“We need to talk about your diagnosis”

As always, my psychiatrist’s gaze was flitting between the screen of his laptop and the pink form he kept on his desk. He rarely turned away and faced me – I wondered whether his laptop had voice recognition software but his use of my name suggested that despite appearances he was addressing me. In keeping with this pattern of communication – and without a laptop to stare at – I had taken to fixing my gaze on the green carpet tiles that took up the floor between us. I didn’t want to startle him with eye contact.

And then that rare occurrence – a swivel of his chair and I could see his knees now pointing in my direction. My heart sank. This was never a good sign. “We need to talk about something we’ve not discussed since we first met” he said, in a voice that hovered somewhere between boredom and pity. “We need to talk about your diagnosis”. My heart sank some more. Despite various chemical and therapeutic interventions, my mental health had only deteriorated over the past 18 months. I dreaded what was coming next, but knew that I needed to hear it. A clear diagnosis with clear treatment pathways – maybe I’d finally start to see some small shoots of recovery.

He began. “Your depression has been difficult to treat. We’ve seen little change despite the medications you’re on. The problem is that it’s complicated by certain factors, namely your emotional instability, obsessive nature and perfectionistic tendencies. And you’re incredibly controlling and impulsive.” Finished speaking, he sat back in his chair. I had started to tremble. “I don’t understand what my diagnosis is” I said, my stammer returning with a vengeance, as it usually did in times of extreme distress. “I’ve just explained,” he said. “Do you want me to go through it again?” I nodded.

What followed next would be quite comical if this were a sitcom, a film – in fact anything fictional – but believe me, it was far from funny. My psychiatrist decided that the best way to ‘go through it again’ would be to repeat exactly the same words, but slowly and in a more patronising tone. On the third time of asking, because I still didn’t understand what my diagnosis was, the patronisation increased, as did the emphasis on key aspects of what I can only describe as a character assassination. My life, my personality, shredded in less time than it takes to rehydrate a Pot Noodle.

After the final onslaught, he again asked if I now understood. With my head in my hands and a familiar ringing in my ears, I mumbled “No. I just want to hurt myself.” And with that, my psychiatrist looked at his watch, told me that we needed to finished and could talk about it another time. I got up and left without waiting for him to see me out.

That wasn’t a new diagnosis, or indeed any diagnosis at all. My failure to understand was not caused by my stupidity, but by a complete absence of the very thing he said we were discussing. I have mental health issues.,I’m not stupid. Labels can be useful. They can also be unhelpful. It all depends whose hands they fall into. I just thought that the guy dishing them out might at least take the time to state the bloody things clearly.


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