SEEN EXAM- BSC(HONS) NURSING- MENTAL HEALTH Question one “Schizophrenia cannot be understood without understanding despair.” R. D. Laing The Divided Self: 1960 a) Taking account of the varying elements that might contribute to the aetiology of schizophrenia, how do you understand Laing’s statement? 25% b) What implications does Laing’s statement have for the concept of holistic care? 25% HINTS how it might feel to be schizophrenic. Or how being with this person will touch you as a nurse. What psychic pressures does a person have to experience that lead to a psychotic breakdown? If you had a psychotic breakdown, what would have happened to you to allow this to happen? Similarly if it was a family member of yours? From this how would you care for yourself? What care would you want if it was your son or daughter? What kind of things would a nurse need to say to you to help you think about your experience? If you are hearing voices, feeling paranoid and persecuted, feeling lost alone and scared, what will help you find a way back? Why does Laing talk of “despair” rather than “sadness”; “unhappiness”; “loneliness” etc? The word “despair”- means “without hope”. How might you instil hope into a schz pt? What might engender hope? What as a nurse are you going to contribute to the care of a schz patient that is different from other members of the MDT? What impact will the pts’ despair have on you as a nurse? How might you make use of these feelings? Your answer needs to be much more person centred. You are not merely describing a set of clinical symptoms for a game of Spot the Illness! You are talking about the care of a person! And you should shape your answer to take account of this. REFERENCES 1.CRITICAL PSYCHIATRY WEBSITE 2. I NEVER PROMISED YOU A ROSE GARDEN . BY JOANNA GREENBERG 3. Knots - R.D. Laing Question TWO: Aaron is a 40 year old business man who owns and runs several successful companies. He is a quiet, reserved man who is married with two children. His wife works part time as a secretary in one of his companies. You have been asked to visit him at home following his attempted suicide. He had tried to hang himself from a rope tied to a beam in the garage. He was found by one of his children who went into the garage to find a toy and who called for help. He had left a note which read “To my darling family. I am so sorry. I can’t keep on living a lie” In your first meeting both Aaron and his wife are present and he explains that he has been having a sexual relationship with another man for several years, meeting him in Gay clubs and bars. His wife believes that he is working late at the office. She has no idea about this relationship. He did not know what to do “I love Mike but I also deeply love my family. I didn’t know what to do.” a) What support will Aaron and his family need in the short term? 25% b) What evidence based interventions will enable you to help Aaron in the future? 25% CONTACT Mobile -07960977720