September 17, 2015

Like like

Not to be confused with the Legend of Zelda enemy that eats your Hyrule shield.

When a psychiatric patient likes you, there's one or more reasons behind it:

They truly like you, no strings attached.  Sometimes the blue box is blue.

They truly like you, no strings attached...for right now.  They may have bipolar or borderline personality disorder, and at this moment in time, they really and truly like you.  But something happens, and suddenly you're Public Enemy #1.   It may be something you deliberately did, something you did without meaning to...or maybe you did nothing whatsoever.  Or it may be something entirely on their end.

They're flirting with you.  Be sure to set and enforce boundaries for all parties--including you--to adhere to.

Transference.  You remind them of someone else that they think fondly of.   It may not necessarily be a physical resemblance that triggers it.

You gave/did something that they wanted or which helped them.  Self-explanatory and possibly fleeting.  Mind you, this doesn't mean they're a bad or manipulative person.  Keep in mind that being in a hospital is stressful enough, and in a psychiatric hospital doubly so.  Try to ease the stress for them when you can.

They're trying to manipulate you.  It may be a patient engaged in staff splitting, especially if they're bad mouthing someone else at the same time they're lauding you.  Or perhaps it's a patient with antisocial or another personality disorder using their charm to further their agenda.  While you may develop a rapport with specific patients, don't fall into the trap of "I'm the only one that understands them!" because patients, especially the ones with personality disorders, will work that to their advantage.

Their pain is relieved.  Pain can really bring out the worst in people, and relieving it can bring forth a lot of warm feelings.  I never understood why new mothers say they wanted to kiss their anesthesiologist until I had one start the epidural during my own labor.

The PRNs are kicking in.  A B52 (Benadryl 50mg, Haldol 5mg, Ativan 2mg), or even individual parts of it, do a lot to take the edge off of a patient.

I have a patient who falls squarely into category 2 (with a hint of 8).  They have a history of falling in and out of like with me.  The most recent shift started out with them throwing things at me (we had parted on good terms the last shift).  One PRN and an hour later, I was their best buddy for the next several hours.  Then I don't know what happened, but once again I was on their hit list and dodging items.