Psychiatric Interviews for Teaching: Psychosis

– Hi, Andy. Do you want to come on in and
have a seat? I’m Dr Taylor; I’m the on-call psychiatrist
for this afternoon. I got a call this morning, from your family doctor, because I think you
went to see him this morning, along with your mum. And I gather that things have been a
little bit difficult for you, you’ve had some rather distressing experiences. So I
think your doctor thought it might be helpful for us to have a bit of a discussion about
that, to see if I could help. Would that be alright with you? – That’s fine. – Would it be alright, Andy, for you to tell
me a little bit about what’s been going on? – Well, you’re going to think it sounds
stupid but my housemates are working for MI5. – Right.
– And they’re… they’re doing stuff to my brain.
– Ok. – And they’re… they’re out to get me.
– Ok. That must be very difficult for you. – [mumbles] Yeah. – How long has this been going on for Andy?
– About 2 months. – Right. And how did you first work out this
is what was happening? – I came home one time and they had moved
the, they’d moved the TV to the other side of the room. – Right
-And I just, I knew then. – And what was it that you knew at that moment? – That erm… that they worked for MI5.
– Right, ok, ok. So it’s been going on a couple of months? – Yeah, this new lecturer started at uni.
– Right. – And he works for MI5. – Right.
– And he basically drafted me housemates in, turned them against me. – Ok, ok. Now I’ve noticed a couple of times,
while we’ve been talking, that you‘ve sort of looked round you, into the room as
if you’re checking for something. Could I ask you what’s happening at those times? – Well I can… I can hear them talking about
me. – Right. Who is it you can hear?
– My housemates. – Right. So you recognise it as their voices?
– Yeah, I can… I can hear them all the time. – Right. How many voices can you hear Andy?
– Three, there’s three of them. – Ok. And do they sound real, like my voice
sounds talking to you now? – Yeah, it’s odd. It’s… it’s like
I can hear them when they’re not here. – Right. So when they’re not in the house
with you? – Yeah, it’s like… Yeah, like they’re
in the other room or something. – Ok, ok. And can you hear what they’re
actually saying? – Yeah, they’re talking about me. -Right, ok.
-They’re always talking about me.
– Ok. -They’re always commenting on everything
that I’m doing. – Right. Can you give me an example of what
they would say? – Well like if I’m packing my bag to go
to uni or something they’ll be, they’ll comment on that like – Right.
– ‘he’s left the house now’, or… you know. – Ok. Anything else? Do they ever talk to
each other, perhaps, about you? – Yeah, that’s what they’re… and now
they know… they’ve sort of… they’ve sort of twigged that I know about them. -Right.
– And they’re saying, like, I’m making trouble
– Ok. – And that they’re gonna sort me out. – Ok, ok. What about actually talking directly
to you, in the way that I am talking to you now? Does that ever happen Andy? – No. – Ok. So you’ve been hearing the voices
of your housemates, have there been any other changes? Have there been any changes, perhaps,
to the way you’re thinking? Sometimes people tell us that their thinking changes in some
way – so for example, they might feel that they are getting thoughts put into their head,
that aren’t their own. Have you had any experiences like that? – Yeah. I do think things that, that aren’t
me. – Ok. – Like the putting thing… they’re putting
stuff into my brain… it’s not, it’s not me. It’s not, I’m not thinking… – So different thoughts in your brain? – Yeah. It’s like… it’s stupid stuff
as well. It’s like the other day I suddenly started thinking about some woman in Coronation
Street and I don’t watch any of that crap. – Right, right. It’s not your kind of thing
normally? Right. – They’re not… they’re not my thoughts. – Right, ok. And do you have any idea how
that’s happening? Or who’s responsible? – It’s MI5. It’s this chip they’ve put
in my head. – Right, ok.
