Psycho-Babble Psychology Thread 426182

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Struggle with pdoc -- thinking of GG (long)

Posted by Aphrodite on December 8, 2004, at 12:51:32

I went to an acclaimed (expensive) pdoc yesterday at my T's insistence. She is a friend of his, and he assured me she was "perfect" and that all of his clients had success with her. (I tend to think the last bit was a warning for me not to let my exacting standards be a problem!)

She was 20 minutes late. She hadn't read the very thorough report my T had sent so we could hit the ground running. She seemed preoccupied. She took a history of my prolonged traumas. I was uncomfortable, but she seemed to be listening so I recounted it all as best I could. It is SO, SO hard for me to divulge these things! That is why my T wrote it up for me in the first place. Anyway, it was a bit emotional to hear all of my life's woes condensed into such a short amount of time -- I felt emotionally overwhelmed.

She put her pen down and launched into one controlled lecture after another. She was accusatory -- "You mean you didn't tell anyone about your csa until now?!?!? Why not?!?!" "Why are you just now seeing a psychiatrist?" My personal favorite was her parting comment, "It seems a shame that you were not placed into the right family of origin, but to then grow up and *choose* to have more problems is especially troubling."

Yuck, yuck, yuck. It's painful enough to be honest but to have that kind of response is devastating for someone highly personally sensitive. I didn't fight back. I was trying my best not to cry.

She also told me I wasn't depressed; I was confusing it with grief. My real problem is anxiety. It was actually a fairly interesting take. I was also pleasantly surprised by her innovative medical approach that did not include an SSRI, and since I absolutely refused to take anything for sleep that was addictive, she gave me a mood stabilizer to calm me at bedtime.

My inclination was to never, ever in a bizzillion trillion years go back to her. I told my T who was very sympathetic and thought that I needed empathy, not a lecture. He said he had forwarned her of my particular sensitivities in the unread report. He said I had his permission to hate her. He even offered to reimburse me for my expense, which I would never take, but I appreciated the offer.

Then I started thinking about GG. She had worked out her issues with her stern pdoc. I often think that my standards are so impossibly high, no one will please me. So, instead of retreating like I always do, I looked at the fact that she has a good rapport and working relationship with my T and that she is innovative in her medication style. I started to blame myself for not communicating well. After all, EVERYONE else likes her, it must be me!

So, I wrote her a letter stating all of my appreciation but expressing my concerns about her tone and criticism and how I felt that I would be inhibited from being truthful if I were met with this kind of response. I said that perhaps we got off on the wrong foot, I blamed my discomfort with the therapeutic environment, but asked her professional advice on this working relationship and told her that since she is so well-respected, could she refer me elsewhere if she thought we couldn't work this out. I was very proud of the letter. I thought I was directly confronting my problem instead of giving up, but I was expressing it kindly and professionally.

I got a voice mail from her today stating, "I was surprised to get your letter. I am perfectly capable of helping you, and I don't know how you could draw a conclusion otherwise based on one visit. Keep your next appt., and if you're still not comfortable, we'll talk about a transfer. I assume you'll tell me if this response is insufficient."

Ack!

I need advice. Are pdocs just like this? Am I expecting too much? Do warm and fuzzy pdocs exist? Should I persevere with this person?

 

Re: Struggle with pdoc -- thinking of GG (long)

Posted by Daisym on December 8, 2004, at 13:33:52

In reply to Struggle with pdoc -- thinking of GG (long), posted by Aphrodite on December 8, 2004, at 12:51:32

Ouch! Ouch! Ouch!


Ouch!!!!!


I'm anxious for you and I didn't even have to meet this woman!!!


Ok, all that said, I haven't heard much in the way of pdocs who are warm and fuzzy. BUT, you aren't going to do therapy with her and if she is a competent medical provider who can monitor your medication needs, and she works well with your therapist, maybe you "use her" for what you need her for. I'm glad you wrote and sent the letter. My guess is that she reacted to just having seen the letter but by the time you see her, she will have more perspective on what you were trying to get across to her. And she took the time to call you and respond. She didn't just stick it in your chart and leave you hanging until the next appointment. That gives her points with me.

You were very brave to make yourself tell her your life history and be so honest about it. I couldn't do that in a million years.

I was struck by what you said about not really being depressed. My therapist and I have been talking about that one and off for a while, which is why he doesn't really push medication, except for sleeping. He thinks I get depressed but I do because of the larger grief process and midlife crisis. Sort of mini-moods within a larger problem.

Of course, I've never seen a pdoc so my advice isn't worth much. I'm sure lots of other people here can help better with this problem. But still, How hard for you!!!

