Terribly Undergrad Psychology Student

The semester has begun. The holidays gave me loads of time to get some stuff done, but I feel pretty tired at the end of it, because I had a much more difficult time trying to take care of my family than I had anticipated. My mental load is really heavy these days. I don’t really feel that rested, and I didn’t achieve my uni holiday goal. I only had one, and it was to fix up the patio. I feel like I might as well have done summer school. If that’s how summers are going to be from now on, I’ll probably do summer school next summer. Let’s see how I feel at the time.

I spent the uni summer break learning how to try and do nothing and be nobody. It sorta worked, but the thing is… I have kids. So it’s really not possible to achieve a state of total nothing even if you’re managing to be a zen master either side of taking care of your family. It’s possible that I’ll never really know what it’s like to be at peace, and maybe that’s something I need to sit with. If only I had somewhere to sit by myself.

I love an outdoor project. Before Christmas, I was in such a lovely state of pleasantly obsessing over it, and I got as far as building two very nice (if I do say so myself) dry walls out of stone that raise the level of the first terrace and welcome the family up into the main body of the yard, out of the patio. I’d been operating on the understanding that there would be at least a tiny bit of money to use on fixing it up, but I was mistaken. Nay. I was corrected. I got kinda depressed for a good many weeks after that. I had pulled the whole area apart, thinking I had the money to do the basic structural work needed to re-floor the patio. But once I had completely dismantled it, my husband told me we couldn’t spare the money to fix it. So I just have this totally destroyed patio now, instead of any patio at all. I just stared at it in despair all summer, and really didn’t find my groove for the entire remainder of the holidays. I just felt really demotivated… like the air had been punched outta me. I need my surroundings to be calm and ordered or I become depressed. After twenty years of learning this the hard way, I just know it to be true, and I know it to be something to put effort into.

I’d been so excited and got myself through the entire semester looking forward to doing it. I couldn’t do anything else because it all costs money, and I was getting scolded for even thinking about a weekly drive-thru coffee. So I couldn’t even spend $5 on this project. Nothing at all. I’d been anticipating being allowed to spend something like fifty bucks a week on it, and I’d been talking about it for ages. When I wasn’t permitted to spend even a small amount on it, I went and earned the money for it. Then I was told that I wasn’t even allowed to spend that. And now I had yanked the whole patio to pieces thinking I’d be able to reconstruct it. So it was like…. sitting out my kitchen window, in pieces… just mess everywhere. I felt VERY triggered, and sad, and deceived. I was depressed because I would’ve just not done any of it if I knew we weren’t going to spend money over summer. I had just been led to believe that it was all approved by The Household Budget Sergeant and that I was fine to proceed with the project. So when I was lectured about why I was no longer allowed to do any of this thing I’d been dragging myself through assignments and exams looking forward to – in fact I could not even spend the $5 note in my wallet that I had earned myself – I just sat and cried quietly for some days, and then focused my efforts on trying to teach myself to sit down without getting up again for at least half an hour. That’s a very difficult goal for me. Also, it doesn’t cost anything.

I still have confused feelings about this controlling behaviour. And it is very much controlling behaviour. It just comes from a very different place. There’s nothing I can do for someone to achieve a bit of balance and perspective in their thinking and their projections of their anxieties before they’ve recognised within themselves that it’s a problem. So I felt stuck. I still feel pretty stuck in that.

I picked up my art supplies and began to draw. I have now drawn a picture every day for 20 days. I call it my “daily doodle”, trying to protect myself against my perfectionistic vulnerability. Whether the drawing is to my liking or not, and whether it’s finished or not, I share it online for friends to enjoy. The idea is that I just do something casually without making it “perfect” and then share it to let it rub unpleasantly against my perfectionism. I even shared my PayPal donation page and earned $40 from doing my drawings. That’s pretty nuts considering it was just an exercise in achieving a bit of mindfulness every day. Even though other drawings were more popular with people, this is probably the one I like the most.

And that $40 is mine and I’m keeping it.

I’m struggling with depression right now. I got my hair cut yesterday and I felt a bit better. I might put some makeup on too before I start my readings. Making my external shell look pretty helps me feel better when I’m sad. I use bright colours and try to make the outside look the way I wish I felt inside.

I just feel pretty lonely going into the uni semester, and it’ll be the biggest semester of my undergrad career. One of my classes is the stats class, and I find it very loomy and mysterious and too-large in general. That’s a common experience to a great many psychology students. But it would be nice if I felt more secure about things in general.

Hope you had a good Christmas. Mine was the best ever.

Since then, I’ve been delving hard into my Chineseness. It’s a long winding tunnel, lit partially by red lanterns, consistently smelling delicious, and usually with a dark spot here and there that I just don’t understand at all.

Today, I’ve begun authoring my second book. I use the term, “second book” loosely, because to say the phrase, “second book” implies that the first has been completed and published, and this is not true at all.

However, the call of the Ancestors is strong, and I have learned better than to ignore them. My nainai is particulary present with me and always has been. I’ve been having a chat to her a lot lately. It’s time to tell her story.

