(no subject)
It's been a long time coming. And Guppy is more than a little nervous when he first catches sight of his psychiatrist. It's not the first time he's had therapy, but it's the first time he's had this level of therapy.
He doesn't know where to start. Fortunately, the psychiatrist does. He looks a very typical psychiatrist, peering at Guppy over his glasses, and asks him a series of questions that prompt him to tell his life story. He makes notes, and nods encouragingly, and basically lets Guppy talk at him for the best part of an hour.
"I think." He says eventually. "That you should have been referred to me a long time ago. But no matter. You are here now." He puts down his notes. "Let us see if we can address a few of the things that give you the most concern."
"Firstly, you ask for a formal diagnostic label. For a number of years you have focused on the assault that nearly killed you, but it is clear from what you have told me that your anxiety started in childhood, and that a number of different events have exacerbated it. Not just the assault, but the traumatic death of your father, your exclusion from the community you grew up in, and the sudden untimely death of a number of friends and colleagues. No single event made you this way. I am diagnosing you today with Complex Post Traumatic Stress Disorder."
"What does that mean?" Guppy asks. "Practically."
"It means there is a reason why your condition is resistant to medication, though you have clearly found the medication better than nothing." the psychiatrist says.
"Your main problem is what is known as catastrophising. You see danger at every turn, and you have reason to think that way. Your fears - getting into danger at work, people around you dying, your various concerns about your children - are not implausible. But many of these eventualities you cannot do anything about. You cannot stop accidents, or disasters, or terror attacks. You cannot save everyone, even with your skills. So catastrophising is not helpful to you. We can help you with that, with a course of thorough therapy.
"Some of the worries regarding the effect of your mental illness on your children I can answer now. While I haven't met your children, you gave me clear descriptions. You mention that your older son and daughter have been hiding things from you out of concern for your anxiety. But what you haven't considered is that most children conceal things from their parents for a variety of reasons. In fact, considering your son's autism, the fact that he is able to distinguish between what you know and what he knows is likely a sign of growth."
Guppy nods. He had not considered this. The psychiatrist continues.
"You have three children who are academically gifted, and a fourth who is clearly very secure in his personal identity. You worry about the rebelliousness of your third child, but from your description, she is arguably the most typical of your children. There is no evidence, in my opinion, that your anxiety has harmed any of your children.
"For the next two weeks I want you to keep a diary of thoughts of calamity, and whether they come to pass. We will see you back with that. I'm also going to teach you some techniques called 'grounding' before you go."
Guppy leaves the session feeling hopeful, and perhaps a little less guilty.
He doesn't know where to start. Fortunately, the psychiatrist does. He looks a very typical psychiatrist, peering at Guppy over his glasses, and asks him a series of questions that prompt him to tell his life story. He makes notes, and nods encouragingly, and basically lets Guppy talk at him for the best part of an hour.
"I think." He says eventually. "That you should have been referred to me a long time ago. But no matter. You are here now." He puts down his notes. "Let us see if we can address a few of the things that give you the most concern."
"Firstly, you ask for a formal diagnostic label. For a number of years you have focused on the assault that nearly killed you, but it is clear from what you have told me that your anxiety started in childhood, and that a number of different events have exacerbated it. Not just the assault, but the traumatic death of your father, your exclusion from the community you grew up in, and the sudden untimely death of a number of friends and colleagues. No single event made you this way. I am diagnosing you today with Complex Post Traumatic Stress Disorder."
"What does that mean?" Guppy asks. "Practically."
"It means there is a reason why your condition is resistant to medication, though you have clearly found the medication better than nothing." the psychiatrist says.
"Your main problem is what is known as catastrophising. You see danger at every turn, and you have reason to think that way. Your fears - getting into danger at work, people around you dying, your various concerns about your children - are not implausible. But many of these eventualities you cannot do anything about. You cannot stop accidents, or disasters, or terror attacks. You cannot save everyone, even with your skills. So catastrophising is not helpful to you. We can help you with that, with a course of thorough therapy.
"Some of the worries regarding the effect of your mental illness on your children I can answer now. While I haven't met your children, you gave me clear descriptions. You mention that your older son and daughter have been hiding things from you out of concern for your anxiety. But what you haven't considered is that most children conceal things from their parents for a variety of reasons. In fact, considering your son's autism, the fact that he is able to distinguish between what you know and what he knows is likely a sign of growth."
Guppy nods. He had not considered this. The psychiatrist continues.
"You have three children who are academically gifted, and a fourth who is clearly very secure in his personal identity. You worry about the rebelliousness of your third child, but from your description, she is arguably the most typical of your children. There is no evidence, in my opinion, that your anxiety has harmed any of your children.
"For the next two weeks I want you to keep a diary of thoughts of calamity, and whether they come to pass. We will see you back with that. I'm also going to teach you some techniques called 'grounding' before you go."
Guppy leaves the session feeling hopeful, and perhaps a little less guilty.