When Doctors get it wrong..

Over the past couple of months I've had two cases of clients being on the wrong medication. The first was a dear old lady who was clinically depressed and had been referred to a psychiatrist, who had prescribed "the latest drug we have for clinical depression - it's very good." After months of taking this drug there was no change in her condition, yet he was still insistant that it was "the best drug available". I suggested that she approach the esteemed Professor with a view to reviewing her medication, and that he might as well be a dustman if he can't help her to feel better. So, with all due deference, that's exactly what she told him, straight to his face. She got what she wanted and, last time I saw her, the "wonder drug" prescription was being phased out in favour of something that will (hopefully) give her some relief.

My other client also seemed clinically depressed, more so than the first one. She was robotic, completely detached; it took me a couple of sessions before I got anything more than monosyllabic answers from her, then she began to open up to me about her miserable childhood. I felt we were beginning to turn a corner. A couple of weeks later there was a dramatic change, she was lively, animated, chatty, we laughed! It was like talking to a different woman. Eureka! I thought. This therapy stuff REALLY works! Roll on another week though, and we were back to square one; the depths of depression, panic attacks, plans to visit relatives abroad cancelled. Damn. Ah well, this therapy business is often a rollercoaster ride, I should have seen it coming I suppose, but at least we've seen a light at the end if the tunnel.

A few weeks along, and the same thing happened again. A sudden dramatic improvement, this time accompanied by a reckless spending spree, followed by a slump back into depression. Alarm bells started to ring, and I queried her diagnosis. "Borderline personality disorder" she said. "You're kidding" I thought, "You're Bipolar Type II. I'm certain of it." I fired off a letter to her Psychiatrist and, in due course, received a stuffy reply thanking me for my input, but stating that she had been diagnosed by a Proper Psychiatrist using a well established structured interview process, and I was wrong. So my hours and weeks of therapy and observation are trumped by a "structured interview"? I think not.

Roll on another couple of weeks to my client's next appointment with her Psychiatrist, and there's a mysterious change in her medication - to Seroquel - prescribed specifically for the treatment of Bipolar Disorder. Within a week she's a different person; the visits to relatives are back on, she's chatty, lively, energetic, friendly, and everyone wants to be her friend. And this time it's sustained.

So the moral of the story is... whoever you are, it doesn't matter what your qualifications are, you're only as good as the service you provide. So if your Doctor, Psychiatrist, or Dustman is not giving you a good service, do something about it. Whether you're a patient or a therapist, don't be afraid to challenge the medical establishment. They're trained to give off an air of authority and inspire confidence, even when they don't have a clue what the problem is, or what they're doing. Sure, they know a lot and they're very clever, but they don't know everything. They're not superhuman. Sometimes they make mistakes, sometimes they're lazy, sometimes they're under too much pressure, and sometimes conventional medicine just doesn't have an answer. In which case I'd rather be told, than be given a prescription for something that won't do me any good whatsoever, just to get me out of the door.

Dr John Gottman on Making your relationship work

Make yourself a cup of tea, click on this link, and enjoy 40 minutes of amazing insight into relationships with Dr John Gottman. Absolutely invaluable for anyone who works with couples, or is in a relationship!

http://www.youtube.com/watch?v=LLXX8wzvT7c&feature=related

Joined up thinking - or - playing with fire?

We held my daughter's birthday party at "Rope Runners" in Kelvedon Hatch on Saturday - a perfect excuse to visit the ex-government nuclear bunker which is on the same site, and has always held a fascination for me since it opened its two ton steel doors to the public a few years ago.

Its musty corridors and displays were a chilling reminder of the years when we all lived under the threat of nuclear annihilation, a fate we're thankfully safe from since the fall of the Soviet Union.

Or are we?

It seems to me that sometimes we're just a little short sighted when it comes to this sort of thing. I read an article after 9/11 about "black swans" - unpredictable events that we look back on, pointing our fingers at various agencies and individuals, screaming "you should have seen that coming!". In some cases people do see it coming, but nobody listens or takes them seriously because they're too busy worrying about which B-list celebrity has cellulite. And in some cases nobody sees it coming at all, like this whole volcanic ash fiasco. One piddly little volcano (it is a relatively small one, we're told), and the whole of Western Europe's air transport system is grounded. Just wait 'til its Daddy wakes up - a very likely occurence, so the geologists tell us. What will happen then?