I began the book and have already knocked out a really good half-page so easily that it has the feel of, “This is flowing from somewhere else” about it. The last time I recall feeling this way about a creative work was when I was sitting on a bed in a motel down in Mollymook one day, penning the best song I’ve ever written. Well, it’s my favourite, anyway. It’s funny how I was sort of satisfied with my songwriting career after I wrote and recorded that song. Some part of me knew I had done some good work and that it was time to move on and do something else.

For a long time, I’ve known that I’d write books. I guess it’s time to start now.

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Helpful links if you’re an ABC wanting to find out more about your Chinese ancestors:

Chinese Last Names: A History of Culture and Family: https://www.familysearch.org/en/blog/chinese-last-names

How to Find my Chinese Ancestors: https://www.familysearch.org/en/blog/find-chinese-family-tree-jiapu

Content Warnings:

• trauma
• family dysfunction
• the psychology of storytelling and of writers
• horses
• university retraumatisation/triggers
• grief
• child torture and abuse

Well, the nonsense of my first semester back at uni is far behind me now. I still haven’t checked my uni email since ghosting a conversation with a terribly immature and spiteful Doctor of Psychology when she was trying her darndest to engage me in a juvenile tit-for-tat conversation that had nothing to do with anything except for her ego. God knows how long she argued with herself in my inbox before I gave up trying to gentle-parent her through the conflict she had decided was necessary. When I finally log back into Outlook and see what is probably a flood of ridiculous emails from her, I shall be deleting them without reading any of them. Sad to come across someone so unprofessional who does our discipline such a disservice, but it is what it is, and those people are, most unfortunately, everywhere. It’s just a shame to see that the prevalence of said personalities is just as high in a discipline which purports to know itself – and others – better.

My god, I’ve never watched so much television in my life. I’d be embarrassed about that, but I don’t give many fucks about what people think. I’m doing exactly what I want to be doing. If I want to see what stories people are telling, I will. Television got real good in the last few years, as it turns out.

I’m now a month or so into my holidays, and I was enjoying myself immensely until Christmas came along. I had torn the patio to pieces and was rebuilding it when we stopped spending anything, so now I have a half-ripped-up patio sitting there and no means with which to fix it. Kinda looks like someone took to it with a sledgehammer in a fit of rage. Oh, well. Next year.

I’ve been working pretty hard on myself now that I have the time to. Until last week I was attending therapy weekly and we were unpacking some old themes that haven’t been examined in some years. We had got as far as kinda opening all the drawers and making an appraisal of the stuff that needs some work, but (for the same reason I can’t fix the patio anymore) I can’t go back to therapy until next year. In the meantime, I’m just using whatever time I can scavenge out of my day to reflect on a fair few things and try to bundle all the thought-journeys I’m taking into rough themes. I can’t actually do any therapeutic work until next year… we only had enough sessions to really look at what’s sore and needing attention. Then we stopped. It kinda feels like I’ve got a gaping wound at the moment, because the therapeutic process has been disrupted at a critical point where the exploratory surgery has taken place and the actual work was about to begin. Oh well. I’ve endured worse and I’ll survive it somehow. But I’m a bit depressed. I felt like I was going somewhere and about to embark on some pretty important trauma healing under the expert guidance of my psychologist, who remains ***awesome***.

It’s interesting how much you begin to appreciate storytellers anew after you reach a certain point in the road of psychology studies. You will find that you get the odd university assignment that asks you to select a fictional character and make an analysis of their personality and behaviour and trauma and so on. It does make me wonder, firstly, how many writers come out of a B.A. but with a few units in psychology to kick ’em off… or perhaps they have entire psychology degrees. Maybe, more often than not, they’ve had to find their road into adulthood out of dysfunctional families, and writing stories or telling the truths of the world via documentary filmmaking is their way of figuring out what happened to them earlier in life, and how the psychological half-life of dysfunction and trauma rolls out across the lifespan. So many times, I’ve viewed a documentary made by someone who is searching with remarkable energy for others like themselves. The capacity of a human being for that search really is something to see. And it’s not like they always have the self-awareness to see that this is what their process is. Even the wisest storytellers need a therapist to pose those questions sometimes. I have found along the way that I have a particular leaning towards supporting those in old age to undergo a life review process and find loads of goodies they can feel good about when they look back over the things they’ve done. Sometimes, I’m not sure why I enjoy this so much and have such energy for it. We all need to reflect on our lives with some sense of achievement and purpose… that’s the obvious one… but why do I love it so much that I do it for free? What deeper meaning am I searching for, as a storyteller? How am I seeking to reassure myself? Surely I’m above such basic fears as that of mortality and meaninglessness. Perhaps not.

I’ve been fascinated by a writer by the name of Taylor Sheridan, who (among other things) dreamed up “Yellowstone”. The fact that he pretty much writes stories to pay for his passion for horses is telling to me, too. Anyone who partners with horses over and over again to achieve (almost) complete trust is someone I know well and can sit down with like I’ve known ’em a thousand years. It takes one to know one, and someone whose dedication to their horses is all-consuming is a figure I have met time and again, as well as having lived that life myself. Where life gave me a shit sandwich or a punch in the face to choose from as a kid, a skinny grey with a nasty buck gave me hope. He’d had people kick the crap out of him for no reason his whole life and didn’t trust anyone. Humans had given him no reason to believe we would ever make sense or be consistent. But I tried to show him he could trust me. And he didn’t just listen because he had no choice. I could see that he was listening because he wanted to give me a shot and that I could tell him anything without fear of judgement, or wilful misinterpretation, or outright sadistic torture. As a 15 year old, I’d never had anyone treat me with such openness.

