The Hostile Nature Of Some Psychiatric Patients
You will find that there any many psychiatric patients who have a hostile nature. If things don’t go their way, they will take it out on you if you catch them at the wrong time of day. There are many reasons for this: they may be disorganized, psychotic or have a personality disorder such as narcissism or antisocial traits.
These hostile patients are extremely difficult to work with, because they won’t allow you to get close to them on a personal level. On the one hand, you want to help them to overcome their symptoms and get discharged; on the other, you feel threatened and start to lose interest in helping them.
Persistence is key with these patients, but at the right time. If you keep insisting on meeting with them on a consistent basis without spacing out your requests, they will only distance themselves even more from you. They may even start to verbally or physically threaten you.
The threats make no difference, because you can always inject them with an antipsychotic or anxiolytic. But you don’t want to develop a relationship that revolves around hostility and injections; this won’t help the patient in the short or long run. You are there to establish a therapeutic alliance with the patient.
It can be very frustrating to observe hostile patients defeat themselves in their own treatment. But one has to understand that sometimes their mental illness is so bad, that their judgment becomes way too clouded. With a poor judgment and a shaky insight, it also becomes more difficult to establish a therapeutic alliance.
But patients also need to understand that psychiatrists are there to help them; we are not their enemies or punching bags. Without our help, patients are only cornering themselves into a deeper hole. Deeper holes never turn out with positive results. Therefore, patients need to take it easier on their psychiatrists and allow themselves to be helped.
But it’s also important to keep in mind that not all psychiatric patients can take it easier on their psychiatrists. Many are too psychotic to make such a decision, even if their personalities do not align with their oppositional behaviors. It’s important for a psychiatrist not to forget how a mental illness can influence a patient’s reaction towards them.
Both parties bring important contributions to the table: the patient provides their insight into how they view the world and their illness; the psychiatrist provides his knowledge and understanding on how to better help the patient. It’s a win-win situation when both parties cooperate and form a strong therapeutic alliance!
Are you Ready? (This is Defeating Stigma Mindfully)
DSM (Defeating Stigma Mindfully) 