A DAY IN THE LIFE OF A PSYCHOTHERAPIST

A DAY IN THE LIFE OF A PSYCHOTHERAPIST

D-r Ksenia Kisselincheva

It’s the hour of musical therapy - I can hear Vivaldi’s Fours Seasons being played -I think I recognize the string ‘torrents’ of coming spring. For a moment I forget about where I am going and I dare contemplate the March sunset. The gently rippling music that envelops my soul for an instant makes me picture pink and white flamingoes flapping their wings through the sky. It’s only a fleeting instant. The chimneys and satellite dishes seem to have voraciously ‘engulfed’ the city sun and it’s seen no more.

 The musicotherapy seance seems to be over-I can hear the dragging of chairs and the chattering and clattering of the participants in the seance. A knock at the door and I find myself into an empty hall . Chairs are lined by the wall, loudspeakers are attached to the padded walls and a mike is hanging from the middle of the ceiling. The ‘concertgoers’ who appear to be of all ages and colors-from babyboomers to teenagers are all patients of the psychiatric clinic. But instead of being hospitalized they are treated on an outpatients’ regime. Some of them have undergone a short but intensive course of treatment with neuroleptics under the supervision of doctors but after that they can go home and feel like normal human beings. While at the same time they go back to the clinic for half a day to get either supervision from their doctor or some kind of alternative therapy-musicotherapy, calanetics, occupational therapy, art therapy and auto training. Most of the patients suffer from psychosomatic disorders like neurosis, depression, obsessive conditions. The relative ratio of the serious psychic disorders is steady - it is about 30%.

 But it is alarming that the latter ailments are on the increase and what is still more alarming drug addiction has boomed for the last 6-7 years and it is affecting mostly youths from the age of 13 to 18. Now that the patients have left I can have a chat with the psychiatrist, Dr. Zdravka Gerdjikova. She is a small energetic woman in her late fifties , short hair cut and prominent charcoal eyebrows which seem to be perennially questioning what she hears. And as you can guess she hears many stories full of ‘sound and fury’. And she has to solve the puzzle and she can’ t make a mistake because if she does, people may commit suicides or suffer a permanent damage of the brain. But this brave little woman is full of laughs and jokes and she does not show the enormous burden she has to shoulder. She is also a deputy director of the clinic and the telephone in her office is ringing most of the time. She is trying to tell me while she making herbal tea that in 1990 she took on a challenge bigger the ones she is used to-she was invited to the National Consultative Polyclinic where she was supposed to deal with the toughest cases which the local treating therapist cannot crack. ‘I find my work there so exciting and dynamic like nowhere else.  Though I must admit at the end of the day I can just about get home and crash into bed. . . ‘

Thank God her children are grown up and at university and she can devote more of her time to her profession. Because she made her choice against the will of her parents - they expected her to choose a more’ feminine’ profession like German philology, for instance. But her ‘infatuation’ with psychiatry started way back into her college years when her beloved biology teacher took the class to the psychiatry clinic. It’s the same clinic where she is working at the moment. What struck her most of all then was the attitude of the staff towards the patients - they were so kind and considerate and never laughed at the patients’ eccentricities. So soon after she became a medical student she joined the psychiatry circle and she became acquainted with the achievements of the three great figures in Bulgarian psychiatry- Prof. Shipkovensky, Prof. Temkov and Prof. Usunov. First she saw their busts in the clinic’s foyer at the time of her first visit. Later she came to appreciate their contribution to psychiatric practice. In the fourth year Zdravka started taking duties at the clinic learning how to do various manipulations.

After graduation in the ‘socialist manner’ she was ‘directed’ to go to work to Karlukovo, 120 km north of Sofia. This is one of the biggest and oldest psychiatric establishments in the country . Dr. Gergjikova loves to go back to that period in her life because this was the greatest time in her life, both in a professional and personal way. ‘There was a very special atmosphere of being together, doing things together. There was a group of older and younger doctors whose motto was to learn and know and to apply it in practice. What bound us together was a keen interest in our work. Sometimes one of us would wake up all of us to become witness to an interesting case . Then we‘ll stay up all night struggling to work out this case or to connect it to other similar ones. ‘ Then there were the endless gatherings on the verandah which started with conversation about the patients and ended only late at night over a glass of wine. ‘Those were the days . . . we thought they‘ll never end . . .’ It was a jocular interjection on my part but Zdravka recognized the song immediately and added that they used to dance to that hit of the 60’s on the verandah well into the night. . . She stayed there for six years. By the third year she took her specialty . There she met her prospective husband, there she married him and there she had her first daughter. But then the times were ripe for a move. But the only chance for her to return to Sofia was to win a post-graduate competition.

