New Doctor’s mental health workshop – tackling crucial conversations

It is fantastic to be running a workshop for RANZCOG addressing doctor’s mental health in one week’s time. I have been advocating in this space since 2003, when armed with the important role of AMA(Vic) President, Doctor-in-Training Subdivision. At the time we were rocked by the news of suicides among our registrar population. In 2003, some of the responses made by consultants included;

Maybe they weren’t cut out for medicine

Maybe they just weren’t ready to face the pressure

Maybe they shouldn’t have sat the exams

Maybe they chose the wrong career

What are the current factors impacting on doctor’s health and wellness?

In 2017, 14 years later, I hear the same thing. I hear that somehow when a tragedy such as suicide occurs, it must be something to do with the doctor’s weakness or vulnerability. Few real conversations have focused on the external factors that push doctors to the edge. Seldom do discussions focus on how doctors reach out for help, are spoken to in the workplace, or suffer when they speak out against intolerable conditions or heartbreaking situations.

Some shifts doctors endure contain enough graphic content that if a movie would attract a R 18+ rating. Doctors are inherently resilient because they turn up again the next day for more. So the conversation we need to have isn’t about resilience or self care. It’s about true advocates standing up for others so we can have safe, compassionate workplaces and rewarding careers.

So, after spending so much time in this space, participating in many committees and panels, speaking at conferences and treating so many doctors and medical students, I am using this opportunity to go straight to the heart of the matter. How to have a crucial conversation. What can happen when conversations go well and what can happen when they don’t. How breaking bad news can lead to suicide or a positive outcome. How third party regulators such as AHPRA and our colleges have conversations with us, whether we are prepared to hear them or not. Knowing when to put our hands up and ask for help and when to keep our opinions to ourselves and go elsewhere for what we need.

Communication is the key.

So, most  of the agenda for the RANZCOG doctor’s health workshop will play out via role plays using the brilliant acting skills of Mr Glen Hancox, professional actor and director of ACTReal. Glen has worked with me for 7 years, and together we have run through hundreds of scenarios to display rather than preach valuable learning. We have coached and trained many doctors in key specialty areas, worked in the corporate world and now developing conversations around doctor’s mental health.

So what sort of conversations will we be examining in depth?

The clinical scenarios I have written to be included in the workshop are based on conversations and interactions I have either witnessed or have been involved with. They will encapsulate the following;

  • doctor’s help seeking behaviour
  • the need for every doctor to have their own GP
  • managing performance rather than being labelled a bully 
  • how to relate to junior colleagues to be the mentor you truly want to be.

 

All are raw and controversial, designed to be so that we can have real conversations to evoke change. They are also completely fictional (including names).

Keen to read more? Here are the teasers:

  1. That corridor conversation. After a multidisciplinary team meeting,  Dr Anne Salter, a psychiatry registrar working in consultation-liaison psychiatry (wanting to be a perinatal psychiatrist) is approached by Dr Alex Scott, an O&G registrar. Alex is being paged but wants to have a ‘few minutes’ with Anne to ask her opinion about something….
  2. Doctors treating doctors. Dr Alex Scott consults with Dr Simone Davige, a GP in a busy family medical centre. Alex is nervous but after talking to his wife, and trusting in Anne, he decides to open up and be honest about how he is struggling…..
  3. The supervisor asking “So,  how’s it going?”. Dr Ian Anderson is a senior consultant in the gynaecology department. He is well meaning, but quite detached from the issues facing junior doctors. His idea of mentoring a junior doctor is to share his own experiences that he thinks are valuable to hear about rather than listening….
  4. The consultant delivering negative feedback. Dr Peter Richard is a consultant and supervisor. He has had feedback from the college and other peers that his registrar Dr Sophie Donald is ‘not up to scratch’ He hates conflict but knows he has to tell her some hard truths….

