Although all these stories are true, they are not exactly true as I have written them. Let me explain what I mean by that.
Firstly, I needed to protect the identities of my patients, so much so that no one should be able to recognize themselves (or anyone else) in what I have written. To this end I have changed all names, and ages, and many other identifying details. This means that if anyone does think that they can see themselves as someone I describe, it is actually a coincidence.
The dialogue is also not ‘true’ in the sense that I cannot recall verbatim what was said in these meetings, and I did not record it at the time. So, I have written all the speech from scratch. But since I have had conversations like these on a daily basis for decades, then the resulting dialogue is very plausible, and must be close to what was actually said.
Sometimes I have also conflated items from the stories of more than one patient into a single narrative. This is partly done to convey the best idea of what one particular diagnosis or situation involves. One individual suffering from any of the common psychiatric illnesses rarely demonstrates all the possible symptoms or issues that arise, and so a combination of stories can convey a more complete picture. My larger purpose in writing these pieces is to try and demystify the much-misunderstood world of mental illness, and make psychiatry seem a little less frightening than it might otherwise appear. In order to do that I need each chapter to be as engaging as possible, and I hope the conflation of two or more narratives will also help me hold the reader’s attention.
Finally, to return to the most important issue of patient confidentiality, the steps I have listed above fulfill the privacy requirements for medical writing given in the Health Insurance Privacy and Portability Act (HIPPA), and which are commonly used by medical journals to protect patient confidentiality. But people are going to be able to identify themselves even less if the name of the doctor is not given, and so I have gone further and written under a pseudonym. I do not believe that there is a practicing psychiatrist called JP Sutherland (I did look), but if there is then I apologize for borrowing their name, and I can attest that they did not write these tales.
JP Sutherland 