Episode 2: Building Trust

Uh, Jared from our Patreon - Oh, hey guys, don't forget to sign up for our Patreon - uh said, "Hey, guys, love the show. I was wondering about how Daphne got these records. Uh, she said last episode that the kids of a deceased asylum board member gave them to her. Uh, can you clarify why they had them and were able to give them to you?

Yeah, absolutely, so my understanding is that the people I spoke to were-were one of the uh, board members kids, and it was basically stuff the guy had put in a box in the attic. They didn't know much about the case, their dad hadn't spoken much about it, I guess, so it was just sort of a box of forgotten files. My guess is he probably didn't talk much about it because he was trying to make sure it stayed quiet.

Yeah, and I think they were sort of, um, I think they sort of knew a bit because they were really hesitant to give it to me, but, you know, me. All I had to do was turn on the charm. Well, Jared, hope that answers your question. Our next comment is from @Ijustwokeupfromanap, who says, "I love that you guys don't over-edit your show, it feels much more authentic." Aw, thank you! Yeah, thanks. You know, we tend to find that our editing style is a little more human. More conversational.

Yeah. Oh, which, like, it isn't to say that people who edit more heavily than us are doing something wrong. Oh, of course not. You know, but, but, I think our style works for us. You know, it feels more... I think it feels like people can connect with us more. Oh, I agree. Uh, anyways, last question from Tree, also from our Patreon.

Uh, "What does research on something like this look like for you guys?" I don't want to speak for Preston, but on my end, it's going through as much of the original case materials as I can, then as many secondary sources as I can, and then trying to put the pieces together myself. Well, I have gone through a lot of paper and yarn for this show, trying to put my thoughts together. (giggles) Uh, Preston? Uh, well, I think it depends. Obviously, I have a bit of general knowledge on psychology.

Uh, you know, I'm listening to this stuff for the first time as Daphne is exploring it with all of us, so there's not, um, you know, a lot-a lot of research I'm doing ahead of time for episodes. Unless it's a topic we've discussed ahead of time-- Like attachment styles. Right, right, like attachment styles. So, you know, my-my process, (clears throat) for the last week has been, you know, uh, doing the reading, you know, um, finding, um, papers, and studies, and journals, um...

Cool. Interesting. Yeah. Anyway, thanks so much to our patrons and listeners for submitting comments and questions. (Mindful Musings jingle) Mindful Musings... So, on the topic of attachment styles, before we get into the new stuff for this week, what do you think of Hazel's attachment style? Uh, so based on what we listened to last week? Yeah. Well, well, I mean, you know, I wasn't listening to those recordings with attachment styles in mind. Of course. So I'm not sure.

You know, it's been a week since we listened to it, but I could say for sure that I don't think Hazel had a secure attachment style. So, just for the audience here, can you give a little more context on what attachment styles are, what they can, uh, what they help us understand? All that good stuff? So, attachment style theory is-is basically how we, you know, form attachments and how we react to threats to those attachments.

Yeah. Uh, so there's four types, anxious, avoidant, disorganized, and secure. Uh, you know, someone with a secure attachment isn't really afraid of abandonment, uh, whereas the other types are afraid of abandonment and use unhealthy coping mechanisms, you know, to deal with that fear. And so today, as we get into more of Hazel and Doctor Burnett's story, you'll be giving us your insights on Hazel's attachment style? Cool. So, before we get into the next session recording,

I wanted to discuss (flipping pages) Hazel's late husband, in a bit more detail, just to help give more context. (page flipping) Oh. Here it is. Hazel's late husband, Charles Edward Finley, born 1920, died in WWII in 1944, at the age of 24. Mmh, yeah. There isn't a lot in the materials I was given about Hazel and Charles. My guess is the letters between them and stories about them are all in the hands of their families, who have not responded to any messages from us as of yet.

Um, but, we know that he was the one who committed her to the asylum shortly before he was deployed. We also know he was the only one who wrote to her once she was committed. Again, we don't have copies of these letters, but we do have Hazel's journals. (page flipping) "Charlie sent a letter. It took me a long time to open and read it. These days, he talks about dirt and blood and going hungry.