By working through these scenarios, and with the guided expertise of Dr Mukesh Haikerwal, and Ms Mayada Dib, we hope to uncover what is at the heart of the matter for doctors who have mental ill-health and need our help. They are, after all, valuable, meaningful people who have devoted their lives to helping others. We owe it to work out how to help them, or not put them in a situation where they are distressed.

And all kudos to RANZCOG who are holding their regional scientific meeting in Albury NSW after they lost a fellow to suicide in Albury in 2016. They have opened the event up to all health professionals regardless of specialty.

If you would like to contribute to the discussion to help our colleagues please register here

See you in Albury,

Best wishes,

Helen

 

Throwing the branding baby out with the bathwater

I wasn’t expecting such a heated debate on Twitter when I woke yesterday, regarding the upcoming state RANZCOG congress, and now known as “Mirenagate”.  But I shouldn’t have been surprised because that’s exactly what happens on Twitter. The reason I love being a doctor on Twitter, and why I know social media has the power to change.

Some amazing doctors that I admire so much on social media, including Dr Nikki  Stamp and Dr Eric Levi has put forward their points of view regarding what could have been an absolute branding nightmare for the RANZCOG on 2nd January 2016. The Australian newspaper revealed that a branch of the RANZCOG was proposing a debate on whether female registrars should be given contraception to avoid breaks in training. It happened outside business hours, as these things often do,  and that is exactly why all organisations regardless of industry and craft need a strict social media policy that can firstly identify and secondly handle anything.

I call this a branding nightmare because I know as a coach and mentor of doctors in training, and past president of the AMA(Vic) Doctors in Training subdivision that the RANZCOG are leaders when it comes to providing flexible and supportive training for men and women. I speak as a total outsider, but hey they leave some other colleges for dead. I know that those within the RANZCOG have worked very hard to establish a brand, their college seal that when viewed by potential applicants, actually means something. To me it has meant that they mean business when it comes to workplace training and flexibility.

BRAND related text inside hand drawn jigsaw piece on chalkboard

This is why branding and mission statements are so crucial, and also why they are so vulnerable. Anybody of official status or anybody who represents the RANZCOG in a public forum needs to protect their brand and mission statement. This is especially at times of crisis, when negative comments hit the media, and should also reflect not just the content but the approach to training registrars. This includes choosing how to phrase topics on conference agendas.

I have spent the last three years learning the art and craft of branding and know a little bit about social media thanks to some wonderful friends I found in the Twittersphere. Oh and a brand accelerator program that cost a bomb. I am writing my article based on two viewpoints, but both on what branding means to me. Branding is powerful, so when messages are delivered that are inconsistent with a brand we feel we can trust, we feel let down. Speaking for myself, I felt hurt and disappointed to see such a progressive college take such a stance when choosing agenda topics, regardless of whether federal council knew about it, and also felt that eerie silence that follows when there is no official response, and the subsequent void which becomes swamped with outcry.

This article is an attempt to explain to those at RANZCOG why so many people were upset and shocked at the headline in the Australian magazine yesterday. I know the new owner of the @RANZCOG handle is an expert on branding and social media too, and I am not trying to tell him how to suck eggs. But maybe others within the college can listen to leaders like Dr Joseph Sgroi and take on what he knows about branding, consistency and social media.

I am also writing this as a mum who, like many who have spoken on social media, really copped a rough deal when pregnant. I wonder how many have suffered as they left parenthood until too late and now face infertility. Men and women that choose to share parenting roles (believe me I know that there a quite a few male registrars who are really looked upon as being totally selfish when choosing to go part time to share parenting).  So I couldn’t help but be shocked by the title for the debate at the RANZCOG congress. Even if it isn’t my college, once again I felt they were a college that were better than this, and it brought back what I put up with.

Here is my story, as a psychiatrist who only ever wanted to be a psychiatrist. At some stage I really wanted to specialise in child and adolescent psychiatry. I also wanted to have a baby. And soon because I went to medical school in my mid 20s, and time was ticking.

