iiinova — where your digital self keeps evolving

Sonja Cowling @sonjacowling.bsky.social · 05/07/2025

Coming to the end of my year-long placement at a mental health inpatient unit and my time as a core trainee. I have so much love and respect for all the patients that I have gotten to know during this time. They have taught me more than any supervisors or books ever could.

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Sonja Cowling @sonjacowling.bsky.social · 02/07/2025

Only a month left of being a psychiatry core trainee. Exams passed, final appraisal passed. What a journey it's been. Excited about what lies ahead as a general adult middle grade psychiatrist.

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Sonja Cowling @sonjacowling.bsky.social · 29/03/2025

On aika mieletön kirja vielä seurana! Suomen junat tuntuu nyt Briteistä käsin katsottuna niin luksukselta. Täkäläiset junat on likaisia, ahtaita, haisee ja kolisee.

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Sonja Cowling @sonjacowling.bsky.social · 29/03/2025

I would imagine it to be beneficial.

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Sonja Cowling @sonjacowling.bsky.social · 29/03/2025

Luckily not working today after a mega busy work week (our ward transferred from a mixed ward to all female and it was hectic!). Hope you have a good shift.

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Sonja Cowling @sonjacowling.bsky.social · 29/03/2025

It's so necessary to be able to name things that are offensive and just pure "wrong" but silencing any points of view is just so dangerous. Really loved reading your thoughts on this.

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Sonja Cowling @sonjacowling.bsky.social · 29/03/2025

There's so many unappreciated alternative treatments for all sorts of things that actually work. Homeopathy is not one of them. It's one of the alternative treatments that never fails to make me feel furious.

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Sonja Cowling @sonjacowling.bsky.social · 29/03/2025

So excited to realise my favourite account is on bluesky 🥰

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Sonja Cowling @sonjacowling.bsky.social · 29/03/2025

I wish learning wasn't so expensive. So many courses and conferences I'd love to go to but everything is so expensive.

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Sonja Cowling @sonjacowling.bsky.social · 29/03/2025

An excellent piece of writing about freedom of speech and cancel culture.

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Sonja Cowling @sonjacowling.bsky.social · 22/03/2025

Nervously waiting to hear whether I get a speciality training post and whether a close colleague gets into core training. 🫣

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Sonja Cowling @sonjacowling.bsky.social · 11/12/2024

Lääkärinä voin sanoa että valittaminenkin on ihan ok jos tuntuu että täytyy saada sillä tavalla kurja olo ulos. Ongelma ei ole valittajissa vaan systeemissä, jossa lääkäreillä ei ole enää aikaa muuhun kun tosi akuuttejen vaivojen hoitamiseen.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

But boyfriends turn into grumpy old men too!

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

I think for mental health services too more money can't come fast enough. The rush seems pretty justified.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

Is Pikachu travelling all by himself?

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

She looks so thoroughly unimpressed by life.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

Gem thinks that to get the benefits of cold water swimming the experience needs to include as much mud as possible.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

The Nightingale by Kristin Hannah ended up being my favourite in November even though I initially really didn't warm to it.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

eggs in all lines of thinking and I'm so sorry to hear you have been harmed. You would have deserved good care without harm. For myself I see critical psychiatry not as an ideology but more just as a way of critically thinking of the way I practice in the hope of avoiding harming patients.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

Context is everything and knowing you've experienced this makes it very understandable that you'd feel this way. Psychiatry and also psychotherapy can absolutely cause harm and I wouls hope that critical psychiatrist especially would understand this and be very mindful of it. There will be bad 1/2

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

Found this BMJ article eye opening. A bit worrying if the psychedelic studies have really been of such poor quality and reporting so misleading. I think we are so desperate for "miracle" cures that we want to believe when told they might exist.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

You've probably seen this more than me. I've only come across a few anti psychiatry psychiatrists on twitter but never in my clinical life. But I do think a lot of clinicians could be a bit more critical. We see more critical thinking on apps like this but I find not as much offline.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

Totally agree with this. Also I feel that NHS is so top heavy. A huge amount of managers and non clinical staff. I'm not convinced this affects the clinical quality as much as we'd think. I trained in Finland where clinical care is similarly good but the system is not as non clinically heavy.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

I identify with critical psychiatry and not antipsychiatry. Can kind of see how it could be easy to be pulled to "the dark side" in the current climate. The practices within services feel to be so driven by the lack of funding instead of best practice. It could be easy to bark up the wrong tree.

