A Letter to a patient

Dear Mr Chong,

This morning I was calling a few patients checking how they have been and trying to answer any question they may have. When I was calling this woman whom I usually called her house numbers as she didn't have a mobile phone, somebody else picked up, and told me she's no longer living. She committed suicide yesterday. The lady answered the call was her daughter. I didn't ask anything further, ended the call after sending my condolences.

It took me at least 5 minutes till I managed to type the note then tell my colleagues what happened. One of my colleagues guessed it straightaway before I opened my mouth, she must have seen it on my face. I keyed in "Deceased" on her profile and informed doctor much later.

I carried on with my work. Then later of the day I was calling you and realized that your phone was temporarily unavailable. I called your girlfriend and finally she picked up, telling me you were fine taking the medicine. About an hour later you rang me from Singapore, and when I said I was just checking how you were getting on, you said you were going to commit suicide. I know you, although only for 3 days now, I knew you were just joking, so I asked by what method you're planning. You laughed, I'm released. I was updated with your current condition, I know you're doing very well, coping well too. Afterall you weren't depressed, just some anxiety and palpitation problems.

This is part of my work. Sometimes a few people tell me they're suicidal within a day, I learn to judge well to make sure everyone stays alive, then happy if possible. I didn't take you seriously, so I didn't tell you that you shouldn't really be joking about committing suicide.


11 Sept 2013

What's wrong with the children nowadays?

I have an in-law who teaches English in a secondary school, and is a discipline teacher. She recently got her car a recorder as her car was scratched (not just hers, but quite many other teachers' cars too). So this recorder is like a car CCTV that records everything including sound as long as there is battery power supply.

Yesterday a prefect approached her and told her that her car was scratched again! She went to check and decided to check the recorder when she got home. So hours were spent and my brother and she found the culprit. Although not exactly clear, it did quite convincingly suggest who did it. 

It was the prefect who came to report the incident. 

He is only form 2 this year. He got straight As in his UPSR. He came from a highly-educated family. He is the only child at home. He gives hands to his teachers when they need help (e.g. he helped my sister-in-law to carry bags and stuff from the car to the office). 

If it wasn't the CCTV would anyone ever think that it was him who did it?

Why a so-called good student like him did this? Something wrong the boy himself? with his teacher(s)? with the parents? with the education system? with the society?

My in-law could only think of the other day where she told him off during an assembly as he was doing homework which wasn't what students meant to be doing, what say a prefect who should set as a role model.

Really? I found it quite difficult to actually believe that a 14-year-old boy was this "advance" in playing psychological trick and had this kind of mind set where (1) he intended to revenge or sent some kind of message to my in law? (2) he did it and then reported it, most likely believing that nobody would ever know it was him?! 

We can imagine that how much it would hurt this boy if the video is published, so we thought about ways to protect him. I think we would rather have some really "bad students" who did it, so that they can be punished straight away knowing they wouldn't really care anyway (I mean it shouldn't bring harm to the bad students in long term). But for a "good" student like this, any minor punishment we thought it is (e.g. having him to resign from being a prefect) can lead to severe consequences, or even affecting the rest of his life... So as long as he knows he was wrong, parents would be notified and no punishment would be given. I think this is a better way, although I do think parents should now give a lot more attention (and love?) to this boy, understand him psychologically and his mental development, perhaps he really needs some proper counselling or psychological treatment. 

Not until something happens to your children, always be so alert with how they are growing up. Is results everything to them? What's the most important values that we should be implementing to our next generation? What do successful and happiness stand for? 

Genuine Suicidal Attempt or Attention Seeking?

She was told by the doctor to come to the clinic to collect her medication and for an injection, after seeing the doctor in the hospital.

When she got here she looked like she was on the phone, but nobody heard her talking at all. Staff told her to come in to the treatment room. She gave no response, made no eye contact – as if she was so concentrate on a spot in the air. Then she walked towards the door, went out, and stood by the stairs. She looked down to the lower floors. A colleague said, “she isn’t going to jump down is she?” I was going to say “Is she looking for someone downstairs?” but before I even completed the sentence, her feet were already in the air, hanging her body on the rail. we all ran out. She didn’t do it fast as her left hand was still holding the stairs handle/rail. So one of the colleagues managed to grab her legs, another her arm.

She was brought in. She continued to say that she wanted to leave, and of course she wasn’t allowed. It took some time till she was injected and given stat dose. The doctor came from the hospital to see her.

It appeared to be something related to drugs, she seemed to be taking illicit drugs, and according to her, she will be charged for distributing drugs (or bringing drugs in from another country). She said she was innocent.

She calmed down later as the stat dose kicked in. Family member was contacted to bring her home. I’m not sure how she is right now, I hope people will all stay away from illicit drugs. 

If it was one of our busy days we wouldn’t have noticed and managed to stop this. Though we doubt if she really wanted to commit suicide, or she really just needed some attention and help maybe. Because of how the stair is designed, it wouldn’t be possible for anyone to jump down straight from 4^th to ground floor (other than a small baby).  She could only fall to the third floor, though her head would have landed on the stair case below. I’m sure she was aware. So attention seeking through a suicidal behaviour?