In 2006, I was working in an advanced training position in child and adolescent psychiatry, and passed my clinical exams when 15 weeks pregnant. I even blitzed the OSCE station based on a CPR scenario, with the mannequin placed at the feet of the examiners so I felt they could look down our tops as we did chest compressions. (The RANZCP did acknowledge this was a problem after quite a few complaints but female registrars were implicated and found to be at fault for not choosing correct work attire suitable for all work situations). Anyway I digress.

At 30 weeks gestation I developed gestational diabetes and hypertension.  At 34 weeks my beautiful son was born. The week before it was decided that I should step aside from my office bearer role within the AMA as it was a very important role and should be handed over to somebody that was not about to go on to maternity leave, rather than seeing out my term (at this stage I didn’t know what was to happen the following week, and trying to come to terms with BSL’s of 11 despite eating food resembling cardboard). The day I was to start insulin, I started being a mum.

I was meant to become a mum around early December 2006. My 12 month post with my teaching hospital would end in January, as all of us registers are only employed for 12 months, hence no accrual of any entitlements. There was no planning or offers of roles, or even a discussion about what my plans were with regards finishing my advanced training. Because I became a mum in October, I got a few extra weeks leave of maternity leave.  Maternity leave ended at the end of my 12 month contract, and in early February 2007, I was an unemployed mother of a premature baby with severe reflux. My post was given to somebody else, but not as a maternity leave role.

I know I was classified as unemployed, despite paying money to the RANZCP to apply for a ‘break in training’. Because outside of medicine, if you don’t have a job, you don’t have a job. None of this ‘just get back in touch and we’ll keep you in mind, we’ll see what we have when you are ready to return’. Westpac bank wouldn’t cop it. I was unable to refinance my mortgage as I was unemployed. That was only one of many examples.

So after coming up for air, and recognising the irony that I was working in a sub-specialty that is based on attachment, infancy and how easy it is to stuff it all up, I didn’t go back to child and adolescent training and I didn’t go back to that hospital. I focused on my beautiful son and made damn sure I didn’t mess up what I could manage when it came to attachment and bonding. I finished my training in general psychiatry and got out. Not only out of training but also the public mental health system.

I know that many of us get caught between the interface of our colleges and our workplaces, both blaming each other, and doing a lot of ’keepings off’.  That comes at a personal price to us. So yes when we see topics like what appeared in the Australian yesterday we will be hurt.  And when we believe in a brand that represents a college that we do look to as one of the better ones when it comes to caring for their trainees regardless of gender, we might take to Twitter and shout the sky down.

 

 

 

OCA fundamentals masterclass 3 hour workshop

Registration fee includes supper, and a complimentary copy of one of our new DVDs, ‘Tips for success’ Data gathering process, valued at $82.50!

Its a new era as RANZCP trainees and IMG’s move from OCIs to OCAs throughout their training. But just because you are being assessed in the workplace, the assessments are as challenging as ever, in that the marking domains from the OCIs are still being used, and you are being examined at a level of a junior consultant from as early as second year.

Now more than ever, you need a structured, tailored approach to your training. We understand that your supervisor and peers are time poor, and your ability to access training for examination preparation is reducing.

Hence, we are hosting a one-off information evening on Thursday 26th November 2015, from 6-9pm at CPD Formulations Pty Ltd. Over three interactive hours, based on small group learning and in vivo rehearsal, we will cover the following topics to leave you with a clear strategy on how to tackle this component of your training.

  • How to approach the interview in different clinical scenarios
  • Rapport building and communication skills
  • Presenting concise specific action plans to your case
  • How to present a mental state examination, including a cognitive examination
  • Managing anxiety and uncertainty
  • Balancing exams and assessments with your clinical work and personal life.

Glen Hancox is an expert in facilitating and presentation skills and has been working with Dr Helen Schultz, helping exam candidates since 2008. We know what trainees go through, and all of our programs and coaching are practical, hands on and tailored to your needs.

