transabled.org

• About
• Login
• Contact
• Accessibility

Home / Thoughts / Sean's Thoughts / Discussion With a New Psychiatrist: BIID and Depression

Discussion With a New Psychiatrist: BIID and Depression

Written by Sean on Friday, September 26, 2008

Last month, I met with a psychiatrist as referred by my GP. He was a locum, only there for a few weeks, and has since left. He recommended I meet with someone else and made a new referral. I went today and met this guy. He is an older gentleman, with a soft voice and a foreign accent, though I was unable to place the accent. I am feeling rather ambivalent about this meeting. I’m not filled with confidence that much will come out of it, yet, I am trying to keep an open mind.

The first sign that things were perhaps not all that good was that when I showed up at the appointed time, I heard the receptionist tell the doctor that I was here, but that "he is in a wheelchair, he can’t get to your office on the second floor". As if it was a surprise. Yet it shouldn’t have been a surprise. The original referral my GP sent to the clinic mentions the fact that I use a wheelchair 100% of the time. My previous two visits to that clinic were done as a wheelchair user. It should not have been any great surprise there…

The second sign that things were perhaps not as good as they could be was that the shrink was a guy. I was expecting, and hoping for, a woman. My GP originally specifically referred me to a woman. I don’t like working with men in therapy. That might have to do with having been sexually abused by a male therapist when I was in my teens…

Anyway…

The visit began by him telling me that my GP had referred me there, and asking if I knew why. I said that I did indeed know why, that there were two issues: depression and Body Integrity Identity Disorder.

He asked me many questions about depression, and history with my parents. He asked questions about BIID.

I asked him if he’d worked with people with BIID before. He said "yes, a long time ago". That surprised me. I didn’t push. I asked if he’d read anything recent about BIID. He hadn’t. That did not surprise me, at all.

During this initial discussion of BIID, I compared the condition to Gender Identity Disorder, GID, saying that the experience of a transsexual is similar in many ways to that of a transabled person (though I didn’t use the word transabled with him). I have no idea how he translated that into "I’m gay", but later in the conversation he was surprised that my partner is a woman. He asked if I was gay or bisexual. I pointed out that I was heterosexual. He looked at me and said "so you are saying you are straight?". Geeesh, how many more ways must I say it?!?

He pointed out that apparently more than 50% of post-op transsexuals regretted doing the surgery. That’s quite possible. But I remember reading somewhere that the high number of people who regretted it were mostly due to them skipping steps in transition and going straight to black market surgeons, or idiotic psychiatrists that didn’t know what they were doing.

At one point he asked if I thought I convinced myself I needed to be paralysed because I needed to punish a body I did not like. An interesting thought, but it doesn’t feel like the right answer. In any case, it’s not a question of needing to punish my body because I don’t like it. It’s not that I dislike my body, it’s just that it feels alien! I know my body is perfectly "normal" (whatever normal means).

He asked about my involvement online, and what it meant to me. I said that I had many reasons for staying online. First, it’s good to be able to bounce ideas off with peers, other people that feel like you do, and understand you. Second, blogging really allows me to sort my own thoughts about issues. These long rambles I have are my way to process my thoughts. Finally, I experience positive reward when people drop me a note and tell me that my work has helped them. In helping myself, I help others, and by helping others, I help myself.

He asked if I didn’t think that being in touch with you guys kept me focused on BIID so much, and that you were just keeping me tied and "obsessed" with it. I said no. Cutting all contacts with the only people I can share these things and discuss my feelings with people who *get it* is the last thing I need. I was cut off, isolated for 17 or 18 years of my life, battling these issues, and working with therapists at the same time before I ever was online. Not being in contact is NOT the answer.

He suggested that maybe there are people who have managed to beat BIID without surgery, but that we haven’t heard of them because they disappeared, left the community. I fully accept that possibility. But I think it is just as likely that there is high number of people who managed to acquire an impairment, which resolved BIID for them, and once they had the impairment, they did not need the community anymore, so they left and we never heard from them again. Or they simply were never part of the community to start with.

He also suggested that the people who have gotten amputations and say they are happy may be fooling themselves, because it is irreversible and they must be happy with their action instead of accepting they did such a big "mistake". Well, I know a few of you lot who have become amputees, and if you’re deluding yourselves that it was the right thing for you, you’re also fooling me!

He seemed dubious when I explained that I did not think there was a solution for me outside of surgery. He seemed to dismiss any of my previous work with other psychologists, psychotherapists and psychiatrists. That annoyed me.

He said something to the effect that finding the solution isn’t that difficult, we "only have to find why you feel that way in your subconscious". That annoyed me more, and made me feel very….. small? Like what I had done to date wasn’t done well, wasn’t worth it.

He asked me if I was thinking of self-harm or suicide. I said I often thought of suicide, though I did not want to die. I talked about my suicide attempt all these years ago. I did not talk about the fact that if there was a safe way to become a para, I would self-injure here and now! If he knew that, he’d probably section me. He can section me all he wants, it won’t make one iota of difference. If they aren’t prepared to keep me for the entire rest of my life, then they might as well not bother at all.

He suggested an adjustment to my anti-depressants, which I agreed to. He did not bring up the use of anti-psychotics, and nor did I.

He said that my case was "unusual" and that he wished to consult with his colleagues. They do case reviews on regular basis, and he would like to present my case, and me, to his colleagues. But their calendar is very full, so it might be a long time before it may happen. <shrug> Whatever. Psychiatry hasn’t sorted me out in the last 20 years, I can’t see how it would suddenly make a difference whether a few more months make a difference.

He further informed me that in that clinic, I would probably not be working with him (no great loss), as psychiatrists only work with the really difficult cases like psychosis, bipolar and schizophrenics… I was thinking "What am I, chopped liver?". Ok, so I’m not psychotic, I’m not manic-depressive, and I’m not schizophrenic. But to just dismiss me on to a psychotherapist because I have BIID which is not deemed "important" enough, or "serious" enough? Clearly this man has *no* idea of the impact of BIID in my life. I’ll have to educate him, like I had to educate so many other mental health professionals. It’s starting from scratch all over again, and again, and again, like pushing the proverbial rock up the proverbial mountain…

But I’ll play, I’ll meet with a psychotherapist if the psychiatrist thinks it’ll make a difference. We know it’s highly unlikely to, it’ll be exploring old ground. But it’s possible, just possible, that some new insight might come up. And mostly, well, it shows willingness to play their game, and eliminate a possibility after another. Perhaps some day, someone will get convinced.

He did say one interesting, as we were discussing depression and its relationship to BIID. He said that he thinks that if we manage to take care of BIID, depression will take care of itself. Interesting thought.

Oh well, stay tuned on this one folks, it’ll be a while before I report any change.

Tags: Anti-Depressants, Anti-Psychotics, BIID, Depression, Paraplegia, Psychiatrist, Psychotherapist

Twitter Updates

Follow me on Twitter