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Sonja Cowling @sonjacowling.bsky.social · 01/12/2024

I think we should all be critical psychiatrists. Not being one to me would imply a closed mind that accepts everything in a "I do it this way because this is how things have always been done". Critical psychiatrist to me doesn't mean anti medication. It just means being open to different ideas.

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Sonja Cowling @sonjacowling.bsky.social · 30/11/2024

Doesn't hurt that it's very beautiful as well. I'm a bit envious! Enjoy!

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Ouch! And how these comments follow us in our minds into adulthood..

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Introduce yourself with your worst feedback from school 👇 I'm Sonja, good job I'm clever because I'm certainly not athletic.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

We used to get Pharma paid lunches and pens, notepads and other small gifts in medical school. The consultants at the time suggested the bigger gifts, paid travel etc would come after we'd graduate. Then the Pharma companies seemed to disappear. Only representation I see nowadays is ads in journals.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

This sounds like a must-buy for all of us medics. Definitely going to order to see what it's like.

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Reposted by Sonja Cowling

Keir Harding @keirwales.bsky.social · 25/11/2024

Great article from @elliebroughton.bsky.social asking whether it is time to dump the diagnosis of BPD/EUPD (it is) Interesting to see support from the head of DBT in the uk and president of ESSPD www.bacp.co.uk/bacp-journal...

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Haha. I've had that sometimes too. Started actually writing the plot down and then pretty quickly realised it didn't make any sense or even have anything very interesting in it. A bit like after a hypomanic episode realising you're not the poetic genius you thought you were. 😭 so disappointing.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Could you ask the consultant about that? To try to preplan to avoid any disasters in the future?

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

I think this too. Don't understand why someone with chronic illness can't be under a cmht even when not needing active care all the time. I suppose maybe it would be too unpredictable. There could then be times where suddenly there's not enough staff for the demand when everyone relapses.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Do you ever wake up and remember really great dreams? I never do and it's made me wonder whether part of the function of dreams could be to kind of rehearse things that our brain feels we need to develop or something.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Packing dream is quite a good one! My other frequent one aside from the exam one is being on a stage ready to perform either in a play or as a ballerina in a proper ballet and then realising I'm the only one who hasn't got a clue on how to dance. Wonder why dreams so often feature failures?

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Same! Often trying to dial the emergency number whilst trying to save someone or trying to escape a murderer and keep pressing the wrong numbers.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Have you ever tried to analyse your dreams by "free-writing". Uncensored writing about whatever comes to mind and that can jump from topic to topic. I often find that way I can find what the dream is about or what it might communicate to me.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

I've often wondered what the dreams about being late or in the wrong place mean.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

I hope you won't get discharged too early!

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

I think consultants are pressured heavily to discharge people as fast as possible. It just doesn't equal good care. I've recently asked to be discharged. Sick of always feeling way worse after any appointments. No support is scary but better than mean spirited and belittling interactions.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

I've had that too. It shouldn't be that hard.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Totally. I think it's my most frequent dream. We're clearly scarred by the pressures of medical school.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

You're not alone. I still regularly wake up feeling really confused about whether I still have some medical school exams to retake or not.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Character building or character destroying?

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

My kids would say Uni is a bigback.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

Hope you've managed to access good care for yourself though. It can be a bit of a postcode lottery and even then depends on who you get supporting you.

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Sonja Cowling @sonjacowling.bsky.social · 25/11/2024

What was your general take from the data? I found The King's fund 360 feedback from 2023 that showed quite low satisfaction with the services. And family and friends survey data that suggested extremely high satisfaction, almost a bit weirdly high and in all areas of UK.

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