Purchase your place at this event and receive a free copy of our latest DVD 4, ‘Tips for success’  Data gathering process, valued at $82.50, prior to the event!

There are strictly limited places for this event, please don’t miss out!

Disrupted passengers both ways. We’re all in this together.

Today I thought I’d write about those that have had a really difficult time during the recent volcanic eruptions in Bali, disrupting their travel plans. Those who couldn’t get here and those who are stranded in Bali draining every cent that would have been put towards future holidays.
As a psychiatrist, I see first hand the emotional and medical consequences of banking up a sleep debt, rest debt and ‘catch up with family and friends debt’ all the time. So many of us, including me, continue to put off what is immediately beneficial and rewarding. How many times have we thought about how much we enjoy having a coffee with a friend, only to lament about how long it has been between drinks? Finding time for a coffee and a catch us seems insurmountable yet the benefits last longer than the coffee does. Likewise, planning a break from relenting commitments, daily schedules, obligations and structure can often be the only way we cope with it all.

I think about how exhausted I was before heading to Bali. I didn’t even realise until I almost collapsed into the lounge by the pool and couldn’t move. Daily morning yoga was a total struggle; I hadn’t practiced yoga for over 2 years and my busy mind made me lose my balance way before my muscles did. But after about 3 days, I was, surprising to me, completely relaxed. After 5 days, one of the guests, soon to become a friend alerted me to the cancellation of flights and the volcanic disruption occurring all around me. Because, from the resorts in Bali, there is no evidence at all there is an ashcloud.  From that morning on as speculation grew we all succumbed to the lack of daily updates, uncertainty and the very real situation that we wouldn’t be returning home on time.

But what about if it was a week before? What if I hadn’t made it to the yoga mat?

I think if I hadn’t made it to my holiday in the first place I would have needed to have thought of a pretty good plan B by now. I admit I have fallen into the trap of ‘it’ll be OK, just get through this week, this financial quarter, this year’, wishing days away waiting for a break. When we do this we take a toll on our own health, often silent, succumbing to more viral infections, or mildly raised blood pressure, chronic fatigue, and so on. We somehow justify that things will all rectify themselves, once we get on that holiday.

In this current situation, many people just like me have banked up the same amount of debt but unlike me just didn’t get to Bali, or did, but are trying to rationalise the situation by eating into funds for the next holiday. If you are one of these people I am sure you have struggled with the uncertainty, the hope you’ll depart then the disappointment when you don’t and by now are absolutely fed up.

Faced with the certainty of a volcanic eruption, completely at the hands of mother nature, it is time to take charge of some certainty over your predicament. Because, if you were operating on limited reserves like me up until now, it’s time to take back some control.

Some things to try;

  • Sit down with your family and work out what it was that you wanted from the holiday in the first place. ‘Chill out’ I hear you say. Reflect on what it is in your daily life that doesn’t allow you to ‘chill out’. Write it down and save for later. Now is not the time to try and make the most of things. You need a break right now.
  • Negotiate your way into a new holiday, whether it be shorter or to a different destination. I’m not saying to put yourselves in debt, but desperate times call for desperate measures, and I know the airlines are very happy to offload passengers to another destination to get them off the queue. It may be shorter, and it won’t be Bali, but it will be something.
  • If you now have unexpected days at home, use them wisely. Don’t try and overload them but instead spend them doing things you always put off.
  • If you are on an extended stay in Bali, live in the moment. None of us know what next year will bring. There is no reason to believe that this delay due to no fault of your own, means you will never holiday again.

Remember your thinking is probably clouded by your current predicament. It won’t feel like this once you do come back from your holiday or get home. 

The one thing I have seen most in medicine is that none of us know our fate and despite our best plans, sometimes things just happen. As humans we don’t think about this that often, until the inevitable happens. As a word of advice, it might be best to avoid call centres as much as you can. Lip service right now, when you are as frazzled as I am, is not going to help. The operators have to behave a certain way, and we all know, if they just said they didn’t know we would all be happy. I understand that the most frustrating thing right now is not feeling heard or understood.