We both knew war would be hard, but I hate thinking of him out there, away from home, scared and alone and cold and famished. And I'm angry at him. He's been away, fighting for freedom, but he's the one who put me here. When the war is over, and my country is celebrating, who will he be watching the fireworks with?" Oh, that's a fascinating passage. It is. That speaks to an anger, you know, I think that maybe stems from fear that Hazel harbored against her husband.

Yeah, I mean, I would totally be upset if my spouse basically imprisoned me and then went off to fight for the freedom of others. But, what I think is interesting here is that she doesn't actually seem worried about him. No. And, you know, she clearly doesn't like the thought of him in the trenches, but, you know, she doesn't seem concerned about him, like-like, but- but again, I wonder if her anger here stemmed from fear.

Like, she doesn't sound concerned, but that doesn't mean she isn't concerned. Like-like covering up fear and worry with anger is a common coping mechanism. That's... yeah, that's interesting. Um, but yeah, uh, so I thought that would be good context, especially because we're about to get into the next part of Hazel and Doctor Burnett's relationship, where Doctor Burnett has tons more time to commit to Hazel's care. Shall we get into it?

We shall. (click) Well, we have a few more minutes, is there anything else you'd like to talk about? We still have time? I thought I was keeping you late. No, I transferred a lot of my caseload, so we have extra time, now. (sniffles) Thank you. Hazel, It's-- No, really, thank you very much. This is the most effort someone's put into trying to take care of me. Thank you, thank you. Hazel, I was happy to do it. (Hazel sniffles) You deserve good care, Hazel. You deserve to feel cared for.

Thank you. Nobody can make progress until they're cared for. You need to have your needs met, and to feel comfortable. Otherwise, the issues you're experiencing will be increasingly hard and overwhelming to tackle. Thank you. You're more than welcome, Hazel. Can I put in any requests for food or blankets on your way out? No, I'm all right. Thank you, again. (sniffles) Have a good afternoon, Hazel. (click) (clears throat) All righty, welcome back, everyone.

So, that was a pretty short clip, but what do you think so far? About attachment styles? Mhm. Well, you know, so far this all feels pretty indicative of an anxious attachment style. Now, now people with anxious attachments are easy to describe as clingy or demanding in their relationships, uh, but, of course, this is rooted in a deep fear of abandonment and, you know, a need for control.

You know, so far we've seen Hazel throw a glass at a wall when she perceived a relationship as being threatened. And she's deeply concerned with expressing gratitude to Doctor Burnett. It's almost like she's trying to give Doctor Burnett a reason to need her too. Really? You know, it's either that or borderline personality disorder. Which is also characterized by a deep fear of abandonment and can also lead to meltdowns.

Ah, but, you know, Daphne, go ahead and give your thoughts. (couch squeaks) I think this clip is just the start of Doctor Burnett really falling for Hazel. I mean, she's so attentive and caring, and she's really trying to reassure Hazel that she's there for her. And, okay, yes, that's her job, but I've never had any medical professional ask me if I could use a blanket. To me, that seems like Doctor Burnett's attempt to show affection in whatever way she can. Hmmm.

Okay, okay, let me show you. (pages flipping) Is this going to be another journal entry? A few actually. Oh here it is. First, I'm going to read you a passage about another patient. "Daisy demonstrates an above-average level of intelligence, and her episodes seem to be rooted in boredom. More enrichment required before increasing dosage." Daisy is a patient that Doctor Burnett handed off to another doctor in the facility. Okay,

So compare that to how she speaks about Hazel. "In my conversations with Hazel, she demonstrates an incredible amount of compassion, and desire for connection, and expresses feeling a disconnect from others. Not only is this not a symptom of schizophrenia, but in my opinion, it is a symptom of fear and loneliness. Continuing caseload hand off to assure further care for Hazel." See? It's different. Oh, I, you know, I don't doubt it's different. Like, I mean, we know they did run away together.