Anyway… we were inseperable. I couldn’t wait to come home from school and be with him. I woke up every morning excited to put my boots on and go feed him and take him for a walk out along the fenceline as the sun came up, even if the frost was biting so bad my gloves would freeze up in the shape of my hold on the reins. We’d go off up over the hill where nobody was monitoring us and thinking the worst of us all the time.

He liked those morning trots up to Joshua Road and back. His ears would be really pricked and a spring would be in his step in some way that told me these dawn jaunts were his favourite rides. He liked when the trackwork riders next door would bring the racers around the track in his direction. I swear he laughed when they got spooky at his ghostly form in the morning mist. Together we saw the sunrise and felt good, even if I did have to go off to school where all hell broke loose on a daily basis.

I’d never felt like that about life before. Some part of me hopes he knew he had gifted me that hope.

The first being I could ever trust was a horse. I can imagine that like my own early life, over there in the absurd and confusing society of American screen and cinema, it could be easy to choose a horse instead.

Maybe Taylor Sheridan’s just trying to make meaning of what family and loyalty really can mean and from different perspectives. Maybe a daughter’s complicated grief following a mother’s sudden death can trigger off personality stuff that mightn’t have otherwise arisen. Maybe that becomes someone else’s trauma. Maybe she becomes someone else’s complicated grief. And the whole time, horses are at the service of the family. Silent, wise old witnesses to the fall of an empire that was built on stolen land. Maybe we all have to fall, inevitably, one way or another, when we built a castle upon the unreconciled intergenerational trauma of others. Maybe man is the coloniser and Country (and her first Peoples) are the horse. Maybe we decided it was a “partnership” when it wasn’t a partnership at all. Tom’s trying to preserve the dignity of his people by beating the white man at his own capitalist game, but building a casino to fleece the white man of money he decided was superfluous in the first place is still just the act of a desperate group, backed into a desperate corner, telling themselves the house will win in the end.

This writing is just so clever and such a mirror for Americans to measure their consciences by. It’s a very American story, but of course, we can all take something from it. You can find sympathy for everyone in this dynamic. You can even find sympathy for John Dutton, whose disproportionately powerful position affords him the ability to turn away from injustices and make excuses for not being able to listen to others less fortunate than himself.

Sheridan doesn’t really tell you what to think. He’s leaving it up to you.

Except, perhaps, in the case of environmental activist Summer, who, at the time of writing this blog entry, is living in the Yellowstone as a guest of the Duttons, a fish out of water, finding herself with a black eye (thanks to Beth) and rapidly-fizzling relevance. But… her arc is not yet complete. Maybe she has a lesson to teach the Duttons in the end. We shall have to wait and see.

I’ve read that Sheridan’s beginnings were a fair few underwhelming casting calls and a few parts that weren’t that exciting and that this led to a feeling of, “Ok. I might try this ‘writing’ gig out for size…” I can’t remember where I read that, but when I first saw the maiden season of “Yellowstone”, I went straight to the credits to find out who made this story. Turns out I’d been lookin’ at him in a small role he’d put into it as an excuse to natter on about horses (I mean, it’s understandable…) It turns out that he’s amazing at writing. But it’s quite clear to me from the outside that it’s not the showbiz stuff he’s after (and after my comparable disillusionment with the shitty bad apples in the entertainment industry in my own country, I can see why). He’s fascinated with psychology.

The more great stories I view in this new world of television and cinema that I’ve been exploring with my partner, the more it seems like people write stories to find meaning… to make sense of deeply personal things. Yeah, it pays okay, but only after the gamble of years of time and emotion. And the humiliation of shopping the idea to a million people who will look down their nose at you.

Actors are storytellers, too. So often, you hear them talking sympathetically about a character they’re portraying when they do a media interview. The very best actors have the language (within or extraneous to the actual script) and the lived experience from which to draw a performance, and I wish that actors could be free of the ridiculousness of celebrity and media so that I could more easily understand how the craft of storytelling works from their perspective. I’m probably the wrong person to be a therapist to celebrities, because I have such strong lived experience of the “business” myself and would be too reactive to their complaints. There’s such a thing in the therapeutic dynamic as being too ready to jump in with furious agreement when a client says that something bothers them or outright traumatised them. You will add instant fuel to the fire of that conversation, bringing the dynamic to a high heat that is very difficult to bring down and construct a foundation from which to heal. To my limited knowledge, there is a time and a place for modelling passionate outrage at something, and that is when a survivor of trauma or some sort of injustice does not seem to feel permitted to express appropriate anger or recognition of those injustices and traumas.

Anyway, the day is getting away from me a bit, and that’s enough non-book writing for this beautiful mild Sydney day.

