There were two minutes left of the session and my patient went quiet and contemplative, her Jackie O look today, bobbing diamond earrings and claret nails.
She had not started the course of anti-depressants she’d been prescribed. When she said she’d changed her mind about wanting them but felt guilty, I said something like: “You feel it’s obligatory to take the drugs in order to please your GP?” She said she didn’t want to disappoint anyone, but that she’d asked for them in a panic.
Therapy and anti-depressants are a confusing area for me. When this lady is in a manic state she does present as quite unwell and I can see why the GP would have given her what she demanded. On the other hand, that was a five minute consultation during which she was at her illest. I see her once a week for 50 minutes and, in fact, she’s very rarely that anxious. It seems to me that she was fobbed off with drugs when really the gap between therapy sessions was feeling long and she just wanted someone to say: “It’s all going to be fine.”
I remember defiantly declaring to my psychoanalyst 16 years ago: “Maybe I’ll just go on anti-depressants or something!” I was needling him and I wanted him to say: “Don’t be ridiculous. Give this treatment time and let’s think together about your need for a non-reflective quick fix.” Instead he said, in a tone that I felt suggested he wished I’d bugger off: “Well, you do seem very anxious.” I felt dropped, evicted from analysis, and I’m sure he will have tried to interpet that and I suppose I ignored him. I took Effexor (unsayable without an American movie-trailer voice) for three months and enjoyed not being frantically anxious, but hated the chemical taste in my mouth and the emotional flatness. I didn’t really see how they were going to help me. The analysis, however, did… tectonically slowly.
I have another patient who keeps crashing off her anti-depressants in the belief that it will please me. Then she gets very unwell and thinks I’ll hate her for going back on them. She refers to them as “the tablets” and they have magical properties in her mind. She attributes all her…