Demystifying This Thing Called Psychiatry . . .Where Every Family Begins Their Journey to Understand Mental Illness for a Loved One
In this episode, Tom kicks off his Shrink Rap series that provides one-on-one interviews with trusted experts who explain the inner workings of the mental healthcare world. His first “Shrink Rap” is with the grandfather of psychiatry at John Hopkins, Dr Paul McHugh. Tom selected Dr McHugh because he believes what parent and family caregivers need to know first is - “I am trusting a psychiatrist with my most precious cargo – How do they assess my loved one? How will they think about and try to understand the human being in front of them?” Tom believes this is where every family needs to begin - having a basic understanding of how psychiatrists do their jobs to make it approachable as a family caregiver and partner in the process.
For this important lesson, Tom chose someone who has trained thousands of psychiatrists how to think AND who has folksy, warm approach to his topic. Most of us are socialized to feel psychiatry, therapy, and all else mental healthcare is a big nebula of confusing, “shrinky” ideas and methods. And psychiatry has done us no favors by being silent about how it works, reinforcing our belief that it is all knowing and we are its demure subjects. Thus, when someone we love is in distress, or worse, we turn to a profession that is a mystery, leaving us feeling even more powerless over how to help our loved one. Tom’s goal is to ensure that experts like Dr. McHugh help you understand this thing called psychiatry, and as a result, participate more confidently in assessments or planning.
Tom wants listeners to take away a couple key ideas. First, that psychiatrists learn how to look at the parts of the picture. That’s because each part ( behavior, feelings, story, etc) are meaningful to understanding your loved one. If caregivers can practice this way of thinking, they can get away from the blur and chaos of the whole picture. Second, it helps you practice being an objective reporter - a key benefit to any provider’s campaign to undertand your loved one.
Full Episode Transcript
Hey everyone, welcome to another episode of Family Psych Consumer. This week we are kicking off our Shrink Rap interview series. Each Shrink Rap is a one-on-one interview with a trusted giving you an inside view of the mental healthcare world. Our talk today is with a respected national voice in the world of psychiatry, Dr. Paul McHugh from Johns Hopkins. I chose Dr. McHugh because he has trained newly minted psychiatrists for decades, and I thought you should first hear from someone I trust to explain the basics of psychiatry.
The first thing I want you to learn is “what exactly does a psychiatrist do? How are they trained? What is the critical thinking they use when assessing my loved one to figure out what is going on? My purpose - always- is to help you navigate the world of mental healthcare. . . which means you need to be conversant when discussing treatment or planning with mental healthcare providers. In this case, I want you anticipate and then participate in the thinking of a provider instead of just waiting your turn to be asked, as most caregivers feel - that is, as outsiders in the mental healthcare process.
I think you’ll find him interesting and his thinking easy to adapt into your own life.
But before we get to Dr. McHugh, a quick sidebar - I told you in an earlier episode that I’m not here to pick winners and losers in the mental healthcare world. That will be your job, with my help. Over time, I am looking forward to our listeners sharing their own consumer experiences of quality or poor care. For now, I AM here to point out the what, where, and who of best practices and delivered outcomes; and to identify those who use quality science and innovation to improve a patient’s quality of life.. Johns Hopkins is one such provider. And as a Hopkins elder statesman, Dr. McHugh has away of simplifying an otherwise complex field.
[Interview with Dr. Paul McHugh]
In all honesty, I think I have a positive bias toward Dr. McHugh because he looks beyond the patient’s reported symptoms to their total life experience to understand how to serve that patient; in short, do you have a known condition?; what are your personality or traits? (are as McHugh says “what you are”); are you doing anything that itself is self harming or interfering with living a healthy and functional life?; and has something happened to you that is impacting your neurological, physical, or behavioral functioning? As a caregiver, I want you to employ the same technique - that is, practice looking at the parts of your loved one’s distress and behaviors first.
When you can look at your family member through this same lens, you achieve two things. First, you practice compartmentalizing the distinct features of your loved one’s experience to step away the chaotic blur of their distress, behaviors, and your guessing about what’s going on. This gives you some distance to view his or her distress as problems to solve versus an emotionally overwhelming event to survive. The second thing you achieve is becoming a better reporter to the doctor or therapist who is trying to understand the complex picture of your loved one; remember that their ability to assess and get it right is dependent of objective, valid data. So the better and more diverse your data reporting, the more you are helping them, and thus actively participating in the recovery process.
What I respect about Dr. McHugh’s view of the patient is its “whole person perspective”. He appreciates that psychiatry is limited in its knowledge and science to help its patients recover . . . .and that recovery needs the expertise of all the mental healthcare disciplines to serve your loved one.
We’ll review all these disciplines in future episodes. But for now, they include rehabilitation counseling, which teaches adaptive skills to adjust to disability in life; occupational therapy, which teaches functional living skills; and different modes of talk therapy, which develop insight and developmental change through their various techniques. Each discipline brings a unique perspective to recovering the life being lived and the disabilities being managed. Lastly, I think Dr. McHugh offers every parent or family caregiver a standing invitation to participate in treatment delivery instead of being a bewildered bystander.
We will talk to more professionals like Dr. McHugh who will de-mystify this thing called mental healthcare and who provide simple but insightful strategies to advocate for someone you love.
In next week’s episode we will kick-off our healthcare toolkit series by discussing “crisis along with both. . . and how to manage yourself and use your skills in the middle of that chaos.
Until next week take care.