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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by wittgensteinz on April 22, 2011, at 18:03:41
I didn't want to sidetrack from Deneb's thread but I read your post where you mentioned your appointment with your T to discuss the potential pdoc.
What interested me the most was your comment about how your T had changed so much in the past month. It just sparked my curiosity that's all. I also wondered whether you perhaps have changed this past month and whether (as a result) you now look at him somewhat differently.
I'm glad he was less offensive this time. That's progress. It's also good he's been thinking about you and what happened. You both deserve that.
I do hope you find a pdoc that does suit you - from my experience that is easier said than done! (Maybe I've just been unlucky - 2 rather odd pdocs further down the line!)
I have an appointment with a new pdoc the week after next - no idea what to expect but I'm hoping she isn't abrasive like the last one - this time a woman but hopefully one that does not remind me too much of my mother!
Witti
Posted by Dinah on April 23, 2011, at 15:02:18
In reply to Pdoc appointment - Dinah, posted by wittgensteinz on April 22, 2011, at 18:03:41
You'll have to tell me how it goes. I didn't even make it to the first appointment this time, the questionnaire she mailed me was so obnoxious. It was accompanied by a letter stating various things that involved extra charges (phone calls longer than five minutes, refill requests between appts, etc.) and stating that no appointments would be made unless there was a credit card number on file. I'd actually have been fine with that if it was a simple list of services and charges and a request for a credit card number. But the letter was phrased as if the clients were the enemy. It didn't even include the amounts to be charged, just that there would be a charge. My therapist said it sounded as if she'd been burnt once too often. I replied that it sounded as if she was burned out.
The questionnaire itself included things like "Do you have a history of promiscuity?" "Were you sexually abused?" Things that I'm not sure I'd have told some one I barely knew at all, and I know I'm not going to answer in a questionnaire before meeting. My therapist was surprised at how intrusive the questions were for a mailed questionnaire. We agreed we likely would not suit, since I was already feeling hostile before I even met her.
I'm not crazy about my current pdoc, but the main reason I want to switch is because he moved someplace very inconvenient to get to and to park. So for right now, I'll continue to see him while I look for other possibilities. My therapist pointed out that a new pdoc might wish to actually treat me (as in suggesting medication alternatives) when I've been stable on my current medications for years.
I don't think I've ever had a pdoc I actually liked, but I do miss the one I didn't dislike. He moved to Montana I think.
I could have sworn my therapist laughed when I called him about wanting an appointment because I disliked this pdoc before I even met her. I have a long history of disliking mental health professionals. But he swears I was mistaken.
It's not that my therapist changed so much as that his circumstances have changed. He was on his way to sign a lease for a new office in what I and my husband (and his wife, apparently) think is a rather seedy area of town. And even less convenient than his current location. He is also in the process of moving his secondary office. It felt like the month I had been gone was way longer than a month because I came back to these changes.
He says he thinks that perhaps part of the problem was that he was bored in general rather than that he was bored with me. And in truth he did seem revitalized when I saw him this time. So maybe there is some truth in that his general discontent spilled over into our relationship. That sort of thing has happened in the past.
He also thinks that he sees some changes in my life that made him feel uncertain of his role. He says my life is shrinking and becoming smaller as I withdraw from people. And that he saw his role as helping guide me in my interactions with others, and that I didn't need that as much since I wasn't interacting with others as much. I asked him if he really thought abandoning me at a time when I was drawing back from others, at least in part because I felt rejected and out of place, was the most appropriate response. He said he'd lost sight of his role as a leg on my support stool, and as my therapist/mommy. That he'd felt at a loss as to what he could do for me.
I don't know. In the end, he's not really saying anything different. He still is saying that he was bored, and that he was unsure what to do with me in therapy. But he's also saying that relationships have ebbs and flows, something I always say myself. And that he doesn't want me to leave, that he wants us to figure out together where to go from here. How to make therapy useful to me, etc.
And I just don't know. He got heavy eyed again when I saw him yesterday. In reflection, I have to admit my energy level was very low. I think sometimes in therapy I'm almost in a self hypnotized state, and I suppose that could bring an answering low energy state in him without meaning he was actually bored. I just don't know. I don't know what will happen.
I know I want things to go back the way they were. I just don't know if that can be achieved. Sometimes things just change and they can't ever go back to the way they were.
That's hard for me to admit. I think I offended him by saying his life never was as stable as mine, and he countered by saying that he preferred that life not be stagnant. He definitely was not talking about therapy with me. But I guess we may just have different world views.
Thanks for asking. I don't think I've really figured things out yet. But I do like not being on bad terms with him, no matter what happens. So I'm glad he reframed.
(I offered to do the stupid egg, and we're discussing it. But he is unsure whether I should do the egg if my goal is to entertain him.)
Posted by TherapyGirl on April 23, 2011, at 19:59:03
In reply to Re: Pdoc appointment - Dinah, posted by Dinah on April 23, 2011, at 15:02:18
This sounds like progress, Dinah. I like that you're still trying and I haven't given up hope that you two can repair this rupture, even if you don't continue regular therapy with him.
