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BM94

Saw my GP today - interesting!

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Hey everyone, 

So I booked myself in for a consultation with my GP this morning, explained to the receptionist that is was mental health related and she got me in on an early slot.

I saw my GP, and explained to him everything relating to my OCD and intrusive thoughts. I explained how sometimes I felt experiences of 'urges' when in triggering situations, and my avoidance, and all about my compulsions, of course alongside the harmful thoughts I was experiencing (and there are many!!).

He sat there and typed everything out that I was saying, giving me confused looks every now and again between his typing. He then proceeded to ask me "Do you think you pose an imminent threat to others?" - which was bloody fantastic! He then went on to say "When you're in your triggering environments, do you feel the desire to hurt someone?".
Oh and then he went on to say "I have OCD too where I would feel like I need to empty my dirty water bottle and wash it out and then fill it up again. It then resolves for me and I'm happy again". I was getting more and more irate, so I said "so you clearly don't have OCD then" etc etc, and then I asked him how much he knew about Intrusive thoughts relating to harm. It went on very much like this.
His element of confusion, him quizzing me on whether I thought I would go out and kill someone, and then telling me he will refer me as urgently needing to see the mental health access team due to me posing an "imminent risk to self or others".

Just wanted to share this, clearly there is still not enough understanding of the issue even by GPs. Self referral maybe is the way forward until current mental health campaigns start influencing the NHS.

Is going private a better idea do you think? But then you need the money for it..

Such a pickle!

 

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I agree there is not enough understanding of ocd with many professionals in my experiences.

I feel like I am banging my head against a wall sometimes and I feel i know more about this condition than the person your are pinning your hopes on helping you.

You sometimes go online and you read columns from experts who do get what ocd is all about, trying to get someone with the knowledge and the experience in dealing with ocd sufferers has alluded me and it just feels demoralising.

Going private or through the NHS I believe would make no difference if you don't find the right person, hopefully things may change in the future or even better, advances in treatments or medicine.

Edited by stanwee lee

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On the bright side, at least he didn't tell you to

"Pull your self together"

To be fair a GP is just your access point to sevices, he probably can't do open heart surgery either, but I bet he knows some one who does.

Hopefully the people he refers you to will have seen it all before, and act appropriately.

On a more general note, it is disappointing, that a GP is pulling the, "little bit OCD" bit.

You would have thought they had to do a "mental health for dummies" type course, to keep them up to date.

Maybe he will read up on things now he has a real person to deal with, and be better informed next time you see him .

I had the occupational health nurse at work give me the old, "lots of people like to keep things tidy", but bless her next time I saw her she had all the info, and even had been reading up on mental health problems in my specific job.

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I am seeing a GP on Tuesday to consider where we are with my OCD as I have been struggling badly last two months. 

I have the same issue with harm OCD. When with a specialist they understand, GPS don't. 

Yet harm OCD is very commonplace. 

I presume GPs are required to do continuous professional development. 

A module on the essentials of the common types of OCD seems badly overdue. 

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It makes you almost want to have a checking magical thinking or other type of OCD. 

But no type of OCD is good :(

 

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I totally agree, there just doesn't seem to be any regular training for this.

You'd think that if most companies are obligated to have their employees complete e-Learning modules on health and safety or safe manual handling, the GPs would need to have some kind of CPD training for mental health disorders.

It didn't throw me into more worries than God, but it just disappointed me where at the very least I wanted a doctor who was sympathetic and supportive. Instead he's worrying about threats I pose to other people.

Let's hope this improves soon, I've said this before but I truly wouldn't wish OCD on my very worst enemies!

1 hour ago, taurean said:

I am seeing a GP on Tuesday to consider where we are with my OCD as I have been struggling badly last two months

I hope your GP consultation goes well on Tuesday taurean!

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I don't have the greatest hope about this, the last time I needed to see a GP about this I had such difficulties as you with less experienced doctors. 

But I do have in my corner OCD-UK. 

