Key Insights from Crystallization happening
in Psychiatry
An
Interview with Consultant Psychiatrist
on
similarities between Psychiatry profession and Crystallization process.
by
Dr. Nitin Arora
 |
| Dr. Abdulkareem Mustafa, Consultant Psychiatrist, Ibn Al Nafees Hospital, Bahrain |
Arora: Ultimately, how do you see a perfect psychiatrist
treatment / counseling?
Dr. Abdul: After the counselling, I want to see my client as a person having no complaint, taking good
care of himself and his relationships as well as doing his jobs. He should have
developed resilience towards life uncertainties by living through them.
Arora: Can you tell about any forefather of psychiatric
profession who has been proved false today.
Dr. Abdul: Definitely, Sigmund
Freud.! His theory prevented growth of psychiatric profession for a
period close to century. Medicine progresses by empiricism. Empirical research
collects facts and then out of these facts you can think of a theory like that
of Freud! On the other hand, Emil
kraepelin’s classification of mental disorders has stood against all the
recent classifications.
Successful Heart Connection with patients
Arora: How do you access deeper layers of patient’s problematic mind?
Dr. Abdul: I need to integrate the bio-psycho-socio-spiritual aspects
of client. This approach Is not only for assessment but also for psychotherapy,
counseling or prescribing medicine.
I am not a great couch fan. You can see that I don’t have any couch in
my clinic. Couch might be good for psychoanalysis which used to continue for 5
years, I prefer psychotherapy. I approach my client’s problem like approaching an
elephant. Exploring its different constituents like tail, trunk, legs, etc and
by all possible means to decode and synthesize the real cause of the
psychiatric symptom. I support all drug therapies & complimentary therapies
like hypnotherapy, diet regulation, reiki, yoga etc. Also, ECT is also one of
the safest treatments in medicine and not only in psychiatry. It depends on my client’s situation that
which one treatment of mix of them solves the problem.
Arora: Is the significance of mind and heart different in your
profession?
Dr. Abdul: There is no such place of Cartesian thinking in
psychiatry. It’s actually an integration of Bio-Psycho-Socio-Spiritual. We have
to encourage all to take care of all and not just a part to remain healthy.
Arora: Do you see any big benefits from winning hearts of your patients?
Dr. Abdul: We have to win
hearts, without building rapport with the client we cannot help him. winning
hearts is important to win trust of patients. We have some terms in psychiatry such
as ‘transference’ or ‘counter transference’. Former term is from
the patient’s side and the latter is from the psychiatrist side. You have to
keep balance between wining heart keeping boundaries. If we don’t know how to
keep the boundaries (the relationship between the patient and professional),
one should not be in psychiatry profession. Keeping boundaries means keeping
your interaction very flexible according to the interest of your client. We
have both positive an negative transference as well as positive and negative
counter-transference. Resolution this neurotic transference if the essence of
the psychoanalytically oriented psychotherapy. Our profession depends on this
basic premise of winning hearts / trust of patients.
Crystal’s
brilliance
Arora: What is that Psychiatric profession’s strength that makes it an
immortal profession?
Dr. Abdul: There are so many specialties in medicine like ENT,
gastro, cardiology, neurology, opthalmology etc. All of these professionals
have to know how to deal with the psyche of the patients. They can afford to
forget the knowledge of many other unrelated specialties but can’t afford to
lose the knowledge of psychiatric aspect of their clients.
One time my colleague, she is a gynecologist saw me in the operation
theatre. She was surprised and asked me
“ What are you doing here?”. I
replied, “ How come you don’t know why I
am here?You don’t know that as you work on the lower end of the patient
and I work on her upper end!!! She
smiled and replied: No I have to approach
the patient from the top so that I can
get through her bottom.” The wise
gynecologist is a good example that psychiatric knowledge is such immortal.
Arora: What kind of patients will remain eternal and why? Any solution if you
can see?
Dr. Abdul: Some facts first! The new development in psychiatric
armamentarium made psychiatry more efficient specialty. Psychiatirc patient now can live normal life.
Even patients with severe mental disorders, 25% of them will always be normal after treatment, the next 50% will be
a bit sub-normal even with treatment. While the remaining 25% will give poor response, even with continuous psychiatric
attention and care. The solution lies in understanding the secrets that are
created in psyche have faith in them and be determined to pool the best out of
the dilemma.
Arora: What is the role of upbringing on your patient ?
Dr. Abdul: Upbringing
shapes and reframes us. In childhood you can see the conditioning theory very
clearly. If the teacher says to his student that he is smart, he will become smart.
If he says he is dumb, he will become dumb. If wrong conditioning remains, psychiatric
hospitals will always be busy with patients till eternity. If conditioning is
positive, they can develop the resilience to life hiccups or even tragedies. Else,
some facts are scary that are out for long. By 2030, Depression will become
number one killer taking over the Cardiac attack.
Arora: How do you define your professional heartbeat (lifeline)? Can it ever become
zero?
Dr. Abdul: Wallahi! I hope, I hope, to find my profession to
become like small pox, a disease which is eradicated from the world. One of the
kings of Egypt, Ramses V, was killed
by small pox. If at that time someone says the small pox will be eradicated, he
could have been seen as crazy. But today, if we look back, as per my info, last
case of small pox was observed in 1975.