Take care and find your yoga mat, it is waiting for you.

Dr Helen Schultz is a consultant psychiatrist currently stranded in Bali. She has had the most amazing time and met some fantastic people but it is time to go home. 

Anxiety may follow you home from Bali, even if you didn’t pack it.

Hi all,

I’m continuing to write and help out where I can, because I feel quite uneasy myself, and really missing home. As a psychiatrist working in private practice I would usually have seen about 15 patients this week by now, and handled a pile of inquiries via phone as well. So having this enforced break in Bali after my flight was cancelled 5 days ago is feeling really surreal, and I am feeling for my patients who have had to move their appointments until I get back.

I have heard that some people have managed to arrive home, but have noticed that the anxiety has followed them there. As a psychiatrist I can understand why, and I know it doesn’t make a lot of sense intuitively. I’m sure these people are hearing lots of comments, which are not helping the situation at all, such as

‘what do you have to be anxious about, you’ve just come home from Bali?’

Returned travelers understandably may have expected to be relieved and grateful when they finally walked in their front door. But instead they may have experienced a range of emotions, good or bad, ranging from mild disappointment to symptoms of trauma and everything else in between.

It is really important to accept it is OK to feel anything you might be feeling when you get home. Only you know and experienced your personal journey to get back in your front door.

As I have been writing about, humans love our structure and certainty. Uncertainty is a fertile breeding ground for anxiety. This structure includes daily routines which work best when they align nicely with our own circadian rhythm, or internal ‘body clock’. When we are on holidays, structure goes out the window in a really beneficial way, and because we don’t have to wake with an alarm clock or fit in with other schedules, we sleep when we want, eat when we want and we feel better for it. However, when we travel home crossing time zones and disrupting sleep (who can sleep on planes at the best of times?) we disrupt our circadian rhythm again, but in a negative way. This has a negative impact on mood and anxiety levels.

It ain’t just post holiday blues, there are known structural connections between the sleep centres and the mood centers in our brain. The good thing is once jet lag or transient sleep disturbance rectifies itself, so should you mood.

But what happens if, on top of all of this, there has been major sadness, disappointment or even illness or loss compounding the situation? What if you have been stranded like I am, annoyed and irritable that I have really no idea what will happen, fed up with comments telling me to enjoy my extended holiday, and then you finally get home? What if, instead of feeling relief and jubilation that you are home, you are teary, on edge and just plain miserable? There may be additional factors, complicating what has already happened with circadian rhythm disturbance that may be making things more difficult for you, including;

  • Nobody at home gets what you have been through. Friends, family and work colleagues only apply what they have seen on the news or have heard from other people, and you can feel they genuinely don’t understand your predicament. This invalidation may make you question your own response, feel deficient in some way, or lead you to holding back or pretending things are fine.
  • You have more FOMO. FOMO, or fear of missing out, may apply if your delays have led to you missing significant events going on for others at home. You may feel inappropriate guilt or anger because this awful unplanned event made you miss something very special to you.
  • As a coping mechanism, and because you felt helpless and uneasy, you may have coped with your extended time in Bali by being somewhat detached from the situation. This is a normal coping mechanism but also occurs when people are anxious. When reality hits you, when you see the credit card bills, or open the mail, all the emotions you may have not experienced while away may come flooding back.
  • If you have been diagnosed with depression or anxiety, you may have inadvertently missed doses of your  prescribed medications due to protracted travel home, or you may have run out while away. These feelings may actually be symptoms of a relapse of your illness and understandable.
  • You are constantly checking FaceBook feeds or news reports as you feel a connection to this situation and you feel inappropriate guilt that you got home. This in an extreme form is akin to ‘survivor guilt’, experienced by those who survive traumatic events and feel guilty that they did. This is complicated when well meaning people remark ‘how lucky were you’ and other things that make people hide their true feelings about their experiences.
  • If your time in Bali was complicated by further adversity, such as illness, theft or violence, you may be re-experiencing the event every time you see more updates, especially if the media at home is sensationalising things. You may feel a need to keep connected to social media as a way of trying to reassure yourself, which is keeping your mind on the past, and not on the healing properties of the present.