– And I… I can feel it all the time. – Ok, ok. So, so you’re getting thoughts
put into your brain that aren’t your own. What about a different sort of experience, what about the experience that somehow other people are able to know what you’re thinking,
even though you haven’t actually told them? – No. They’re… no.
– Nothing like that? – They’re just putting stuff in my, my head. – Just putting stuff in… and can I just
check Andy as well, that you’re not getting the experience when your thoughts just stop
all together? Like you have no thoughts left? – No. If anything there’s too much in there.
I wish I could unplug it. – Ok, ok.
– Just get this thing out of my head. – Right. And you mentioned this, this chip,
or this device in your brain, do you want to tell me a bit more about that? – Well it’s… it’s a tracking device
– Right. – So they know where I am at all times. – Right.
– I can feel it moving round, like rotating round. – Ok, so you can feel the physical sensation in your brain. – Yeah, yeah. – Ok, that must be very difficult for you.
– I don’t- I don’t know why they’re doing this to me
– Right, ok. – I’ve done nothing wrong. – Ok, ok. Can I just check – are there any
problems Andy, with the rest of your body? Any changes in sensation or any bits that
feel different in any way? – No, I feel fine.
– Right. – I’m not ill or anything. – Ok, ok.
– I just want this thing out my head.
– Ok – It sounds like a very difficult time for
you. Can I ask you Andy, how are you coping with all this? How is it affecting you? – Well, I’ve not been leaving my room much.
And, so I have to wait until they go out, just to go down and get some food but… – Right, right.
– They’ve been doing stuff to my food now so I… – Right, ok. What do you think is happening
to your food? – They’re, they’re poisoning it. – Right, ok. Are you actually eating much
at the moment? – No. – Ok. Now with all this happening – it sounds
like you don’t feel very safe. Have I got that right? Ok. Have you felt the need, I
don’t know, to take steps to protect yourself in any way? – Well, I’ve, I’ve got a knife.
– Ok. – And I’ve got like… a baseball bat. – Right.
– It’s just in case they get in my room, I just…
– Ok. – I don’t want to hurt anyone but
I just feel like I’ve got to protect myself, it’s like, like they’re cornering me to
do this. – Right, ok. Have you felt the need to use
either the knife or the baseball bat, so far? Take it out with you for protection? – No. No, I don’t want to get caught.
– Ok, ok. – No, no. It’s just in my room. – Ok. Has it ever got so bad Andy that you’ve
felt the need to hurt yourself, or even kill yourself? As the only way out – the only way
of coping with this? – Well I, I thought about getting some pills
but I couldn’t, I couldn’t leave the house. -Right.
– So I didn’t, I didn’t get anything. – Right. And when you say about getting some
pills – would that be to take an overdose of tablets?
– Yeah. – But you’ve not actually done anything
about that so far? – No. – Ok. In the past have you ever had any problems
either with your temper or getting into fights, being aggressive either with your housemates,
or anybody else? – No, I’m not that kind of person. I don’t
want to, I don’t want to hurt anybody but they’re just driving me to this. – And can I just check again, you’ve not
been in trouble with the police, or anything like that? – No, never.
– Ok. With all this that’s going on, is there anywhere at the moment Andy, that you
feel safe? – Yeah, my parent’s house.
– Right, ok. And have you seen much of your parents recently? – Yeah. I thought about going back there but
I, I don’t want to drag them into this. – Right. – I don’t want MI5 knowing about them.
– Right – And throughout this last couple of
months, when you’ve had all these worries, have you ever worried that your parents might,
in some way, be involved in this conspiracy? – I thought about it – but no.
– Ok, ok. – Can I just check out a couple of background
things with you Andy? Your general health is that ok? You’re generally fit and