Sometimes when it comes to mental illness (and I guess many chronic physical illnesses), family members get fed up and lose their patience after a period of time, due to the time, money and attention needed to care about the patient, but also the stigma that come with it. But without any support from close family and friends, it’s almost impossible for someone to completely recover from mental illness…

Morbid Jealousy

There was this young beautiful girl, who from the age of 16, got into her first relationship with a working guy. She then became so obsessed, and had the delusions that the boyfriend was flirting with other girls, having an affair with others etc. She skipped classes, and went to her boyfriend's working place to "watch over" him, see what he was doing, who he talked with...

Over the years the girl got into various relationships, because of how beautiful she is, guys get attracted, and when she becomes attached, she also gets really obsessed and possessive, especially when the guy having any contact with other girls, despite how faithful the guys were. The girl slowly realized this a problem, and consulted a psychiatrist. Over the years she also gained insight with her problem -- a condition now called "morbid jealousy".

Morbid jealousy is a psychiatric condition where the person holds strong belief that his/her partner is being unfaithful without any convincing or "solid" evidence that this belief is true. It tends to happen over and over again no matter how many partner this person changes and how "innocent" the partner is.

It is getting to quite a common condition nowadays. As we would probably all expect that conditions like anxiety disorders and depression would be a lot more common, now probably every 1 in 10 people with a psychiatric condition comes to the clinic due to this problem, although most of them may not understand this as their problem (but only think that they can't sleep, get anxious easily, feel unhappy, got no appetite, is bad-tempered, gets agitated easily... which can simply appear as anxiety depression).

Here it's important to clarify that morbid jealousy doesn't apply when actually you find some convincing evidence, or when you are just feeling a bit insecure whether your partner gets a bit too close to someone (yes, just a bit insecure, which does not affect your life that much, and problem may simply be solved after you speak calmly with your partner), or when it's just part of a more sensitive type of personality.

For the patient's partner to come to understand that their partner has this problem would be helpful to the patient, and being understanding, considerate, supportive and patient to the patient will be significant to the process of recovery. 

Psychology In Malaysia

If you've ever wondered why I'd entered the Psychology field, here is a short reflection that I've written couple weeks ago, about my passion for Psychology and about my job in North London Forensic Service, NHS. 

Putting your heart into it 

The blog "Psychology in Malaysia" is run by a very inspiring friend. It's also the kind of subject I'm now becoming interested, especially after all these years in the UK. 

I'm Lunatic!

I learnt this word - lunatic - from one of my patients. The first time I heard it, he was saying to me "you're lunatic!" I didn't know the meaning, but I thought it was related to "lunar", so I was thinking the word may be saying someone whose emotion fluctuates a lot (just like how the moon changes every day). Of course he was just having fun by saying that.

But that day I heard it a second time, and checked it online later, the online free dictionary says:

1. Suffering from lunacy; insane.
2. Of or for the insane.
3. Wildly or giddily foolish: a lunatic decision.
4. Characterized by lunacy or eccentricity."

At the same time coming out from the search is a BBC News - "How offensive is the word 'Lunatic'?" and it mentions that the word originally "referred to a kind of insanity that recurred according to the cycles of the moon". Hahaha so I was right to think about the moon, but still get the meaning wrong. It reminds me of Dragon Ball (hahaha) and other werewolf movies.

Anyway, it was inappropriate to use the word to "normal" people. But when my patient said that to me [jokingly], I [jokingly] said back "You're lunatic too!" He just laughed and continued to repeat that I was lunatic...

My whole intention of this post wasn't actually about introducing the word "lunatic". In fact it's an introduction...

I realized there have been quite a number of this so-called "mad" people in my life, mainly due to my work. I have also been talking quite a lot about stigmatization people hold towards those suffering from mental health problems. Whenever I thought about helping and standing up for these people, my patients come across my mind.

I thought I no longer hold these stigma and prejudices like everyone else. And I was wrong. The other day I went to Wood Green, and there was this man, I probably have seen him a few times, who was talking loudly in front of Morrisons, what he talked makes no sense. I avoided standing too close to him like everyone else, but undeniably I think he was mad, he was dangerous. (although I work in a forensic ward, but no, people with mental health problems are no more likely than "normal" people to commit crime, to hurt others!)

No matter how many "mad" people I have met, and how much fact about "mad" people I come to know, when I walk on the street I behave like everyone else. I'm not saying that I'm wrong behaving this way. But I realized I can only be confident to work with people with mental health problems, in a safe environment or, with patients I already know for a period of time, in any environment. I don't have the ability to approach a ["mad"] stranger on the street and attempt to help him/her.

What can we do about this? Create a safe environment any and every where, change everyone's attitudes towards the mental illness and the people who suffer from them.

How do we achieve that? I dont know... 

Behavioural Experiment for Social Anxiety - Walking a Banana

I have long heard about behavioural experiment in the CBT. We used to have a guest lecturer in the uni who shared quite a lot different types of behavioural experiments she has done throughout her life as a therapist. One of them that I remember quite well was working with a woman with OCD (Obsessive Compulsive Disorder), who was very obsessed with hand washing. And in short what they did, was putting their hands into the toilet bowl, reaching the water in it! then what? Without washing hands, they used their hands to eat!!!! It was like OMG, REALLY?! But yes that's what was done, the therapist was going it with the client, and really, nothing happened afterwards, and the client realized her obsession with hand washing really wasn't rational (of course this is kind of simplified, you should assume that they have done a lot of work in identifying irrational/negative thoughts, doing relaxation techniques and also discussing the rationale of designing such experiment etc).