So if any of these factors (and I’m sure there are more) sound familiar, first and foremost do NOT beat yourself up for feeling the way you do. I often tell my patients that they feel anxious, depressed, sad, angry, lonely or whatever just because they do. Acknowledging how you feel regardless of whether you feel it is inappropriate or not is your first step to accepting it, then nurturing and healing yourself.

Other practical strategies to try (once again these are general guides and not specific to all cases);

  • Limit or avoid news updates about what is happening in Bali. It doesn’t help to let your mind wander into what is still happening to others. There is a fine line with feeling connected to others who understand, and perpetuating feelings of helplessness and sadness.
  • Connect to 1-2 friends who truly understand and talk to them. But if you feel overwhelmed by sharing, retreat for a while until you feel stronger.
  • Get your circadian rhythm back on track ASAP. Do not stay up late reading updates. Re-establish your normal daily routine. As bad as you have slept the night before, get up at the same time and go for a very short walk, not for the purpose of counting steps but to get some bright sunlight on your face. This will reset your melatonin levels and ensure your sleep cycle returns to normal as soon as it can. Sneak in a coffee or tea on the walk, it may help with motivation!
  • Connect with good memories and times that did happen. Print our photos of smiles, beautiful scenery, a picture of you in a relaxed happy state. All the reasons why you went to Bali in the first place.
  • If these tips do not work in a couple of days, or if you are having worrying thoughts, see your GP as a matter of urgency. You might be going there anyway, for that often needed dose of Bali-belly remedy. Make sure you tell your GP if you are not coping. Key symptoms to report are sleep disturbance, excessive worry, disturbed concentration, and more seriously thoughts of self harm.

This is not a time to think all the feelings you are having are due to you being weak, ungrateful or any other silly idea that may try and pop into your mind. Be kind to yourself, don’t avoid your feelings or excuse them away. Stay grounded. At home.

 

Dr Helen Schultz is a consultant psychiatrist in Melbourne, Australia, generally reachable by air from Bali. Right now she is stranded in Bali, churning out blogs and missing her son like anything. 

While I wait to get home, home finds me here

I am so amazed and truly inspired by all the people who read my blog yesterday and left such thoughtful comments. Like many of you I am feeling quite helpless as the days drag on and my proposed departure date is further behind me. It is really comforting for me to share my knowledge and try an help, while I am so far away from my patients in Australia, who keep getting moved to new appointment times.

Yesterday I wrote about the importance of keeping your health and safety as key priorities. That includes your mental health. Mindfulness is key here; if ever there is a time to be extremely vigilant about remaining in the present, it is now. Constant distractions and worries about home will only hamper our efforts to stay calm and we all need to be calm.

Once again, I need to impress upon anybody working in customer service and trying to assist us;

We don’t really want to call you or make your day any more stressful than it is. In fact, we would rather leave you alone, but we need to do so as the delays drag on and we search for certainty to combat feelings of despair. So please understand from our point of view that if you continue to provide consistent, clear messages and update when you promise, we will feel reassured and take ourselves out of the queue of calls waiting for you.

If you are experiencing an exacerbation in anxiety or your mood is affected adversely, remember to do what ever you can to stay calm. That may mean avoiding busy places that you may be visiting in order to kill time, or use WiFi. Sensory overload may not be helping inner anxieties, once again check in with your own anxiety and see how much you can withstand. Consider it a finite, valuable resource.