(((Aphrodite)))

 

Most pdocs are like that. (Sorry Dr. Bob) Aphrodite

Posted by Dinah on December 8, 2004, at 14:09:15

In reply to Struggle with pdoc -- thinking of GG (long), posted by Aphrodite on December 8, 2004, at 12:51:32

In fact my therapist's response to any problems I run into with Dr. Bob is "But he's a *psychiatrist*!" as if that explained everything.

I keep mine to just symptoms and side effects. And he's the nicest one I've run across!!! The other stuff I save for my therapist. My therapist isn't crazy about my keeping things that he thinks are important to my total picture quiet, but I figure if they aren't med related he doesn't need them.

I'm with Daisy. Use her and see if she's helpful medication wise. Draw back otherwise. If she's not helpful medication wise, leave her.

Just my two cents.

 

Re: Struggle with pdoc -- thinking of GG (long)

Posted by Smeegle on December 8, 2004, at 15:24:02

In reply to Struggle with pdoc -- thinking of GG (long), posted by Aphrodite on December 8, 2004, at 12:51:32

I see my p-doc primarly for med so some sessions are strictly about how stable I am (or am not), side effects, etc. However, I always feel 100% comfortable talking to him about whatever is on my mind. He mostly just listens and comments or asks a question here and there.

I don't think I could stay with a pdoc that I felt uncomfortable with. So what if you have high standards. Maybe you just haven't met the right pdoc for YOU. My son didn't connect with one until his 4th and then they clicked right away. Then again, perhaps the pdoc was just trying to gain insight into your thought process. Reading the write-up would have certainly helped, but sometimes I think they want to hear it out of our mouths (observing body language, etc) to get a better "feel" for things. It's so hard to tell with just one visit when you were justifyably on the defensive.

Smeegs

 

Re: Struggle with pdoc -- thinking of GG (long) Aphrodite

Posted by alexandra_k on December 8, 2004, at 16:07:50

In reply to Struggle with pdoc -- thinking of GG (long), posted by Aphrodite on December 8, 2004, at 12:51:32

Grrrr. I feel for you, I really really do.

>I got a voice mail from her today stating, "I was surprised to get your letter. I am perfectly capable of helping you, and I don't know how you could draw a conclusion otherwise based on one visit. Keep your next appt., and if you're still not comfortable, we'll talk about a transfer. I assume you'll tell me if this response is insufficient."

I would write her again saying something like:

-'I did NOT draw the conclusion that you could not help me - that is why I wrote you the letter with a repairing relationship kind of intention'.

-'I was attempting to communicate what was hard for me in seeing you. Do you have any sympathy at all for anything I have said, or do you think you will just blunder on and keep being insensitive to my trauma etc?'

-'Your response is insufficient because you aren't really answering the problems I addressed. (see point two).

If she doesn't get point two then run, run, run for the hills.

Just MHO.
You deserve better than that.

 

Re: Struggle with pdoc -- thinking of GG (long) Aphrodite

Posted by Pfinstegg on December 8, 2004, at 18:29:35

In reply to Struggle with pdoc -- thinking of GG (long), posted by Aphrodite on December 8, 2004, at 12:51:32

It sounds like she was blaming YOU for the things others did to you- totally off and unacceptable.

However, there were things I liked- the mood stabilizer, and her view of your feelings as a prolonged grief reaction. If you can work out the interpersonal aspects so that you get to a working, collaborative relationship, you may have someone very good, medication-wise. I think it's great that she didn't insist on an SSRI or SNRI as first lines of treatment. She's probably ahead of most pdocs.

Great letter, too!

 

Re: Struggle with pdoc -- thinking of GG (long)

Posted by gardenergirl on December 8, 2004, at 19:15:45

In reply to Re: Struggle with pdoc -- thinking of GG (long) Aphrodite, posted by Pfinstegg on December 8, 2004, at 18:29:35

I agree, great letter, and I think you were really brave to send that and to keep trying even though the first experiene was not so good.

In my case, I know she was a pdoc willing to prescribe MAOI's, which worked in her favor despite the rocky start. Also, I had called about 12 before I found one who was taking new clients. So that also was a good reason for me to go back even though I left the last time feeling poopy.

You know, I got mini lectures, too. I wonder if, like in psychotherapy, the modal number of visits is one. Perhaps the psychiatrists feel like they only have the one shot, so they have to learn it all and do it all in one session? And then if/when you come back, they relax a bit and get to real working WITH you? Just a thought.