Guess what I did today? Hehehe, oh the title tells - I walked a banana in Croydon, London. YES I BLOODY DID IT. Me and Krishna did it together, initially we didn't quite get into the state, and we were laughing and stuff. But after that we realized we really need to be so serious, so people know, yea we're serious about it. Believe it or not, so many people looked at us! (Well refer to the video below although it wasn't quite obvious in it). Some people asked Pei Man (she was following behind us and taking video). Some just stared, some tried to look covertly Haha. We went into the McDonalds, and obviously people were looking. I saw a guy taking pictures of us. I heard the staff saying "people coming with a banana on the string". At the end a guy approached us and asked whether he could take a picture, even asked for their names and age. LOL. The staff in McD also asked us. We left, another black woman on the street was like "what's this for?" Another two women walked past and we could overhear them saying "look at these stupid people". Hahahahaha. Stupid, I kind of enjoy this stupidity!! There were also quite ignorant people, who walked past like nothing happened. In front of the hotel, there were 4-5 teenagers, some just stared at us, while one who was obviously more extrovert approached us, and patted on Bobo (Krish's banana, and my banana is Nana), although another friend of his almost gave Bobo a big kick!

Okay up to this point you probably going to ask me, why were we doing this for? The idea came from Donald, our lecturer on the hypnotherapy course, who treats people with social anxiety. Oh yea this was one of this behavioural experiments with his clients. The idea is to do something and make people really look at you. In fact some people are often so self-conscious, being worried about what other people think about them, whether they look stupid, look anxious or too awkward etc etc. With experiment of this sort you probably find out the reaction could be quite different from what you think. But even if it was what you think (that "you look stupid", "you look so anxious", "you look like an idiot"). Those are just their thoughts! So what?? It's nothing catastrophic. Let them think what they want.

It's like people who are overly anxious doing public speaking, worrying they might make mistake. Well okay there are a lot of thing you could do to present your best, but what if you make mistakes? What if... you make a mistake deliberately?? Laugh it off? Chances are you are going to survive it anyway, why worry? This is my way of seeing it, though Don said people can test by making a mistake deliberately and see what happens, see what's so catastrophic about it. Of course this doesn't mean that I'm no longer anxious, and no longer worried in public speaking, but when you really analyze your reason of being nervous, rather than focusing on hiding your nerve/anxiety, the results are most likely going to turn up better.

I also forget to mention, at this very same day when Don realized we're going to do his banana walking experiment, he was also interested in joining. So I gave him a string and he got himself an apple to walk, but that apple fell off. And what did he do?! - he went to a toy shop, got himself a pink piggy soft toy, which could fart if you sat on it - and he MADE the shop assistant showed him how the pig fart in front of a long queue / big crowd of shoppers. Then he put the string on the big pink pig and walked it back....... You probably going to say he's such a weirdo. Hahaha well he is... not. I suppose it can get addictive, so additive. But to go to shop and ask for certain things to be done, is part of assertiveness training (and other things). And doing all those things can get quite addictive! Well, in fact at the same time you're also helping your clients and being a problem-solver.

I just have got to say, I have really enjoyed it. And Krish did too - know what? She's a mum of two, and she was as passionate as me if not more, in stuff like this. Hahahaha.




P.S. I just think it's important to give credit to Donald Robertson, given how much of his ideas I quoted here (you can google about him if you're interested).

The Power of Social Networks

Warning: What I'm going to write is probably quite random to an extend that the title may turn out irrelevant.

Last week I was attending the Stage 2 of the Cognitive Behavioural Hypnotherapy diploma course. Then we sort of discussed the opportunity of practicing as a hypnotherapist in the future, and Donald shared his experience, tips and advice of setting up one, including a website as a start-off point. He then also mentioned twitter. And with this I have something to say, I realized there have been a lot of random people following me on my personal account, just, for example, for me saying the word "dissertation", there was a proof reading company following me, then I mentioned "hypnosis", and there I attracted another 3-4 people following me. Other than that there is also a pet food company (I think it's because I said I'm going to "walk a banana like how people walk their pet dog")... Really?!?! So you think I'd need to buy food from you for my pet banana? And there were some photographer, random whatever commercial stuff. 

So I sort of tested this, for the following days I tweeted a bit more about hypnosis, and really, there are then people who offer hypnotherapy in the area coming to follow me. (Sorry if you are one of my followers and were wondering why I've been talking so much about hypnosis - especially if it didn't interest you). 

This is kind of powerful, just to make yourself having more followers, although I'm not sure about when it really comes to offering your service (or selling your products), eh but, there is no harm of doing it, really. Don also mentioned some people use blog, write about controversial issues in the field. I suddenly remember one of my posts that received quite a lot attention - at that point I thought about this one - "Swollen Fingers due to Excessive Writing" (wow huibee you're random). And honestly, this completely random post (even the pictures went missing due to my setting after I joined Google+) is still receiving attentions! Now I remember the top post of my blog, which is "A Letter by a Malaysian living in the USA", ironically though (well done if you realized before I said it) - I live in the UK, not the USA, so that wasn't written by me (acknowledged in the comments... a few times)... But I'm not sure why it appeared to be the first source people come across if they google it. Now this is a very good example of controversy. (Just if you're interested, this post in 2009 received on average 2+ view each day now). 

So I guess one important thing now is to do more reading, to assure the quality of my post/tweet (unlike most of my personal posts hahahaha). Though, to call myself a blogger I think I need to start writing a bit more regularly, and I do hope to share more about my reading and experience on hypnosis and my work in NLFS, while protecting my patients' confidentiality!

