Posted by Cece on March 1, 2001, at 1:07:32
In reply to Re: 'virtual' therapy , posted by Steffany on February 24, 2001, at 19:15:38
Steffany-
Sorry to take so long to get back to you- I have been thinking about your question re therapists/pdocs and substance abuse history- both trying to remember my experiences, and gathering my thoughts.
I guess I never had any really bad experiences in this area. When I was still drinking and smoking dope, I was in therapy and I was upset with myself, scared, but not ready/not able to stop- I thought that I could work out some way to control my use, and episodically succeeded. I made an agreement inside myself to be honest with my therapist about my use and my feelings about it. I wasn't really aware at that time that I was self-medicating- or actually, originally I was self-medicating, and eventually I just got caught in the whole horrible addictive cycle. The "medicine" didn't work anymore, it made everything worse, but there I was.
That therapist left the problem to me, with periodic reminders about AA and the futility of "control". But she didn't grind my nose in it, and we went on with therapy (for 6 years). About halfway through that time, I got into a really crazy relationship and really scared myself. The only thing that was clear to me that I could change was my addiction- so I crawled into AA and surrendered.Later I was in a substance abuse program at my HMO (the program was very good), and sought the help of a pdoc there for my mood problems. He was a real tight-ass by-the-book kind of guy, and saw everything through the filter of my addictions. I didn't trust him, and decided not to work with him.
I wound up going outside of my HMO and paying out of pocket to see a young doctor affiliated with a medical school (I had originally met him when I went to the teaching hospital for an evaluation- sliding scale, cheap). By that time I had been clean and sober for about 6 years. He did not make a big deal of it, although of course it was part of my history and diagnosis- he looked at it as part of the larger picture of my life and my mood disorder. I've worked with him for 8 years, and among the meds I take are benzodiazepines- great benefit to me, and something that the HMO doc would never have considered safe for someone with my history. I have never had even the slightest temptation to abuse them- they are just useful tools to me. I don't go to AA anymore- at some point I stopped identifying myself as an alcoholic/drug addict. I am now, that my mood disorder is (at least reasonably) in hand, able to drink, without effort or control, in moderation. I have no desire to abuse alcohol, or any other substance. I know that this is AA sacrilege, and I hesitate to tell this part of my story, cuz I wouldn't want to give anyone an excuse to return to the horror of addiction. But it is my true story.
The problem that I HAVE had with docs (even some pdocs) is that when they see the list of medications that I take (it is long), they either assume that my doctor is crazy, or that I am crazy, or both. I can watch their faces and see it happen, even if they don't say anything outright. They don't even know what the meds are, or the significance of the dosages that I take (most are very low, even sub-clinical). It infuriates me completely! I have finally come to the point where I don't give the full list unless there is really a reason for them to know. And even then, I usually write on the form under "medications taken", the words "will discuss". And sometimes all I say then is that I take medication for a bipolar disorder. I play it by ear and use my good sense.
I don't think that it is unreasonable for a therapist/pdoc to spend some time on your SA history- it's necessary to sort out its significance for treatment. Are you maybe being a little too thin-skinned about it? But then, I also agree completely that shock or fascination are unprofessional, ignorant responses, and should send up a big red flag as to this person's ability to truly help you. So it's that chronic therapy dilemma- combining trusting and respecting yourself with letting down your defenses and being open to new input. I guess I'd suggest monitoring yourself and trying to figure out when you're being defensive as opposed to being self-respecting.
By the way, plenty of therapists and docs are quite unprofessional about being rejected. Don't worry about it- it's their problem.
Cece
poster:Cece
thread:54711
URL: http://www.dr-bob.org/babble/20010221/msgs/55198.html