Doctor's Office Says It All
by Mara McWilliams
First published in The Bright Side Professional Center, September 2003
A few words about the doctor's office from a bipolar client: I have patiently sat in many a waiting room waiting to be seen. If I am coming to therapy, it's because I have issues. Be courteous and have a nice box of Kleenex in the waiting room, and if possible, access to water like a water cooler would be very wonderful.
As the doctor, you know the demographics of your clientele. Perhaps you could keep that in mind when putting magazines in the waiting room for us to read while we are waiting for our appointment that should have started 5 minutes ago. More updated and interesting reading material would be nice: how about pamphlets on depression, quitting smoking, stress reduction, weight control, schedules to the closest AA, NA, or co-dependent's anonymous meetings. Help us get the help we need but that we still might be too afraid to ask for. If you put that type of reading material and general access info out for your patients, we just MIGHT take it when you're not looking.
Also, along those lines, I would like to make a very important statement about ER's, typical doctors offices, and a psychiatrist's office: if you have anything in those cabinets or drawers like disposable scalpels, gloves, licopene, bottles, LOCK THAT STUFF UP! Again, you are in an industry dealing with people who admittedly have some issues in their lives that they would like to address. While they are in your care, they should be safe. That is a doctor's responsibility to his client. Please, lock your drawers. I have mentioned this to several doctors over the years and they all replied that it never even occurred to them. Now that I've put it out there, please hear me, it could save lives.
Ok, now into the office we go. I understand, as a former office "owner", that your office generally reflects your own personality, but I believe in this field the office area should be focused on soothing the client and making them feel comfortable enough to trust and open up to you. I am not suggesting by any means that you don't express yourself visually in your office, just take the patient's point of view into mind when decorating.
Most doctor's offices are FILLED with extremely brilliant books about the conditions that we suffer from. I say, if you have that book on a bookcase in your office, you should be willing to loan it out to me if I ask to borrow it. If nothing else, if the book never gets returned you can take it as a loss on income taxes. But perhaps that book you turned me onto will have some answers that I had to discover on my own through reading. My bet would also be on the book being returned.
Plants are always a wonderful addition to any space. For some reason they generate a feeling of safety and vitality. Maybe it's because you notice that they are ALIVE and thriving and being taken care of in THIS PARTICULAR DOCTOR'S OFFICE…hmmm…to a patient the perception might be…She/he CARES. Plants' health and appearance say a lot about the personality of the person occupying the office space.
Again, a couple of boxes of Kleenex readily within reach of the client so they don't have to ask for some is very important to me. It's funny how there is often Kleenex in the office, but sitting on the doctor's desk or on a credenza behind them completely out of reach of the patient. Perhaps this is done deliberately for some reason unknown to me, but Keep it Simple, let me just be able to lean over and grab a Kleenex without having to ask for one. It's the little things that mean the most in these intimate moments shared between therapist and client.
Personally, I'm not into the lying on the couch scene. I prefer a nice comfortable chair and if I am fortunate enough to have a window view I am just about in therapy heaven. It's also less intimidating when the desk is NOT used as a divider between client and therapist -- a more open and inviting atmosphere where the doctor can face the client without barriers is much more comfortable. I have found that I can more easily interact with my therapist if they are sitting to one side of me or straight across from me without any barriers, and if they are good, they can then tell when I begin to dissociate during a session.
I think it is important for the therapist and client to pick certain areas they want to work on and come up with a plan for achieving those goals.
Also, being bipolar, I am sometimes too depressed to leave the house even though I have a therapy appointment later that day. It would be VERY BENEFICIAL if doctors realized that those with mental health concerns do have anxiety and panic attacks that sometimes, there is nothing we can do about. If more doctors were open to changing their in-office appointment on a BAD day and convert it to a phone appointment, that would be extremely helpful. That way the commitment is still kept on the patient's side and we are still able to receive the assistance we really need. It's generally when we can't leave the house that we need our doctor's help the most, and if we are incapable of getting to the office, what other solution can we come up with to keep these patients safe? I suggest the emergency telephone appointments I described.
There are a lot of things I want from the person I am willing to trust with my mental health. I expect honesty, straightforwardness, respect, the ability to stand up to me, the willingness to comfort me, their vow of silence about my intimate life. I think most importantly, I want them to know that I am not just another chart number with a diagnosis. I am a real live feeling person, coping day to day, trying to live with my mental illness the best I know how. I want them to be interested in the things I tell them. I want them to learn about me enough so that when I slightly shift to the left, they KNOW it is for a specific reason and they tune in to it.