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Session Transcript

23/10/2024:
Dr. Swan:
“Hi Paul, how are you doing today? How have things been since our last session?”

Paul:
Sitting a little more upright, but still fidgeting
“Uh… I think it’s been a bit better. Not great, but better.”

Dr. Swan:
“That’s really good to hear, Paul. Can you tell me what feels a bit better? Is it the voices, the sleep, or something else?”

Paul:
“The voices… they’re not as loud. I can still hear them, but it’s like… far away, you know?”

Dr. Swan:
“That’s progress. So they’re still there, but they don’t bother you as much. Does that sound right?”

Paul:
“Yeah, I guess. They’re quieter. I can sort of ignore them more.”

Dr. Swan:
“That’s great to hear. It’s a good sign that the medication might be starting to help more. Have you noticed any other changes in how you’re feeling?”

Paul:
Thinking for a moment
“Uh… I’ve been sleeping better. Not perfect, but I don’t wake up as much. Maybe once or twice now, instead of all the time.”

Dr. Swan:
“That’s really positive, Paul. Sleep is so important, and even small improvements can make a big difference. When you wake up, do you find it easier to fall back asleep?”

Paul:
“Yeah, sometimes. I try to do the breathing thing you and Nurse Claire talked about. Sometimes it helps.”

Dr. Swan:
“That’s excellent. It sounds like you’re really using the techniques we discussed. It’s great that they’re helping you get back to sleep. Do you feel more rested during the day now?”

Paul:
“Yeah… I think so. Not as tired as before.”

Dr. Swan:
“That’s fantastic, Paul. It’s all progress, even if it feels slow. I know it’s been tough, but you’re doing really well. Have the voices been telling you to do anything, or are they still just there?”

Paul:
“They’re just there. Still saying the same stuff, but not like before. Not telling me to do anything.”

Dr. Swan:
“Good. As long as they’re not telling you to do anything harmful, we can keep focusing on reducing how much they affect you. How about your mood? Have you noticed any changes there?”

Paul:
“I dunno… maybe I’m not as angry as before? Still feel down sometimes, though.”

Dr. Swan:
“That’s okay, Paul. Feeling down sometimes is normal, but it’s important that you’re noticing less anger. That’s a good step. Have you been able to focus on any activities this week, like drawing or writing?”

Paul:
Shrugs
“A little bit. I drew something yesterday. It wasn’t good, but… I did it.”

Dr. Swan:
“That’s great, Paul. It doesn’t have to be perfect. Just doing it is important, and I’m really glad you gave it a try. Do you think you’ll keep doing it?”

Paul:
“Maybe. I’ll try.”

Dr. Swan:
“That’s all we can ask for, Paul. Keep trying when you can, and don’t be hard on yourself if it doesn’t always work out. You’re making progress, and that’s what matters. Do you have any worries or things that have been bothering you?”

Paul:
Nods slightly
“Just… sometimes I still feel like I’m useless, you know? Even when things are better, I still feel like I’m not doing anything right.”

Dr. Swan:
“I understand, Paul. It’s common to feel that way, especially after dealing with everything you’ve been through. But the fact that you’re showing up, trying these techniques, and improving is proof that you’re doing a lot right. It takes time, but you’re on the right path.”

Paul:
Quietly
“I guess… it just feels slow.”

Dr. Swan:
“It does feel slow sometimes, but slow progress is still progress. Every small step forward counts, and you’re making those steps. You’re doing well, Paul, even if it’s hard to see it.”

Paul:
“Yeah… thanks.”

Dr. Swan:
“You’re welcome. We’re going to keep moving forward at your pace. I’ll keep monitoring how you’re feeling, and if we need to, we can adjust things. Does that sound alright?”

Paul:
“Yeah, okay.”

Dr. Swan:
“Great. We’ll continue with the current medication for now since it seems to be helping, but I want you to keep an eye on how you’re feeling. If the voices get louder again or if anything changes, let Nurse Claire know, and we can adjust things.”

Paul:
“Alright.”

Dr. Swan:
“Thank you for talking with me today, Paul. You’re doing really well. Keep focusing on your sleep, your activities, and trying the relaxation techniques. We’ll meet again next week, and we can see how things are going. Sound good?”

Paul:
“Yeah, sounds good. Thanks.”

Dr. Swan:
“You’re very welcome, Paul. Take care, and remember, you’re not alone in this.”

Paul:
“Okay, I’ll try to remember. See you next time.”

15/10/2024:
Dr. Swan:
“Hi Paul, it’s good to see you again. How are you feeling today?”

Paul:
Shifting in his chair
“Uh, kinda the same, I guess. Some days are better, some are not.”

Dr. Swan:
“I understand. Last time we talked, you mentioned the voices were quieter but still there. How have they been this week?”

Paul:
“They’re still there. Some days… they’re louder. It depends.”

Dr. Swan:
“Do you notice anything in particular that makes them louder?”

Paul:
“Yeah, when I’m stressed… or if I’m just sittin’ alone. They come back stronger.”

Dr. Swan:
“That makes sense. Stress can sometimes make things feel worse. What do the voices say when they get louder?”

Paul:
“Same stuff. Just telling me I’m no good. Sometimes they say it louder, sometimes it’s more… like a whisper.”

Dr. Swan:
“That sounds really challenging to deal with, Paul. Have they told you to do anything harmful since we last spoke?”

Paul:
“No, no. They’re just… annoying. It’s like they wanna mess with me, but they don’t tell me to do anything.”

Dr. Swan:
“Okay, that’s good to hear. You mentioned before that the medication was helping a little. Do you think it’s still helping, or has anything changed?”