But I think Doctor Burnett was just offering a blanket. I think that-- I mean, Doctor Burnett mentions Hazel's fear and desire for connection. I think it's entirely possible that she recognized that Hazel needed a feeling of security and safety, you know, and was catering to it. You know, You know what, she said herself that she wanted to make sure Hazel's needs were met so she could improve. And? Then, obviously, you know, Doctor Burnett got a little carried away eventually. (laughing together)

Okay, getting us back on track a little here, let's listen to the next clip. (click) (Hazel sips water) It's been two weeks now since we took you off your meds. How are you feeling? Not much different. Any withdrawal symptoms? I don't think so. I'm having fewer headaches and dizzy spells. You were having headaches and dizzy spells? Yes. Minor ones though.

Well, those are common side effects of the medications you were on... (flipping pages) but I don't see any indication of headaches or dizziness in your chart or in your notes. Hazel, why didn't you tell us you were having headaches and dizzy spells? It's important we have a good overview of what's troubling you. Is there a reason you didn't indicate any side effects? Did Doctor Green ever ask you about adverse effects? No. Mhm. Okay. That's not your fault. That's okay.

Hazel, I'm asking you right now, If I ever add anything to your regimen and you feel any adverse effects, I want you to tell me, Okay? I don't want to trouble you. You're not troubling me, you're helping me do my job. I'm here to help you, to make sure you feel better. Do you feel at home here? I don't know. I don't think so. Okay. Is there anything uncomfortable about your room? I don't know. If you think of something, let me know. You live here, it should be comfortable.

I can't help you if I don't know what's hurting you. So if there's anything even a little bit off, I want you to tell me, Hazel. (shaky breath) Thank you. (click) Okay, so that was from right after Doctor Burnett initiated a med review and transferred a bunch of her caseload. So now we're going to listen-- uh, we're going to skip ahead a couple a sess-- a session-- Oh, my gosh. We're going to skip ahead a couple months and listen to another session. (click) Did you hear what I asked,

Hazel? (Hazel picks at her plastic cup) Hm? Sorry. Are you feeling okay? (Hazel continues picking at her plastic cup) They're using different oats for the oatmeal now. I don't like the texture. Okay. (Hazel continues picking at her cup) How are you feeling? I know this must be a tough time of year for you. (Hazel continues picking at her cup) These oats get too mushy. They soak up too much water. Mhm. Is that affecting your mood?

No. (Hazel continues picking at her cup) My morning just feels unfinished now. I didn't eat most of my breakfast, and then I didn't want to change because I wear my nightshirt until I'm done breakfast, but I didn't finish breakfast, so I didn't know if I should change-- Are the oats the only reason you didn't finish your breakfast? Nurse Amelia noted you didn't eat your fruit either. (Hazel continues picking at her cup) I didn't want to eat mushy fruit. The fruit... Hazel, are you hungry?

No. Are you having trouble waking up in the mornings? I don't know. Maybe. Everything feels mushy and gray. Like the oatmeal. (Hazel continues picking at her cup) Okay. Are the oats affecting your mood? (clears throat) I don't see a point sometimes. (Hazel continues picking at her cup) A point to what? To you trying to help me. To trying to get better. I'm going to be stuck here for the rest of my life.

I don't know what I'm supposed to be trying for. (Doctor Burnett writes something down) It sounds like you're feeling a little depressed. Is that accurate? (Hazel stops picking at her plastic cup) Is there a reason you didn't want to talk about it? Maybe. I don't want to go back on the pills I was on before. It had been... a long time since I had a day without a headache. Or where I was able to stand up without getting lightheaded. I don't want to go back.

We won't put you back on those medications, I promise. If you don't want them, you don't have to have them. Do you trust me to take care of you? Yes. Let's try a morning walk, shall we? Really? Yes. Sunlight might be good for you. I'll have Nurse Amelia take you tomorrow after your breakfast. Alright. I'll be good. I know you will. Thank you. (click) Okay, uh, you know, I want to update my attachment style theory. Go for it. I think maybe she's presenting more of an avoidant attachment style.