If you’re Taylor Sheridan and somehow self-Googled your way into finding this blog entry, firstly THANK YOU for choosing to write, and thank you for educating people on why horses are for some of us the lifeline we’ve needed at times to survive this world. I haven’t got a buck to my name (in either definition of the word) and nor have I got a horse these days, but the lessons I’ve learned alongside a horse’s big old face (and on his back) are some of the most valuable of my life. Seems maybe you got to see that, too.

R

Well, as keen and consistently-engaged a student as I am, I still managed to finish my first semester back at uni with a resounding, “FUCK!”

As expected, my academic performance was pretty underwhelming, because I had to learn lots of new things upon my return to uni… how to care for my family – whose needs are a heavy load on me – at the same time as study, how to navigate the student portal, how to use Turnitin again (which I was always pretty mystified about in the first place), how to use APA7 referencing and formatting, how to access lectures and course materials and just the INFORMATION about when things are due… and it turns out that when there’s conflicting and quite ambiguous information about the times things are due, you might see the wrong source with incorrect information and take that as gospel.

I thought I was so organised at the beginning of the semester, because I used a diary (which I need because of my memory/recall/attention issues) and found all the information I could about DUE DATES. Because if you’re not paying attention to those dates and times from the first DAY, you’re already doing yourself and the lecturers a massive disservice.

I hit something that said “29 Oct 2:59” and wrote that into my diary. To me, that was all I needed. So when all the cramming students – which is A LOT OF STUDENTS – all came in at the end of semester asking silly last-minute questions about when things are due, I tuned out. “I sorted that out in week 1, I said to myself. “I’m glad I’m not one of those students who ignores deadlines all semester then panicks at the end. I’m being a very good girl,” I said, patting the open diary beside my desk with 11-week old handwriting on it that said “29 Oct 2:59 – PART B DUE!” on it.

Well, it turns out that just below that Really Important Underlined Writing at the top of the page, there was more text that said the 28th. Even better… it was 2:59am. Not 2:59pm. Take that an even bigger step? Surprise! It’s actually 11:59pm! It’s NOT EVEN ANY OF THE 2:59s AT ALL!

I have dedicated myself to my family all semester whose diagnoses and everyday needs are FULL ON every day and every night and every weekend and in school hours of every school week I just SMASHED those two classes.

Except it turns out that pacing myself, organising myself, writing out all the dates and being extremely well-prepared and engaged with the learning ends in your failure of classes.

I am just devastated today. It has been a hugely triggering assessment period, because the behaviour of all the lecturers is above all extremely hypocritical and it’s all very reminiscent of the abuses I had to endure in the criminal and family courts as a DV survivor. They sound EXACTLY the same and they’re just as hypocritical as those awful people. I’ve been just debilitated with the mental health effects of their robotic approach to education for days and it’s taken a heavy toll on my husband who already has enough of his own barriers to face each living HOUR of his life.

Today I choose to let the goodness shine in, and I’m working away at all the housework I couldn’t do during last week’s hard and utterly fruitless work. I will be working some more on my book, doing loads of laundry and dishes, letting my poor old therapy dog do her work on me, and thinking of all the people waiting for me to finish university so that I can get out there and be a part of solutions. Psychology school is a much more self-congruent faculty and I just can’t wait to be done with these terribly ironic counselling people. It’s been a horrid experience, letting the wonderful teaching fill me with such joy, then finding that the assessment of all I learned is such a retraumatising experience for anyone who finds it easy to spot abuses of power.

Having spent most of the semester enthusiastically participating in class, I’ve observed countless students suddenly rushing into the class forum towards the end of semester just trying to fish for information, grab at quick-fix shortcuts to passing the class, and generally just trying to use students who have been present and engaged for the whole semester.

It stinks.

If you do this to your peers, you suck. I mightn’t say so in the forum or even in the psychology & counselling Facebook group. But I’m disappointed in you for not being there all semester when your classmates needed a CLASS, then suddenly showing up at the end wanting cheat notes. What are you even doing in the class if you planned to do it that way, and what will you say to your clients when you’ve kneejerked a response to their distress that is out of an unprofessional, unobserved place?

Some of us are in that class each week despite our difficult and busy lives checking off all the readings, doing all the exercises, going into the forums and trying to pick ourselves apart as is required for our future responsibilities to our clients. Some of us take that responsibility seriously. When we can’t attend classes or get across all the readings because of sick children (and one of mine has been desperately sick the entire semester) or other unavoidable troubles, and then you go in and try to take advantage of others who have actually done the work, it is incredibly disrespectful.

I have been participating with my whole heart the majority of the time, before my eldest needed a heavy load of support in the past few weeks. Every week I’d do all the work and then to close off my study day I would post to the discussion board, as is encouraged to get the most out of the class.

Every week, I’d barely get peep out of the class, who it would seem were not doing the work, or bothering to participate in any meaningful way. Only a handful really seemed to commit to making the discussion board truly enriching and interesting, and the rest just turned up if it was absolutely necessary to “make an appearance” to get their mark. The things they’re writing are carefully shaped to sound like what the lecturer wants to see. It’s the same comment over and over again. Dozens of people carefully re-wording what the last person wrote.

In short, they’re “playing the game” to get the pass.

Is this really a meaningful learning experience?

