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Psychiatric Interviews for Teaching: Psychosis

University of Nottingham · 2,452 words · 12 min read

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0:13- Hi, Andy. Do you want to come on in and have a seat?

0:18I’m Dr Taylor; I’m the on-call psychiatrist for this afternoon. I got a call this morning,

0:23from your family doctor, because I think you went to see him this morning, along with your

0:26mum. And I gather that things have been a little bit difficult for you, you’ve had

0:29some rather distressing experiences. So I think your doctor thought it might be helpful

0:34for us to have a bit of a discussion about that, to see if I could help.

0:37Would that be alright with you?

0:39- That’s fine.

0:42- Would it be alright, Andy, for you to tell me a little bit about what’s been going on?

0:48- Well, you’re going to think it sounds stupid but my housemates are working for MI5.

0:56- Right. - And they’re… they’re doing stuff to my brain. - Ok.

1:02- And they’re… they’re out to get me. - Ok. That must be very difficult for you.

1:06- [mumbles] Yeah.

1:08- How long has this been going on for Andy? - About 2 months.

1:13- Right. And how did you first work out this is what was happening?

1:19- I came home one time and they had moved the,

1:23they’d moved the TV to the other side of the room.

1:26- Right -And I just, I knew then.

1:28- And what was it that you knew at that moment?

1:31- That erm… that they worked for MI5. - Right, ok, ok. So it’s been going on a couple of months?

1:38- Yeah, this new lecturer started at uni. - Right.

1:42- And he works for MI5.

1:44- Right. - And he basically drafted me housemates in,

1:48turned them against me.

1:49- Ok, ok. Now I’ve noticed a couple of times, while we’ve been talking, that you‘ve

1:54sort of looked round you, into the room as if you’re checking for something. Could

1:58I ask you what’s happening at those times?

2:00- Well I can… I can hear them talking about me.

2:03- Right. Who is it you can hear? - My housemates.

2:08- Right. So you recognise it as their voices? - Yeah, I can… I can hear them all the time.

2:12- Right. How many voices can you hear Andy? - Three, there’s three of them.

2:16- Ok. And do they sound real, like my voice sounds talking to you now?

2:21- Yeah, it’s odd. It’s… it’s like I can hear them when they’re not here.

2:27- Right. So when they’re not in the house with you?

2:30- Yeah, it’s like… Yeah, like they’re in the other room or something.

2:34- Ok, ok. And can you hear what they’re actually saying?

2:37- Yeah, they’re talking about me.

2:38-Right, ok. -They’re always talking about me. - Ok.

2:42-They’re always commenting on everything that I’m doing.

2:45- Right. Can you give me an example of what they would say?

2:48- Well like if I’m packing my bag to go to uni or something they’ll be,

2:52they’ll comment on that like

2:53- Right. - ‘he’s left the house now’, or… you know.

2:56- Ok. Anything else? Do they ever talk to each other, perhaps, about you?

3:00- Yeah, that’s what they’re… and now they know… they’ve sort of… they’ve

3:05sort of twigged that I know about them.

3:07-Right. - And they’re saying, like, I’m making

3:11trouble - Ok.

3:12- And that they’re gonna sort me out.

3:17- Ok, ok. What about actually talking directly to you, in the way that I am talking to you

3:21now? Does that ever happen Andy?

3:23- No.

3:25- Ok. So you’ve been hearing the voices of your housemates, have there been any other

3:29changes? Have there been any changes, perhaps, to the way you’re thinking? Sometimes people

3:33tell us that their thinking changes in some way – so for example, they might feel that

3:38they are getting thoughts put into their head, that aren’t their own. Have you had any

3:41experiences like that?

3:44- Yeah. I do think things that, that aren’t me.

3:50- Ok.

3:51- Like the putting thing… they’re putting stuff into my brain… it’s not, it’s

3:55not me. It’s not, I’m not thinking…

3:57- So different thoughts in your brain?

3:59- Yeah. It’s like… it’s stupid stuff as well. It’s like the other day I suddenly

4:04started thinking about some woman in Coronation Street and I don’t watch any of that crap.

4:07- Right, right. It’s not your kind of thing normally? Right.

4:09- They’re not… they’re not my thoughts.

4:11- Right, ok. And do you have any idea how that’s happening? Or who’s responsible?