well? – Yeah, I’m. I’m not ill, I don’t – there’s
nothing wrong with me. – Ok.
– It’s just this thing in my head. – And you’re not on any regular medication
from your own doctor, at this stage? – No, I don’t take any pills.
– Ok. What about other drugs – and by that I’m meaning alcohol, cannabis, pills, anything
else? – Well, I don’t, I don’t drink much alcohol.
– And what about drugs like cannabis? – Is my mum going to know about this?
– No. It’s important that I hear about this. This wouldn’t be something that we would
be discussing with your mum. – I smoke a bit of weed.
– Ok. Would that be regular use or most days? – Yeah. – And how much would you be spending on weed? – I don’t know – I get like a… I get
like a ‘ten bag’ and it lasts me a day or so. – Ok. So you have a ‘ten bag’ lasting
you a day, of weed. Any other drugs? I’m thinking in particular, things like speed
or, or pills. – Done a bit of speed.
– Ok. Is that on a regular basis Andy? – I’d just go out with my mates at the weekend
and we’d do a bit but… – Ok. When was the last time Andy that you
would have had any speed? – About a week or so ago.
– Right, ok. Any other drugs at all? – No… no. But I know what you’re getting
at though – it’s not, it’s not the drugs. – Right.
– This is… It doesn’t matter how out my face I get.
– Yeah. – This is constantly there, it’s always
there. – Ok. I guess the reason why I was checking,
I think that’s what you’ve picked up on, is that sometimes when people are having the
kinds of experiences that you are – they find that if they take certain drugs it can
make things feel a lot worse. I just wanted to check that hadn’t been your experience? – No.
– Ok, ok. – I appreciate from what you’re saying that
you’re really very worried about this MI5 conspiracy and that that’s the cause of
the difficulties that you’re having at the moment. I just wanted to check with you – do
you think it could be due to anything else? I mean – I’ve obviously met people who have
had similar experiences and sometimes they’re extremely stressed, some people might be actually
mentally unwell and just whether any of these things might be relevant to you at the moment? – No, because I’m not ill.
– Right. – It’s them. And I’ve read books on this
as well, I don’t… the government know about them. – Right.
– They know that they do this to loads of people.
– Right, right. – And I don’t know how they can get away
with it. – And I’ve done nothing wrong – I don’t
know why they’re doing this to me. – Ok.
– I just want – I just want it to stop. – Ok, sure. And I think I can appreciate that.
I guess what I’m wondering is whether you think there’s anything that someone like
me might be able to do to help you, as a doctor? That sometimes meeting someone like a psychiatrist,
or having medication or for some people even coming into hospital, for a short time might
be helpful. Do you think any of those things would help you at the moment? – I don’t… I don’t know. I mean… I’m
only here really because of my mum. – Right.
– I tried to… I don’t want to worry her. I’ve tried to talk to her about it. – Yeah. – And she doesn’t understand, she doesn’t
really believe me. I mean… Do you believe me? – Well I certainly believe Andy, that you’re
having a really difficult time at the moment. I guess, what I’m not as sure about is what’s
causing this – I’m less sure that this is due to MI5. I guess what I’m wondering is
that perhaps you’re not as well as you might be at the moment. I mean, we’ve been through
a lot of questions and what I’m thinking is we need to try and come up with a way of
supporting you through this. So I’m wondering, because I know your mum is… I think she’s
waiting in the waiting room. It might be a good chance now to get your mum in and then
perhaps the three of us can put our heads together, have a bit of a discussion about
where to go from here and try and think of getting you some proper support. Would that
be alright if I got your mum in? – Ok.
– Ok. If you want to sit there then Andy, I’ll just get your mum, ok.