Why am I going? I have experienced a bad relapse after a really good two year period. So I want to see if a change of meds, maybe the addition of antipsychotics might help. 

But I doubt the GP will understand the stepped model on the NICE (National Institute for Clinical Guidance) model for treatment of OCD, which allows for such consideration and augmentation of treatment. 

My financial circumstances are such that I can again, if need be, go privately for more treatment - since 2001, when needed, I have gone for CBT treatment privately, initial through my firms medical insurance, then on my own when cover limits were reached. 

I may need to refer to a private psychiatrist specialising in OCD to try adding an antipsychotic drug if considered worth trying. Or switch SSRI. 

 

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Hi BM94

Your GP was following a checklist of questions pertaining to mental health. Your account of your problems triggered a routine. As Closed for Repairs indicates the GP is a generalist as the name implies. In other health services such as the Germanic you see a specialist at first point of call. The same applies for accident and emergency. In Salzburg in the emergency clinic I was immediately seen by an  an ENT specialist  when I had a hearing problem with near complete deafness in one ear. I have a similar problem when seeing NHS staff about my diabetes. The staff, especially if non specialists, follow a script. If you can manage it, for both physical and mental problems see a specialist or go to a specialist clinic. It is an organisational problem as much as a problem of a lack of knowledge of a GP. We need to compare our health service with other European models. And learn from them

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3 hours ago, Angst said:

Your GP was following a checklist of questions pertaining to mental health. Your account of your problems triggered a routine

Thanks for your input Angst.

Here's my one issue with this though, there was no mental health checklist he was going through, they were repeated "but do you think you have hurt someone then?" Or "do you think you will go and hurt someone?", and then he demonstrates a confused (and quite frankly concerned) response which I'm not going to lie made me feel uneasy talking to him further.

There was no script I'm afraid, just a 'let's just ask that you're not gonna go and kill or sexually assault someone today and then refer you to someone who deals with this kind of thing'. 

That's what is disappointing I think, I'm having enough trouble with OCD making me question my own thoughts, memories, sanity... to then have to confirm for the doctor that I haven't actually done anything. It's just counterproductive.

Just a bit of compassion and support from a GP when you take your first steps to healing would go a long way, that's what I would fundamentally like to see changed at this point. The specialist help can then follow.

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I'm really sorry that you experienced this @BM94. I personally had a horrible experience when I first sought help for my OCD, I have the same issue as you (mine is about self harm), I didn't know I had OCD and went to see a university counsellor who completely panicked and thought I was going to hurt myself. It was the worst thing he could have done and it's not until I got to see a psychiatrist that I actually got a diagnosis and then saw a specialist that helped me. So, I am very careful about what information I reveal to people, especially GPs because I don't think many of them understand. I usually give minimal information until I am referred to a specialist and then I know I can tell them anything without them freaking out about it. 

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15 minutes ago, malina said:

I usually give minimal information until I am referred to a specialist and then I know I can tell them anything without them freaking out about it. 

I think that is probably good. I am not sure how my appointment will go, but OCD has been on my records for 19 years so that may help. 

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I think malina is right. In the context of a GP visit, I always try to visit the same sympathetic person. It is not just an issue of knowledge, it is also an issue of sensitivity.  The advice to give minimal information is sound. GPs are gatekeepers to specialist services. The goal is to get a referral. GPs don’t do cognitive therapy. 

Edited by Angst

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1 hour ago, taurean said:

I think that is probably good. I am not sure how my appointment will go, but OCD has been on my records for 19 years so that may help. 

Roy, I'm really sorry to hear that you are struggling. Just know that you have given all of us such incredible advice. Your help, insight and kind words have meant so much to me and I'm sure to many other people. I have no doubt that you will get back on track very soon! Good luck with the GP!! 

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1 hour ago, Angst said:

The goal is to get a referral. GPs don’t do cognitive therapy. 

Agreed, that is a very good point. 

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22 minutes ago, malina said:

Roy, I'm really sorry to hear that you are struggling. Just know that you have given all of us such incredible advice. Your help, insight and kind words have meant so much to me and I'm sure to many other people. I have no doubt that you will get back on track very soon! Good luck with the GP!! 

