Show Notes:

Welcome to Hello Rebecca Ray, our collective home for courage, growth, and human to human connection. I’m your host, Dr. Rebecca Ray, human, clinical psychologist, author, and educator. I know only too well how fear, comparison, and self-doubt can stifle your potential. This podcast is all about brave and meaningful living, and how you can make your authentic contribution to the world today and everyday.

Hello, lovely ones. Welcome to Hello Rebecca Ray the podcast with me today is Dr. Xavier Mulenga. A psychiatrist with subspecialty training in addictions who works primarily in Sydney. He aims to provide comprehensive assessments, education and treatment to patients with mental health and addiction issues. Xavier is a mental health advocate in the African-Australian community. He was born and raised in Lusaka in Zambia, and imigrated to Australia in 2004, where he undertook medical training at the University of Wollongong. After becoming a doctor Xavier found his calling in psychiatry, which suited his curious nature and love of open conversations. Welcome Xavier.

 

Dr. Xavier Mulenga
Yeah, welcome. That’s quite the intro. Thanks, Beck. Come back, I think is that is that me?

Rebecca Ray
Yeah, it’s totally you and I’m sitting here impressed. I am first of all most interested because you know, my love for and fascination with Africa. I’m most interested in how we got lucky enough to have you on Australian shores and practising as a mental health professional over here. Can you tell me about your journey from Zambia to Australia? And everything in between?

Dr. Xavier Mulenga
So I always knew. So being raised in Zambia, I always knew that I was going to have to study abroad, I was fortunate my parents did have a bit of money saved up and said, “Listen, we should probably get you one of these first World Education”. You know, that was always the big go back home. So Australia was never been on the map at that time, because everyone wanted to go and send their kids the UK or America because this was well established place in Canada. Well, it’s for international students. And I think when we started when we finally had to make the decision, you know, I always joke around that I was keen in America. I was like, 100% Mum, I’m going I wrote SATs got accepted into the university with a partial scholarship. And then my mum and I were both watching American Pie. So I thought, Oh, that’s my life. It’s gonna be amazing. It’s gonna have parties. Then my mum said, too much sex and drugs in America. So I was like, wow, okay. And then she really just cancelled it, I think, which was rightfully so I think too many people played around there. Because one, they didn’t even monitor your attendance at uni. So that could cancel off the bat, Canada was to cold UK too expensive. And then Australia had sort of like the way they advertise to the Asian market, like China and India, they started doing the same in southern Africa. So about that. And I said, what’s this place? Australia, Sydney, Brisbane, and invariably, it worked out because we realised it was a growing African community. So it wasn’t gonna be like a minority minority. And the really good universities. And the biggest thing I think, that really got her was with international students was you got marked attendance. So if you don’t go to 80% of your, this was back in the day, I don’t think it’s the same now. But as a student visa, if you don’t attend 80% of your compulsory classes, you could get deported.  It just meant you studied you had to go to classes, that’s all it really meant. So if people ask like, “Wow, you guys attended the classes”. Lots of Australians, they can miss a few classes here and there. It doesn’t matter. It was it was quite high stakes. And I ended up in Brisbane initially, because Sydney was too expensive. And Melbourne was too cold. I didn’t think of what temperatures. That was my thing. Yeah, but then that’s what I came across when I was 19. So really, I always knew I was going to do some sort of science. It was either medicine, dentistry, or even pharmacy was thrown around. But when push came to shove, I got into med school in Wollongong really went in. And I think that was the first time even though I lived in Brisbane for four years when I went to Wollongong just because by its nature, its regional. I think that’s why I became more Australian quote unquote, because you really met your average Australian citizen like people who were just, you know, nice people from the town blue collar people trying to make it and I think those Australian cultural norms that we read about were more true there. You know, that was a way that got me there. So fast forward a lot you know, you go through med school says lots of study. Don’t recommend do dentistry instead, I always joke to people just do dentistry.

Rebecca Ray
I must admit that I did consider medical school and I just, I was overwhelmed just the thought of it. So I thought perhaps this is not for me. I don’t think I would have made it I just I’m sitting here like, I’m in aware of anyone that does medicine, congratulations, we are not worthy.