Certificate in Hypnotherapy

I completed a Certificate in Hypnotherapy last week. There are still stage 2 and stage 3 to get myself a Diploma in Cognitive Behavioural Hypnotherapy.

I'm not going to say how Hypnotherapy was defined academically and practically, just would like to say it is really nothing like how the TV or medias depict it. Yet it is something really powerful, to help people think positively, to treat phobias and minor clinical depression, to manage pain, to relax and release stress etc etc. One thing worth noting is the pain control and management. There have been people who gave birth or had their teeth removed without any anaesthesia yet feeling completely good and positive throughout the process and after it. We tried it with some minor pain in class and shockingly it worked (we had a clip on our hand, that didn't cause that major pain although it wasn't really anything comfortable). At one point I could feel no pain at all. But what's important is the way you see the pain. I'm still going to do an experiment myself at one point with similar sort of stimuli without self-hypnosis and see if that pain-free feeling was due to habituation.

From the class I also learnt meditation. With his lead I really enjoy meditation, and at times I did it on the train while we were on our way to the class. But after that I started to fail, because of my ability to really focus and concentrate. It's now getting better. I probably need more time. To be really focus and concentrate is always my problem anyway. I also did a self-hypnosis yesterday due to my sore arm. Of course I didn't come out from the hypnosis pain-free, but I was able to see the pain differently and soon forget about it.

I will share more when I have time. Ask me anything about it if you want (and surely it doesn't mean I will always have the answer). If not then try to find some more established site to learn about it. It's something very useful and interesting. At one point I hope I can learn about then practice it more and really let people benefit from it. 

Another Leaving, this time a Discharge

先前写过一篇一名病人因癌症去世 今天我送走了另一个病人
可是这次他是被 discharged 了!! 这是我的 ward 里最年轻的病人 是我比较喜欢的一个
可是后期因为他有很多 overnight leaves, 外加我减少工作时间所以不常看到他
看到他被 discharged 真的很开心... 虽然其实有点不舍得 可是我还是不断告诉他请他不要回来
不管要做什么都要 think twice before doing any things that might bring you back
希望他有听进去吧 毕竟他还年轻 (才大我一岁) 大把前途 没道理把一生困在医院里 (话说爸爸在英国是医生 妈妈在美国是律师 父母我都见过 我一直不明白他怎么会在这里!! [医院])
话说在这个 ward 里工作已经一年十个多月 这才第三个被 discharge 的
话说第二个被 discharge 的还回来了 (不过没有回来我的 ward)
其他大部分离开的 有的回去监狱 有的去了更 high security 的医院 虽然也有两个去了更低 security 的ward 可是他们到现在都还呆在那里 每次在 grounds 看见他们都会问他们怎么还在
虽然这样问其实很残忍 (谁不要自由?) 可是其实我也很心疼看这些人把大把青春耗在这个地方

今天送走他 我在想其实我或许不适合这分工
不喜欢离别 虽然有的病人比较不熟 可是相处久了 送走谁都会有点不舍
当然还是最希望他们的离开是好的 希望他们不再碰不该碰的东西 不再做不该做的事 病也不再复发...
还是庆幸今天能送到他 衷心祝福他 也希望其他病人会慢慢好起来并被 discharge.

还有一个老人家 一个超烦的老人家 超喜欢烦我的老人
他是个很挑战我的耐性的人 可是我这么久以来就今早差点对他"发脾气"
因为其实他很可爱 他只是很"病" 外加牙齿掉光 今天又拔了几颗 现在只剩三颗 所以他说话的时候很好笑 (也很难明白)
他的病情不轻 常常在 ward 里叫 要不是因为他年纪大 早被其他病人殴打了 (话说病人虽然是病人 敬老这件事 他们其实还真的是会的...)
昨天就告诉我他 700 岁了 后来又问我要不要做他的 sister (我想他 700 / 60 岁 怎么能做我 brother) 他还继续说 这样也就做了 Obama's daughter... 原来他是 Obama 的儿子 所以我要是做了他的 sister 我也就是 Obama 的女儿了 XD 能说他不可爱吗?
不忙又有心情的时候 耐心听他讲话其实很有趣... 他心情好的时候也会在 ward 的走廊上唱歌 然后会害我(们)也不自觉的跟他哼起老歌...
当然他凶起来生起气来还是很恐怖的 只是他不 violent 他也还是会对我还有几个他比较喜欢的 staff 很好...

有时间的话 我或许该多写这些 因为我想以后的我 会觉得这一切像梦 也会很怀念这一切... 

Virtual World

It's the last day of term. No, not yet. I have yet to graduate. It's the last day of Spring term, I still have Summer term! Had quite an "interesting" lecture day in Mill View Hospital today, which is really not what most of us had expected. We thought we were going to get more practical kind of things but who knows?! They made us travel there then what? Sit in the lecture theatre for whole day!

And I'm going to talk about the final talk "Projected Research and Business Developments" by Susan Conboy-Hill. Let me try to be unbiased and say what this talk is about. They are trying to bring in technology to "do" treatments. So here she talked about the people who are hardest to reach, people who stay at home all the time, people who are scared of human interaction or touching, people who hate leaving home, people who are scared of crowds (perhaps, I added some of these myself), yet all are people who need psychological helps. And they proposed (or in fact are going it already) this "virtual world" where people can learn about interaction, get support, feel "well-being".