Thanks for that malina. 

It's always been an episodic problem with me and despite so much treatment and knowledge it can still take root and become more than a blip. 

I am taking an honourable retirement from the main forums in general. I need less time considering OCD and more time for hobbies and other interests. 

 

 

Edited by taurean

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8 minutes ago, taurean said:

Thanks for that malina. 

It's always been an episodic problem with me and despite so much treatment and knowledge it can still take root and become more than a blip. 

I am taking an honourable retirement from the main forums in general. I need less time considering OCD and more time for hobbies and other interests. 

 

 

That sounds like a good plan! There is so much more to life and to us as people than just this disorder. 

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I do need to keep myself busy in retirement, but without regular commitment. 

 

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21 hours ago, BM94 said:

Here's my one issue with this though, there was no mental health checklist he was going through, they were repeated "but do you think you have hurt someone then?" Or "do you think you will go and hurt someone?",

In his defence all health professionals have a duty of care to assess danger to self or others.  So in that respect he is doing his job and you would find the same question asked across the board.  It is his assessment of the situation and lack of knowledge that is shocking (but not unusual sadly)

You can read about risk assessment in OCD HERE on our OCD-UK information pages

The paper referred to can be read HERE  In the past I printed it off and presented it to the very uneducated young woman I saw via IAPT

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OCDUK has great resources for finding the right treatment person. 

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it's so disappointing when GPs lack understanding of OCD.  I am very careful about what I say to GPs and generally just tell them very vaguely and only focus on the stuff they can get on board with like checking or contamination. I see GPs as like receptionists more than anything, you need them to do something for you (whether refer you, or prescribe a medication, or do a test, or whatever) and I think the key is to go in with a clear idea of what you want from them and don't go into any more detail than you need to.  That's just my opinion anyway. 

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Like you I've had all kinds of comments from GPs - from "I'm a bit OCD too" to "oh do you have a magic number then?" (followed by laughter).  I once went to a GP who described having depression as "being cuckoo".  It is so frustrating.  I have challenged it before, and I've made a complaint before, but sometimes you just want things to be easy and not have to be constantly taking a stand. 

Edited by gingerbreadgirl

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Last two discussions I had, the moment you say the theme of your OCD is harm it gets difficult. 

It's on my records anyway because they put it on there before, but I did explain that these are unwanted obsessional thoughts. 

I shall simply mention wanting a treatment review as I am badly struggling. 

 

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1 hour ago, gingerbreadgirl said:

Like you I've had all kinds of comments from GPs - from "I'm a bit OCD too" to "oh do you have a magic number then?" (followed by laughter).  I once went to a GP who described having depression as "being cuckoo

Oh my days, gingerbreadgirl that must be so annoying. And also tells us everything we need to know about the lack of understanding around this. They just don't seem to get it's a debilitating, cruel and unrelenting disorder that can (in my case) torture you every minute of the day.. 

48 minutes ago, taurean said:

Last two discussions I had, the moment you say the theme of your OCD is harm it gets difficult. 

It's on my records anyway because they put it on there before, but I did explain that these are unwanted obsessional thoughts

I found that too, as soon as I mentioned anything relating to Harm OCD he completely phased out and started asking me unhelpful, let's just call them "checklist questions".

Because he seemed so confused I felt I had to keep saying that they are only very unwanted intrusive thoughts, just to reassure him I wasn't a complete psychopath. 

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To be fair, I think they have to do some sort of safeguarding assessment when it comes to harm themes. I do think it is responsible to do this but it should be done in a sensitive way that doesn't make you feel like they think you're a danger to yourself or others!

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The problem is you get 10 mins - or a little longer - to state your piece. 

I am 69 and OCD has been on my record since I was diagnosed at 50. So in theory I can say I am having a bad time, need med review perhaps from specialist probably need referral to the mental health team. 

I would think I shouldn't need the OCD-UK paper but may take it along. 

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