You know, she's shutting out Doctor Burnett in an attempt to prevent the development of an attachment, you know, because she doesn't want to rely on someone else. Could it also be trauma related? Like, with Doctor Green having been so dismissive? Well, I mean, all insecure attachment styles, you know, stem from some sort of trauma, you know, usually childhood neglect, but a more recent trauma can certainly exacerbate it. Um, so you have more details about what happened with Doctor Green, right?

Not much. (clicking) Most of what I was given is stuff that the asylum’s board tried to bury that-- And they weren't overly concerned with Doctor Green, so... I only really got stuff that's relevant to Doctor Burnett's treatment of Hazel. So the final chart he handed over to her, and like, some of his notes. Yeah, there’s not much here from Doctor Green himself. We've kind of already been over his stuff. But, there are notes from Doctor Burnett that mention Hazel's thoughts on Doctor Green.

Um, "Hazel seems hesitant to share when something is bothersome. It is apparent to me that she does not expect her doctor to take those concerns seriously." (click) "Hazel voiced a pleasant surprise at my attempt to help her. When asked why, she said that she was anticipating a denial. She holds the belief that when I'm told about one of her symptoms, I will tell her she's wrong."

Ugh, yeah, there's a bunch of little notes like that. Yeah, It sounds like Doctor Green was, you know, neglectful, uh, to put it nicefuly. It does. You know, it only makes sense that Hazel would be so hesitant to tell Doctor Burnett what's going on with her. You know, based on those notes, I think it's very possible Doctor Green exacerbated Hazel's struggles with an avoidant attachment style. You know, if I'm being honest. Hazel is displaying symptoms of abuse trauma.

You know, I kind of wonder if Doctor Green was maybe... Doing something worse? Perhaps, yeah, you know? I mean, this looks like a trauma response to me. You know, the way she's so wary of Doctor Burnett. Well, you want me to play the next clip, so you can get a little more insight? Yes. Okay, so this next clip is from another month or two later. (click) Have you eaten since our last session? No. Are the oats still bothering you? I don't know. Maybe. When was the last time you got out of bed?

I don't know. Nurse Amelia says she hasn't seen you move in three days. Hazel, it's possible she missed you moving, she's not monitoring you around the clock. Hazel? She didn't miss it. I'm sorry. What are you sorry for? I didn't want to-- I don't mean to waste your time. You're not wasting my time. Am I wasting yours? No. I'm glad. Are you hungry? Do you need to use the restroom? I don't know. I can't. Can't? Aren't you ever just so tired, Doctor Burnett?

You have to feed yourself three times a day. You have to go to the bathroom every time you drink a glass of water. You have to brush your teeth and floss twice a day. You have to shower and wash your hair, then dry your hair, and you have to be standing that whole time. It's just... so much upkeep. And at the end of it all, I'm still... here. Alone. I hear you. You're not alone. I'm here. But I know you're lonely, and I'm sorry. I'm worried about you, Hazel.

What's happening to you right now, not eating, not using the restroom, that's... not normal. I think we should think about trying something like a low dose antidepressant. No. No. No, I won't. (crying) Okay, we don't have to-- Please leave. I'm sorry. Thank you, but... That's okay, Hazel. I'll leave you for now. (click) (clears throat) Okay, uh, last update, uh, to my attachment style theory, I think Hazel has a disorganized attachment style.

You know, so a disorganized attachment style is characterized by both wanting intimacy and, you know, like, deeply fearing it. You know, which seems to be what Hazel is doing, and also, I think, is why I thought she was anxious and then avoidant. (Daphne laughs) Hazel is very much afraid of being vulnerable with Doctor Burnett. You know, she's afraid to be honest about what's bothering her. She's afraid Doctor Burnett will dismiss her or deny her care.

But, clearly, Hazel wants Doctor Burnett's company and care. You know, she had a total meltdown when another patient pulled her away from a session. You know, and she does answer Doctor Burnett's questions, that's right, but, like, you know, she clearly doesn't want to make her job more difficult than it has to be. But then Hazel will apologize for being difficult. You know, it seems very... disorganized. Well, that makes sense.

