Afraid to Talk to the Psychiatric Patient


Pastor Dave had always been a softy. He was the chubby boy who cared. The one helping in the kitchen when his siblings were outside and elsewhere. Taking care of his little sister after their mother diminished her with words. After seminary school, he knew he was designed for this.  He was destined to care for those who had needs.

Driving down Highway 79, he pulled over for the man shambling along the sidewalk, thumb out. Dave asked,

Where ‘ya going?

This wasn’t the first time Pastor Dave has picked up stinky, filthy people. He loved serving the homeless. His church had one of the largest programs for the homeless in their county and he knew that if he weren’t employed by the church, he’d be doing it anyway. That’s how he knew he was doing what he was brilliant at and when he saw this man sitting in the passenger seat, his energy went up.

Unfortunately, after fifteen years of picking up the homeless, Pastor Dave picked up someone who was hearing persecutory command type hallucinations. Pastor Dave was taken off guard with the first fist to his face. He wasn’t expecting the second either. Raising his arms to cover himself, he took several punches to his gut. Falling down, his head broke on the car frame and then asphalt below.

It was many months later, his jaw wired shut, and wet tears rolling down a scabbed face in my office that we met. I felt scared. I didn’t know what I feared at first. Yet somehow he nailed it for me when he told me that he didn’t know how to look at the world any more.

This attack on Pastor Dave’s body was an attack on his identity, his sense of self. His belief of what he thought his very DNA had been created to do was traumatized. It was like someone who had been raised to be a baker, was never able to get into a kitchen after fifteen years of bread and pastry dough. Pastor Dave was bewildered by his visceral response to even thinking about talking to someone with possible mental illness. He felt like throwing up looking at them. He shook. And without freedom to serve others, his energy dropped and dropped and became the vapor of a memory of some other person. That guy with energy was almost like a story of a previous acquaintance.

In my research about this topic, how to talk to a psychiatric patient, I’m learning about attitudes and stigma out there toward them. It’s incredible. But there are not many who take it to the street and help us just talk to each other.

Many months later, I asked Dave his answer. He said, at this point, he had become a psychiatric patient himself and supposed it just started there. With one’s self. Too good.

Everything starts and ends with Me.

I ask with you, how do we talk to psych patients?

When we say, “Give it up, give up the stigma, get the attitude of gratitude and get out there and be kind,” are we talking about getting into a shark tank? No. We’re not encouraging people to put themselves in a place of danger. What are we saying?

Question:  How do you talk to a psych patient? Please share your stories.

Self-care tip: Have a day knowing you are a person of value. Let this moment and then the next, for today, be one when you let yourself join into the great and the not so great parts of who you are, more than a spectator, more than either-or, more than healthy brain or unhealthy brain. Keep on!

Thank you, Farida – A Woman of Courage


Dear Farida,

I’m writing to you to thank you for the opportunity to share your experience with postpartum depression and anxiety. You are in a class where the most courageous of the courageous live. I remember when I told you that and you asked,

Why? Why do you say that? I can hardly get up in the morning. When I think about going into public places, I want to throw up! I don’t look people in the eye. I avoid everyone. I know they will see that I am crazy. I am ashamed.

When I drive, I have to pull over at least once every two miles to catch my breath.

Some days, I don’t shower. I smell. I don’t eat so my breath stinks too. I don’t want to exist. Why would you say that about me?

And that is exactly why. That and the fact that you pushed despite the wall of fear and bottomless gloom and came through our office doors. You came again. You swallowed medications you at first didn’t believe in. You took chances every time you put hand-to-mouth, hand-to-mouth, with those damn and blessed pills that remind you every time that you have this illness. You did that long enough to start believing and to hope again. You do that even when you think you don’t need to anymore.

You are brave.

There are too many of us out in our community who don’t know about this incredible heroism. It is heroism when mother fights for her health, wife fights for her health, fighting for her family. You have the guts to start with yourself. Over and over again. You are the hero who, when it feels like regression to say the words, “I need help for the way I feel,” when it feels like failure to take pills, “…to live better,” when thoughts don’t make sense with feelings and are collectively, exactly at that point in time, when the word “crazy” is broken out into all it’s bright rainbow glory, you are the hero just then.

You are courageous getting here. Getting here in the first place was and is no small feat. But you took it further. You take it further still. I am inspired.

Dear Farida, Thank you for letting me be your physician. Thank you for letting me believe a little more that I am more than my own emotions and behaviors. For driving me to discover my identity. I am scared too. I’m scared of being that vulnerable to something as seemingly sure, like “brain health.” My own beliefs are being challenged by it. It changes how I see the world. And, I know our community is challenged by you too.

You help me hope, in the context of being someone with a changing body and mind. I’m learning about what I can control and cannot. I’m learning about goodness that is more than cooking a meal for someone, bringing in a paycheck, or basic needs.

You are a part of this journey-discovery.

And agenda – as doctors are not supposed to have any… (Ahem! Anyway!) Your bravery lets me bravely disclose even to myself. My agenda. Being your physician, in the face of so much courage, I think about what I’m working with you for. Thank you for giving me your life story as an opportunity to discover more of why I want to know Me. You are my teacher as well as my patient. I hope to live each day with courage too.

Keep on.

Dr. Q

Question:  What are you doing that is courageous? How is your life one of bravery? Please tell your story.

How to Talk to a Psych Patient, outside of the psychiatrist’s office

So what about other practitioners not in the mental health field?  How do they talk to psych patients?  Do you have any stories of your own that you’ve observed or experienced?

Say the cardiologist?  The nurse checking blood pressure?  The patient on a medical unit for a broken hip?  In these, out of context, contexts, psych patients are still treated differently at times than other “medical” patients.

I’ve heard a ton of stories about the ER (emergency room), when a patient comes in with chest pain, for example…

Tears are flowing down Frank’s stubbled face.  He is shaking, and sweating, and is sure he is going to have a heart attack. Everyone takes Frank seriously, that is until they see Frank’s medication list.  Some not so nice words are exchanged, and so forth after that.

Frank’s story and others like it are all bummer stories. But it hits me hard when later, if one such patient was fortunate enough to press the issue and the work up, and later it is found that they were having symptoms of both anxiety and heart disease, and would have died if that wasn’t discovered. I can’t help imagine and remember real people who were not so “fortunate.”

Or a someone is inpatient on the infectious disease ward for a MRSA+ leg cellulitis.  They are, in the hospital staff’s opinions, a sad patient.

Let’s call her Susie.  Susie’s finger never hits the nurse’s call button. She cries alone and people stay away. Who knows why.  Without asking her about her emotional and behavioral symptoms, they practice as if it was assumed that it is normal for someone in her condition to “get a little depressed.”  Susie recovers from her leg cellulitis and is feeling better.  She is feeling good enough in fact to realize that she doesn’t want to live, and hangs herself by the hospital sheets.

How do we talk to a psych patient?  Please speak out!  Tell your stories.  Tell your thoughts!  Good experiences and bad ones.  Good opinions and lesser.

Keep on!

How to talk to a psych patient??

Hello Friends!

I believe the last NAMI meeting went well. Huzzah!  On to the next…

I was invited to speak at the IACC Annual Conference, April 22nd at the Riverside Convention Center. Guess what they want me to speak about? “How to talk to a psychiatric patient.” Interestingly, I was also asked to speak on the same topic for the AMA Annual Meeting in June. Who would’a thunk?

Before you throw your popcorn at me, please put it into words here, at FriendtoYourself.  What do you think?  What to say?

Will you help me?  How to talk to a psychiatric patient…

Keep on!