If you have run out of medication or are experiencing symptoms of a relapse of mental illness, it may be a good idea to try and call your GP at home. Although they may not be able to assist you as comprehensively as a visit to a doctor in Bali, you may be able to get some basic advice, and they may be able to reassure you. Likewise, your pharmacist at home may be able to help out. I would imagine that the local hospitals and GP clinics in Bali will currently be overflowing with requests for repeat prescriptions and treatment of acute physical and mental symptoms. I would imagine that they cannot cope too well with the huge demand, and my heart goes out to the doctors and nurses trying to help. If you are already anxious, an extended wait in a crowded emergency department may make things worse. Having said that, if you are feeling unsafe or acutely unwell, you must attend there for care.

So, from a psychiatrist’s perspective, here are some things you can do to boost your mental health reserves. they are not a substitute for specific medical advice, but they might help;

  • Use psychological and behavioural strategies such as distraction and relaxation techniques. Believe me, they work. Anything that can bring baseline levels of anxiety or depression to a more manageable state should be your first priority.
  • Exercise is extremely therapeutic. Nature walks are much better than trying to walk along crowded roads. Walk along the shore and feel the water on your feet. Cover up, and focus on your breathing. Leave the FitBit behind (I drowned mine in the pool, oops) this is not about steps or fitness. It is about the very beneficial mental health benefits of exercise. Walk as slow as you need to and as far as you need to until you notice your thoughts calm down.
  • Try and only focus on real concerns immediately affecting you, not the ‘what if’s’. Believe me, I have a huge list of ‘what if’s’, as a mother with a son back home in Oz that I was meant to get home to 4 days ago. This is what I am doing, you may find it useful as well.
    • Pull out a piece of paper and pen. Place all of your most important concerns in a column down the left hand side.
    • On the right hand side, allocate each concern to somebody to manage. You may be able to delegate some tasks related to home to someone at home. It will seem better when you notice that a lot of the tasks, such as getting someone to water the garden, pick up the pets, check the mail, contact your employer for updates, cancel or postpone appointments waiting for you can actually done by one person at home in a short space of time.
    • Authorise someone at home to speak on your behalf and this may cut down on your need to call from Indonesia. The time you free up can then be used to work on your relaxation strategies. And seeing a list with items ticked off is extremely therapeutic.
  • For all your fears, worries, what if’s, try visualisation work. Every time an anxious irrational fear pops into your mind, rather that fight or ignore it, put it somewhere – visually. Whether it be in a suitcase or an elaborate parcel made with banana leaves and decorated with frangipanis… you get the idea. Use your imagination to take the heat or the fear out of the worry. Let the worry know you have acknowledged it, but it is not that useful right now, so you will put it away for later. If you fight it, it will get louder and scare you more. The more you feel in control of your worries, the less they can hurt you.
  • If you are looking for medication substitutes, I would strongly advise against purchasing herbal preparations, or products with ingredients you don’t recognise. Any preparation, ‘natural’ or not has the capacity to interfere with your prescribed medication, and may cause a whole new set of symptoms. Avoid health related discussions on chat rooms,  or calling on Dr Google. If you are really desperate, once again a call to your pharmacist in Australia may help, if they have a list of ALL your medications, not just psychiatry medications.
  • It may be tempting to pass the day away with a few extra cocktails, under the proviso that you ‘deserve’ them. I am not trying to be a party pooper here, but if you already feel anxious or depressed, a big night on the Bintangs will make everything a whole lot worse tomorrow. And tomorrow might be the day you get that call you can fly home, so you need to be prepared to cope with a crowded airport, different route home, different airline (breathe, visualise….). Everything in moderation. Including social media.

I’ll endeavor to write daily whilst I am stranded here, and when I get home. Notice I say ‘when’ not ‘if’. Make a conscious decision to only say things to yourself that help you feel grounded, calm, and ready for whatever tomorrow may bring.

Best wishes,

Helen

Dr Helen Schultz has found herself stranded in Bali after booking a well-needed holiday, and writing her first book, How Shrinks Think. She is now spending her time practicing what she writes about, and writing. At any other time, she would consider this her dream life. 