I don't want to miminize your reaction in any way. It's real and valid. I know I questioned myself a lot after my first visit. But then everyone here helped me to calm down and also made me feel validated. I went into the second visit with the intent to just use her for meds, but then things got better. We don't do therapy the way I do with my T, but she does listen to what's going on recently, listens to and validates my theories about it, and offers her own. It's rather comforting, which is so not what I expected from her. Funny, my T still questions some of the things she says...I feel a bit like they are in some sort of competetion. But after that first visit, it helped to process it with my T. I still do process those visits with him at least at tiny bit. (Oh, and Dinah...my T says similar things how Dr. Bob is a psychiatrist the couple times I've mentioned Babble stuff. Only he uses an adjective before the word "psychiatrist" that I can't repeat here. :D)

I'm glad you wrote the letter. Her response suggests to me that she felt a bit defensive. Hopefully she will get over that and listen to you, and modify her style a bit based on your expressed needs. Mine did. It's possible, even from a pdoc! (Sorry Dr. Bob).

Good luck and let us know how things go.

gg

 

lol (nm) gardenergirl

Posted by Dinah on December 8, 2004, at 19:23:12

In reply to Re: Struggle with pdoc -- thinking of GG (long), posted by gardenergirl on December 8, 2004, at 19:15:45

 

Re: Struggle with pdoc -- thinking of GG (long) alexandra_k

Posted by alexandra_k on December 8, 2004, at 20:42:34

In reply to Re: Struggle with pdoc -- thinking of GG (long) Aphrodite, posted by alexandra_k on December 8, 2004, at 16:07:50

ok so maybe thats my typical knee-jerk reaction that i later regret...

 

Re: Struggle with pdoc -- thinking of GG (long) Aphrodite

Posted by fallsfall on December 8, 2004, at 20:51:44

In reply to Struggle with pdoc -- thinking of GG (long), posted by Aphrodite on December 8, 2004, at 12:51:32

I've seen the same pdoc for 9 1/2 years. He knows me pretty well, and we do discuss meds and what to do and he really does take my opinions and feelings into account. Sometimes he makes assumptions that aren't valid, but usually I can tell him that they aren't valid and we go from there. He's very available to me - like it's fine with him if I schedule an appointment with him while my therapist is on vacation (even if we would go longer if my therapist wasn't going on vacation).

He used to schedule 3 patients/hour, but now he's doing 4. So he is more rushed. But he does check on what I'm working on in therapy. And I know that if I had an emergency that I could see him and he would take care of me.

 

Re: Struggle with pdoc -- thinking of GG (long)

Posted by Shortelise on December 8, 2004, at 20:57:20

In reply to Struggle with pdoc -- thinking of GG (long), posted by Aphrodite on December 8, 2004, at 12:51:32

I have a warm, gentle, caring psychiatrist who has never spoken to me in any way similiar to how the pdoc you describe spoke.

He is my therapist.

He has gently brought my attention to things when he has felt I was ready for them. Gently, and kindly, with careful respect of my feelings. I have had a great deal of difficulty facing some things, and he has helped me learn to do so with a little more grace.

I don't know what things are like in the world of other shrinks, but I would be just as wary as you seem.

It took me 30 years to get the courage to ask for help. On examination of myself I expected I was an even uglier person under the under the ugly perception I had of myself. Going for therapy is not easy.

You know, she could have said all of that to you in a tone of great sympathy, feeling for you the pain you have been in, lamenting with you that you were unable for so long to get help. That would have been ok. Feeling criticised is not ok. Not for me, at least. I mean, I don't need to see a therapist to get beaten up - I do a fabulous job of that all by myself.

ShortE

 

Indeed! (nm) Shortelise

Posted by alexandra_k on December 8, 2004, at 21:22:28

In reply to Re: Struggle with pdoc -- thinking of GG (long), posted by Shortelise on December 8, 2004, at 20:57:20

 

What my T said . . .

Posted by Aphrodite on December 9, 2004, at 20:37:51

In reply to Struggle with pdoc -- thinking of GG (long), posted by Aphrodite on December 8, 2004, at 12:51:32

I wish I had the physical strength and mental clarity to respond to each of you. Thank you so much for your support and validation. Alexandra, your "knee-jerk" reaction was awesome! It's exactly what I wanted to say!

And yes, I think to a certain degree now that I have gone to 3 horrid pdocs, they *are* just like that, with the exception of Dr. Bob of course. :) I think I was expecting another person as concerned and caring and empathetic as my T.

I had my T listen to the pdoc's phone message reponse to my letter asking for she and I to work things out. My T tried to be open-minded, and I started to cry and said he was supposed to be on my side. I told him how she made me feel blamed and retraumatized, especially her insensitivity to my csa. He said very sternly, "That's it. She's fired!" He asked for more detail and ended up as indignant as I. He said she had betrayed both of our trusts and that we were to do everything to soothe and protect young Aphrodite.