You remember, I know, what my T was like the last 15 months before she retired. Not at all like her usual self. I quit several times before she retired, but in the end I'm glad I stuck it out. She and I are now having email conversations about spirituality in the wake of my father's death and she has responded with her best self.
I wonder about the energy thing. Sounds like he doesn't manage the low energy of the room very well. I wonder if he could learn some tools to keep himself alert without changing the energy, which I would think would be startling and inappropriate.
((((((((Dinah)))))))
Posted by Dinah on April 25, 2011, at 8:29:23
In reply to Re: Pdoc appointment - Dinah » Dinah, posted by TherapyGirl on April 23, 2011, at 19:59:03
Reading it over again, I think I made it sound worse than it was. I'm concentrating on the things that support my point of view, and that I may have dug out of him. And I'm probably phrasing it rather negatively.
Not the initial bad session, where he said things that were not only insensitive but also far more foolish than he's generally guilty of being. However, he was far better this time, although I don't get the sense that he's even trying to deny what he said, or suggesting that I misunderstood.
It's just hard to rebuild anything on that foundation. But definitely I don't want to be angry with him on a long term basis. A short term one, sure. Trust is different though. Trust is never easy for me.
I'm glad you and your therapist have reached this place in your relationship! It is definitely forging a new path, and the two of you are to be commended for finding a balance that works for you.
Posted by wittgensteinz on April 25, 2011, at 14:53:49
In reply to Re: Pdoc appointment - Dinah, posted by Dinah on April 23, 2011, at 15:02:18
Thanks for sharing. First I'll respond to your post then I'll write a separate post with something about my upcoming appointment.
It sounds to me like you made a wise decision about the potential pdoc. Hopefully there are more to choose from and someone more along the lines of your present pdoc who has moved - i.e. someone not money-crazed and not in the habit of sending intrusive, highly personal intake forms! Yuck!
Regarding the possibility of a new pdoc wanting to revise the meds: If the meds have been working - why change them? I guess there could be a med combination that would be even more effective?
You said about your T signing a lease for a new office. Will that mean that his primary officer will move location?
I still wonder in a way why it should even matter if the therapist is bored (of course it matters if he says he's bored or if it is obvious he is bored). I mean, I have asked my therapist enough times "you're bored with me, aren't you?" - sometimes he says "no" (so presumably on those occasion he is not) but other times he has said something like "and is it your job to entertain me?" (so maybe he does find it boring). Long term therapy is very repetitive - the same old stuff goes round and round again like a piece of music with countless variations. I don't know, I get the feeling you are assuming too much responsibility for what essentially is something you cannot help and which really rests on him.
I'm glad he seems revitalised and maybe once the office move is complete things will improve. I'm glad you still feel able to seek his help and advice - you've built up this relationship over many years and while this rupture is not yet repaired (and it's true you don't know for sure when/how/if it will ever be) it doesn't sound like all is lost. I guess it will be a matter of keeping an open mind, which it sounds like you are doing (and he too - he is actively thinking about it and at least is becoming 'less offensive').
It's interesting - to you he is your therapist mommy - but the way you write about him, I sometimes get the impression that you also have motherly feelings toward him. He is the one who became teary eyed while you were the one to picked up on the fact of the relative lack of stability in his life).
You said about him not knowing what to do with you in therapy. I wonder though whether he has to 'do' anything - I always thought of therapy as a time that the client can use as he/she wants (within reason). Maybe this comes down to the orientation of the therapy he conducts? I mean, if you should want to then you should be entitled surely to just go there and sit in silence hour after hour - and yes that might well be boring for the therapist but if that's what the client needs then so what? Has he missed the point somewhere in this? I think it's true, the therapeutic relationship ebbs and flows - mine does too - sometimes the sessions are intensive - electric even - other times they are slow and I'm looking at my watch and I wouldn't be surprised if he is too. I don't feel at fault though. Sometimes I feel frustrated.
I'm sorry you have been retreating, cutting down on your circle of contacts - it does strike me as odd that he would interpret that as a reason to question the need for therapy.
I'm glad you are no longer on bad terms with him. The way you write, the closeness and engagement between you is still very much there. I hope things work out between you - or in any case continue to improve.
As for the egg - you hate that wretched egg - he's right, don't do it just to entertain him - being yourself seems to be the most basic ingredient in making therapy work - being entertaining is secondary - a novelty if you like.
You have seen him for a long time - have there been any episodes vaguely resembling this one in the past? How did they resolve?
I'm not sure how helpful my response is - hopefully not offensive at least - just my free flowing thoughts.
Witti
Posted by wittgensteinz on April 25, 2011, at 19:21:29
In reply to Re: Pdoc appointment - Dinah » Dinah, posted by wittgensteinz on April 25, 2011, at 14:53:49
My previous pdoc was a bad match - maybe just a bad pdoc? He never failed to say something provocative that left me upset afterward, he tried to interfere with my therapy and he was chronically unavailable i.e. a session within 3 weeks would be considered 'urgent' in his books - not very handy if you are having an acute depressive episode.
