I Shadowed Psychiatrists for a Month

Content Warning: this blog post contains mentions of drugs, substance use and abuse, mental illness, suicide, historical trauma and genocide (but please read on if you want to learn about my Winter Term project which wasn’t as scary or heavy as the content warnings might suggest)

In the Fall 2018 semester, trying to come up with a Winter Term project was a big source of stress in an already stressful semester. On paper, Winter Term sounds great: a month to yourself to pursue any project you want in the name of experiential learning! In practice, though, before this year, I wasn’t sure I actually liked the idea of Winter Term. There can be pressure (self-imposed or otherwise) to come up with a meaningful project, and the transition from Oberlin to Winter Term back to Oberlin can be jarring, at least for me. This attitude partly has to do with my experience last Winter Term. Last year, I spent the month at home teaching myself a lot of German, and while I did learn a lot during that month, I also felt isolated, lonely, and depressed. To be fair, I did a very bad job of getting out of my house, but most of my friends were out of town, and my parents and sister had work and school, so a lot of the time it was just me alone in my house with a neurotic German Shepherd foster dog as my only companion. 

HOWEVER. This year, I have a renewed appreciation for Winter Term. I spent the month at home again, this time shadowing various psychiatrists affiliated with the University of New Mexico, where both my parents work (having connections is great). Since I’m majoring in psychology and want to go into mental health care someday, this past month provided me with a very unique opportunity to observe mental health practitioners in a way I initially didn’t think possible. I observed Telehealth clinics (remote therapy provided over video technology) and rode alongside psychiatrists from the Assertive Community Treatment (ACT) Team, a group of psychiatrists, nurses, psychologists, and social workers who conduct home visits for people with severe mental illness. I also did some supplementary reading: articles and parts of a developmental psychology textbook. If you want more details about what I did during this past month, I wrote a Winter Term specific blog that you can access here: https://rbiebers.wixsite.com/wt-2019 

Besides being forced to leave my house, seeing an actual meth trailer on my first day of work (yay Albuquerque?), and interacting with strangers who know a lot more about mental health care than I do (every other student I shadowed with was a medical resident), this Winter Term gave me a lot of insights I didn’t expect to leave with, and was really rich and valuable for a lot of reasons. For one thing, as I’ve already alluded to, I was reminded about how effective experiential learning is. I have yet to take an abnormal psychology class in college, so there was a lot I didn’t know about mental illness in terms of diagnostic criteria. Because of this limitation, I’m sure there were things in the patients I observed that I could have looked out for but didn’t know to. That being said, learning about different mental illnesses by observing actual people was far more valuable than learning about disorders from a textbook. Textbook learning can be important but learning through observation meant that anything I learned stuck with me so much more. The things that I saw in the patients—their symptoms, their concerns, their ways of processing and their goals and desires—were so much more real, relevant, and memorable. 

The other wonderful thing about my project was that it didn’t go in the direction I expected. What’s this, you say? Ruth is glad that something didn’t go EXACTLY to PLAN? Why, yes! It’s true! I value unexpected moments of learning more than I love my Google calendar! All jokes aside, I learned things this month that I did not expect to learn. So, while I did learn all about things like the Telehealth and ACT Models, and about psychiatric medications and conditions and disorders like Autism Spectrum Disorder, PTSD, depression, anxiety, schizophrenia, schizoaffective disorder, psychosis, etc., the most valuable thing I learned about was historical trauma. 

One of the articles I read (by Maria Yellow Horse Brave Heart, a nationally renowned Native American scholar, who I had the privilege to meet) defined historical trauma as “…cumulative emotional and psychological wounding across generations, including the lifespan, which emanates from massive group trauma.” 

Now, as a privileged white person who has never really experienced oppression, I am lucky that I didn’t have to know about historical trauma. I have never experienced its brutal effects. I got to learn about it from an outsider’s perspective and didn’t have to perform any emotional labor when I learned about it. Still, it made me really upset. I come from a state with a profound history of oppression, colonization, and genocide of indigenous peoples by Europeans (mostly Spaniards). I know about New Mexico’s past but before this Winter Term I wasn’t aware of this intersection of history and psychology. What I learned made sense, but it also shocked me; and it shocked me because I come from a place of privilege. 

Those who are victims of historical trauma exhibit a psychological and behavioral Historical Trauma Response (HTR). Some visible and related effects of HT on American Indian and Alaskan Native (AI/AN) populations include the following: 

      ·  AI/AN populations rank higher for health disparity than any other ethnic/racial minority in the United States

      ·  Alcohol-related deaths are 5 times more likely for Native Americans than for white people

      ·  Suicide rates among AI/AN groups are 50% higher than the national average 

      ·  AI/AN communities experience heightened depression rates, PTSD, interpersonal loss, unresolved grief, alcoholism and other forms of substance abuse, lower life expectancy, and so on.

I don’t want to fill this entire blog post with facts about historical trauma, because it could turn out to be very long indeed: but here is a link to the blog post I wrote about historical trauma on my Winter Term website. 

So, TL:DR, I didn’t think I would learn about historical trauma during Winter Term, but I did, and learning about it was incredibly important because I know now that it is extremely important to understand my positionality and the culture and identity of any patients I might treat one day.

The three biggest take-aways from my project are as follows:

1. I feel affirmed in my career goal of working in mental health. However, shadowing psychiatrists this month has taught me that I would prefer to be a psychologist, not a psychiatrist. Managing medications and symptoms is very important, but I’m more interested in working on the deeper, more personal aspects of a person’s life or mental illness. Both careers are important and needed, but this Winter Term gave me some clarity about the direction I want to go in with my career. 

2.  I was reminded of the importance of empathy in the mental health care arena, and also of the importance of self-care on the part of the practitioner. Being a mental health practitioner is draining work mentally and emotionally and achieving balance and taking care of oneself while also taking care of patients is a tricky thing to navigate. This is something I will be mindful of if I pursue a career in mental health care. 

And, number three, the most important: 

3.  I understand better the legacy of historical trauma and the importance of culturally informed and culturally sensitive health care. New Mexico in particular is a state with populations deeply affected by historical trauma. Despite living here my whole life, I didn’t have a good understanding of the lasting psychological effects of colonialism and genocide. But now I do. And while I am sure that I have only just begun to understand the true devastation of historical trauma, I have learned that understanding it, and practicing healthcare that takes into account the culture and identity of the patient, is paramount. 

To sum it all up, I had a great Winter Term. It was hard at times, but I learned so much and this was a very special opportunity for me. This type of experience is what I imagined when I thought of ‘Winter Term’ as a prospie. Now that I’m here, I have a renewed appreciation for the value of Winter Term and I’m excited for Winter Terms to come. 

With that, I hope everybody enjoyed their Winter Terms, and good luck with the Spring Semester!