Preventive psychiatry was also a movement that if they study it,
psychiatrists could be avoided. But so far it’s not possible. Psychiatric treatment makes changes on
cellular level. It’s not just a thought or suggestion but it is capable of
changing structure organically.
Arora: Is there a space in Psychiatrist’s profession for providing innovative
treatments?
Dr. Abdul: Each patient is a separate book. You cannot generalize.
But there are no innovations as such. But treatment can be tailor made to each
patient and this is innovation in our profession. The good mix of
psychotherapy, ECT, drug therapy, social therapy, unique approaches etc. makes the
psychiatric treatment innovative.
Crystallizer (Predictable and Unpredictable
Intelligence)
Arora: What one drastic change you have observed that has crystallized in psychiatric
services?
Dr. Abdul: Addictive drugs like cannabis were taken lightly in the
past. Now we are sure that cannabis is cause of relapse of all other addictive
drugs so look at hashish now as one of the most dangerous addictive drugs. It
is not only gate way drug but it works like a prisoner which keep a drug addict
in his addiction until he takes overdose and dies. Actually, it was not scientific. In Egypt,
they still have hubbly-bubbly, we say ‘Sheesha’
in arabic language. They have a long history of consuming hashish as something
a common prescription for mental disorders. Even I have read Freud’s
prescriptions of Cocaine when I was at John Hopkin’s University as a research
scholar. It was common then but now it
is banned as it is addictive and is very dangerous. Once you take even for one
time, it creates great craving and the addict never gets free from this
addiction. So this prescription of this common drug is banned even though many
say it is less dangerous than nicotine based cigarettes.
Arora: What is your organizational & professional ‘possessed
predictable-intelligence’?
Dr. Abdul: Big & clean sources of professional knowledge from
journals, conferences, readings; my clinical experience; and using the sources
around the patient like family therapy, marital therapy. So , they are these
three categories.
Arora: What ‘unpredictable intelligence’ you are eager to capture?
Dr. Abdul: Yes, I am working on building my research center to
capture deeper insights, and intelligence. But it needs investment. If someone
can invest in my research center, I can assure you that I can change the face
of psychiatry. Other specialties are quick in data collection but it is not the
same in psychiatry. It needs time, patience, organizational support and big investment
in research to capture this unpredictable intelligence which could unleash
great insights that can help psychiatric patients.
Factors preventing
Super-Saturation in your profession
Arora: What factors in social environment has supported the society to become
mentally insane?
Dr. Abdul: You may laugh if I give you first the reason for
becoming a psychiatric patient. People who survive the deadly diseases in the
past by virtue of their immunity strength ‘natural
survivors’, they will have less mental disorders. But those who survived
because of antibiotic and rehydrants, ‘forced
survivors’, they will not be mentally healthier than natural survivors.
These forced survivors have more chances of having mental disorders. But I don’t
say that that medicine is bad or I am against it. I am saying that ‘vaccination of psychiatry’ (in a
metaphoric sense), should be developed to help them to cope with the life. ‘Vaccination
of psyche’ has a very bright future.
I see, Bullying is one of the major reason where people abuse each other,
whether at home or at work. This is increasing and I see this to be one of the
leading reason of people having mental disorders. Bullying someone and getting
bullied is not much different. They are two faces of same coin in context of being
prone to mental disorder. They both have a heavy impact / influence on ‘forced survivors’ in comparison to ‘natural survivors’.
Arora: What factors you see supports the society in becoming mentally healthy
than before?
Dr. Abdul: Love, Faith,
Self-confidence, Social skills. All of these factors can help and I see them rising.
The more ways you have to connect with others, the stronger your connection is with
others and with oneself too. Mental health is just a stronger connection with
oneself and with others. When these connections go weak, the person becomes
weak and becomes less aware of his weakness. This lack of awareness of one’s
weakness and eventually acting out of from this state makes one of a kind of a mental
patient.
Recrystallization
Arora: What purification treatment is majorly suggested to patients after the
completion of consultancy period to avoid recurrence of same problem?
Dr. Abdul: Adherence to medication as prescribed, or follow up visits
will suffice this final purification process. .
Harmony
Arora: What does harmony means to you from Professional perspective?
Dr. Abdul: Harmony means developing effective ways of giving consultation
to my clients with the best possible support of my hospital administration and
my personal life. Balance between client’s needs, hospital administration
rules, and fulfillment of my intellectual / social priorities is crucial for bringing
harmony in my profession.
Closing
Arora: Any advice to young students and
professionals on how to keep themselves mentally fit?
Dr Abdul: Learn how to deal with stress. Stress is inevitable! Acquire
Social skills, communication skills, Conflict resolution skills. Learn how to
be serene. Don’t become a money making machine. Life is a thousand page adventurous
story with the morale to aim for happiness and comes with a small footnote on your
possessions.
List
of Previous Interview based Articles:
1. Arora, N. (2014) Key
Insights from Crystallization happening in Advisory Services.
An Interview with Mr. Adnan Fareed, Senior Financial Consultant, Talal Abu
Ghazaleh Organization, Bahrain. (Interview Date: 10th June 2014,
Manama)
2. Arora, N (2014); Crystallization
of SpaceTime: An exploratory Mystical insights for Business. The Proposed Model.
No comments:
Post a Comment