4:16- It’s MI5. It’s this chip they’ve put in my head.

4:18- Right, ok. - And I… I can feel it all the time.

4:24- Ok, ok. So, so you’re getting thoughts put into your brain that aren’t your own.

4:29What about a different sort of experience, what about the experience that somehow other

4:33people are able to know what you’re thinking, even though you haven’t actually told them?

4:37- No. They’re… no. - Nothing like that?

4:39- They’re just putting stuff in my, my head.

4:40- Just putting stuff in… and can I just check Andy as well, that you’re not getting

4:43the experience when your thoughts just stop all together? Like you have no thoughts left?

4:47- No. If anything there’s too much in there. I wish I could unplug it.

4:52- Ok, ok. - Just get this thing out of my head.

4:54- Right. And you mentioned this, this chip, or this device in your brain, do you want

4:57to tell me a bit more about that?

5:00- Well it’s… it’s a tracking device - Right.

5:03- So they know where I am at all times.

5:05- Right. - I can feel it moving round, like rotating round.

5:08- Ok, so you can feel the physical sensation in your brain.

5:10- Yeah, yeah.

5:11- Ok, that must be very difficult for you. - I don’t- I don’t know why they’re

5:17doing this to me - Right, ok.

5:18- I’ve done nothing wrong.

5:19- Ok, ok. Can I just check - are there any problems Andy, with the rest of your body?

5:23Any changes in sensation or any bits that feel different in any way?

5:28- No, I feel fine. - Right.

5:30- I’m not ill or anything.

5:31- Ok, ok. - I just want this thing out my head. - Ok

5:36- It sounds like a very difficult time for you. Can I ask you Andy, how are you coping

5:40with all this? How is it affecting you?

5:44- Well, I’ve not been leaving my room much. And, so I have to wait until they go

5:51out, just to go down and get some food but...

5:54- Right, right. - They’ve been doing stuff to my food now so I…

5:56- Right, ok. What do you think is happening to your food?

5:59- They’re, they’re poisoning it.

6:01- Right, ok. Are you actually eating much at the moment?

6:04- No.

6:05- Ok. Now with all this happening – it sounds like you don’t feel very safe. Have I got

6:09that right? Ok. Have you felt the need, I don’t know, to take steps

6:14to protect yourself in any way?

6:18- Well, I’ve, I’ve got a knife. - Ok.

6:23- And I’ve got like… a baseball bat.

6:27- Right. - It’s just in case they get in my room, I just... - Ok.

6:31- I don’t want to hurt anyone but I just feel like I’ve got to protect myself,

6:34it’s like, like they’re cornering me to do this.

6:38- Right, ok. Have you felt the need to use either the knife or the baseball bat, so far?

6:44Take it out with you for protection?

6:46- No. No, I don’t want to get caught. - Ok, ok.

6:50- No, no. It’s just in my room.

6:51- Ok. Has it ever got so bad Andy that you’ve felt the need to hurt yourself, or even kill

6:56yourself? As the only way out - the only way of coping with this?

7:01- Well I, I thought about getting some pills but I couldn’t, I couldn’t leave the house.

7:09-Right. - So I didn’t, I didn’t get anything.

7:12- Right. And when you say about getting some pills – would that be to take

7:13an overdose of tablets? - Yeah.

7:17- But you’ve not actually done anything about that so far?

7:20- No.

7:21- Ok. In the past have you ever had any problems either with your temper or getting into fights,

7:26being aggressive either with your housemates, or anybody else?

7:29- No, I’m not that kind of person. I don’t want to, I don’t want to hurt anybody but

7:35they’re just driving me to this.

7:37- And can I just check again, you’ve not been in trouble with the police, or anything like that?

7:41- No, never. - Ok. With all this that’s going on, is

7:45there anywhere at the moment Andy, that you feel safe?

7:51- Yeah, my parent’s house. - Right, ok. And have you seen much of your

7:55parents recently?

7:56- Yeah. I thought about going back there but I, I don’t want to drag them into this.

8:01- Right.

8:02- I don’t want MI5 knowing about them. - Right

8:04- And throughout this last couple of months, when you’ve had all these worries,

8:07have you ever worried that your parents might, in some way, be involved in this conspiracy?

8:12- I thought about it – but no. - Ok, ok.