100 thoughts on “Psychiatric Interviews for Teaching: Psychosis

  1. If you have a family member or friend that is like this, they tend to explode in anger when you point out the flaws in their perception of persecution – then they'll blame you and everyone else instead of looking inward or asking for help. They'll look for anything and everything to back up their theories – even a glance from a stranger walking down the street can be enough to make them think they are persecuted.
    It's one of the worst mental illnesses because it all seems so real to the person whose suffering from this, and the patient can be at real risk of being hurt or hurting someone

  2. It's very interesting that although the cause of the delusions is likely chemical/biological, the actual delusions themselves are deeply culturally rooted (e.g. housemates, Mi5, tracking devices, brain chips, conspiracies, etc). In some other cultures schizophrenic people are more likely to have positive delusions, and their delusions are not often viewed negatively by family and friends. In many cases, delusions involve voices of dead loved ones, and these "patients" are viewed as chosen people who help the dead to communicate with the living. They're viewed as having a gift, not a disease. I find that fascinating.

  3. 0:50 – "My housemates work for MI5 and they're doing stuff to my brain" = Persecutory delusion/paranoia
    2:00 – "I can hear them talking about me" = Auditory hallucinations
    2:40 – "They're always talking about everything I'm doing" = Running commentary
    3:50 – "They're putting stuff in my brain…they're not my thoughts" = Delusion of control/thought insertion
    4:15 – "It's MI5" = Preoccupation
    5:40 – "I don't leave my room much" = Isolative behavior (negative symptom)
    7:00 – "I thought of taking some pills" = Passive suicidal ideation
    9:00 – "I smoke a bit of weed" (cannabis associated with increased psychosis in pts w/ schizophrenia)
    10:45 – "I'm not ill" = Lack of insight

    Also of note: Poor eye contact, fidgety/distractable.

    Anyone notice anything else?

  4. I'm surprised that the probation, jail, prison populations are so large in America. Did anyone ever consider how simple it would be to put LSD on 13 dollar bills and to then deposit the bills in various machines around the country? LSD is fairly simple to manufacture from what I understand.

  5. I could think he has psychosis but with all I went through since 2006,i think otherwise: He can be like me a victim of a crime. It can be by keeping chip in the brain and if not by chip there must be a way that criminal get to your brain and mind. Either chip in d brain ,voodu spell or whatever way they access your privacy and thenafter your life turn to hell..And Best way to cover the crime however is rubish of psychosis diagnosis by unkind psychiatrist. And with that,criminal will throw d victim in the wells forever and criminal psychiatrist cover d crime by put the lid on the wells. And that is causing emotional dead of the victim.

  6. One of my mental health teachers said that they had a consumer that thought he was being followed by certain intelligence organisation and that they knew everything about him and they were plotting stuff… anyway, the health care team decided that they could write to this organisation explaining the situation so maybe he could be dissuaded of his belief… They answered something like "We can neither confirm nor deny the surveillance of Mr X" hahahahah it didn't work at all! I bet all got paranoid by that response!

  7. Not stigmatising much! I've got psychosis and therefore I have acquired both a knife and a baseball bat and some "pills". Jesus Wept.

  8. I would go with the differential diagnosis. Looks like drug induced psychosis. A gram a day of good quality weed + frequent binging on amphetamines. Some predisposition and whammo, M15!

  9. What if, in these case studies, the person is trying to comprehend something very real for all of us? It is easier to see the symptom and stop there. Human beings know so little about our existence here. What if higher dimensional beings, or a government entity, are experimenting with mind control, and then the distressed individual tries to comprehend what he/she is hearing by creating a disjointed story? The medical/scientific community doesn't have an open mind; otherwise, they would be hearing my voice telling them they are full of it. The cure is not to tell the patient that they are experiencing symptoms and then medicate (without going any further), but to gather these cases up and critically examine the text of these shared experiences in the light of history, philosophy, sociology, theosophy, etc.

  10. Imagine this.. how do you think the patient would present themselves if the hospitals, therapists, psychologists, and medications were all conspiring with the evil entities? This video is 'convenient', simply because he trusts the treatment staff. That HUGE detail changes everything. Imagine how every answer would change if his psychosis had advanced to the point that he believed self-preservation mandates that he must completely isolate himself from any potential positive support towards getting help. He would see her as a huge liability, an enemy, one of 'them'.Welcome to my world.

  11. MI5? I only ever heard of MI6, I didn't think there were other number secret intelligence agencies. Is there an MI4, MI3, MI2, and MI1?

  12. getting 'proper support' will likely mean prescribed mind bending drugs, a stay in some chaotic hospital for 'talk therapy' these might reduce some symptoms or make him much worse – none of them can deal with what has happened to him and or what is happening to him in the world where his problems are. The culture is making people ill people are not disordered but are responding how anyone might respond to a disordered world

  13. The way she says "that must be very difficult for you" sounds very raw and apathetic, in my opinion at least. A better way I guess would be "I imagine that must be very disturbing for you" in a more slow and passive way.

  14. Well it's a good video, but as a person with schizophrenia no one is that honest with a strange person/therapist on the first meeting. It took my a year before I trusted my therapist. In my experience I would be coiled like a spring. Sitting in a corner so no one can get behind you, checking every exit.