Dr. Xavier Mulenga
eah, I’m gonna keep that in my mind. The mental health side of things really start growing in med school, because in med school, that’s when you really start seeing all the different specialities into med school just know we can be a doctor, what type surgical physician and I think mental health was good. And I realised I used to do really well in mental health, psychology subjects, as well as cardiology, and gastroenterology. And back then, you know, mental health wasn’t sexy, so I thought, Okay, I like psychiatry, but I’m not doing that. Because, you know, how am I going to explain that to my parents, everybody’s quite ashamed of it. I think. I can’t tell my parents, I’m going to be psychiatrist, but it’s going to be cardiologist instead, you know, the sex appeal is better. Perhaps it was most socially acceptable as well, like, it’s more medical, if you’re a cardiologist rather than a psychiatrist. 100%. And I think that did well, in my mind, even though my parents were good. They didn’t pressure me in any way to be that it’s just something where you hear in the communities, even Australians were like, oh, mental health doesn’t really work. Like no one, really, in 2011 was finishing med school was saying, oh, psychiatry is the way to go. It wasn’t really what was back back was specialties. But when I started working, I found I started doing more gastroenterology terms. So I thought, Oh, I’m gonna be gastroenterologist, so that’s okay. And then I entered a liver clinic. So I was doing a liver term. And as we saw lots of people with alcohol problems, you know, a lot of the liver disease was, and I was just fascinated like, you’re drinking yourself to death in a way, you know, that’s in stage and the liver clinic is seeing people who are sort of, not always in stage, but a lot of them are in stage dying, very permanent liver damage, cirrhosis, and comorbidity. So we used to work with the psychiatry team, and the psychiatrist. I think I was talking about this there was this one client who was like, 25, I think it was roughly the same age. And he was dying from liver failure, because he had been drinking like a bottle of whiskey.

Rebecca Ray
And he was 25. Did you say?

Dr. Xavier Mulenga
Which is the youngest person I’ve seen dying from something that you could argue is preventable, right? Because you see other young people die by cancers, leukemias, things that make sense to you. In a way. I don’t know if that makes sense? What had happened was, I just was treating this person. And I remember thinking, I think I was just just so overwhelmed. I could ask him how this happened. And we’re saying what I used to drink, and he didn’t like talking about it. And I think I was just pushing so I took a step back. And then we got the mental team to come in, because he had at one point been feeling a bit suicidal. So we got a psychiatrist to come in, and the psychiatrist came in, actually, I thought, oh, this guy’s not gonna get anything from this kid. I’ve been trying the whole week, you know? Just the way he moved and just said, “Would you like some water?” Just the gentle things, and just the way he approached him, I think was more empathy. And that’s why like this, but more, how can I help you. And he got this information of trauma from this person, you know, abusive parents,you know, lots of siblings who were drug and alcohol issues. So he was almost set up to fail, you could argue, and this was just his way of coping with life. And the psychiatrist didn’t say, you know, we knew he was dying, but the psychiatrist was like, how can we make you comfortable do you need some medications for sleep? You know, and it was almost he was doing palliative care, but not really like, being a human, I guess, was being very empathetic. And, you know, medicine doesn’t always tend to be as empathetic as we’d like. No, it doesn’t have that compassion does, it doesn’t have the cushion of compassion, really. That’s why in medical schools, they’re now pushing that angle, because they realise that these doctors were book smart, and sure, they can get diagnosis and cures, but then patients can, you know, leaves patients or anything with where they could have argued that they want to see the doctor to begin with. Once I heard that story, and so what he did, I just said, I gotta try this. So I actually signed up to do a term in mental health actually throw in another term booked in for cardiology, as of now with the mental health really upset loss of nice mentors at the time, but then yeah, that really sealed the deal for me. And I do think because I started in that sort of liver clinic, gastroenterology field and addictions was really prominent there. I don’t know if that’s what in my mind led me to specialise in addictions later. So, you know, in 2013, when I applied for it, I got it and I called my mom and dad, and they actually were happy for me because they said, Oh, you like talking a lot. Yeah, go to psychiatry, you know. I remember that was like so relieving I thought they were gonna be disappointed for whatever reason, even though they had never actually been pushy parents in that way. But that was we got your back. I didn’t apply for anything else. except for psychiatry and a lot of my friends were like, “What I thought you were gonna be a gastroenterologist?” And I thought nah this is me but I work with lots of gastroenterologist cuz I work in addiction. So it’s funny, it’s like, full circle come round.

