IntroductionThe interaction that was recorded was with an 81 year old Caucasian female, referred to as X. X. The main diagnosis with this particular individual was a combination of psychotic disorder, severe depression and hallucination. At an Axis 1 level, the patient was defined to have psychotic disorder. Axis II, the developmental disorders, were deferred. Axis III, had no physical conditions that related to the state X X was in. Axis IV, was unspecified, with no psychosocial disorders that could be specified. Axis V, the highest level of functioning for the patient, was 35/45.
The psychiatric unit visited was a lock in facility in which X. X. was admitted to. X.X met with me in her room to talk with me as a visitor. There was continuous assistance available to those in the area from nurses, as well as other patients who were more sociable in the area. The goals set before this interaction was to get to know about X. X and the specific disorder she had. This included the ability to interact and understand the psychosis and level of hallucinations.
This goal also included the ability to learn to communicate with an individual who had these specific types of disorders and what this meant for the client. Understanding how therapeutic communication could work with someone suffering from psychosis disorder and hallucination was the main concept linked to this. The next goal that was set before meeting with the client was based on the desire to have a clearer understanding of the clients psychosis disorder by gaining information about the client or their past. The thoughts and feelings that I had prior to the interaction that occurred were a combination of being nervous and excited.
Interacting with a patient in a psychiatric ward is a new experience to me and caused me to have several questions about what would happen when meeting with the client. This was combined with only a slight understanding on how the client would behave or act, which caused more of a sense of nervousness. Because one of the goals was to understand therapeutic communication at a different level, I was also cautious of how I dealt with X. X and wanted to make sure that I was able to interact correctly when meeting with the patient.
InteractionThe first interaction with X. X was based on the patient talking to the wall, specifically with stating that she saw her husband having a heart attack. This was known to be caused through hallucination as well as depression. This was combined with the fact that X. X did not receive sleep for the past two days. Because of the hallucinations it was difficult to define communication strategies with the patient. After a brief introduction, empathy and silence were the two main components used.
As the client continued to talk of the hallucination that was seen, the interaction became lessened. X.X continued to move into her state of seeing her husband dying of a heart attack. The more this occurred, the more she was tied into interaction with the wall, while all communication between the patient and myself were lessened. If the patient was able to slightly come out of the hallucination, it was only briefly. During this time, the response used was empathy for the patient during the interaction.