On any future classes that require class discussion in an online forum, I’m just going to “play the game” too. I’ve poured my heart out all semester and tried so hard to add new dimension to the conversations, only to be met with crickets.

I’m feeling pretty discouraged.

The learning content has been a joy; it’s been hard at times as we learn about the injustices or systemic failures out there… but it’s been an absolutely amazing two classes with excellent lecturers and excellent reading material to digest. I’m just really sad that I’m forced to make the same concessions as my classmates, when that’s not how I want to learn. I want it to be a journey. Not a grades-obsessed bare-minimum effort. But because that’s how the majority is choosing to engage with university learning, that’s how I’m being forced to engage too.

It’s not fair.

Gosh it’s such a busy time of the semester.

With multiple assignments and exams happening within the same few weeks, the temptation to rush one’s work is definitely there.

However, I am a baby psychologist who is determined to be more than just “qualified”; I want to be good. In keeping with this, always read way more research than I need to in order to complete an assignment. I don’t just read “enough”; I let my interest lead me happily down the rabbit hole. This past few weeks, I’ve been reading almost entirely about sex and sexuality for older adults. This is part of my class on therapeutic practice with older adults.

I’ve read about a few studies this week, but the one that stands out is a 2020 paper by Levkovich, Gewirtz-Mayden & Ayalon called “Communicating with older adults about sexual issues: How are these issues handled by physicians with and without training in human sexuality?”

It’s a global conversation. The lit review discusses the reading (and research) by the authors which includes research out of (but probably not limited to) Australia, Canada, Sweden, Israel, the US, South Africa, Turkey, the UK, France and New Zealand. Are doctors all over the world feeling a little shy about asking their older patients about relationships, intimacy, sexuality and sexual function unless they have specialist training?

The present study kept the sample small. Of the 38 physicians interviewed, 17 “did not have any training in human sexuality” and 21 of them were “certified as sex therapists”.

Aside from my surprise that there are any physicians at all who are not trained in human sexuality, I was interested to know if training is the difference. It would certainly seem so. Furthermore, the physicians who had not received sex therapy training tended to reach straight for medication as their prime treatment plan for sexual problems. That’s not good.

In an Australian context, the authors actually mentioned an Aussie study (Malta, et al., 2018) in their lit review which “showed that that the GPs had several constraints to discussing sexual health related to their perceptions that their older patients either did not have sex or were not interested in addressing this topic.”

The paper I’m writing promises in the abstract to relate the issues for older people in context with the broader Australian healthcare and social frameworks, so I’ll be reading that one later tonight.

In any case, it’s pretty sad to me that this issue is still so stuck in the fifties. I have certainly decided that I will not be one of those clinicians who misses a great deal of a client/patient’s potential story for want of asking about relationships, intimacy and sex.

Oh my gosh, life is so crazy that I haven’t even had time above and beyond my studies to sit and actually blog about my studies. Whether it was my child’s mental health challenges, my family being all-hands-on-deck just getting stuff done, our time in the city managing our work and parenting commitments, attending to the needs of my friends, or just plain family time at home keeping me away, it’s just been impossible to keep blogging every time I study.

That said, I’m pleased to report that my studies have remained on track and ahead, despite my lack of actually writing about it. My home and family life continues to be a joy, and my newfound freedom in just being able to explore my academic and creative potential just keeps on being there for me to be amazed by, or even shocked. I have never felt so liberated and free to be me. I’m even designing and building new garden for my house this week, and I have no barriers to doing that. Well, none except a quite bad spinal injury. But she’ll be right. I’ll take lots of breaks.

I love my two classes. They are actually drawing to a close soon, sadly. I have really learned a lot about how to deliver responsible, sensitive, authoritative clinical care to culturally and linguistically diverse communities as well as informed care for older persons, whether they’re coming into clinic or in a hospital.

Today I’ve been doing a lecture for COU1212, which is a gerontological psychology class, basically. The responsible and educated and caring delivery of counselling for older adults. We’re going into some fairly meaty assessment and diagnosis stuff which is always exciting, and we’re really looking at a cross-disciplinary approach. With the client who is older, so much of what makes life good is going to be related to how their health’s going that week. For this to be something we hear and understand in the most compassionate way, we really have to do some work on understanding the illness and risk for older adults in more detail than just “What is dementia?”

I have been feeling pretty disappointed in fellow students for dropping off in their online participation. I have realised over the last week or two that the majority of them aren’t in the class to actually get as much as they can out of it; it’s about achieving a “pass” for themselves. So, once they’ve written their idea of a “compulsory” forum post, they tend to bugger off and stop interacting. For the student who really wants to be the best possible therapist they can be, this is pretty disappointing. If there’s no class to interact with, you’re sorta left to your own devices.

So, today I have really jumped headlong into learning more nuts-and-bolts knowledge of delirium. I mean real diagnosable measurable delirium.

I think the word is bandied-out a lot, like many other words, but it’s a medical and psychiatric reality for many individuals and their families. In fact, about half of the elderly patients you see in a hospital are going to experience delirium. It’s confusing and distressing and above all, exhausting.