Rebecca Ray
You still got you still got a hand in that side? Isn’t it interesting how you unconsciously applied the stigma against psychiatry to yourself in your own journey of study in your assumptions around how your parents might react? I think that’s really interesting. And I think that both speaks to likely the culture that you’ve come from, and the the acceptability of any kind of mental health issue. But also, how just, I think how stigmatised things even were in 2013. I mean, we’re nearly 10 years down the track. And I would say that social media has really helped perhaps this acceptability also the generations coming up now who are communicating about their stuff, it’s much more acceptable for them to talk about their therapist and things like that, but I just find it so interesting that it’s actually really recent that you were stigmatising yourself for studying psychiatry. That’s fascinating, isn’t it? And also heartbreaking in a way, because it makes me think of all the patients that have come before this chat that we’re having today that have struggled, because socially, it’s not acceptable to be able to speak up about your mental health.

Dr. Xavier Mulenga
Yeah, exactly. And, you know, it’s it’s one of those things where the training is really good in Australia, it can take a while. But the first few years are really sort of breaking you down and taking away those assumptions. And you have to de-stigmatise the actual trainees, in a way, because everyone I worked with in psychiatry training, you know, all I saw was the end products, I saw a psychiatrist doing an amazing job. But yeah, when you start training, you’re not there yet. So they have to build up on all those, like your bedside manner. Do you know how you come across the pit? You know, so many things, I found out learn boundaries, all these things that I guess you’ve heard the words, but you were talking about boundaries love better now, but back then, so worried that you could argue people are saying boundaries, but then people would also be saying that person’s difficult, or this person never wants help? Or whatever,  Or that person’s got a personality disorder so it’s too hard Yeah, you know, it’s addiction or the near be cured does, like versus going to asylum or that, you know, I saw my grandma get ECT. So many, so much misinformation, I suppose as well. That’s the part which you breaking down. And I think the first year of psychiatry is interesting, a lot of people actually drop out in one year when they start because the expectation what they thought it was, is not really it’s a stepping stone, because people think I’m going to be an analyst, a therapist, by the end of this is like, no, it’s just the first year you barely know how to provide medications. Someone has psychosis or manage the personality vulnerabilities clients bring and present to you while also recognising your own personality vulnerabilities that came later you doing lots of reflective thinking? Yeah, I think it’s quite challenging, because doctors normally, the way the training set up, it’s not, I wouldn’t say it’s done this everywhere. But the way it’s set up is patient has problem. You a doctor with answer, you provide treatment patient gets better, yay, shake hands, they go off, you know, that’s, that’s the medical model, as we know, means that you are just decision detection and treatment plan. But in psychiatry, you also someone’s potential trigger. So there’s certain reason why certain clients would prefer seeing a male psychiatrist or a female psychiatrist. I mean, being a minority just brings up different clients.

Rebecca Ray
Oh, I see. So you have to realise that you being you is going impact on someone else, and it’s how you manage that and negotiate that. They’re pretty good relationship really. And that’s the whole thing. I think with psychiatry, it is a relationship, isn’t it? You’re not just, I mean, you have a relationship with your GP to I hope, I hope listeners have a relationship with their GP that feels supportive and collaborative and trusting. But certainly with the psychiatrist, your inner and with a psychologist as well, you’re probably going to spend time, over time with that person, and it’s a journey that evolves between the two of you. So it’s not just like going and seeing a cardiologist, your cardiologist doesn’t have to reflect on the functioning of their own heart in order to be able to treat your heart right?

Dr. Xavier Mulenga
They really don’t they don’t. But with the echo that ECG. That’s your problem. You know,  Done, here’s the data. 

Rebecca Ray
Now, can we explore addictions? Why addictions? Obviously, you had that profound experience when you met the 25 year old who was so was his diagnosis terminal?