Before she even finished introducing the whole ideas of it, my colleagues already started to raising hands objecting how this can probably work, then I joined the debate... We are psychologists (or "worse", we were trained "critical thinking" so much that we criticise everything all the time lol), we emphasise human interactions and think it's incredible central to human lives, well-being, contentment, satisfaction, recovery etc etc.

So I asked her, if Yuko (she just happened to sit next to me so I used her name) had problems interacting with people and thus is prescribed with "Virtual World", how is this going to help her with her situation and to get back to normal life? She answered, "how do you know she wants the interaction?" and carried on with her whole idea of how this can work. I agree, recovery quite often doesn't mean get back to "normal" or "how it used to be", and recovery can simply mean "a sense of well-being" very subjectively, but does she mean Yuko is going to spend the rest of her life in "virtual world"?!! Sometimes in Psychology, even Yuko doesn't know that she wants the interaction, at least not until we help her to do it, then slowly she realizes she really enjoys it and gets the most benefits out of it.

I'm so against technology in some ways. Of course I love technology too. I remember seeing a quote on the train, saying if the world hadn't invented mobile phones, we'd all interact more. Yes, so true. It was meant to assist communication, but nowadays how often do you sit in front of a friend but s/he is using phone on facebook/whatsapp etc?!

I appreciate the kind of convenience technology brings us undeniably. Or I wouldn't be able to Skype with my mum whenever I want. I also appreciate that technology can help with recovery, for example if you have a spot above your eye you google and find out what it possibly be then only decide whether to seek help. But technology can't be a treatment as a whole. Just because we're human... People can often read self-help books and understand more about themselves, can learn how to make themselves feel better etc. There can also be an iphone or android application to help people understand depression or monitor alcohol intake. But how are we going to treat someone with bipolar personality disorder with......... an app? with virtual world?!!!

She acted as if she's very "in" and initially perhaps she also kind of thought she'd get all kind of agreements and acceptance from us because we're the generation who have used and benefit most from the technology ever since. I suppose she was quite shocked to have heard us and turned really defensive, and didn't really make obvious points to answer most of our questions. I don't mean that I don't see the potential of their proposal. But I hate spending so much time in front of the laptop, with the phone. I still do it because there's this habit/addiction/whateveryoucallit. I certainly don't hope to see in the future facebook/twitter/smart phone apps replace all part of our social lives. (She loves twitter so much..) Oh let's go out for dinner... I mean in virtual world?!

And one day when I see you, I lost the ability to interact. (we all are certainly losing it... I just think we should stop before it becomes part of evolution)

Qualitative and Quantitative Methods in Psychology

I'm not writing to introduce these methods, so if this is what you're looking for please close this page.

I'm doing my dissertation this time again in quantitative method, originally I thought this reflects my interest and what I thought is the best method. Until recently I realized it doesn't reflect my interest, it reflects what university is able to provide their students with.

I did my undergraduate in University of Gloucestershire. There we had a professor who was a bit sissy (sorry! and worse I can't remember his name now), and he was really good in Discourse Analysis (a type of qualitative method), so that was what we were taught. I remember me and Pei Man did an assignment together regarding religions, in which we interviewed the head of our uni chapel (christian) and a malay friend who practices Islam religiously. I wouldn't say that I was very keen in that assignment, afterall that was something completely new, we weren't even sure what we had to do. This university we have Tom Farsides who is specialized in Ground Theory (another type of qualitative method), so again that's what we were taught in. He is quite a good lecturer, but I didn't pay too much attention during his lecturers, I thought, yes I thought, I wasn't interested, I thought I have decided to be a quantitative researcher.

Until recently, when I start to talk to people regarding my MSc. project. Most people found it very interesting, and quite often people share what they encountered in their lives with me. Today I was speaking to a lady in the language institute, she was like completely surprised and happy with what I'm doing, and told me she is really looking forward to my work. She continued to share some of her knowledge, and more importantly, some of her experience ("there had been lots of tears in this room (her office)"). I'm surprised how much she knows, despite the fact that she is an English and isn't someone practices in the social science field, but she sees a lot of international students.

You might think I must be happy to meet someone who can provide me with more information about my study. Unfortunately no, I'm slightly upset, with the fact that I'm going to disappoint her with my work. Because quantitative method can never capture so much information, I can never share her experience (and some of others) in my studies, my project is fixed, although it's complicated enough, but still, it's fixed.

Before I left I told her perhaps I can do an interview with her and learn more about her experience.. then we both smiled and said "for my (your) phd". Of course I was just joking, I told myself I am NOT going to take phd, at least not now.. but this is the first time...

(1) I feel I have to use qualitative method to capture how human behaviour really is like

(2) I think about doing a phd!!!

When you become a Psychologist

I have become a Psychologist a few years now, although I don't really see too much difference in myself but I slowly realized how people see me differently..

Another day I was talking to a psychologist-wanna-be, we were just talking about a guy she likes etc, then towards the end she claimed that she can see how "professionally" I formed my questions and she was suitably impressed. I was a bit surprised because I really thought we were just having some girls talk, quite casually although I certainly concern about how she feels. So I explained to her there was nothing psychology related..

When you complete a psychology degree people somehow see you differently, it is like you can never have girls talks or chat normally any more, because people will keep be reminded that they are taking to a psychologist, not a friend. But they forget that I can be a psychologist, a friend, and also a psychologist friend, or, just huibee.