I don't wish to be a portent of doom, but let's look at a few possibilities. Scientists in the nuclear energy industry are forever reassuring us that nuclear power is completely safe, environmentally friendly, and A Good Thing. Apart from the all the deadly mucky stuff left over at the end that they don't know what to do with. But let's not worry about that, we'll just dump that in a poor country somewhere. No, modern nuclear power stations are completely safe, we've learned the lessons from Chernobyl and Three Mile Island, and we've fined Magnox for the 14 years of radioactive leaks from Bradwell in Essex, so it will never happen again.

But just imagine that i'm a terrorist, with an imagination. Instead of hijacking an airliner and flying it into a skyscraper, this time I'm gonna charter one myself, and fly it straight into a nuclear power station. Or, imagine some kind of disaster that creates a huge tidal wave, one that makes the boxing day tsunami look like a splash in your bathtub, let's say, a medium size comet landing in the middle of the sea. Now that's something they tell us will happen sooner or later, we just don't know when. But when it happens, not only would we have massive destruction to contend with, but what's gonna happen to a power station on the coast when it's under 100 feet of water? I wonder what their contingency plans are for that one? Once the flood waters have receded and we're breathing a sigh of relief that we're still alive, we all start dropping dead with radiation sickness. Nice.

So, as you've probably guessed, I'm not a big fan of nuclear power. Give me wind farms, solar power, tidal energy, anything you like as long as it doesn't involve splitting atoms. And in the meantime, I really must drop in on that bloke who owns the bunker at Kelvedon Hatch. I wonder what he likes to drink?

Two pints of lager and a coke

How times have changed.

A couple of years ago my hypnotherapy practice enjoyed a steady trickle of smokers with the occasional cannabis user thrown in for good measure. Then, a couple of years ago, someone approached me regarding their cocaine habit. "Why not?" I thought, and adapted my smoking cessation strategy to meet this new challenge.

Well, what do you know? It worked. "A one-off" I thought. I didn't even bother to advertise it on my website, just didn't realise the client base was there. (I don't get out as much as I used to!)

I wasn't surprised when I got another enquiry about cocaine, but as the trickle has turned into a steady flow, I'm truly alarmed about the explosion in coke use, and the casual attitude surrounding it. Around many social groups it's become a regular part of the weekend scene. Go out for a few drinks, do a line of coke in the toilets, or go back to John's, he's got some at his flat.

Trouble is, it all ends in tears because, although the price has come down, it still ain't cheap, and people are wiping themselves out financially trying to keep up. When I asked the client I saw yesterday to visualise his life without coke, he could see his wedding, and a happy life with his partner and his little girl. With coke, he saw himself destitute, his relationship destroyed, living on the street, or even dead. It doesn't get much more stark than that.

Science

Well, our neighbours, the Cumbers family, are back from their extended stay in Cyprus, thanks to the intervention of a volcano in Iceland. Of course, their journey home, along with the journeys of thousands upon thousands of other people, needn't have been delayed at all, because the scientists got it wrong.

I'm not saying that volcanic ash isn't harmful to jet engines. Of course it is. But here in my corner of the UK there wasn't any. There were just clear blue skies, completely devoid of clouds, volcanic ash, and aeroplanes. Any fool would have thought it was perfectly safe to fly, but oh no! The Scientists convinced us all that those clear blue skies were actually deadly. Utter rubbish of course. They just didn't have any data to go on, so they lost the plot and went into meltdown, rather than just applying common sense.

So what do we learn from this?

i) Scientists don't have any common sense.

ii) We shouldn't be letting the cast of The Big Bang Theory make decisions.

Now we're supposed to decide who we're going to let run the country, based on their performance on The Weakest Link. God help us.

Introducing Me

Hello, I'm Peter Phelps, an integrative therapist in London and Essex, husband, and father of two lovely kids.

My approach as a therapist is no-nonsense; I believe there's a lot of wishy-washy therapy out there that doesn't hit the spot. People come to therapy because they want to change, and that's what I'm here to do.

I don't subscribe to any particular model of therapy, because I think all models have something to offer, but I believe that connecting with the person in the room with me is essential to enable them to make progress.

Come back soon for my thoughts and feelings of the day.