Dr. Xavier Mulenga
Oh, yeah. No, it was terminal. So he had the end stage liver failure, long term alcohol dependency. Right. So that was before you’d even chosen psychiatry and that was clearly profound in your journey. Why did you continue on with addictions? What is it about addictions that piqued your interest? Oh, that’s a good question. Because what I found is even going into mental health, and you see a lot more addictions, right? General medical terms can seep through with addiction problems. But that’s not my problem. I’m working on some of the body parts of some system. But in mental health you found that when you’re working holistic model, drug and alcohol issues were quite prominent in lots of people with mental disorders. So people with drug induced psychosis, lots of cannabis dependence and some methamphetamine, cocaine and alcohol, you know, so you, you found that it was everywhere. And I thought, the doctor, the psychiatrists who are more comfortable with addictions, were able to they also do the general psychiatry. So for example, you have someone who comes to you with generalised anxiety, so let’s say anxiety, and drinking heavily. Back in the day it used to be or treat the addiction first, then try and treat the or, you know, treat one or the other. But usually, you have to try and do both. At the same time, that’s where most of the evidence is, I mean, at the same time, if we see if your client is able to do that, because some people say, you know, doctor recommended stop drinking, and that’s where you have to then try and work side. But psychiatrists who had more exposure to drug and alcohol issues and more, I guess, just has more knowledge. And we’re comfortable at getting better outcomes from that patients. People who have drug and alcohol problems also tend to have personality vulnerabilities, past history of trauma. So it’s good to know about that and how to sensitively ask those questions to get to those answers to that therapeutic alliance, and then enact treatment. Yes, so we’ve got a complexity that you’re seeing. It’s not just one part of the picture where someone’s presenting with panic disorder, we’re seeing trauma, we’re seeing personality, we’re seeing, perhaps a childhood upbringing that was less than competent by their parental influence, and then also the coping strategies that they’ve chosen that are not helping them to live in healthy ways. Yes. So those will update the initial triggers, I should say, back in the day, I had an uncle who was trained to be a psychiatrist in Zambia. So he was very influential. He dropped out to become an orthopaedic surgeon at some point, because I think, because, you know, he was training in the, in the, in the 90s, in the 2000s. And that was just not sexy in Zambia.

Rebecca Ray
And also, orthopods are quite the opposite of psychiatrists, aren’t they, like, orthopods have, for listeners that don’t know, I haven’t been in the medical field, orthopods have a really strong reputation of actually being very unempathic.

Dr. Xavier Mulenga
You know, they do have that. Even though they’re training, they actually tried to enforce that a bit more saying, Listen, we have to learn to be empathetic.

Rebecca Ray
You can’t just fix the hip, you’ve got to actually be nice to the patient beforehand and after.

Dr. Xavier Mulenga
Exactly, exactly, you know. And it’s interesting. I think, for him, it was more psychiatry had its limits in Zambia, and a third world country, you know, you just have limits, not enough research and enough medications, not enough education, lots of stigma. So I think over time, he just got tired, by the system, so he wanted something that was just straight, you know, logical. So I think that’s, yeah, orthopaedic surgery, clearly just just made sense to him. And he already has good communication skills. So he actually finally did very well, in those settings. Actually, I think that was his was good for him in the end. If Zambia is more developed in mental health spaces, I’m sure he would have finished his training in that, but it just wasn’t that in that time. Then going back to the addiction question I found, you know, it’s, it’s also around us, like, you know, everyone knows someone with a drug and alcohol problem. You know, it’s, it’s, 

Rebecca Ray
Well, that was gonna be my next question, like, what kinds of addiction are you seeing? Are we talking about, you know, your uncle who tends to drink every single day and will clinically be diagnosed with some kind of alcohol dependence, even though he doesn’t consider himself to have a problem with alcohol? Or are we talking about people who are using illicit drugs that are coming off the street? Or are we talking about people who are misusing drugs from a chemist that they’ve gotten for pain relief or something?

Dr. Xavier Mulenga
All of the above.

So addiction is addictions is quite wide. And I like what you did there. It’s a spectrum, right? Yeah. So alcohol is predominantly the biggest thing we deal with because it’s just the anytime you have illegal drug, you know, it’s easy access. So people in Australia the culture, we will talk about this Australian culture being a drinking culture but that’s a lot of actually you go to Africa, you go to Brazil go to London. It’s actually more it’s across the world even in China, Japan, you know, quite we should just say it’s a global issue at this point of time people say Oh, well we’re more drinkers than those people but it’s like two alcoholics are arguing about who drinks less.