Sometimes they really want to consult about something, for example a cousin who seems to be autistic, an uncle who has severe sleep disturbance, or just basically themselves having insomnia. At this point its okay you try your best to say what you know and think can help..

But at other times, they talk about their problems, so you listen and try to comfort like any friends will do, they then start becoming annoyed, wondering or even asking cant you just behave like a normal friend but not talk like a psychologist as if they need psychological helps! Well, in fact there isn't such thing (the psychologist-style-talk), it's all in their mind, their own illusion! All this time huibee is still huibee, the way I talk doesn't change much, in fact I still say what I want to say!

I know this sounds quite nonsense. But I face this situation quite often, especially to friends that I newly come across "wow psychology! I better watch what I say", "wow psychology? do me!" (DO WHAT?!).. or worse, they just take it and bear in mind subsconsciously and we carry on to talk, then towards the end they suddenly say "so that's what you think as a psychologist", "so that's how psychologist xxx", wrong wrong wrong! thats what I think being myself...

Now even worse, even myself start getting that illusion. When friends come to tell me s/he having insomnia, I start to wonder what s/he is expecting.. a psychologist's advice? (err I dont know! I can only use general knowledge..) or a friend's comfort? or just a listener?!

*Confused*

A Day in the Life of a Mental Hospital Patient

Just read this:

A day in the Life of a Mental Hospital Patient

Going to a mental hospital is nothing to be ashamed of or embarrassed by and I encourage everyone to take that step if they find it necessary. Life can be overwhelming and sometimes we just need to heal.

I find that quote good - stigma-free. Maybe becoming a patient for a period of time will make me a better carer too? Anyway, that isn't the main purpose of my post..

I can't help comparing how a day of this particular person (no longer patient)'s day compared to those that are on my ward. Some parts of it are quite similar, but I just really want to point out the main difference, which is the rehabilitation activities. Similarly, we have all those structures (certain time for meals, medications, basic activities like garden breaks), but how about the rehabilitation part? Someone on my ward can sleep through the whole shift (7.5 hours) and not doing anything. Others can just get up only for meals and leaves and do nothing else for whole day. What's good for keeping them in there and not doing anything meaningful and productive? And worse, not even helping with their mental states and general health (well most of them are obese). There isn't structured rehabilitation activities, if there is, there are way too loose (e.g. one to one session that only takes place every one to two weeks, psychology sessions that happens only once a week etc). What can they do other than those?

Sleep + Eat.

And can you believe for these people to Sleep + Eat peacefully every single day, how much are we taxpayers paying for that?!!!! It's okay if it helps, but does it?

One used to tell a member of staff, when the latter told him he's good at cooking, he can be a cook when he leaves the hospital, the patient said "no I'm not going to work. I'll receive benefits for the rest of my life." So oh yeah, more money for his benefits, travel pass, accommodations etc. This is what the service leads them to. Ouch! that's my moneee :(

"I want sex!"

No no, it wasn't me who said that, lol. I was doing response today, and went down quite a few times to an acute ward, doing reviews on this man in the seclusion room. He's a massive mad man, and has hit two of our TAMVA instructors (who are supposed to be very professional and the top people in restraining patients). I'd never met this man till today. But I have heard a lot of stories from others who have done response in the past two weeks. One of the significant event that I remember was that he pooed in the seclusion room, and made it really dirty, then that day when they tried to do a review, he stood up, slipped on his own poo and fell on his own poo! (hahahahah, how dramatic is that?!) Apart from that he's always naked (not today, just half naked) and very very inappropriate to female staff.

Today when I went, I was thinking I would be really useless, as a little young female nurse. It turned out he's obsessed with females again, then was telling the other staff that he wanted to talk to me (the other female staff around are at more mature age..), so I became a lure, to keep his attention, while they put his food and drinks via the toilet sides and unlocked the room before he realized. I found that quite funny, because I basically just had to talk (through the interphone/viewing panel), then I've done my part. xD Though one of the times he kept asking me to come closer, then when I told him to put the mattress back to where it should be, he started repeatedly saying "I want sex!" The nurse in charge said directly, okay! it's over!

His behaviour is entirely unexplainable (apart from the word 'madness'). His speech is incoherent, and is so obsessed with females. At the same time he is also strong and can be so violent. He can be naked in front of so many staff not feeling a thing; He stuffed his food below the door; He doesn't use toilet but anywhere of the room...

He will be sent to a high security hospital next week. I'm just wondering how people like him get well.. I'd like to learn that and be part of someone like that's progress, but then it seems the control and restraint that we learnt is nothing when we face someone like him.. I know some of the guys on my ward used to be very mad before too. I hope some time in the future I'd get to explore the more severe area. :)

Equal Opportunity and Diversity

Attended a mandatory training course today which covered Equal Opportunity and Diversity, Health and Safety, Fire, Safeguarding Vulnerable Adults and Children, Infection Control, and Confidentiality and Information Governance. The first session was the one with the most discussions and debates, that the presenter didn't even manage to complete 50% of her slides within the given time.

As a woman, I think quite often we receive positive discrimination (PD). PD, according to the presenter, is unlawful. Give a very obvious example. The ward that I'm working on is a male ward, although there are slightly more female than male staff in the ward, there are quite a number of jobs that could only (or preferably) completed by male staff. E.g. searching service users coming back from unescorted (ground/community) leave, there are about 4-8 times a day in my ward now (more coming); doing their UDS (Urine Drug Screen) etc. And yet, I couldn't really think of a job (in my ward) that can only be done by female. So see? It could be unfair... (just could be, because we are very nice females, so we would even that up with doing some other jobs for the male staff).

