My Experiences of Psychatrists

18 Jun

Editor's Note

This transcript has been lightly edited for clarity, readability, and flow. Repetitions, filler words, and transcription artefacts have been removed while preserving the original meaning and perspective.

Introduction

People often talk about psychiatry as though it is a single thing.

My experience has been very different.

Across two episodes of psychosis, inpatient admissions, tribunals, community treatment, academic research, and eventually working alongside psychiatrists professionally, I encountered clinicians with radically different styles, personalities, and ways of understanding mental distress.

Some focused on diagnosis. Others focused on meaning. Some were deeply interested in my experiences. Others were primarily interested in risk, symptoms, and treatment.

In this video, I reflect on every psychiatrist who played a significant role in my journey. Along the way, I explore how language can influence delusional thinking, why certain interactions stayed with me for years, and what I think makes a good psychiatrist.

The aim is not to criticise psychiatry or psychiatrists. Quite the opposite. The aim is to explore how different approaches can shape the experience of care from the perspective of someone living through psychosis.

Key Concepts

Psychosis and language
Delusions and interpretation
Psychiatric communication
Clinical relationships
First episode psychosis
Recovery
Schizophrenia diagnosis
Psychoanalytic and medical models
Lived experience
Therapeutic alliance

Watch the Video

https://www.youtube.com/watch?v=AH9WJOt4GM0&t=5s

Transcript

Why I Wanted to Make This Video

I've spoken elsewhere about the differences between my first and second episodes of psychosis.

What I haven't discussed in as much detail is the fact that I've also had very different experiences with psychiatrists.

One thing I've learned is that psychiatrists are not interchangeable.

They have different personalities, different philosophies, different communication styles, and different assumptions about what psychosis is and how it should be treated.

Looking back, I've had encounters that were frustrating, fascinating, reassuring, confusing, and sometimes unexpectedly influential.

This is a chronological tour through those experiences.

The First Diagnosis

My first significant encounter occurred during an acute psychotic episode.

I was taken into a consultation room and asked what was happening.

I responded with what I would now recognise as severe thought disorder and word salad.

The clinician listened briefly, turned to the people who had brought me there, and said:

"I'm going to go ahead and diagnose psychosis."

The consultation ended there.

What interests me now is not the diagnosis itself but how I interpreted it.

At the time, I was experiencing a complex persecutory delusion involving surveillance, conspiracy, and murder.

Within that framework, the statement wasn't processed as:

"You are experiencing psychosis."

It was processed as:

"We are officially declaring you insane so nobody believes you when we kill you."

The same sentence acquired an entirely different meaning because of the delusional framework surrounding it.

That experience would later become one of the reasons I became interested in the relationship between language and psychosis.

When Ordinary Language Becomes Delusional Material

Later that evening the same clinician phoned and explained that no medication could be prescribed immediately and that the crisis team would be seeing me.

He ended the conversation by saying:

"Try and make it through the night."

To most people, this is an entirely ordinary statement.

To me, at that moment, it sounded sinister.

Within my delusional system it became:

"Try and survive what we're about to do to you."

This is one of the most important lessons I learned about psychosis.

The problem wasn't the sentence itself.

The problem was the interpretative framework I was bringing to it.

Psychosis transformed neutral language into evidence.

"I'm Going to Take Your Blood"

My next major interaction occurred on an acute psychiatric ward.

A doctor entered the room and explained that blood tests were needed.

Unfortunately, the phrase he used was:

"I'm going to have to take your blood."

Again, this was a perfectly ordinary clinical statement.

But to someone experiencing psychosis, words carry unusual weight.

The phrase immediately connected with a series of existing fears and associations.

Suddenly "take your blood" became linked with persecution, imprisonment, and symbolic meanings that existed entirely within my delusional world.

Looking back, I don't blame the doctor at all.

But the experience taught me how important lexical choice can be.

Small differences in wording can have surprisingly large consequences when someone is psychotic.