That’s the term I tend to use it offends a lot of people but it’s just the way I think it’s good to look at.

Yeah, so then we have alcohol being the bread and butter. Lots of actually cocaine use, Cannabis, prescribed medications that one at least has been clamped down over the years. So we used to have a big problem Xanax and Valium. So whether you’re prescribing and then people would be doctor shopping a lot more but we have systems in place that are clamping that down, and a lot more GP practices, it’s hard to get a valium if you want, you should go to a GP practice if you’re not known to people. Yeah. And the government’s are auditing our prescribers because I guess we’re the ones who can also give people these addictions. So reducing how they give painkillers, they have to be very reducing. So they have to think about it before they just give you morphine based opioids really You get abused that and we’ve seen the opioid crisis in America. So in Australia, we sort of banned that, you know, because you’d be able to get to over the counter medications as your parent forms and everything like that, but it says anything with any codeine or opioid in it, you have to get a prescription, which then tightens things up. So that’s really been good.

But yeah, all the above. And I think given going to the alcohol example, I always tell people that addiction is a spectrum, but at any point of that you can come in for help. So you mentioned the uncle was drinking maybe a bottle of wine every day, that’s a problem clearly gonna have negative impacts. So that’s the obvious example and says that that’s what everyone thinks addiction purely is the person who’s homeless, injecting heroin, you know, as extreme examples, but then going back to alcohol, those people who actually binge drink so they’re not drinking every day, but basically, every weekend, you know, and then and then that mental health gets affected and over time, that’ll still give you problems should speed as if you’re drinking every day, there are people who drink in crisis, someone’s relationships are broken down, divorce, and they go into spiral drinking, very heavily disruptive behaviours, and that some people actually recognise that maybe they don’t have a formal problem, but they think that drinking may be a bit too much because of the more awareness was sort of having the community and it’s like social media. So many young people should bring it Tik Tok say so this Tik Tok, which, which is funny, because now I watch more Tik Tok because of patients, and also the younger friends, but it’s interesting when patients come to me like, oh, you know, so as I treat people, 18-19 year olds who are coming into clinic, well, you could argue this person’s just bingeing at uni, which was accepted, you know, it was, yeah, binge drinking culture, but they recognise No, I’m getting to this vulnerable situations and a sexual assault or this man, this young students being aggressive, got arrested, arrested, they almost got charged DUIs, they’re coming in. And that’s a good thing.

Rebecca Ray
And are they getting to you because of Tik Tok or Instagram or something? Is it that they’ve seen something on Tik Tok that has triggered them to think, oh, maybe I do have a problem? Or is are they actually finding out about or do they have concerns about their behaviour from some other source? Like, is it their friends saying, mate, you know, like, you passed out in the street the other night? And perhaps you need to look at your drinking? Like, how are they knowing to come in and see you?

Dr. Xavier MUlenga

That’s a good one. Love the time actually, that the conversation with the mates ones is interesting, because I think a lot of friends would have said something. But even when I think about myself, when you’ve had friends with me before I did the training for good friends with a problem like drinking, how strongly do you advocate, you know, you unless they’re really, really close friends can bring in say, Hey, I’m actually worried about you, should we get you help? But they’re also easy to also ignore it’s like, so that’s the thing. So I find friends, unless they’ve got really diehard friends, most of the time, get information on Tik Tok, Google a bit, some people read it, so And there’s lots of good sources out there also lots of misinformation. But by and large, they then take it to the GP. So a lot more people are recognising that everyone just says go see your GP because your GP and people go into GP and GP is now learning to treat somebody themselves. But where they feel that okay, this needs a psychiatrist. They’re able to sell it to patients. So actually, so GP is now learning to sell mental health to patients and psychologists, because historically, if a GP said, “Oh, I think you see a psychiatrist”. But like, Oh, why?