The learning psychologist really does need to have a firm handle on the responsible identification and diagnosis of delirium, though. It’s different to dementia, and mainly distinguishable by its onset. It will come on with quite some speed and strength, whereas dementia is more of a slow thing that comes on over months or years and will – most unfortunately – hang around. Delirium, on the other hand, will come on over hours or days, then can be done in just as quick a time. In some cases, it will not fully resolve for months.

I’ve witness delirium firsthand and I have also had delirium myself when I was in ICU for pneumonia. I remembered things very differently to the reality, and I also have “recollections” of things that weren’t really a thing. I was only told of the true sequence and nature of events by my husband once I had recovered. It was only when he told me of how things REALLY unfolded that I realised I had some sort of other version of it; a version my brain had fabricated. There are entire days missing in my recollections of that critical week, too. I also had a strange experience of being able to view the television in my room; a quite trippy perspective of the Black Panther movie and a news item about Morris dancers, of all things!

The causes of delirium are not that well understood, but we do know who the high-risk patients usually are. They’re the ones with recent surgery who might have been treated for pneumonia, UTIs, constipation, or dementia. They are also possibly going to be quite sleep-deprived. This sleep-deprivation can become a cyclical problem, when they delirium itself has kept the patient awake overnight, they are also not resting properly because they’re in a hospital with lots of noise and a chaotic schedule and many unknowns… and this fatigue can then further increase the risk of continued delirium.

When experiencing hyperactive delirium, the patient may:

With hypoactive delirium, the patient may:

In a mixed state, the patient will be fluctuating between both hyperactive and hypoactive delirium types.

The shortcut for provisional and registered psychologists is this:

60% of cases of delirium are suspected to be missed by clinicians despite the symptoms being so obviously delirium! Be aware, be educated. Remember that many sufferers of delirium will have recently had surgery or otherwise been hospitalised for pneumonia, urinary tract infections, constipation, and dementia. By the time the episode YOU witness comes along, they are already one very tired cookie. Do all you can to advocate for their comfort and rest. Refer to other experts if you have reached the outer limits of the capacity of your own expertise.

50% of older people in hospital are going to be experiencing delirium. It’s a serious neuropsychiatric condition that we need to be knowledgeable about and prepared for, not just for that client but for the information and reassurance of their families. They can also access medications such as antipsychotics or Haloperidol to deal with it so definitely work across disciplines with other healthcare professionals to ensure this individual accesses the treatment they deserve (N.B. we definitely wanna avoid opiates).

People experiencing a delirious episode are statistically much more likely to have a fall, leading to injuries, further compications, an average 10 days longer in hospital, and ultimately, a higher mortality rate.

Our prime responsibility as psychologists is to provide a calm, reassuring presence as well as assisting to identify environmental factors that can be adjusted to make it more quiet and serene. For example, turning off televisions or anything else making too much noise, dulling the light in the room, keeping voices calm and low, and so on. It’s really important that the individual gets enough sleep, too.

Sources:

Bernadette Brady, ECU

https://youtu.be/lJH1AoVuVS0

Therapeutic Practice with Older Adults:

Smith, G., & Pearson, M. (2011). Counselling clients from an older generation. Psychotherapy in Australia, Vol.17 (3), 12-18.

This peer-reviewed bit by Smith and Pearson begins by pointing out a few key things:

1. We’re living longer, and finding that differences between generations could be viewed as a cultural issue.
2. There’s a research gap in the area of generational difference between counsellor and client; what do we understand about the dynamics between vastly different ages in the therapeutic setting, and what are the questions we should be asking in our future research?
3. This is a qualitative study, and it met some expectations from prior data in some cases that are implied to be rather sober, but with this new study, they did find some happy news. The relationships that therapists are building with significantly older clients than themselves are bringing forth personal rewards for counsellors, as reported by the counsellors. These are, namely, self-awareness, personal insight, and empowerment to live well in the present and into their own future.

The study aimed to “explore the challenges and rewards for counsellors who work with client from an older generation”. When reviewing the evidence in play up til this 2011 work, the authors noted that despite a mention by Beutler, Gastonguay and Follette (2006) that there may be poorer outcomes for clients more than ten years older than their counsellor, there otherwise stands very little evidence that a difference in age between counsellor and client has any impact on outcomes.

I was writing on the class discussion board earlier today that while the material for this week seems to be working on assumptions supported by the literature about the attitudes of younger therapists having to work with older clients, I’m a bit of an outlier because for the longest time, I’ve actually preferred to work with either very young people or much older people. This is reflected in my social life; not so much with the younger people as friends, but with people who are at least 15 years older than myself. For a few years there, it also reflected my dating preferences!

I am now happily married to someone who’s only a year older than myself, but in his own words, he’s pretty much a 78 year old in a 43 year old’s body. I suppose we both break the rules a little.

After a couple of days worth of reading on this topic I can see that where counsellors are concerned, they’re not too keen to load up their books with older folks, but once they actually gain some experience, they’re finding it actually very rewarding and the misconception about older people being a drag to counsel is actually working against their own professional and personal development. So if you’re a counsellor or psychotherapist or psychologist reading this, chew on that for a little more food for thought today! Older people rock and I actually choose them above people my own age as my friends. I have done this since I was 16 years old, and I really believe that as a result I’ve become a stronger, wiser person.

