Therapy and Regression

One of the patients asked me for access to his huge stock of sweeties. Although on a diet care plan, he had recently returned from a shopping trip with two large bags of jelly babies, two bags of sugared bon bons, four tubes of mints, two cream cakes, and a lot of receipts for the cash book. He had preceded these purchases with a fish and chip lunch, one can of non-diet coke, and a ‘ninety-nine’ ice cream with extra “sprinkles”. His laboured breathing now followed me down the corridor and after five minutes of key juggling I was able to release the requested items into his sticky grasp. I had a pang of conscience as I observed the folds of his painfully obese form rock and roll back to the lounge, but I knew that to refuse him access to ‘his own property’ would have brought opprobrium down on me from all sides. I was even more regretful that we continued to treat many of the patients like children, and wondered if it was strictly necessary to unload sack loads of sugar and fat on them every week, and then foolishly remark on their disappearing teeth and scale-breaking weight.
As part of this approach, all the patients received a large ‘Walt Disney’ type of birthday cake every year, which was usually so sickly and garish it would have turned the stomach of Billy Bunter. Unfortunately, staff seemed to forget that the recipients of these cakes were often forty to fifty years old, and that the patients were already keen enough to see themselves as life long dependants without the staff reinforcing it with organised puerility. Some of the patients were actually suffering from a psychotic ‘regression’ which had taken them back to their adolescence, and in their cases it was even harder to see how Walt Disney icing was going to reverse the process. Often the patients in question were in need of a new electric razor, a hairbrush or even a basic clock, suggesting perhaps that a more constructive approach to gift selection was well overdue. Anyway, at least I always knew what the key workers wanted for their birthdays; but would it be a cheeky Donald Duck or a cuddly Minnie Mouse this year?
http://www.windowsofmadness.co.uk

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2 Responses to “Therapy and Regression”

  1. One major concern about caring for psychiatric patients is how you never know what makes them scared, sad, depressed, angry…etc. However, I agree…if the patient is receiving counterproductive or sub-par care how can this person ever improved! That’s when I began sympathizing with the patients even if they are getting professional therapy…what are Disney Land gifts seriously encouraging? Anyway, great blog! keep it up.

  2. Hi,
    Thanks very much for your interesting comment. As always. psychiatry reflects the dominant values and beliefs of society at any given time. Unfortunately, the only dominant culture at the moment is one of individual self-indulgence (often bordering on infantilism) because we have no firm social direction. In my view, psychiatric care has become contaminated by these beliefs – encouraging some practitioners to act as though they’re playgroup leaders of some sort…..
    Thanks again. Please tell your friends/colleagues about the blog.
    Cheers,
    Leo

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