Anyway, I wrote a post a long while ago about it and I remember a number of people suggesting I find another pdoc. The problem with that is that each time you switch pdocs (other than for practical reasons) the chances of being pre-judged or starting off on the wrong foot are elevated so I decided it was better just staying with him and seeing him as infrequently as possible.
Anyway, a little more than a year ago I came across a special clinic specialised in people with personality disorders (PDs). It offers help with crises and provides a psychiatrist and so on. Before the previous pdoc I had never been diagnosed with a PD but within the space of the first 45 minute session he came to the conclusion that I have borderline PD (low functioning and probably psychoanalytically untreatable - fortunately my therapist disagreed). At the time I wasn't very happy about this because I didn't feel he asked the questions he really needed to in order to establish this and it's not really the kind of diagnosis you should give someone on a gut feeling.
So this clinic seemed like a good alternative to searching for another private pdoc (all pdocs where I live are covered by insurance). Finally I had my intake a few weeks ago. I saw a clinical psychologist for several long intake sessions and by the end was rather dreading what label might be put on me this time. Anyway, the BPD label was lifted ("no you definitely don't have borderline") and pretty much the same diagnosis was made as that prior the previous pdoc - oh and 'attachment disorder' was added to the list. Fine - but then I thought "but if I don't strictly speaking have a PD can I still receive services from this clinic?" - that would be annoying after a year long waiting list - and then what - would I have to go back to the previous pdoc again? Anyway, that fortunately isn't a problem (I'm guessing because of the history of sui and the attachment disorder) and now she has matched me up with a "not too provocative" pdoc.
So in just over a week I have my appointment - exciting as it was my primary motivation for getting a referral to the clinic. I'm not too interested in taking regular meds (ADs) but it would be nice if I can get something during the 'acute episodes' (fortunately I haven't had them often the last 2 years - but when I do, it's hard without anything to soften it) and maybe I can finally get something for the anxiety (previous pdoc insisted it was 'worry' not anxiety grrr).
I guess I've learned to take the DSM (and pdocs for that matter) with a pinch of salt. The question "what's wrong with me?" used to preoccupy me but now I feel rather at peace with it. There probably is no simple answer.
Witti
Posted by Dinah on April 26, 2011, at 19:48:23
In reply to pdoc appointment, posted by wittgensteinz on April 25, 2011, at 19:21:29
I can understand that. I used to be obsessed with understanding why I do the things I do. It doesn't seem as urgent anymore.
Almost all my meds now are "as needed" and it works a lot better for me. I hope this pdoc understands the need for anxiety/dysphoria control.
It sounds promising. I hope you'll let me know how it goes.
Posted by Dinah on April 26, 2011, at 19:54:56
In reply to Re: Pdoc appointment - Dinah » Dinah, posted by wittgensteinz on April 25, 2011, at 14:53:49
Not at all offensive! Rather comforting really.
My therapist isn't analytically trained and I think is more comfortable with the more directive CBT type work. He has always told me that we need to work on this long term therapy together, because he doesn't have a roadmap.
I'm glad we are on better terms, because something very upsetting at work came up today, and I was able to get his advice on what to do. I took notes. Which is a bit more directive than he generally is, but he asked my permission first and I told him that's why I was asking him.
I suppose as Daisy said a while back, when things are going ok I'm able to use my internal therapist, but when something bad happens I still want to turn to him.
Posted by wittgensteinz on April 27, 2011, at 1:38:04
In reply to Re: pdoc appointment » wittgensteinz, posted by Dinah on April 26, 2011, at 19:48:23
Yes "as needed' is exactly what I'm hoping for. Something to cushion things when my normal coping mechanisms are overstretched.
Oh, I wrote in my other post about 'attachment disorder' but it doesn't make much sense to me as to my understanding it is a diagnosis of childhood, not adulthood. When I read the report again it seems to be a retrospective diagnosis. It would make a lot of sense given the circumstances in which I grew up and the symptoms I exhibited as a child.
I guess many distrusting children become distrusting adults. While I wouldn't say I am incapable of attaching to and trusting people it takes a lot of time and it goes against my intuition. I still think the social phobia/avoidant traits are the strongest in my case. Or at least, they are the ones that limit me the most.
Witti
Posted by wittgensteinz on April 27, 2011, at 1:52:34
In reply to Re: Pdoc appointment - Dinah » wittgensteinz, posted by Dinah on April 26, 2011, at 19:54:56
I'm sorry about the upset at work but I'm glad you are able to turn to him for help. He's still there and he's still your T.
I'm assuming that you are (probably) your T's most long-standing patient? Was there are particular moment when a decision/realisation was made that the typical stretch of time-restricted CBT would not be right for you?
He's obviously open to adapting and going 'outside the book' so to speak - so maybe this is just another moment of adaptation on his part - a fork in the road, where both of you have a role in the decision as to how to go on.
Personally I find the combination of CBT and psychodynamic/analytic attractive. Sometimes I wish my T was more directive and practical - I wonder how much further it would take me. In the beginning it wouldn't have worked - it would have scared me away but now maybe he could get away with some CBT (as far as I can tell, he has an aversion to it - I never have to worry about the egg at least).
Witti
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