Culture and Diversity in Therapeutic Practice

Gosh it’s super-duper back to basics with this class, and I’m really getting a lot out of being prompted to revise those very basic fundamentals of social psychology and sociology. I’ve done a shit-tonne of sociology classes, and only a tiny fraction were actually recognised by my current university, pretty much because my first university was a bit shit. Still, I did have a handful of really great lecturers there. I’ve even done HR (ugh, never do summer school unless you’re a young bounder with no dependents!). I really don’t see the unrecognised units as a loss, because you really can’t do too many sociology classes, as far as I’m concerned. I wish everyone could have the opportunities that I’ve had to expand my learning on sociology and social psychology. I will have a psychology degree next year, but I’ve probably one 30% more units than I needed to in order to be awarded it. And I remain glad and grateful for those “unnecessary” classes.

This week’s reading for this class is from all the way back in 1959! It’s a chapter called “The Promise”, out of a book by Penguin titled The Sociological Imagination. C. Wright Mills wrote this when he only had a few years left of life on earth. I love these words from the very first page:

“When society is industrialised, a peasant becomes a worker, a feudal lord is liquidated or becomes a businessman. When classes rise or fall, a man is employed or unemployed; when the rate of investment goes up or down, a man takes new heart or goes broke. When wars happen, an insurance salesman becomes a rocket launcher; a store clerk, a radar man; a wife lives alone; a child grows up without a father. Neither the life of an individual nor the history of a society can be understood without understanding both.”

The author’s annoying insistence on the default “men” descriptor (and the assumption that kids are lost without a father, coming from a dude who kept having babies with women and then leaving them for another woman) aside, it’s such an interesting and also a kinda bleak reading from a very comfortable white bloke living in a decade that really did not feel the real pinch of devastation and fragility we’re feeling in 2022. However, there’s a lot of prophecy in it, too. He predicts that “political colonies are freed; new and less visible forms of imperialism installed”, as if to be gazing through a crystal ball directly at 2022’s Western sociopolitical landscape.

C. Wright Mills continues on to talk about how society is now awash with information and yet it’s kinda totally illiterate if it doesn’t have a sociological imagination (I’m paraphrasing his more detailed take, but that’s basically it).

“The first fruit of this [sociological] imagination – and the first lessons of the social science that embodies it – is the idea that the individual can understand his own experience and gauge his own fate only by locating himself within his period, that he can know his own chances in life only by becoming aware of those of all individuals in his circumstances. In many ways it is a terrible lesson; in many ways a magnificent one.”

This passage tells me that maybe the author knew a little something about suffering early in life; if something was trauma-informed in 1959, maybe that’s what it sounded like. The whole idea of someone being quite afraid of the world around him, feeling it’s a series of traps that wants him to fail. It makes me reflect on my own trauma. I have only just begun to start really unpacking the learnings by myself, after recently drawing to a close my continuous trauma therapy, which I’ve been receiving for over ten years. Before that, I’d had stints with psychologists and counsellors sort of as a “PRN” mental health medication to deal with childhood and adolescent trauma. Something you come to realise is that during the ongoing trauma, you really only pull apart the actual trauma itself, with perhaps some sessions devoted to trying to remember who you were before DV totally destroyed your sense of self. It’s only after the offender is removed from the picture and can’t continue reoffending that you realise that you’re now free to finally look forward.

I’ve mindfully ended the continuous appointments because I felt it had run its course for the time being, and I wanted to have some time to really let my reflections echo within the bounds of my own daily life, without living week to week between psychologist appointments. It’s really done me some good, and my husband really deserves credit for it, too, because without him, I’d still be living with the daily trauma of poverty. We’re not wealthy, but we’re not hungry anymore. I haven’t skipped a meal in more than a year. (It shows.)

I feel I now have the headspace to write the book in a committed way. But it does take consistent work on oneself, and all the readings you get from uni are useful in terms of training for the future, but the odd reading or viewing you’re prescribed by a lecturer also invites you to go back into the past and re-organise and re-pack it, if that makes sense. That revisiting and honesty about ourselves of course has to be primarily about dealing with trauma so that we can live a healthy, functional life, but it does indirectly safeguard our future clients, too. You have to deal with your trauma before you can truly be in command of the therapeutic space others are trusting you to provide. There’s no delaying it and there’s no sweeping it under the rug. And it’s ongoing. You don’t just deal with it once; you have to deal with it every single day.