The presenter gave an example of "positive action" (which is lawful) - a university lower the entry requirement for the ethnic minority (I think she used "Blacks" during the presentation, which I think isn't appropriate), so the Whites have got to have 3As to enter while the Blacks could enter with 3Bs. She added further, it ended up with more Blacks dropping out, simple because they couldn't follow the course, as they were not as competent.

What do you think?

In that room, there were more ethnic minority (opps! so no longer "minority"?), there were more Blacks than Whites as well. I don't know what the others think. But to me, to give this example at the first place, IS already a discrimination itself! Think about it again. One, the whole example based on that "fact" (what they believe genuinely, but I don't think it's true at all) that Blacks are less intelligent than Whites (so that most of them can only enter with 3Bs, so that they would drop out even after they were admitted). Isn't this a discrimination? Nobody pointed that out, and of course I wouldn't. Because I'm neither a White nor a Black, and I wouldn't want to cause more debates or war. Two, I see no point of giving this example!

I don't know what made the Whites always think they are more capable, more competent than the Blacks. From the people that I've known, I can confirm that Whites are no more intelligent than Blacks. Of course I have a Psychology degree, I should know how that conclusion came out, that some researchers did some research that they thought it was very well considered and fair - then concluded that Whites are simply better. I can tell you two things. One, it COULD be true in the past, but it's definitely no longer true. Given that they always think they're better, so they are far less hardworking (ok, I mean they're lazy), over decades they ended up with people who think they are good but only in talking Big. Two, the 'fact' just can't be true. Because research can never be fair, in a field (i.e. investigating intelligence) like this. Language is one thing, culture is another (and many more). Of course a Black could be born and brought up learning and speaking only English, in the Britain (as an English speaking and English culture example here), but how about his parents and external families? How about friends that he makes? Can the intelligence tests consider all these factors? It just can't be fair.

I don't know why I get myself into that Black & White Intelligence debates. It seems that I'm in favour of Blacks. But the fact is, no, I'm not, I'm just not in favour of Whites (see my post Discrimination), especially when it comes to the feelings that they think they are better in any and every way than the others.

Of course, there are very intelligent Whites, very intelligent Blacks, very intelligent Mixed, Brown, Yellow, Colourful, whatever. I'm not writing to offend anyone, especially my White friends. I'd happily accept if they're in "fact" more intelligent, yet this thing can't be proven (and we dont have to! What is the point of doing that?). And more importantly, I wish the Whites are aware, that their thought of they're better naturally, are going to make them less competitive and more lazy, are making them worse which in some days later, would reflect through genes.

P.S. I wouldn't disagree that myself is also discriminating. Afterall, that's just a mean of "categorizing" like I mentioned in my other post. There are always debates. But I'd suggest the presenter who do topics like this should have more concerns.

Just a little add-on

I mentioned languages, so often one of my White colleagues enjoys correcting others' grammar mistakes, I remember there was once my Black colleague replied, "please! English is not my first language". Exactly! Can you speak Mandarin, Malay, Hokkien, Cantonese like me? If you could, I'm going to speak English just as good as you do! Although, I'm quite happily corrected, because that's a mean of learning, but sometimes this man could be annoying to others who don't pay as much attention to grammars.

That's why I always say communication is important

Read this:

Study: A Complete Stranger Understands You About as Well as Your Spouse Does

I don't believe this is true, despite the fact that the study found no significant difference comparing the two. But still, I find that astonishing, since it could be true to a certain degree, for most people.

...

The more I think about real life situations and examples, the more I'm convinced that these researchers are right.

So, speak out. =)

Discrimination?

I didn't realize myself take that by heart, that I woke up early in the morning, recalling what they said, just like that. I thought I've been in this country long enough to be immune from discrimination - remember there was once when I was chatting with the ward doctor (a british who was born and brought up in the uk, and of India origin), I told him I don't care about (racial/colour) discrimination anymore, I'd just take it, because we're all human and it's normal to discriminate (in other word, it's just "categorizing"), I even gave him an example that through the 3+ years part time job that I've got during Uni, White people from this country are certainly far more lazy than others (and are only good in "talking" instead of "doing"), and I said "see? I discriminate them as well".

Yesterday came in a shift realized my favourite colleague was sent out to do two community leaves during one shift, and somehow I felt they bullied her, of course I didn't put it that way, but when she came in, I just said XXX you're a star!!. Then the other two started to tease me, saying "look at you". I know they were joking, but still I told them I came in 4 shifts in a row, and going out every single shift, which they didn't really listen to. The two person who teased me, one was a nursing assistant who never really does community leave, and whenever she is put down to do it, she would pick the person that she wants to take (and there are only 2 of them), or else she would do whatever to get herself out of it. While another is a qualified who probably has done only 1-2 community leave since the ward started 6 months ago. Opps, I forgot - both are Whites.

The whole incident was behind my mind all day long. I really didn't realize I actually mind it. It seems like my brain didn't manage to resolve the conflict feelings through dreams (a theory by Griffin & Tyrrell), so I was waken up and ... decided to blog about it ha ha.

And yes, I feel better. =)

NHS, are you helping them?

