesterday I was all but spent, and decided today was a good day to do nothing. No training, no running, no cycling, just popped to the shops, and then did some work. The rest of the week is a bit full on, but that is probably a good thing. Days like today remind me that I need to keep my mind occupied, as time alone with my thoughts is not always a good thing. In fact, writing this reminds me that regular blogging is also great exercise for me too. Something I need to do more of for sure.
Right, I will leave it there, I have already started rambling!
Thanks for reading, and as ever, look after yourself, and look out for others.