Relationship is Key to Communication

Checking for something on my GP record I came across the report from my recent psychiatrist review. I'm not normally under a psychiatrist but everyone under mental health services is offered a psychiatrist review after having a baby. This means the psychiatrist and I hadn't met before and didn't know each other other than them having read a brief summary of my medical notes.

At the time I was aware there had been some gaps in our communication but over all I had a neutral feeling about the experience - it happened and it wasn't particularly significant. 

When I read the report I realised the size of the discrepancy between what was received and my experience.

The more I think about it the more I realise how much less than optimal that appointment was. It wasn't anybody's fault, but it made what could have been a useful checkpoint into a box-ticking exercise.

I am aware that I wasn't doing my best communication on the day. My brain function was a bit compromised and my emotions were offline so I didn't even think of some of the things I could have expressed (like how the matter of what therapy I may or may not be getting has been going on for about a year and is driving me mad). 

Some things I might have wanted to say two weeks previously didn't seem important because they had faded as my priorities changed and my perspective skewed. Other things I tried to communicate but obviously didn't quite succeed at.

If I lived a few miles up the road I would have known the psychiatrist. I have practised communicating with that one. I have developed ways to tell her the most difficult of things and get round the troublesome bits of my brain. She is familiar with my idiosyncratic style of communication. And there's simply the fact that she knows me and would have been able to tell just by how I was presenting that I wasn't doing great.

I know that my situation is perhaps unusual in that I don't know my local psychiatrist and I do know the next-door one, but the point I'm getting at is the importance of relationship in communication. Especially for people whose communication is not "typical" or who appear to communicate fine but actually might not.

It wasn't anybody's fault - I could have communicated better but wasn't really in a state to do so, and the psychiatrist could have helped me more but she didn't know me so she didn't know there was anything to help with or how to help. 

But reading the report showed me that even what I thought I was communicating or tried to communicate hadn't reached its target effectively and that the gap between us was bigger than I had thought. Even things I had corrected on were still written wrongly. The group I mentioned in my previous post had a session on effective communication last week and one of the features highlighted was relationship. I've noticed it before in my post about continuity of care and here it pops up again. I think the frequency with which it appears means it's important. Not always possible, but important.