I'm not sure where to go from here, but I was so relieved to get my T's support and not feel like I had to appease him.

This is discouraging, though. It just makes me go to the place of, "I'm too damaged. I'll never be well because I've never deserved it. It's all my fault."

That's a horrible place to be this evening. :(

 

Re: What my T said . . . Aphrodite

Posted by alexandra_k on December 9, 2004, at 21:01:46

In reply to What my T said . . ., posted by Aphrodite on December 9, 2004, at 20:37:51

Well she did say 'I assume you'll tell me if this response is insufficient'. So I say - go on, tell her!!! It isn't that hard to say the odd thing like 'this must be really hard for you' while doing an assessment. I know that the average p-doc may well not bother, but IMHO there is no excuse. I am glad that you liked my response.. I wasn't sure whether it was the kind of response that gets me into trouble or not. I was just thinking that if you tell her that it was really hard for you and that you are not sure whether she understands that then the situation could be clarified before you decide whether you want to work with her or not. I wouldn't work with anyone who was so insensitive (I would tell them how I took them and request for someone else). If she cannot see how she hurt you and at least promise to try to be more sensitive in future then why should you, why would you go back to her? Why would you trust her? I wouldn't


 

Amen! Letter #2 alexandra_k

Posted by Aphrodite on December 9, 2004, at 21:46:26

In reply to Re: What my T said . . . Aphrodite, posted by alexandra_k on December 9, 2004, at 21:01:46

Thanks so much for your thought. I too think I sometimes get in trouble for being a tad to quick on the trigger, but sometimes those intial reactions are right on the money. My instincts were kicking in. I found myself worried that if I stood up for myself with the pdoc, my T would be mad and I might jeopardize other patients of his who go to this pdoc.

After getting reassurance from my T to do as I pleased, I sent another letter stating that since she gave no indication that things would be any better during a second visit, I was not going to gamble my financial or emotional expense on her.

 

Re: What my T said . . . Aphrodite

Posted by daisym on December 9, 2004, at 23:46:19

In reply to What my T said . . ., posted by Aphrodite on December 9, 2004, at 20:37:51

Oh Aphrodite, it isn't your fault. You aren't so damaged that you will never heal. It is just going to take a while.

I'm glad you felt support from your therapist. I want to raise a question though -- and I might be completely off base. When I began to think about medication, there was a reaction from the younger parts of me. In some way she felt like my therapist wanted to medicate HER, to shut off what she was saying, when really we were talking about finding a way to help me sleep. You talked about having to protect young Aphrodite. Is this only about an insensitive Pdoc? Or are you protecting her from you too? (Again, my stuff, so I might be way off.)

I hope you still try to figure out which medications you need. For me, figuring out how to sleep was really important for coping with all of this.

 

Re: Amen! Letter #2 Aphrodite

Posted by alexandra_k on December 10, 2004, at 1:06:23

In reply to Amen! Letter #2 alexandra_k, posted by Aphrodite on December 9, 2004, at 21:46:26

>I sent another letter stating that since she gave no indication that things would be any better during a second visit, I was not going to gamble my financial or emotional expense on her.

Um. I would have put the issue out there, and then given her a chance to respond rather than kind of burning the bridge already... It is really hard in a situation like this where one can never be sure whether one is overreacting or whether one is standing up for oneself appropriately... That being said, there are other p-docs in your part of the world - right?

Just MO but maybe you could also tell her how impressed you were with her on the medication stuff and that you would like to repair if poss...?

RRmm. I am sorry


 

Getting worse . . . daisym

Posted by Aphrodite on December 10, 2004, at 12:11:33

In reply to Re: What my T said . . . Aphrodite, posted by daisym on December 9, 2004, at 23:46:19

I really understand about the suggestion of meds causing a reaction of being "too much" and being silenced. I may have felt that several months ago but not now. Since the focus of the meds has been on reducing my anxiety so I can sleep, that feels to me like it's not interfering with my relationship with my T.

It has only dawned on me, though, in the last couple of days how damaging that pdoc experience was. Having to divulge all that csa information has pricked an old and deep wound, and I feel like I'm bleeding to death.

Each day since my meeting seems to be worse.

 

Re: Struggle with pdoc -- thinking of GG (long) Aphrodite

Posted by Joslynn on December 10, 2004, at 12:22:49

In reply to Struggle with pdoc -- thinking of GG (long), posted by Aphrodite on December 8, 2004, at 12:51:32

(You wrote) "My personal favorite was her parting comment, "It seems a shame that you were not placed into the right family of origin, but to then grow up and *choose* to have more problems is especially troubling."