And she certainly made it- in 1972 she won the tough nation-wide competition and was appointed as an assistant at the newly founded clinic for alcoholism and drug addiction. She made it back to Sofia but she had to face to new challenges-the clinic was still under construction, the medical staff was being recruited, and Zdravka had to learn ‘a new trade’. So far she had seen just two drug -addicts in Karlukovo. By 1975 there were 198 drug addicts - it was no longer something you read about in thick medical books. Also there were quite a few patients from Greece since at the time there was no such unit in the country. Zdravka says that what kept going in those hard times was her sense of duty to her patients. In the early 80’s Zdravka suffered a few shattering blows in her personal life. Her elder daughter got seriously ill and she and her husband separated and later divorced. But she never lost her sense of humour and always made people feel better around her. She used to listen to Vissotsky in those days and she used to sing with him-did she gain some moral strength from the magic of the maestro’s electrifying voice? Dr. Gergjikova pours me another cup of tea telling me more stories full of ‘sound and fury’.

 ‘After 1989 , we, the doctors from the clinic warned about the oncoming boom of drug abuse with hard drugs. But nobody believed us then-everybody was too busy shouting at political rallies. Today , in 1998, we are in a state of emergency. Teenagers smoke marijuana at school instead of tobacco and the number of heroin addicts is ever rising. . . ‘ But Dr. Gergjikova cannot sit back and do nothing. And she starts another one of her stories. . . She invited quite informally mothers of drug addicts to a New Year’s party. And they came up with an idea to set up an Association of Victims of Drug Addiction. At present they are in the process of registering it and they have regular weekly gatherings. They educate themselves how to cope with drug addiction, some of them have already lost their beloved sons or daughters. Little by little Zdravka came up with the idea of setting up a Rehabilitation Center for Drug Addicts based outside Sofia. There are such centers all over the world and the Association is trying to establish contacts with such institutions in Germany, Israel, Italy. In some cases they are supported by the church. And the members of the association are on the search of sponsors and supporters. They have already negotiated the opportunity of taking over a neglected monastery and refurbishing it for the purposes of the Rehabilitation Center. One of the mothers who is an architect is ready to make a project for the readjustment of the building.

But there are moments when she wants to escape all her duties and responsibilities and she has found a way to do it. She loves to put together puzzles representing paintings of famous artists. Also she loves to read science fiction and detective stories in her spare time. But most of all Zdravka loves to log into the Internet and to browse through for hours. When I asked her what was the thing she liked best after 1989, she did not hesitate to say it was free access to information. And when I harped on the topic how hard the times were, she reminded me that the Chinese hieroglyph for development meant ‘crisis’. Zdravka answered the phone - she had to consult a colleague of hers on a tricky case of manic depression. She invited me to join her. I was apprehensive but curious to witness the partial revelation of the human psyche in one of its extreme and distorted manifestations. Moreover some of them are intensely happy and pleased with themselves, something which rarely befalls normal humanity. This brings to mind Kurt Vonnegut’s saying: “It’s not necessary to be mad to work for us but it can help a lot”. Isn’t our brave new world of today more like a madhouse than a utopian vision?

Sofia Western News monthly, 1998

ANDREY GURKOVSKY: “SELECTIVE IMMIGRATION IS AN ALARMING TREND”

ANDREY GURKOVSKY: “SELECTIVE IMMIGRATION IS AN ALARMING TREND”

“How would you identify your place within the various generations of Bulgarian immigrants?”

“My generation of immigrants has been cut off from our native country for over 20 years. We have been excluded from the Bulgarian community and have been branded as ‘traitors’. To be able to live normal meaningful lives, we had to forcefully forget where we came from. I, personally, realized in a most poignant way I had done it when I arrived in Casablanca on a three year working contract. I placed the keys from my house in Paris on the table and I said to myself: “I won’t need them for at least three years now.” That meant I would be away from home, which by that time meant Paris. Later on, fate’s fickle finger wished so that I move from one place to another, the world over, so I finally forgot all about where I came from...

“When did you come back to Bulgaria again?”

“Ever since 1991, I have been coming back here almost every month. It turned out, that in the depths of my soul, I hadn’t forgotten my native country and I immediately started showing a keen interest in everything going on here. Unlike my generation of expatriates, those who left for France or US in the last ten years, they have a completely different attitude to their sense of identity.  They don’t seem to have any sense of national belonging, living in the age of globalization and high tech revolution. Rather they feel like citizens of the world and are ready to move from one country to another, moreover there is a trend of national differences getting blurred in many respects.

