Duty of care

Dr F writes – Burn out is not the same as PTSD although there may be superficial similarities. To say one is a form of the other conflates and devalues both conditions. It’s all in the word Disorder. Burn out sounds like a descriptive term and does not have the kudos of, say, Chronic Occupational Stress Disorder, COSD.

The British psychiatric community initially opposed the concept of PTSD seeing it as American preoccupation with litigation. Occupational health similarly oppose COSD because it implies a failure in duty of care on the part of the employer.

If you can’t hack it, just quit. It’s not our fault (if we have ground you down and destroyed all the interest and optimism that originally drew you into this career)

At Fulbourn in 1976, Dr C deliberately recruited the idealistic young that drifted through Cambridge to become the “Social Therapists” on his wards. It was some years past the peak of Anti-Psychiatry, but there was still sufficient distrust of over-qualified psychiatrists, for them to be pulled back to some instrumental role, whilst the under-qualified, who were obviously more in touch with what mattered, were pushed to the front.

It was interesting to watch how faced with the task of bringing about real change (an oxymoron in psychiatry), the idealistic youth became progressively disillusioned, only to be quickly replaced with a fresh cohort of hip holistic therapists. Of course what was completely lacking was any dynamic supervision, so that, oblivious to the counter-transference, the young untrained waded into enmeshed rescue fantasies, acting-in with disastrous consequences.

But I don’t think their experience was traumatic since they were so self-obsessed that they saw their failure as vindication of their struggle against the establishment.