It’s a mental thing going on here. So you should see the professionals, but no one wants to see a psychiatrist. I often joke with people that a psychiatrist, if you see a psychiatrist, things can’t be good. So whenever I hear something like, well, how are you going today? To say, Oh, I’m good, Doc. I was like, Oh, I guess my job is done. You know.

It’s just a light job to get to, you know, to build up rapport. I still use humour quite a fair bit. But it’s interesting, because people know that going see a psychologist means shits hit the fan or something. Yeah. And you know, and people who will also shame about it. So yeah, thing a lot better. And the younger crowd actually know that. Even if they don’t get along with their GP, they’re like, No, I have to see a psychologist, psychiatrist And when they come, it’s good, because they come with lots of information, sometimes too much. But I think it’s better than before where no one would come at all. Yeah, because people say like, oh, the young people have a problem. I mean, historically, drinking less than we are, you know, but they are coming in early, and that’s the thing that we shouldn’t miss out. They’re coming a lot earlier, before they put more chronic, the more rigid in personality structure that will make chronic medical issues and so that’s a good thing.

Rebecca Ray
It’s a very good thing, especially with the treatment outcomes, and to make sure that if they’re coming earlier, that means they’re younger, which means we can train them and educate them in their own health behaviours, which hopefully leads to a longer life or at least better quality life. Because I think that’s the thing people talk about, especially addiction, and talk about, you know, cuts like five years off your life or 10 years off your life. Some people don’t give a shit about that some people just care about living for the now you know, and I think that’s fine. That’s your choice. But do you want to make sure that the time that you do have however long that is, is quality? How do we do that? You know?

Dr. Xavier Mulenga
Yes, exactly. And that’s just the centre line, like, we’re just improving your quality of life. Yeah. And then people can vouch at that, because mental health, when you’re going through, it makes you very myoptic. So we’re talking big picture items to certain clients, if they’re not there yet, you have to sort of meet them where they’ve come to see you. I think that’s probably one of the reasons why I like addiction is it’s sort of this building up of skills. And it’s not always about the medication, because a lot of you will come and say, “Definitely I need medication to stop me drinking.

But meds, they sort of work. I mean, some some more effective than others. But same time, it’s probably we have to check your behavioural cues, what environments are you in? Why you should quit drinking all these things that people invariably would rather just have quick fixes for, you know, but you have to sort of coach someone to it, and you have to know it yourself. So you have to be able to build up on that. So it’s interesting. If it keeps you keeps me busy each day, I think?

Rebecca Ray
Absolutely. This has been so valuable, and we’re approaching the end of our time. So I would love to know, if someone is listening and has thought to themselves throughout our conversation today that maybe I’ve got a problem with my drinking or with my cannabis use or with some other drug that is in their life in some way. What should they do? Where should they start? If there’s just been this kind of, you know, ding in their minds, throughout this conversation, what would you like people to hear in terms of encouragement? And what’s their next steps?

Dr. Xavier Mulenga
Well, I guess in terms of encouragement, the fact you’re thinking about it is good. You know, I think lots of people wouldn’t think about these things as much. But nowadays, people do think about substance use or whatever mental is a bit more seriously. Definitely. Number one is always I always bring up the GP. And even when I say the GP, it’s good to go talk to a GP, if they know you well, and that’s your regular GP, that’s a plus. But it’s also good to ask in the practice of their GP was well versed in mental health or addictions, because every GP is good, their own speciality, you know, some a skin specialist, some people do more, you know, chronic health conditions and some people’s mental health and addictions and you find they actually quite savvy to either start initial treatment plans before getting you the referral, because going to see a psychiatrist is going to take a while anyway. Before you use a psychiatrists, you know that so many other options that GP community mental health centres, so even wherever you live, you just sort of Google was my nearest Community Mental Health Centre. And usually they have a drug and alcohol team, which, in person, they give you a number, and they actually triage the problem with you and say, Okay, you’re depending on what you call in for some people, it’s like, Whoa, I recommend a detox, why recommended I see drug and alcohol counsellor, or there’s a doctor’s appointment can offer you and you find is quite a quick entry. This is what’s important want you to be linked in with the GP, because normally, we like to pull it all the information we get and bring it back to your primary source, which is your GP, in Australia works. And then lots of numbers as well, for every state is quite different. But if you just ring your drug and alcohol numbers to contact, even if you call through the lifeline, they’ll refer you to the numbers. They’re quite low numbers on drug and alcohol issues where they’ll say, Okay, we’re your nearest general community centre, how can we help you? And you can actually just go talk, and again, it’d be for someone else, you know, I, you know, so there’s, there’s so many pathways, but usually, those are the main ones I’ll let people know. And I think also not being afraid. If you do need see a psychiatrist, sometimes it’s just to confirm what everyone’s knowing, because we get a lot more time with certain skill set we can add in. So if someone’s got a drinking problem, that maybe we throw in that oh there’s a bit of underlying anxiety, they’re complex trauma, insecure attachment, and then things that we can maybe reflect on to the patient. No, okay, this one with therapy for because some people think go to see a psychologist to say, Okay, what, what are we going to do? And sometimes you have to spoon feed people a bit, not everything, because the therapist, the therapist will do that with time. Yeah, but if they can see the reasons why you think they should go, you know, when I sit in have maybe a background of borderline personality disorder, and you start talking then about DBT dialectical behaviour. Yeah. And people think, Oh, well, I can target things specifically because some people like problem checkbox, and sometimes that personality structure even though mental health and addictions doesn’t work quite that logically.