 

 

Announcing my new range of DVD ‘Tips for Success’ in the psychiatry clinical examinations!

Greetings all,

I have had a great time creating and producing my new range of DVDs for psychiatry trainees and medical students. It has been 6 years since I released the original series of Present2Pass ‘Tips for Success’ range, and i felt it was time to add to the range and refresh the content!

Thrilled to be working with the talented Glen Hancox from ACTREAL again, and combining the filming and production skills of Mick Russell from LinchPin studios.

Anyway, enough explaining, watch our trailer!

And click here to order them!

The power of story in psychiatry

Book concept Landscape young boys walking through crop field at sunset
Book concept Landscape young boys walking through crop field at sunset

As a psychiatrist I have the privilege of hearing many stories, those of my patients and also the stories they tell me about their loved ones. The narrative they use often tells the story ‘between the lines’ and these subtle clues make the structure that forms the basis for psychotherapy.

For some patients, the only place their story is heard is within the walls of the therapy room. In this place of impartiality and non-judgement, they can lay out the impact of their journey, and examine the magnitude of events that have occurred within their lives. Often they are moved by the story themselves, once they express it openly thus unlocking many years of thoughts and images and seeing them for what they really are. Often the unveiling of the story is way too confronting and they run from the therapy space, only returning when they have fostered more resilience.

So, yes, one of the most rewarding and powerful aspects of my work is listening to stories. I hold them confidentially, they can play on my mind, but hopefully they are always treated with respect. If I have to relay aspects of the story in referral letters back to their GPs I hope I reframe what I have heard as carefully and accurately as possible. Sometimes when I hear a story that is filled with injustice or total praise I want to tell that story to others so I can advocate for the patient and the system. Sometimes I can do this in a de-identified way, but I write with trepidation, as I would never want a patient to recognise their story in another medium.

As a psychiatrist I often hear the remark “ I bet you could tell a few stories”

The voyeur in all of us would like to know other’s secrets and inner pain. Sometimes people open up to me and reveal their story because they know I am a psychiatrist, others more wary, but I hear stories wherever I go.

So, as a passionate writer I did in fact publish a story. My story of my journey through psychiatry training, what I do all day and what I think about my profession. It was arduous, confronting and difficult at times, but it is one of the things I am most proud of. People bought copies and told me what they thought. And on quite a few occasions I have been told my story resonates with theirs. The most humbling and rewarding comment I could receive; that when my story fell out onto paper it had true meaning to somebody else.

Nowadays I take any opportunity I can to blog and continue to tell stories. And the more I write, the braver I get. Because there is so much to say in psychiatry, and certainly so much to do in advocacy, especially for those that don’t get to tell their story.

Dr Helen Schultz is a psychiatrist and author of How Shrinks Think, her story of her journey through psychiatry training, and life beyond. She is appearing at “The Power of Story” on Friday 4th September 2015 in Melbourne, alongside other health care radicals who are passionate about storytelling in health.

Sleep and psychiatry – time for a tweet chat!

Greetings all,

I have been involved in the area of sleep psychiatry and have been running medical education workshops, known as SleepSchool since 2008.

I have been running these in conjunction with Dr David Cunnington, director at Melbourne Sleep Disorders Centre, and creator of Sleep Hub.

We have run quite a number of workshops around Australia since 2008, but haven’t done so for a while. We used to have great support from pharma but for many reasons this is no longer the future of medical education.

Anyway, not to worry, as now that both David and myself are actively engaged on social media, and I am guesting at @WePublicHealth this week, we have decided to trial a tweet chat that highlights the intricate relationship between sleep and mental illness. This will occur on Friday 22nd May 2015 at 1430 AEST.

We will be using the hashtag #sleepschool although popular around mums and babes with sleep issues, it carries on our workshop name as it moves into the Twittersphere!

Find out more about #SleepSchool here