I am pissed off. I was reading a book earlier and it annoyed me, enough that I felt I needed to blog about it. The book is 'Bedside Stories - Confessions of a Junior Doctor', by Michael Foxton, and it is a good book. It is basically a Junior Doctor's account of his first 2 years working as a Doctor. I found him likeable, and the book was funny, parts of it very funny. I would recommend it if you like that kind of book. However, what pissed me off was his attitude towards personality disorders. Fairly on in the book there was a reference to PDs, which I thought seemed quite negative, but it was brief and I just kind of ignored it. Then later on there was another one, but again I was able to gloss over it. This one I wasn't able to gloss over. He was working in Psychiatry, and was risk assessing a girl who was presenting in A&E as suicidal.
'It's a blatant personality disorder, a world full of frustration, untreatable, incessant, lifelong maladaptive, manipulative, anxiety inducing nightmare punters from hell. I just don't get them. I think that's because nobody does.
Right then, don't hold back - let's hear what you really think about personality disorders shall we? What really got me about that quote was how accusing he sounds. A 'blatant personality disorder'. Sounds like it could be rephrased as 'Blatant attention seeking'. So what if someone has a personality disorder? Personality disorders are valid mental illnesses. Patients with a Borderline Personality Disorder make up about 20% of inpatient admissions, and approximately 10% of people with a BPD diagnosis commit suicide. I really genuinely do appreciate that some personality disorder presentations must be frustrating for staff. I know people with personality disorder diagnoses who frequently attend A&E having taken a few painkillers, or having self harmed superficially, and I understand that A&E staff must get frustrated with this. But people doing this ARE still ill, and I think the fact they are needing to do that implies that they probably need more, or different, support to that which they are currently receiving. And finally, not everyone with a personality disorder is the manipulative attention seeker that he is making out.
Turning up at A&E when you are feeling strongly suicidal is really not an easy thing to do. For a start, you feel very divided about going full stop - after all, you are suicidal. But sometimes you can just manage that last grasp for help before you fall totally off the edge. And then you come across staff who clearly have the sort of attitude expressed above, and it just succeeds in making you feel worse about yourself. Michael Foxton's attitude towards people with Depression is very different. He seems sympathetic and understanding. So why the change when someone has a personality disorder diagnosis? It really makes me angry when I hear of professionals with this type of attitude. It is unhelpful and distressing, and I think probably still far too common.
Oh, and at the end of his House Officer training years, Michael Foxton became a Psychiatrist. Comforting, huh?