Took a patient out on grounds today, had a very thoughtful conversation with him, or should I say, he has told me about his thought regarding the way this place treating mentally ill patients, and whether or not this is helping them.

I have had this thought probably since the second month I work there - are we helping them? are they progressing? should they be here or in the community? You wouldn't believe it until you actually work there, that how much money NHS is spending on them, and what is actually coming in returns.

Well, I'm not a qualified nurse, neither am I a clinical psychologist (yet), I might not give the most accurate fact that reflects the truth, but the patients, they are the central of the whole system (the hospital, the treatments, the multidisciplinary team, the nhs), shouldn't their thought count and be deeply considered? I know, some of them are really not that well, what they say might not be beneficial to themselves, and they might be saying all these simply because they want to get themselves out of the hospital. But this particular patient, he just spoke out what I think, that there is no point of keeping them there, for years and years, doing nothing every day, not knowing when they will be discharged, not being involved in the outside world etc etc. If we want to give them treatment and make them better, we should do it every day, every single day, not like once a week. If we were to organize courses, make it a daily one, not like once a week. The thought of not knowing when they can leave is simply depressing - and I strongly agree with this. They all know they are wasting their time, their lives, missing many important parts of lives, losing contacts with theirs loved ones. I actually feel sad when I heard these, because I know he is right.

Unlike yesterday when another patient told me that he has wasted too much time in the hospital, he wants to get out and carry on with his life, I was still aware that this patient will still have to stay for longer, as I know his condition isn't really good, especially when he first came, he was so unsettled. But patient that I took out today, I deeply hope that he would get himself out asap and never come back.

You know, I don't mean that all the patients should be discharged in 2-3 months.. There are always cases taking few years until they really recover. The thing is, when we keep them in there, why are we keeping them in there? And are they progressing? Are we helping them? I mean if we were to keep them for 10 years, make sure they are getting better in these 10 years, but not getting depressed not knowing when the stay would come to an end. Like what the patient said, they would have to be very strong, very tough, to be able to stay there for that long without any suicidal thought. I could imagine that, it's not easy, at all.

And guess what, I will listen to him - the day and the time when I become a clinical psychologist, I would do my best to make sure myself, also including the system are helping these people (just that, by the time I wouldn't be in the UK anymore). I know how advance this country is, but it doesn't mean their methods are always right and good, and sometimes, things keep on developing, and it could simply and blindly not developing to a right direction.

Patient Kicked off

It was my first day doing response in the ward yesterday.

Firstly I think I'd explain what is "response"? Basically every single staff and visitor would carry an alarm whenever they are in the ward. And when emergency cases happen (e.g. patients trying to attack you, patients fighting, patients doing self harm etc), we would press the alarm. In every ward, there would be one staff who is doing response in every shift. They carry a radio, a bunch of keys and a pager. So when someone presses the alarm, it would first come on the pager, saying, for example XX ward, staff base (or games area, or dining room, or west corridor etc, wherever the emergency case takes place. and yes, the alarm would locate where the person who presses the alarm is).

My first ever experience doing response yesterday was in another ward down stairs, which is an acute ward. I was the first two arriving there, and saw a patient was kicking off, but was restraint by 2 female staff (which apparently was from that ward itself), so the male response team took over the restraint (we learnt this during the TAMVA course, see my previous post).

The patient was very very unstabled, apparently he was responding to external stimuli, asking "why are you doing this to me? come fight me! you coward! come fight me. you spoilt my life. i lost everyone in my life now. now! come fight me" etc etc. For 10 minutes, he was talking with another person who doesnt exist. Staff trying to calm him down, but he couldn't listen to any of us and just carried on shouting. He tried to hit his head, tried to kick (his hands were restraint, and at the end so were his legs) and refused any medications.

About 15 minutes later, he stopped. And I could see his hands really trembling, he asked, "what happened?" The staff said they would discuss it later, they want him to rest for a while first, and calm down first. He said "I'm really scared. What happened? What just happened? Did I hurt anyone? I'm really scared" Despite staff stating that he did not hurt anyone, apparently he was so worried and scared about what just happened, he had entirely no memory on what just happened, and his hands were really shaking. At this point, he took his medications, but still asking what just happened. We left his room after he took the medications.

I went back to my ward after that, about 3 hours later when I was on another response in the same ward, I saw him, and he looked really fine, calm and steady, pacing in the ward. (This second response was another patient refusing depot and got a bit aggressive).

I'm happy he wasn't sent into seclusion room. I guess one main reason was because their ward seclusion was occupied at the moment, if they wanted to send this patient to seclusion, it would have to be the seclusion in my ward.. and that would really keep my ward busy and more unsettled. But I'm happy not because of this reason, I think sending patients like this into seclusion room wouldn't help them, when you're in an total empty room, four walls, one mattress and nothing else, for 24 hours every day, that would just make their conditions worse. They would simply become more unsettled.

It's the first time I really noticed one patient actually kicked off, it was really a shock in me, especially when I saw how he trembled and scared not knowing what himself just did. and am glad how settled my ward patients are. Though it's good, that I start doing response and see what is happening in other wards.

When I went back to my ward, passed by my manager's office, he asked how it was and I told him what happened. He said "good stuff", I thought that was just his habit of saying it. But when I went back to office, they all asked me how it was. Haha, the charged nurse told me, Phil worried that I couldn't handle it, but she said I look like I could survive everything, and I'd proven her right. =)