Could you describe the exam for becoming specialist? What about the one that brought your present position?
To be a specialist I had to pass a test consisting in 100 multiple choice questions and a written case presentation where I had to follow the patient both from a psychiatric and psychotherapeutic point of view. Here in Switzerland, there is a great focus on the patient-doctor relationship and how one can build a “bridge” of trust between them.
I found my present position through an advertisement. First I sent my file, than I was invited for an interview and later I was informed that I received the position as chief of the geriatric-psychiatry section. Meanwhile, I was lucky to obtain Swiss citizenship, otherwise I could not be hired. I also kept my Romanian citizenship.
Sometimes I have the impression that in Romania people believe that Westerners live without worries and problems. What do you think?
Compared to Romania, one is less worried of every day surviving here. However, there are other problems: the race against time, the stress of financial problems, many have troubles meeting the end of the month. Even though, due to a good state care system people do not face starvation, there are a lot of existential problems here.
Could we speak about „Westerner illnesses“?
According to the specialised literature, people suffering psychic illnesses as schizophrenia or the schizo-affective illnesses represent all over the globe (that is here, in Africa or Romania) the same percentage of the population: 1%. Depressions, for instance, do not depend on the living place or the financial situation of a person. One might say that here in Switzerland there are more patients suffering of the so called „distymia“ – states of depression, of „unhappiness“, which appear on a neurotic background and can last several years. I think this happens not because here is the West with a certain wealth (as they say in Romania “they suffer of too much wellbeing”) but rather because people think more about certain aspects. They have more time for reflection because they enjoy a satisfactory salary, a good social system, vacations, therefore - because they do exist - people dedicate more time to their personal problems.
When one is facing marriage problems he or she goes to qualified persons in order to solve them, one tries a couple therapy. (However, the rate of divorces is very high in Switzerland, 43%!) Of course, there are such problems in Romania too but people have less time to ponder the psychological implications: one gets the divorce and that’s it. I also think that in Romania one does not give enough attention to minor depressions as they do here. From minor depressions one can develop serious depressions which could even end in suicide. Sometimes the family and close ones perceive only the advanced stages, and often it is too late for an efficient intervention. Because of difficulties, the fear to admit that you are sick, the stigmatism that a psychic illness might bring, the lack of time or simply because one can still „function“ quite well while having a depression, many people „keep going“ until … they face a nervous break down.
As western illnesses on which now there is a strong focus I could mention the nutritional disturbances as bulimia or anorexia. But they also exist in Romania. There is also the drug addiction but unfortunately this is becoming a serious problem in Romania as well.
The Swiss press indicates an increase of psychological disturbances among children and youth. Do you face such problems?
I treat adults. According to my experience at this moment in the psychiatric anamnesis (not only here in Switzerland but also in the US or other countries) there is a great focus on what a patient experienced during his/her childhood. One attempts to find out disturbances as soon as possible, because it has been noticed that most of the patients’ problems originate in childhood. It is well established that people confronted with childhood or adolescence difficulties are more vulnerable and eventually they can develop more easily psychic illnesses. At this moment around 30% of the sick persons in Switzerland suffer a psychic or psychosomatic disease (I read recently a statistic). Such disturbances are very stigmatising both in Switzerland and Romania and the patient suffers a lot. Here however, their perception starts to change. When I was applying ambulant treatment, I noticed that approximately 20% of the patients came to us out of their own initiative. They were asking for professional help, saying „I feel bad because of…” „I broke up a relationship and feel depressed“ or „I need help because I have been sexually aggressed“. Such attitudes prove that people are more open to accept psychological problems. This also increases the healing chances.