Psycho-Babble Psychology Thread 253227

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Fun in Therapy

Posted by fallsfall on August 22, 2003, at 17:33:46

I had a yucky therapy session yesterday.

My therapist doesn't like me taking meds. I'm supposed to start to stop my meds in September. But he thinks that I have a psychological dependency on the drugs so that when I stop them I'll feel worse even if the drugs aren't helping. I do not know what I can do for that not to be true (either to not be dependent, or to have the experiments with the drugs be correct).

So that brings me back into transference hell. I think he is unhappy with me, but there isn't anything I can do to fix it. I believe that if he is mad (or some other negative emotion) at me that I am evil. Somehow, this doesn't feel very good.

He did say that I could call if I wanted to - so at least he understood that I was upset.

It is hard to figure out how I feel about him. I haven't been with him long enough to love him to death, but I'm trying to look at this situation analytically so I don't get too sucked into the emotions. I don't know if that will work.


Re: Fun in Therapy fallsfall

Posted by Dinah on August 22, 2003, at 18:27:37

In reply to Fun in Therapy, posted by fallsfall on August 22, 2003, at 17:33:46

I have this funny feeling that he might be "prescribing the symptom". Was his presentation such that that could be a possibility? He might be afraid you won't do well, so he's suggesting that you won't so that it won't surprise or distress you if it's true.

Looking at it analytically sounds like a good idea as well. I'm trying to remember the DBT skills Is there one that would apply here?

But in the end, remember that he is a psychodynamic psycotherapist. That's good in a lot of ways. But there might be a slight anti-medication bias. He's not your psychiatrist, and your medication regimen is not his to control. That he is upset about your meds doesn't mean anything at all about you, but more about him.

But, all that being said, I'd be upset too. Perhaps you could write a multi-page treatise on the subject for him to peruse at your next session. Worked for me. :)


Re: Fun in Therapy fallsfall

Posted by stebby on August 23, 2003, at 19:57:23

In reply to Fun in Therapy, posted by fallsfall on August 22, 2003, at 17:33:46

It seems so odd that your therapist would want you to go off meds. What does your pdoc say? Do they consult with one another? It seesm like they should be working on this together.


Re: Fun in Therapy

Posted by allisonf on August 24, 2003, at 15:19:11

In reply to Fun in Therapy, posted by fallsfall on August 22, 2003, at 17:33:46

It does seem odd to me too that he is so convinced that your meds aren't doing anything for you. Is he just against meds in general or is there a specific reason he thinks they aren't working for you? I agree it must be making it awkward for you--if you do try to go off them and you have trouble, there really would be no way to know if it was that the drugs were helping or if you there was some kind of psychological dependence. Are you comfortable going off the meds or is it just that he wants you to?


Re: Fun in Therapy

Posted by fallsfall on August 24, 2003, at 21:36:43

In reply to Re: Fun in Therapy, posted by allisonf on August 24, 2003, at 15:19:11

Dinah and Stebby and Allison,

I do take a lot of meds (9 different meds every day, 3 PRN, plus vitamins and calcium and fish oil). He is concerned that some of my symptoms (fatigue) are a side effect of the meds that I'm taking, rather than part of the depression.

I've been with my pdoc for 8 years, and my therapist for 2 months. So my therapist wasn't around to see how I was doing before and after each med change. He sort of doesn't "believe" in taking lots of meds. The two docs exchanged voice mail messages a while ago. The only result I heard was that my therapist was ticked that my pdoc thought that my therapist thought that "I should be off meds" - which isn't what I told my pdoc. My therapist seemed to understand that I had told my pdoc one thing and my pdoc heard something else.

My pdoc and I have agreed that (as a result of my therapist's suggestion) I will try (slowly and carefully) to reduce my meds. We have agreed on an order to try reducing them in, and discussed a pace for the first one. I will start on September 2 (I wanted to get kids launched for the school year first).

I would be thrilled to reduce the meds. I currently believe that they are helping me (I wouldn't be take them otherwise). But I am very willing to experiment and see what each one is doing for me and assess their benefit vs. their side effects. I believe that I would have enough control so that it would be safe, and my pdoc and I have agreed that if it starts to look like I do need a med I am trying to reduce that I'll go right back to what I am taking now.

I am not aware of any dependence on the meds. I believe that I am compliant with my pdoc's instructions. I have not been able to understand what makes my therapist believe that I am dependent. The only thing he's said is that some of his patients come in telling him that they hate their meds. Well, I think they help, so I don't hate them. Does that make me dependent?

I don't believe that he was "prescribing the sympton", but I could be wrong. I think that he chose this issue to create my transference. So it could be that he doesn't care so much about it, but I don't think so.

We'll see on Tuesday.


Re: Fun in Therapy fallsfall

Posted by Penny on August 24, 2003, at 22:22:59

In reply to Re: Fun in Therapy, posted by fallsfall on August 24, 2003, at 21:36:43

Just really be careful when coming off the meds. I'm actually doing the same thing right now - not because of a recommendation by anyone but because of my own lack of clarity on what is working and what is not. My pdoc is, of course, working with me on this and my therapist is keeping her eye on things as well.

But I agree that the medication is your pdoc's call. I'm sure that there's always a possibility of a psychological dependence on a medication (hence the placebo effect) but we all know that there is definitely hard evidence that proves the effectiveness of these drugs. That said, it does become difficult to determine sometimes for me whether a problem I'm having is med-related or depression-related. So a med vacation might (hopefully) turn out to be a good thing.

Is there any way your T and your pdoc can actually talk instead of exchanging voice mails? Perhaps there could be a conference call between the two during one of your sessions? That way there might be a meeting of the minds on your treatment plans.

Follow your instincts on this one.

Take care.


Re: Fun in Therapy fallsfall

Posted by noa on September 1, 2003, at 9:59:10

In reply to Fun in Therapy, posted by fallsfall on August 22, 2003, at 17:33:46

If you have a psychiatrist who is prescribing the meds, maybe it would be good to discuss this with him, too, and maybe even have your therapist and psychiatrist talk to each other.

Is this therapist anti-meds? Some are. If he isn't, and really sees you at risk of unnecessary med dependence, this should be discussed among the three of you--pdoc, therapist and you.

I am dependent on my meds. I am also dependent on my breathing machine. I'd love not to be dependent on either, but they are necessary dependencies. Certainly, the solution isn't to just stop them!

My own experience is that without my meds, I would have continued to be too much of a basket case to use therapy well.


Re: Fun in Therapy noa

Posted by fallsfall on September 4, 2003, at 21:32:56

In reply to Re: Fun in Therapy fallsfall, posted by noa on September 1, 2003, at 9:59:10

Thanks, Noa.

I talked to my pdoc a month ago, and he and I agreed that I would start cutting back on one med at a time - very slowly - starting in early September. (So I have started, and it is fine so far) My confusion was why my therapist thought there was still a problem. He wanted me to reduce meds. So we came up with a plan to reduce meds. He wasn't happy????? We talked about it on a day when there was lots of stress in my life (my son was going into the Army that day), so he was gentle. It seemed like he understood me finally. Either that or he didn't bother to argue. I didn't tell him I've started cutting back. I'll tell him Monday that I see my pdoc on Tuesday.

This therapist is new. He hasn't seen me on meds that aren't working. Hopefully he'll figure this out before it comes to that.

I would LOVE not to have to take meds. That would not break my heart.

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