Once the ongoing trauma has ended (as it did for me last December), you have the grateful release of the trauma vacuum. It’s a hard process and a hard feeling to describe to the uninitiated. After over eight years of ongoing trauma, I have to be careful I don’t over-analyse everything too quickly, or I’m going to become overwhelmed all over again in a different fashion. I think the first six months for me has just been about learning anew how to spend time with myself, how to rest, how to sleep without nightmares, and how to set new goals. I also fell prey to a trauma response that not many people talk about; a pathological need to stay busy every single day, in a sort of panicked rush which serves the function of “I am far too busy to sit still and allow painful trauma flashbacks to commandeer my brain”. This dysfunctional habit of setting myself up with too much community work also served the purpose of keeping me from hope; blinding me from trying to see too far into the future. Like countless survivors of PTSD before me, I have long found it very difficult to imagine successfully setting long-range goals, let alone reaching them. I had continually tried to access education and a working life, hitting impassable barriers, and then I was judged or exiled for my failure to overcome the barriers, rather than having people judge the barriers themselves. The war veteran who is diagnosed with PTSD receives a hero’s welcome. The domestic violence survivor who is diagnosed with PTSD is judged, even when she’s doing all she can to help her children and herself. This is why trauma continues so long after the last punch is thrown. Society lacks the sociological imagination to see the wider picture, choosing instead to judge the individual in their immediate view. It’s not just memories of being abused and controlled that haunt you. It’s the memories of the people who failed you in the years which follow; the abuse begets continued abuse from other people while you are still so injured and vulnerable, opening the door for things like religious coercion and abuse from family members or institutional abuse when your children need to access police protection, social workers, charity help or other welfare services.

One of the big things that happens to traumatised people is that you cease being able to see a future for yourself; you become convinced that you’re probably not long for this earth. It’s the brain’s way of trying to process the unimaginably horrific; trying to accept its fate… that you will die soon, probably traumatically, without anyone to love and house and feed your babies for you, and without anyone who even cares you’re gone. The traumatised mind, I suppose, is attempting to process the unprocessable. It’s trying to make sense of cruelty and horror which should never make sense to anyone. Yet, here we are.

The way that C. Wright Mills writes about sociological imagination, you can see that he might’ve been the child who once looked around him and saw only a minefield. In the same way the traumatised mind attempts to make sense of horror, the sociological imagination attempts to manifest context and the possibility of healing in a world where there are others with your same experiences. Without it, I’m not sure I would have survived domestic violence.

Reference:

Mills, C.W. (1959). The Promise. The Sociological Imagination (pp. 9-32). Great Britain: Penguin Books.

I’m taking a break from my readings to eat something and write something. It’s 12:29pm, it’s sunny outside, I am 42 years old, an ex-smoker, retired musician and lover of fine foods who does not particularly like men but married one anyway.

Look, it sounds funny, right? I am so much more than this description. I’ve done amazing things in my life, and I’ve been so much more in both a professional and personal capacity, but a few short words to sum me up is all you get in that paragraph. It’s so reductive. It’s the red wine reduction of biographies. It’s the soap crud of a life. It’s something you can digest so that you can move ahead to the “point” of the chapter. It’s… kinda bad!

Yet, in days of diligent reading, I read chapter upon chapter of clinical psychologists introducing people the same way. The human beings described in these papers and books are people who have twice the number of years on planet Earth that I’ve had. But it all begins the same way, even with the best of the author’s intentions. A “core” reading for this class, for example, is written by a team out of the UK who appear to have suddenly discovered the power of storytelling as a therapeutic tool. Their enthusiasm and delight is lovely, but it troubles me. Their writings seem to exclaim, “Oh! Look what the old people did when we listened to them! It’s working!”

I mean, I’m really glad they’re doing this and that they have realised that it’s more than just a little special moment between a therapist and a client. I’m glad that people are now recognising that this is a real, measurable intervention to which both psychologists and medical doctors should pay close, serious attention. Still, I admit to rolling my eyes a bit. I’ve been doing this for years and I’m an undergrad. You people just figured it out? Really?

It seems a hopeless inevitability that we’re going to categorise people in an effort to reduce cognitive load. That is, our brains really don’t want to work that hard. We categorise and reduce other human beings to a snapshot, because, in short, our brains are Norms who cannot be arsed with complexity and full colour. That’s great and it keeps us from being overwhelmed, and maybe today I’m a bit saddened by all the readings because they’re full of people in their old age telling us that it’s lonely, it’s hard, our bodies won’t work properly, we can’t poop alone anymore and we can’t drive ourselves to get a burger. We had to give up our driver’s license, the nephrologist has told us we can’t eat burgers anymore, and what’s more, there’s nobody to get a burger with anymore, because they’re all dead.

Bleak, huh?

I guess the lecturers prescribe all these readings never actually expecting that any of the students are actually going to read them all.

I do wonder, though, if psychological science stands to improve its game a little on how we’re going to continue to frame old age and death and end-of-life care in our writings and textbooks. We keep attempting to teach ourselves not to describe the aged as “them”, as in, “us and them”, because the residents of aged care are us. As a speaker in a prescribed viewing thingo from my week 3 module says, “We were once our mothers; there’s no ‘us’ without you….” Despite always saying never to “us and them” anyone, we go ahead in the same breath, and do just that. Language is restrictive. Researchers focus on a sample. That is always going to come with categorisation.

For the uninitiated, the standard psychology degree is a real test of one’s command of English. I’ve joked more than once that I don’t have a psychology degree; I have a “formatting degree”. However, I do wonder that the strict style guides and research reports, while existing for good reason, don’t implicitly and concurrently teach us to view human beings from “other” categories to ourselves in a way that is cumulatively, collectively somewhat harmful, or at the very least, a restricted view.

So how do we break the habit? Tradition is very powerful, and the irony with psychological science is that it is just as prone to socialised effects as every other discipline. Food for thought.

R