8:20- Can I just check out a couple of background things with you Andy? Your general health

8:24is that ok? You’re generally fit and well?

8:27- Yeah, I’m. I’m not ill, I don’t - there’s nothing wrong with me.

8:32- Ok. - It’s just this thing in my head.

8:33- And you’re not on any regular medication from your own doctor, at this stage?

8:37- No, I don’t take any pills. - Ok. What about other drugs – and by that

8:41I’m meaning alcohol, cannabis, pills, anything else?

8:43- Well, I don’t, I don’t drink much alcohol. - And what about drugs like cannabis?

8:52- Is my mum going to know about this? - No. It’s important that I hear about this.

8:56This wouldn’t be something that we would be discussing with your mum.

8:58- I smoke a bit of weed. - Ok. Would that be regular use or most days?

9:04- Yeah.

9:06- And how much would you be spending on weed?

9:08- I don’t know – I get like a… I get like a ‘ten bag’ and it lasts me a day or so.

9:15- Ok. So you have a ‘ten bag’ lasting you a day, of weed. Any other drugs? I’m

9:19thinking in particular, things like speed or, or pills.

9:26- Done a bit of speed. - Ok. Is that on a regular basis Andy?

9:30- I’d just go out with my mates at the weekend and we’d do a bit but…

9:35- Ok. When was the last time Andy that you would have had any speed?

9:40- About a week or so ago. - Right, ok. Any other drugs at all?

9:45- No… no. But I know what you’re getting at though – it’s not, it’s not the drugs.

9:54- Right. - This is… It doesn’t matter how out my

9:57face I get. - Yeah.

9:58- This is constantly there, it’s always there.

10:00- Ok. I guess the reason why I was checking, I think that’s what you’ve picked up on,

10:03is that sometimes when people are having the kinds of experiences that you are – they

10:07find that if they take certain drugs it can make things feel a lot worse. I just wanted

10:11to check that hadn’t been your experience?

10:15- No. - Ok, ok.

10:19- I appreciate from what you’re saying that you’re really very worried about this MI5

10:23conspiracy and that that’s the cause of the difficulties that you’re having at the

10:26moment. I just wanted to check with you - do you think it could be due to anything else?

10:32I mean - I’ve obviously met people who have had similar experiences and sometimes they’re

10:36extremely stressed, some people might be actually mentally unwell and just whether any of these

10:40things might be relevant to you at the moment?

10:44- No, because I’m not ill. - Right.

10:47- It’s them. And I’ve read books on this as well, I don’t… the government know about them.

10:52- Right. - They know that they do this to loads of people. - Right, right.

10:54- And I don’t know how they can get away with it.

10:56- And I’ve done nothing wrong – I don’t know why they’re doing this to me.

10:58- Ok. - I just want – I just want it to stop.

11:02- Ok, sure. And I think I can appreciate that. I guess what I’m wondering is whether you

11:05think there’s anything that someone like me might be able to do to help you, as a doctor?

11:09That sometimes meeting someone like a psychiatrist, or having medication or for some people even

11:15coming into hospital, for a short time might be helpful. Do you think any of those things

11:19would help you at the moment?

11:21- I don’t… I don’t know. I mean… I’m only here really because of my mum.

11:27- Right. - I tried to… I don’t want to worry her.

11:31I’ve tried to talk to her about it.

11:32- Yeah.

11:33- And she doesn’t understand, she doesn’t really believe me. I mean… Do you believe me?

11:41- Well I certainly believe Andy, that you’re having a really difficult time at the moment.

11:44I guess, what I’m not as sure about is what’s causing this - I’m less sure that this is

11:48due to MI5. I guess what I’m wondering is that perhaps you’re not as well as you might

11:52be at the moment. I mean, we’ve been through a lot of questions and what I’m thinking

11:57is we need to try and come up with a way of supporting you through this. So I’m wondering,

12:00because I know your mum is… I think she’s waiting in the waiting room. It might be a

12:03good chance now to get your mum in and then perhaps the three of us can put our heads

12:07together, have a bit of a discussion about where to go from here and try and think of

12:12getting you some proper support. Would that be alright if I got your mum in?

12:17- Ok. - Ok. If you want to sit there then Andy,

12:20I’ll just get your mum, ok.

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