September 23, 2014

By Mark Edmund Hutcheson
First published: Sunday Independent September 21

The psychiatrist's room is a difficult place. On the one hand, the patient may not be fully aware of where they are and what is happening, or they may find talking about the deep personal trauma that has them there very difficult.

On the other, the psychiatrist has to listen very carefully and astutely, take in what is being said, and, even more importantly, what isn't; they then have to devise a treatment plan, implement it, and review it in the light of progress being made, or not being made.

In the not-so-distant past, psychiatry was usually about locking patients up, and keeping them from being a nuisance to society; today, the emphasis is on recovery within the community. Prof Jim Lucey's In My Room is all about psychiatric recovery, its subtitle being The Recovery Journey as Encountered by a Psychiatrist. Prof Lucey is well placed to write such a book – having worked as a psychiatrist in London and Dublin for over 25 years – and has made an excellent job of it.

His purpose is, he says, to "demystify the hidden zone that exists between the psychiatrist and the patient, and illuminate in part the journey some people take to mental health and recovery."

All too often the psychiatrist is something of a sphinx, asking lots of questions, but giving very few answers. It's hard to know what they're doing, if anything at all. Prof Lucey reveals that psychiatry is a well-developed branch of medicine that has clear and detailed understanding of mental illnesses, and a range of approaches to treat them.

He shows that psychiatry is a series of questions and answers leading to diagnosis and treatment, and that it has self-conscious strategy and method. It is reassuring to know this.

It is also reassuring to know that medication isn't the only therapy available. In the past psychiatry has been described as "toxic" for its almost exclusive reliance on pills. Prof Lucey certainly believes pills can have a role, but equally he prescribes counselling, psychotherapy, attention to diet and exercise, the value of work, and of good family relationships. He breaks the mould of the medical approach – medication or electro-convulsive therapy alone – and uses other, additional remedies.

However, in psychiatry more than in any other branch of medicine, the greatest therapy is kindness, caring for one's patients, genuinely wanting to help them.

Not every doctor has this, many seem to think it's unnecessary, that medication suffices – diagnose the condition, prescribe the appropriate pills.

The truth is, however, that the doctor who doesn't care will do little good, and perhaps much harm. Prof Lucey appears to be a psychiatrist who does care, who is kind, who places the welfare of his patients first.

The great message of In My Room for patients and their families is that recovery from mental illness is possible. Lucey details 15 case histories over a very wide gamut of conditions from anxiety through depression and alcoholism to bipolar affective disorder. Recovery isn't always easy, and may take time, but it is achievable.

Hope, therefore, is Prof Lucey's watchword. However, even he has been unable to help some patients, depression has been so deep-rooted that it has resulted in suicide. Depression can be a life-threatening illness. Yet even if it doesn't literally kill, mental illness can – and does – rob some people of their lives: they live in a depression they shall never escape, a psychosis that will never release them. As we take comfort from In My Room, we should spare a thought – and a prayer – for these poor unfortunates, forever lost.

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