top of page

CL psychiatry – the psychiatrist as collaborator

Interview with Siv Elin Pigantiello


Siv Elin Pignatiello believes she is privileged to work alongside dedicated and engaged colleagues from somatic specialties. She also sees the need for CL psychiatrist from all over the country to get together and discuss professional issues and form collegial fellowship. In the future she wants to involve neurologists and other professional groups and individuals interested in the field to strengthen the collaboration.

Early Interest in Psychiatry

During medical studies in Bergen, psychiatry was what most sparked Siv Elin Pignatiello's interest.

She worked extra shifts at Sandviken and Haukeland hospitals during her studies and began specialization as soon as she could after completing her studies in 2002, followed by subsequent internship. The specialist training began in Bergen and was completed in Vinderen, Oslo. She stayed at Vinderen until 2015. During her years at Vinderen, and then for six years at Lovisenberg Diakonale Hospital, Siv Elin mostly worked in acute psychiatry. She also spent 11 years at the Psychiatric Emergency Department alongside her job, as well as completing training as a cognitive therapy supervisor.

Transition to Psychosomatics

In 2021, a colleague informed her about an available position in the psychosomatic department at Rikshospitalet. She has now held this position for over two years and thoroughly enjoys it.

"I conducted quite a few consultations on somatic wards during my time at Lovisenberg, so I had some idea of what I was getting into," Siv Elin explains. "I was ready for something new and really enjoy the varied and exciting work done in the Unit for Psychosomatics and CL Psychiatry."

Siv Elin believes she is privileged to work alongside dedicated and engaged colleagues from somatic specialties.

"I truly feel that we make a difference," she says, recounting how many people with serious conditions have had their lives turned upside down.

"Most serious illnesses can have psychological consequences," she believes.

She recounts a meeting with a patient that made a strong impression on her. Siv Elin met the patient a couple of years after the dramatic hospitalization.

The patient had been long-term hospitalized in an intensive care unit due to a serious somatic illness. It turned out that the patient developed a delirium state with vivid, nightmarish experiences. The patient was left with dramatic and frightening sensory experiences and a feeling of total helplessness, leading to the patient being traumatized by the experience. The patient did not receive help in local mental health care.

"It was surprising how little was needed for the patient to improve," Siv Elin recalls. "Psychoeducation was what was needed."

Siv Elin had not previously thought much about the possibility of being traumatized by experiences during delirium, but afterwards, she became focused on the importance of early detection and treatment of delirium to prevent psychological aftereffects.

Committee for CL Psychiatry and Psychosomatic Medicine

The dedicated psychiatrist was elected as the leader of the Committee for CL Psychiatry and Psychosomatic Medicine at the annual meeting of the Norwegian Psychiatric Association in March 2022.

During an international conference in Oslo later that year, she spoke with colleagues from Finland. They talked about monthly digital conferences with several hundred participants.

"I immediately thought that this is something for us," Siv Elin smiles. "In the CL community in Oslo, we were used to meeting regularly, but since we relied on physical meetings, it became quiet during the pandemic," she explains.

In Norway, mental health services in somatics are organized in many ways. Some places have separate departments, while in other places, individuals or teams provide the services. Both organization and tasks vary from place to place.

"There are many professionals sitting quite alone in many places," Siv Elin believes, who now offers monthly online conferences. "I believe such meetings can lay the foundation for professional development and collegial fellowship."

First meeting completed on January 31, 2023, on Teams.

"We are very pleased," Siv Elin says. "Over 40 professionals participated. There were many more than we expected. The participants were active, and we had good discussions."

Until the summer, the CL committee was responsible for the content of the monthly meetings, but she hopes that professionals from all over the country will contribute with presentations in the future. The frequency is set because the committee believes that once a month is neither too frequent nor too rare, and the meetings last for one hour.

"It would be nice if the responsibility for the professional content could rotate over time," she says. "There are so many skilled colleagues who can contribute with a lot of exciting content. Perhaps we can also involve neurologists and other professional groups and individuals interested in the field."

In her notebook, she has listed topics such as functional disorders, catatonia, skin disorders, and mental disorders, but little has been finalized yet.

"It has gone quickly from idea to action," Siv Elin smiles, "so the road is being paved as we go." □


bottom of page