Wednesday, June 28, 2006

a day at work

Today I saw patients for four straight hours. May not sound like much, but that didn't include the hour or two of prep and paper work and the additional hour or two tomorrow finishing more paperwork and doesn't include the time I spent talking with the therapists, consulting on diagnoses and treatment options and other minutiae which is all extraneous to the actual medical practice. The stack of charts waiting for me tomorrow is huge.

I listened to stories for hours. Husbands blame their wives, wives blame husbands, partners blame each other, everyone feels like a victim. Some are depressed. Some anxious. Some psychotic. Some manic. Sometimes people get better on medication. I counsel them about the importance of therapy. So many of their problems aren't going to be solved by medicine. But they may be solved with the assistance of therapy, if the patient wants to badly enough.

There seems to be a culture of victimization; certainly I see an awful lot of people who had been beaten or molested or both as children. Surviving victimhood and not reproducing it with their own spouses and children is a daunting task. These people often welcome therapy. They welcome a place where they are not judged, where they can learn skills, where they can learn how to be better than their parents, where they can learn not to hate.

But those who are victims because they choose to be is a more difficult issue for me to deal with. I have seen women so taunt and badger and complain and whine at their partners so that eventually even the most patient man cracks. Then she goes hysterical and calls the cops and has proof that she is a victim.

I know. I'm sounding really judgemental. No one's story is as simple as I'm making it out to be. Unfortunately, how we think of ourselves is a choice we make. We can think of ourselves as failures, so we don't try too hard because that would just prove ourselves right. Or we can think of ourselves as victims, and create barriers to taking responsibility or trying to change our thinking, so that we can unwittingly continue to blame others. Or we can stay angry about who knows what.

Well, this section isn't going very well. I'm tired.

But the stories we tell about ourselves do shape the options we have in life. We can practice telling other versions, we can focus on what we do well, rather than what we do badly. We can think about what effect we have on others and modify our behaviors, act purposefully in difficult situations. It certainly works when I interact with my child. It is harder for me when I disagree with my husband. And my patients have difficulty as well.

My work is fun when it is my job to point out the positives, point out options to the story lines, and have a patient get excited about the possibilities they have of making changes. It is frustrating when patients blame everyone else and get trapped in their own victimization. Today was a frustrating day.

1 Comments:

Blogger normanack said...

You touch a nerve, and that's a good thing. It's easy for me to see fear-of-failure or victimization in others, but then wham, realize that I do those things to myself. Thanks for the reminder!

June 30, 2006 1:26 PM  

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