“How do you view the role of the Bulgarian Diaspora in the development of this country?”

“The overall number of Bulgarians, living abroad comes up roughly to about 2, 500 000 people. In spite of the fact that according to Bulgarian legislation, we are not eligible to being elected to key positions, we amount to a significant political force, which is entitled to representation in Parliament. But, we, generally do have an openly critical attitude to the negative trends  here, that because of this we happen to be inconvenient. No matter, which Western country we live in, we tend to share a mentality, values and criteria quite unlike the Balkan ones. Most of us do believe that decent hard work is the only worthy way of personal fulfillment in a civil society.

“What is your attitude to the Bulgarian project of Euro-integration?”

“For us, Bulgarians, living abroad, this is certainly a positive development of things and it will facilitate and give a boost to our trad4e and economic activities here. The experience of Portugal and Greece is often referred to within the context of a more successful preparation for EU membership. But, we must bear in mind that the success story of Portugal is not primarily due to EU subsidies as much as the impetus, given by expatriates who returned from the ex-colonies during the second half of the 70’s, Most of them were people of entrepreneurial spirit, big money and know-how. If we assume that half a million Bulgarians of such a caliber come back, I am convinced that things will improve quite soon.

“Would you tell us about the Greek way of getting ready for EU membership?”

“After the fall of the military regime in the 70’s, thousands of seriously rich Greek expatriates came back to their mother country. For instance, at that time, I attended negotiations with Onassis concerning the construction of a power station in Ptolomeis, which is in Greek Macedonia. Enterprises on this scale bolstered up in a major way the economic prosperity of the country. Moreover, there must be more a million and a half Greeks the world over who own and run a business on a really big scale. While, in contrast, there are few Bulgarians who are millions of dollars worth.

“Would you comment on the “Bulgarian way” in adopting the principles of market economy?

“My observations for the last ten years make me think that hire, like in the West, an exchange of favors takes place, but with a difference. Here, the procedure implies elimination of the competitor, i. e. the rivals don’t get a fair equal chance of competing. In the West, power and influence are used in order to manage to secure better conditions for doing business, but this does not imply an absolute priority for a given competitor who is being favored, such opportunities are provided for the rest of the candidates. That means that doing favors or exchanging them works in a positive constructive direction, it bolsters the competitive power of the rivals in a given area.

What do you think about the lack of protectionism on the Bulgarian market?

I, personally, think that the lack of protectionism on the Bulgarian market makes things look dramatic. You can’t enact the laws of the free market in case there is a significant difference between the investment level in one country, compared to others. If you turn to Japan and Germany, you will notice that there is a marked preference for local production. And to give a chance to Bulgarian products to make a breakthrough on the world market, it is necessary to create a number of conditions - in the least 5, 000,000 dollars investment, surmounting enormous administrative hurdles and observing very high criteria.

“Are there good prospects for higher investment levels in this country in the near future?”

The want of capital on the world market is tremendous and none is going to invest 50 0r 60 million dollars in a high-risk environment. And the Bulgarian economy at present needs at least 15-20 million dollars to get it going. But such a lump of money has to be correctly invested and well managed. Are there competent people who are capable of this? Without taking the wrong step or being tempted into embezzlement. My impression is that a proper market way of thinking and reflexes are still missing here.

For instance,  a transportation company, let me not name it, could not secure me haulage of some merchandise from the Croatian border. How could they finally state: “This cannot be done!”

“What is your opinion about the “brain drain” trend in the last ten years?”

This is an alarming trend  f late, there were only individual cases earlier, while now it has turned into a mass1ive trend. Each specialist brings 180 000 dollars to the recipient country. And the US and Canada have a consistent national policy of selective immigration in this respect. It is dangerous for any society to continually invest into the education and qualification of potential emigrants.

“Which, according to you, is the best form of participation of foreigners and Bulgarians in the economic activities of this country?”

I, personally, think that this the joint venture company. Because the foreigner comes here with a good knowledge of the market and a confidence that a certain product can manufactured here at a competitive level of quality. You can see examples of such a form of cooperation everywhere round Bulgaria. Look at the success story of “Ideal-Sevlievo”, for example. They are manufacturing faucets, batteries, fixtures etc. The local manager who is Bulgarian can best solve the problem with the personnel selection and the range of the wage. This is the most prospective and optimal option of international collaboration presently. But, it will take this country quite some time to get in pace with world standards of quality and sophistication, but I believe it will happen rather sooner than later ...

Interviewed by Dr. Xenia Kisselincheva

Sofia Echo weekly, 2003