I would have been tempted to say: "Hmm, you know, that's an interesting point. I shouldn't choose to have more problems, so, I won't choose you as my psychiatrist. Buh bye!."

Honestly, how can a doctor be so naive as to not understand why someone would be reluctant to divulge CSA? All I have is a psych minor but even I understand why there would be displaced shame, suppression, etc. Duh. And to scold you for it?!

I wouldn't want to be around someone like that for free, let alone pay them.

 

Re: Struggle with pdoc -- thinking of GG (long) Joslynn

Posted by Aphrodite on December 10, 2004, at 13:27:55

In reply to Re: Struggle with pdoc -- thinking of GG (long) Aphrodite, posted by Joslynn on December 10, 2004, at 12:22:49

That's a perfect response! I hadn't considered that she was a problem I was considering choosing. I hate that I never think of pithy responses on the spot. Thanks for giving me that point of view, Joslynn.

 

Re: Struggle with pdoc -- thinking of GG (long) Aphrodite

Posted by Dinah on December 10, 2004, at 20:34:37

In reply to Re: Struggle with pdoc -- thinking of GG (long) Joslynn, posted by Aphrodite on December 10, 2004, at 13:27:55

Aphrodite, after thinking about it, I think the others may be right. Once you already have negative feelings about someone, it may be too late to salvage the relationship. I left the pdoc from h*ll for that reason.

But I *do* think that many many pdocs are like that, and I protected myself from bad feelings about my new pdoc by limiting my vulnerability. I didn't tell him anything that wasn't symptom or side effect. I told him bare bones history having more to do with symptomology than anything personal to me. I chose someone who was unaffiliated with my therapist, and resisted giving my therapist permission to contact him.

I consider most things about me none of my pdoc's business.

With those parameters in place, I think I could get along with a fair number of pdocs. My therapist doesn't think it's a great idea, but it really worked for me.

 

wise philosophy Dinah

Posted by Aphrodite on December 10, 2004, at 20:47:42

In reply to Re: Struggle with pdoc -- thinking of GG (long) Aphrodite, posted by Dinah on December 10, 2004, at 20:34:37

Dinah, When and if I ever try a pdoc again, I will certainly consider your advice and try to adopt your philosophy which is both self-protecting and helpful. I think I was trying to find a carbon copy of my T who just happened to have a prescription pad. I too resist the communication between the two because I lose conrol (big issue for me) and it just feels creepy to me though I know ultimately it could work in my interest. Thanks for your comments.

 

Re: Getting worse . . .

Posted by daisym on December 11, 2004, at 1:19:37

In reply to Getting worse . . . daisym, posted by Aphrodite on December 10, 2004, at 12:11:33

Aphrodite,

I'm really sorry you are having such a hard time. I know those really tough nights so well--where the old memories are over whelming and the pictures so clear. Talking about it really triggers it off for me too...

I hope you are getting extra support right now. It is important that you keep telling yourself that just because this woman acted like you were making conscious choices doesn't mean any of this is your fault. It must have been so hard to make yourself say all of it to a stranger. My therapist is very gentle when we talk about this stuff because he says that forcing it can be like a retraumatization. That sounds like what has happened to you.

Keep processing the feelings. Don't pull inside and hide. Please keep posting. I'll be around all weekend.

 

Re: Getting worse . . . daisym

Posted by Aphrodite on December 11, 2004, at 15:36:19

In reply to Re: Getting worse . . ., posted by daisym on December 11, 2004, at 1:19:37

Thanks. It's definitely been retraumatizing. I've actually considered calling my T today, and I have never called him on a weekend. I'll see him Mon., so I think I can wait it out.

It just feels like a band-aid was ripped off a horrid wound by an unfeeling caretaker instead of soaked and gently peeled by loving hands.

 

Re: Getting worse . . .

Posted by Daisym on December 11, 2004, at 17:54:45

In reply to Re: Getting worse . . . daisym, posted by Aphrodite on December 11, 2004, at 15:36:19

Maybe you can write down everything you are feeling in order to contain it over the weekend. If this doesn't work, I'd call him.

There are times when my insides hurt so bad that I am sure there must be something physically wrong with me. I just need to curl up and sleep, or work myself into exhaustion for the distraction. It still floors me that something that happened 30 years ago can hurt so bad. And it hurts this bad when I have to revisit it, tell about something. So I can only imagine how much you must be feeling, having had to run through the whole history.

Try to remind yourself that you are in control now and you don't have to go back again. No one is going to hurt you. And spend lots of time hugging your little one. They are the best balm for these kinds of wounds.


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