The Psychiatrist Who Wanted to Understand

During my stay in the psychiatric intensive care unit, I met a psychiatrist whose approach was completely different.

He was warm, curious, and genuinely interested in understanding how my delusions worked.

Rather than dismissing unusual ideas, he explored them.

He asked why certain things felt significant.

He wanted to understand the symbolic connections I was making.

For the first time, I felt that somebody was interested not only in what I believed but also in how those beliefs were constructed.

Those conversations helped me begin seeing humour in my own experiences.

At the end of every meeting he would say:

"It was very interesting talking to you. Thanks for coming in."

I still remember that.

The Psychiatrist Who Had No Time for Nonsense

The next psychiatrist couldn't have been more different.

He was efficient, direct, and had little interest in discussing the broader meaning of my experiences.

Everything felt highly structured and task-focused.

At one point I handed him a carefully written letter explaining my understanding of my situation.

He took it from my hand and simply said:

"I can read."

That interaction told me everything I needed to know about his communication style.

It wasn't necessarily wrong.

It was just very different.

The Psychiatrist Who Saw Me as a Person

After leaving intensive care, I was transferred to an acute ward and met one of the most influential psychiatrists in my journey.

What stood out was that he treated me as a person before treating me as a patient.

When family dynamics complicated ward rounds, he calmly redirected attention back to me:

"Oli is my patient. I'd like to hear from Oli."

That moment stayed with me.

He also took time to explain legal entitlements, discuss recovery, and engage with my interests.

At one point he noticed references in my notes to Philip K. Dick and started talking with me about Dick's writing, psychosis, and A Scanner Darkly.

For the first time in months, I felt as though I was having a genuine human conversation rather than simply being assessed.

The Community Psychiatrist Who Helped Me Finish My Degree

After discharge, another psychiatrist played an equally important role.

At the time I was sleeping excessively and struggling to complete my university dissertation.

Rather than telling me to lower my expectations, he focused on helping me succeed.

When medication was causing difficulties, he explored alternatives.

When physical health concerns emerged, he took them seriously.

Most importantly, he supported a gradual reduction in medication following recovery from my first episode.

That decision ultimately created the conditions that allowed me to complete my degree, pursue postgraduate study, and eventually undertake a PhD.

The Psychoanalytic Psychiatrist

Years later, during my second episode, I encountered a psychiatrist whose approach was strongly influenced by psychoanalytic and psychodynamic traditions.

He was fascinated by meaning, identity, masculinity, and unconscious processes.

Our consultations often lasted hours.

He was far less interested in diagnosis and medication than any psychiatrist I had previously met.

At times I found this refreshing.

At other times I found it frustrating because I wanted practical solutions and symptom management.

The experience taught me something important:

Different psychiatrists can have radically different assumptions about what psychosis actually is.

A Shared Language

The final psychiatrist I worked with approached things differently again.

Because of my academic background, he was comfortable discussing psychosis using technical language.

We could talk openly about hallucinations, illusions, diagnosis, and phenomenology.

The relationship felt collaborative.

Rather than translating everything into simplified language, he trusted me to engage with the concepts directly.

Those conversations often felt less like assessments and more like attempts to solve a problem together.

What Makes a Good Psychiatrist?

Looking back across all of these encounters, no single psychiatrist did everything perfectly.

What stands out instead are recurring themes.

The psychiatrists I remember most positively tended to:

Listen carefully.
Take an interest in my perspective.
Explain their reasoning.
Treat me as a person rather than a diagnosis.
Remain curious.
Respect my goals and ambitions.

Psychiatry is often discussed as though it is a uniform profession.

My experience has been that individual psychiatrists can differ enormously.

Some focus on symptoms.

Some focus on meaning.

Some focus on risk.

Some focus on relationships.

The best clinicians, in my experience, manage to balance all of these perspectives without losing sight of the person sitting in front of them.