Playing Games With The Vulnerable

It’s been a long time since I get unduly bothered about the reaction of people to Steven having a meltdown or just being Steven when we are out and about. Unfortunately though, and it’s one of the legacies of 2010, I still get very wary of how the professionals will spin Steven’s behaviour and general reaction to stuff for their own self-serving ends.

Yesterday, Steven had his six monthly appointment with the psychiatrist. I’d always been fairly ambivalent to his input until he was commissioned to perform Steven’s mental capacity assessment whilst he was at the positive behaviour unit. When we received the social work records prior to the court hearing, I saw the referral letter from the social worker to the psychiatrist and it couldn’t have been more biased towards the outcome that she wanted. The assessment itself, all 90 minutes of it, consisted of Steven repeatedly saying that he wanted to live in the Uxbridge house. Sadly, the 22 occasions Steven stated his need (I got one of the support workers to count it using a five bar gate system) were never recorded on the final report, which predictably concluded that Steven lacked the capacity to decide where he wanted to live.

Fast forward to the latest appointment. This psychiatrist is a games player and refuses to shake Steven’s hand on greeting. This really confuses Steven as his understanding is that whenever he meets someone he knows, he offers his hand and asks for a handshake. The psychiatrist won’t even acknowledge the request: he sits thumbing through his notes. Sometimes, in his confusion, Steven gets distressed by this refusal; sometimes he is able to take it in his stride. His distress seems to please the psychiatrist; he becomes more attentive and makes copious notes.

Not knowing how Steven is going to respond to this manipulative bollocks, I get pretty anxious before I’ve even walked into the room. How is Steven’s confusion and possible distress likely to be interpreted and recorded? And then what will Hillingdon’s psychologist and the positive behaviour team make of his report? A few years back, after the psychiatrist refused a handshake seven times, Steven got so upset he picked up a file that was sitting on the desk and threw it across the room. That incident was reported as “uncontrollable behaviour” and myself and the support worker “unable to set clear boundaries”. See what I mean – its dark stuff.

I have asked the psychiatrist several times if he wouldn’t mind shaking Steven’s hand but he then tries on the games with me: “It looks like the conflict increases your anxiety Mr Neary”. We’ve tried to explain to Steven that Dr S doesn’t shake hands, which he seems to understand as we prepare him for an appointment but upon arrival, hand shaking becomes a reflex action to him. Foolishly once I said that Dr S doesn’t shake hands as he has a sore scab on his hand. That made it worse as Steven was then determined to examine the scab.

Apart from that, we are in and out of the door in 15 minutes. It’s the same thing every time. Medication? Tick. Behaviour? Tick. Sleeping? Tick. Appetite? Tick. See you in six months. Steven, a support worker and a dad that is wet through with nervous sweat sidle out of the room.

Sad how some people get their sport.


4 thoughts on “Playing Games With The Vulnerable”

  1. well the level of understanding for our children is shocking with so called professionals , not only have i experienced this with my own two son’s on the spectrum also as a advocate for parents and children i have been feeling more shocked and disappointed on a daily basis . i will no longer subject my children to the NHS CAMHS , just had a letter through the post from them that is so wrong on all levels with complete incorrect information , for me that is the last i am only going private from here on out . The questions my children have been asked and how its been asked i could have just pulled someone off the street to do a better job .

  2. I am a “professional” and your account makes me so sad and angry. Just exactly why can’t this psychiatrist shake Mark’s hand?! I am so sorry you both have to go through this. I hope you find a more compassionate clinician soon.

  3. “It looks like the conflict increases your anxiety, Mr Neary.”

    “It looks like provoking outbursts affords you gratification, Dr. S.”

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