Paul:
Pauses, thinking
“It’s… I don’t know. It helps sometimes, but other times… it feels like it doesn’t work at all.”

Dr. Swan:
“That’s useful to know. It might be that we need to adjust your dose or consider a different medication. How are you finding your sleep? Are you still waking up during the night?”

Paul:
“Yeah… still the same. I wake up a lot. Sometimes, I don’t even know why.”

Dr. Swan:
“And when you wake up, are the voices there, or do you feel anxious?”

Paul:
“Sometimes the voices are there. Sometimes it’s just… I wake up and can’t get back to sleep.”

Dr. Swan:
“That must be exhausting. Have you tried any of the relaxation techniques Nurse Claire talked to you about?”

Paul:
“Yeah… they help a little. I try to breathe and stuff… but sometimes my head’s just too busy.”

Dr. Swan:
“I understand. It sounds like you’re really trying. We’ll keep working on managing those busy thoughts. Have you been able to do any of the activities we talked about? Maybe some drawing or writing?”

Paul:
Shrugs
“Not really. I tried… but I couldn’t concentrate.”

Dr. Swan:
“That’s okay. It’s good that you tried. Maybe we can think of other activities that might help you feel more settled. What about your mood? Have you felt more down or frustrated lately?”

Paul:
“Yeah… I get frustrated a lot. Just… tired of feeling like this.”

Dr. Swan:
“It’s completely understandable, Paul. You’ve been dealing with a lot. But it’s important to remember that even small steps forward are progress. We’ll keep working together to find what helps.”

Paul:
“Yeah, I guess… I just want it to stop, you know?”

Dr. Swan:
“I hear you, Paul. It’s not easy, but we’re here to help. Do you feel like you can keep going with the treatment, or is there anything you want to change?”

Paul:
Pauses
“I don’t know. I’ll keep taking the meds if that’s what you think I should do.”

Dr. Swan:
“I think it’s worth continuing, but I also want to make sure it’s helping. We’ll review everything carefully, and I might adjust your dose slightly to see if that improves things. How does that sound?”

Paul:
“Yeah, okay.”

Dr. Swan:
“Good. We’ll also keep working on managing stress and finding activities that help. Nurse Claire will help you with that. Is there anything else you’ve been worried about or want to talk about?”

Paul:
“Not really… just the same stuff. I just want to feel better.”

Dr. Swan:
“And that’s our goal too, Paul. It might take time, but we’re getting there. I’m proud of the progress you’re making, even if it doesn’t always feel like much. You’re doing well.”

Paul:
Quietly
“Thanks… I’ll try.”

Dr. Swan:
“That’s all anyone can ask. We’ll meet again next week to check in on how the changes are working. You can always ask Nurse Claire if you need anything before then, okay?”

Paul:
“Okay, thanks.”

Dr. Swan:
“You’re welcome, Paul. Take care, and we’ll talk soon.”

08/10/2024:
Dr. Swan:
“Hi Paul, how are you feeling today?”

Paul:
“Umm… I dunno. Not bad, I guess.”

Dr. Swan:
“That’s good to hear. I know it’s been a while since we last had a proper chat. Today, I’d like to talk about how you’ve been feeling and how the medication’s working for you. Does that sound okay?”

Paul:
“Yeah, I s’pose.”

Dr. Swan:
“Great. Can you tell me if you’ve had any strange thoughts or worries recently?”

Paul:
“Sometimes… I still hear things. Not as loud, but they’re there.”

Dr. Swan:
“Okay, and what kinds of things do you hear?”

Paul:
“Voices… telling me things. Not nice things.”

Dr. Swan:
“Do the voices tell you to do anything, or are they just talking to you?”

Paul:
“Mostly talkin’, but sometimes… they say to do stuff.”

Dr. Swan:
“Have they told you to hurt yourself or anyone else?”

Paul:
“Uh, no… not really. Just… just things like, ‘You’re useless,’ stuff like that.”

Dr. Swan:
“That sounds really difficult, Paul. I know you’ve been trying hard. How does it make you feel when you hear those things?”

Paul:
“It… makes me feel bad. Like I don’t wanna do anything.”

Dr. Swan:
“I can understand that. Do you think the medication is helping at all with the voices?”

Paul:
“Maybe… a little. It’s quieter than before. But I still hear them.”

Dr. Swan:
“That’s a good sign, even if they’re still there. We’ll keep working on that. How about your sleep? Are you able to rest at night?”

Paul:
“Sometimes… other nights I wake up a lot.”

Dr. Swan:
“Do you remember what wakes you up? Is it the voices or something else?”

Paul:
“Sometimes it’s the voices… sometimes I don’t know. I just wake up.”

Dr. Swan:
“That must be frustrating. Have you been feeling more tired during the day?”

Paul:
“Yeah… tired a lot.”

Dr. Swan:
“We’ll look at that. We might need to adjust your medication a bit. Do you have any other worries or things on your mind?”

Paul:
“Nah, not really… I just want to feel better.”

Dr. Swan:
“We’re going to keep working towards that, Paul. You’ve been doing really well, even though it’s tough. Do you feel safe here at the moment?”

Paul:
“Yeah… it’s alright here. Better than outside.”

Dr. Swan:
“I’m glad to hear that. It’s important that you feel safe. Is there anything else you want to talk about today?”

Paul:
“Umm… no, don’t think so.”

Dr. Swan:
“Okay. Thank you for talking with me today. We’ll keep adjusting things to help you feel better. If you need anything, you can always ask Nurse Claire, alright?”

Paul:
“Okay. Thanks, doc.”

Dr. Swan:
“You’re welcome, Paul. Take care.”

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