Checking in – pd2ot and the brain.

brainIt’s been quite some time since I blogged. The dissociation post remains a 70% complete draft and my list of blog topics I want to write about is growing, yet I have been pretty silent on here and Twitter (except for much needed #teamduvet chats at the weekends). So I thought this post could be a brief update and pave the way for more regular blogging.

At the moment I’m getting to grips with unstructured time again. I’ve just finished an 8 week placement in neurosciences and now have some assignments to do before I break up for the summer. A big part of me is terrified of the thought of several months with no placement or assignments, so I’m noticing I’m having problems engaging with my work for fear of finishing it. Mindfulness is helping and I know I’ll get there in the end.

Placement itself… Possibly my most challenging placement to date, and also probably the first one that I could see myself working in as a qualified occupational therapist. I think the variety appealed to me. My youngest service user was in their teens and my oldest in their eighties. I worked with people with a wide variety of conditions (in fact most of my preparatory reading about Parkinson’s Disease and Multiple Sclerosis was in vain as we experienced a series of referrals for people with much more uncommon neurological conditions). The interventions used ranged from work on personal activities of daily living and equipment assessment to work on leisure occupations and vocational rehabilitation. The settings included inpatient wards, outpatient appointments and community work. Needless to say this variety prompted me to feel a little(!) overwhelmed at the start, AND I loved it – because I wasn’t going to be bored or unchallenged.

Before starting the placement I was worried about a number of things. Firstly, this was going to be a ‘properly physical’ placement. My comfort zone is mental health and while I enjoyed my first placement in a physical setting (social services) I was still afraid that I wouldn’t be any good at the ‘bread and butter’ occupational therapy required in this setting. Fortunately my fears were unjustified and the combination of university work, previous experience and transferable skills from other settings made this nothing other than a manageable learning opportunity.

My other worry had been about the requirement to be ‘bare below the elbows’ when working with patients. My arms are scarred from past self-harm and it is only within the last year that I have done any, literal, ‘exposure work’ of having them uncovered when exercising, I also have not yet had a placement that required me to be bare below the elbows. I was worried it might cause judgment from others or prompt me to feel insecure and exposed. Mostly, I feared it would be a barrier to my usual ‘apparent competence‘. The reality? I didn’t experience any overt negative attitudes from others and mindfulness prevented me attempting to mind-read their thoughts. However, the internal fallout, initially, was huge. I spent the first two weeks cycling home from placement at high speed, as an attempt to escape the discomfort of being there. I drafted many an email to my tutor and the placement co-ordinator saying that I couldn’t cope and wanted to quit. But, like in other placements where there were challenges I also knew that I didn’t want to give up, and this particular placement experience was not an opportunity I wanted to lose. I think I knew the emails would never be sent and were simply a way of validating the experience to myself. I’m also grateful that I tend to be incredibly stubborn and it takes a lot for me to stop doing something. Gradually, as I became more confident in my work being bare below the elbows was easier to manage. I don’t think I ever became less aware of it but I did become much more secure in my role as a competent occupational therapy student.

While the personal and professional challenges of this placement were probably the biggest I’ve encountered to date I know I benefited from the time of year of the placement. Like many, I really struggle with the winter. Although we had several weeks of bitterly cold weather at the start I found my energy levels were helped by the increasing daylight. I also found being able to cycle to placement so helpful, not just in the reduced journey time compared to previous placements but also starting and finishing the day with physical activity. I also found myself able to get to the gym several nights during the week, which I find so helpful for my mental health but just hasn’t been possible during my placement experience up until now. Fortunately my final placement falls at the same time of year next year, so I feel confident that I can manage it with similar success.