  15. My over simplified thing I do is to tell yourself that your just not important enough to warrant there attention. Overall I am useless to the world, so I try to help. Just keep humble.

  16. The majority of psychiatrists are not very informed people, they just take one look at you when you need a little help and decide to section you, inject you and give you pills, plus they don't know what these drugs actually do to the brain

  17. He sounds like a Manchurian candidate talking to and hearing his alter personalities. Is amazing how psychiatrists can't diagnose patients. Dissociative Identity Dissorder is often times misdiagnosed as psychosis.

  18. Give him medicinal CBD cannabis strains.. Helped a schizophrenic friend of mine.. Might give it a try

  19. I experienced only drug induced psychosis when I used to take high doses of dextromethorphan, and smoked weed on it, or from taking just high doses of dextromethorphan, and redosed it several hours later. I did too hear voices talking to me, and controlling my movement, and what I would say. That induced fear and anxiety in me up until a point where I would get psychosis later down the line, and that fear and anxiety just disappeared all together, right up until my doctor prescribed me 2 antidepressants, and that put a total stop of me taking DXM anymore. I still don't feel fear, and very rarely experience only very low levels of anxiety. I am fine now, and I know for sure if I were ever take that stupid DXM on my antidepressants, I could get serotonin syndrome, and that is very bad condition that I could even die from.

  20. Poor man, he is going to get drugged to the hilt with psycho active drugs for the rest of his life. Get out of there and run for your life. The psychiatrist is not your friend. Find solutions and ways to live outside the system; the drugs will destroy your life.

  21. What if you are being stalked by an ex and they say your delusional?And he still continues.☹A free pass.

    I went to the psychiatrist and he told me I had a duel personality. When it came to paying the $100 bill, I gave him $50 bucks and said get the other 50 from the other guy ?

  23. Bad interview, she guides him to an answer… "Do you feel like someone planted thoughts in your head?" Really bad phrasing of this question…

    google zersetzung
    soviet union 2 electric boogaloo

  25. The girl is really not a good interviewer >.< She is talking too fast, is interrupting the guy all the time and talking over him! It's soooo frustrating!!!!

  26. why do most patients talk about "chips in the head" "government agents after me" "aliens are talking to me" "they want to kill me" "voices in my head that comment every time"? why is it so similar across cultures, religions and geographical locations?

  27. What are the clues that this person really suffers from psychosis rather than Munchausen disease? How can we distinguish it? How would a psychiatrist understand this person isn't a con man who is interested in getting disability payment by mimicking the symptoms of psychosis?

  28. God love him, now he not only has to worry about MI5 and an implant in his brain, but now his Mum might find out he smokes pot!

  29. This was helpful . But the psychiatrist is speaking a bit fast . I had difficulty understanding the last few sentences . She did risk assessment …. but what about mood and sleep . The execution of mental state exam is not straightforward … because it varies with every psychiatric patient . My question is , when one has got to wrap up a case in 8 mins before an examiner . What to do then :-(. MSE is tough !

  30. Really nice line of questioning without escalating the situation. Feeling safe is really important I love that she asks about this and continually keeps him at ease as much as possible.

  31. I am an avid #MentalHealthAwareness advocate and performer, and I love this so much. I travel the country trying to bring that awareness on stages, in classrooms, hospitals, and on my YouTube channel, so I get excited when I see other advocates. ?❤

  32. Dear Andy
    Hope this message find you will, i feel sorry of knowing that you are in bad and sick situation ,i want you to know that we are all supporting you and we are there in helping you .
    Hoping that you get will soon .

  33. with my all respect to Dr. Taylor experience and skills one point that is very obvious for me in this interview was about the flow of speech of psychiatrist! I think it is a little bit fast, may be cause of native language or anything else but at all she well done to create contact with patient and to know about diagnosis.

  34. My question is does the patient alwys seek help this easily.? Or agree to health care workers to open up this way on the very first visit when person is already suffering with hallucinations.

  35. while he may actually be an actor and no eactual pathological test which should be done first and foremost

Leave a Reply

Your email address will not be published. Required fields are marked *