livingwithablackdog

sit. stay. good boy.

Black Dog, White Knight 03/08/2011

If there is one thing more frustrating than the battle with the black dog, it’s the battle with the white knight.  The overprotective protector.  Oh to be able to call the white knight to heel along with a well-controlled dog!

Take for instance the plan to return to work.  A sensible return to work plan is graded with appropriate supports according to the nature of the illness or injury.  My most recent absence from the work place involved an epic trial to accomplish reentry.  It took five months to the day from the time my psychiatrist of eight years cleared me for graded reentry to the workplace – and almost two months after he cleared me for full hours – for my employer and independent occupational physicians (not psychiatrists) to clear me for a very slow and protective graded reentry programme, more suited to someone with chronic pain or active symptoms.  I, however, have an episodic illness – certainly, with excessive stress and sudden change as triggers – however having been all but symptom free for some time now, the rate of change laid out was a looooooong way from sudden.

The starting plan was laid out as 4 weeks of 3 days of 4 hour days.  This would be followed by 4 further 3 day weeks where hours increased by an hour a day per week.  Finally, a half day would be added on the ninth week to bring me to full hours.  Such a programme would have been appropriate in at the beginning when I was cleared for graded return to work by my doctor.  But five months later?  I had been stable for some time.  Depression is an episodic illness, not a static one.  I would agree that grading is wise for maintenance purposes, but given the amount of time that I’d been stable for it would have been feasible to start with a 3 day week at 4 hrs, progress from there to 6 hrs, then 8, before returning to full hours.  And that would be conservative.

The key factor that will make or break the return to work will be the provision of personal support within the workplace throughout this and over the coming months.  A clear plan for what to do with symptoms in the workplace.  A way of taking control of the situation when things get difficult.  I speak here both as a clinician with experience in work rehabilitation and as person who has treatment resistant depression.

The white knight needs to step back and stop blocking the path.  There are no dragons.  It’s a dog.  A black dog that is currently walking patiently at heel.  Please don’t let it get so bored that I trip on it.  A worthy helper walks beside, notices when the going is hard or easy and helps me to adjust the burden so that I can continue at a pace with just the right level of challenge and focus.  They are about helping me engage with what is around me without losing track of my dog.  The white knight will ultimately drive my dog crazy with all the attention and fuss.  If I don’t trip over the dog, I’ll trip over the knight – although they’ll default all responsibility and blame the dog.  Get rid of the protective sword, the suit of armour and all the pomp and ceremony.  Rather put on your hiking boots, pick up a pack, bring me a spare map and compass for if I lose my way and throw in my dog handling manual in case I lose mine; then come and walk alongside me.