Yeah, but the end of the day if you’re seeking treatment early, the outcomes are better for you. And this never too late people have seen through in the 70s and 80s. I’ve seen people as early as 17-16. So just go for it. There’s nothing you stand to lose.

Rebecca Ray
Yes, and please don’t  think that the shame exists for us, when you come to see mental health professionals, we’re here to help not to shame you further. And I think that’s what stops people from often accessing treatment, just want to add one thing to the GP, you mentioned before, sometimes your GP doesn’t know you all that well. Sometimes your GP, you might not get along with your GP, I just really want listeners to take that seriously, you have a right to go to a different doctor. And I really encourage you to advocate for yourself and to find a doctor that does fit with you and that you can collaborate with. Because if you’re going to a GP that you feel judged by or that you feel shamed by or that you feel he’s just not hearing you and just not taking your concerns seriously, then please go to someone else, go to someone else, because it’s really, really important that this person is going to be alongside you for likely years and possibly even decades of your life. And it’s really important that you have someone that you can go to and be vulnerable with. So that if you do ever need to see a psychologist or a psychiatrist or at least talk about any issue that you’re not sure about that’s making you feel vulnerable, that you can do it in such a way that you feel safe.

Dr. Xavier Mulenga
Yes. Do you mind if I add something from that. Let me think about is how the secure nature of addictions is so let’s say with alcohol problem we treat this year you’re good just in therapy psychologist so sorted. It’s not a guarantee that it’s gone forever. So long for the landline you have a trauma, you lose your husband, your mum dies, or you get unemployed and you find so financially trouble. It’s also potential that could come back and having that in place already know your history. It’s quicker to get it’s easier to get you back on track.

Rebecca Ray
So true. Dr. Xavier Mulenga, thank you so much for being here today. I love this chat. Where can people find more of you? Is The Guardian the best place for them to go?

Dr. Xavier Mulenga
I hadn’t mentioned that yeah, because I’m bad at the social media I need to get sorted.

Ideally most of the time in private practice. I work at Northside clinic but if you just google me but I think it’s still yet to have any sort of social media platform because so many people in that space anyway and I guess I have to think of what I’m going to do with mine but there are many of us out there and the addiction field is definitely growing. But yes, my name you find me out there. It’s very easy to.

Rebecca Ray
Also you have written for The Guardian some great articles for The Guardian, so Xavier Mulenga. Google him and you can find more of his wisdom out online and perhaps maybe we’ll drag you on to social media one day.

Dr. Xavier Mulenga
Yes you will. I think I’m getting the point where I have to you know, somebody’s talking about the Guardian article. It’s interesting how many clients and I meet in the waiting room and they’re reading it while I’m there. It’s like well, hello.

Rebecca Ray
It’s it’s, it’s great, though. It’s a good introduction to you. Thank you so much for being on the show. I really, really appreciate your time.

Dr. Xavier Mulenga
No problem. You take care.

 

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