I also think it probably does have to do with what you said earlier about trauma responses. The way she apologizes for wasting Doctor Burnett's time, for example, I was like-- Yes, I completely agree. I think Hazel must have felt so surprised that Doctor Burnett was so committed to listening to her and taking her concerns seriously. Like, that, Doctor Burnett was giving her some agency with her medical care, in a way it doesn't seem like a doctor had given her before.

That must have been, like, surprising, but then also very nice and comforting to be seen like that for, like, the first time. Mmm. If it's all right with you, I'd like to read Doctor Burnett's notes from this session with Hazel. Okay. (flipping papers) Medical terms... Medication names... Oh, okay, here it is. "Hazel's case is very complicated.

Here is a woman who spent adult-- whose entire adulthood has been spent isolated from anyone but doctors and nurses, who's been misdiagnosed, dismissed and ignored. Meanwhile, she is dealing with moderate-to-severe depression, moderate anxiety, dysfunction, and dysregulation on a pathological level, and there seems to be no diagnosis I am aware of that encompasses all of this. I don't know how any doctor with an average caseload could provide Hazel with the proper care.

I am sure there is a solution. That is science. That is medicine. We experiment and find answers. There is something I can do for Hazel, and I will find it, if it takes my whole career." Interesting. I think it speaks to Doctor Burnett's dedication - no, devotion, even - to Hazel. Yeah, I, I could see that. Yeah. Okay, here. I have one last clip for today, and then we'll wrap it up. (click) Hazel, let's get started. Alright, How are you feeling today? I've noticed you're sitting up in bed.

I suppose a little bit different. Better? I don't know. Do you want to try something to feel better? I can get some food to you, or we could go for a walk around the wing. No. I feel sick. (Doctor Burnett takes notes) Are you feeling feverish? Nauseated? No, no. There's something broken in me. Hazel, I've met a lot of patients like you. Nobody was ever broken. You are not the first. What did you do to fix them? Well, a lot of things. Exercise and sunlight helps most people. And... Yes. Pills.

Pills? They're no different than when you take medicine for a fever, or an infection. I'm scared they'll just make me sick in a different way. Hazel, I promise you, if you don't feel better after two weeks on new medication, we will take you off of it and try something else. My job is to help you feel better. I have no interest in keeping you on a treatment regimen that doesn't do that. (sniffles) All right. Yes. Thank you. Oh, come here,

Hazel. (Doctor Burnett hugs Hazel) (Hazel cries softly) Thank you, too. What for? For trusting me. (click) For those who didn't quite catch it, at the end of that clip there, Doctor Burnett is hugging Hazel. I think that's a very sweet moment. I agree. Yeah. You know, I think it's very heartwarming that Doctor Burnett was able to get through to Hazel like that, you know, and that Hazel was able to trust her, you know, with her care. Yes, and

I think that moment where Doctor Burnett says thank you to Hazel is so, uh, profound. To me, that really seems like the first moment where they establish a firm connection, and-- Oh yeah, for sure. And they've built up some trust, and they're able to express it and lean on it. Oh, it's so cute. Anyway, that is it for us this week on "Mysteries of the Mind." Join us next week as we..? We'll be getting into the start of Hazel and Doctor Burnett's actual relationship.

Oh, which means we're getting closer to them running away together! Exactly. So again, join us here next week for even more of Hazel and Doctor Burnett's story, exclusively here on "Mysteries of the Mind." I'm Preston Knight, our psychology nerd-- and I'm Daphne St. Clair, our hopeless romantic. Thank you for tuning in, and we'll see you next week. Bye! Doctor Love is written and directed by Maya Appavoo and produced by Maya Appavoo and Monica Gate.

Starring the voice acting talents of Madeline Harsh as Daphne, Jacob Martin as Preston, Abby McDougall as Doctor Burnett, and Emily Lizotte as Hazel. Post-production management by Monica Gate. Sound design for this episode by Ace Luke, and music by Ken Kosowick. The full list of credits and disclaimers can be found in the episode description, or on our website: appoova.ca/portfolio/doctorlove Follow us on social media! We are @doctorlovepod on everything.

Doctor Love is supported by the Edmonton Arts Council, and the City of Edmonton. Thank you for listening.