Posted by SLS on May 18, 2004, at 10:07:01
In reply to Seeking advice, posted by Racer on May 18, 2004, at 1:38:04
Dear Racer,
I have a feeling that what I'm going to write here is going to make you angry at me. Maybe not, but if it does, please just disregard it as being wrong for you and try to understand that I was only trying to help. Some of this might simply be me playing devil's advocate. You were asking for suggestions, right?
I went ahead and starting writing this post. I'm about half the way done, but I have returned here to write this paragraph to tell you that I am probably wrong about everything I had to say. However, I would feel cheated if I were to let so many words go to waste. Maybe they would apply to someone else who reads this. I can see already that I have not read your post thoroughly enough to digest it and get it right, but I am truly limited in the volume I can consume in reading. I can write more than I can read sometimes. You see? :-)
Back again. This stuff is really going to upset you, so perhaps you better not read past this point. Tough love sort of thing, I guess.
> OK, you all know that I cancelled that appointment with the REAL psychiatrist, because of the money angle.
Sounds good so far. It makes sense to save as much as you can and channel your limited funds towards addressing the most urgent issues. Who is the REAL psychiatrist, and who is Dr. EyeCandy? Are they two different people? I have only recently started posting here, so I don't know your history and its cast of characters.
> After the first day of work, my husband says that there may be even more trouble on the insurance front, but something will happen soon, at which point I'll go to see a doctor who maybe will listen to me and treat me.
That sounds pretty encouraging.
> Dr EyeCandy seems to be listening to everyone else except me, and no matter how crazy it may sound, I do think he was being punitive in prescribing Remeron to me.
I think the key word here is "seems". Perhaps he is. But I'm pretty sure your doctor is sane enough not to prescribe you a drug that will hurt you for the sake of spite. What are the things that he listens to coming from others that are not coming from you?
> (If for no other reason than that its two main side effects are two of the main reasons for discontinuation of other drugs in the past. That seems to me to be good reason to avoid it, right?)
Perhaps your doctor can't come up with a better idea than to treat you with one of the few drugs you have not tried yet and that he knows is effective for many people. How long have you been working with this doctor? You might need to see someone else who has more experience treating difficult cases. Maybe your doctor can help you find one. Perhaps asking for one will motivate him to do some homework and develop more innovative treatment strategies.
From the wording in one of your prior posts, I gather that you are a partial responder to nortriptyline, despite its side-effects. Is this true? Which other drugs have been partially effective?
> Now here's my dilemma: our marriage counselor has a therapist she supervises who will see me -- IF I'm medicated.
This is the point at which what I offer you are things that would be very good for me, but may not be at all good for you.
Why are you spending money on a marriage counselor when you haven't yet successfully addressed your current psychobiological crisis? You can't climb to the top of the stairs without accomplishing the first step. Is it possible for you and your husband to agree to temporarily defer your marriage counseling until your immediate needs are met? Would your marriage be any better were you to be free of depression and anxiety? Remember, I don't know the first thing about you or your marriage. How can the marriage be made better without making you better first? For this to work, both you and your husband must communicate and recognize the order in which these tasks must be performed. How imminent is the dissolution of your marriage? How much energy and patience do you think your husband has to hang in there with you? I don't even know if you have any children. Will the children continue to act as a cement to keep you together for the foreseeable future? If you can afford the marriage counseling and the pursuit of your mental health at the same time, this whole paragraph is moot. If not, it seems to me that you have no better choice than to focus on that first step.
Pollyanna? I don't know. I can't possibly appreciate the complexity of your life to know.
> She left a message for me today, saying that I need to see a psychiatrist for medication in order to be seen by this therapist. It was unclear to me whether that was a prerequisite or a 'in order for the therapy to help, you'll need to be more stable' lecture.
Step #1. It is too obvious to ignore. I guess I am lecturing. Sorry.
> Whichever it was, this therapist will have an opening for me in early June.
What would happen if you were to stop seeing a personal psychotherapist?
> On Friday, we'll talk about whether she can start seeing me before I get a real doctor, which will clear some of that up. (I'll probably call the counselor before then, to ask for clarification of that.)
It would be ideal for you to be treating the biological and the psychological at the same time. I hope things work out with finding a new therapist.
> Here's the question: the therapist I'm seeing now at the same agency as Dr EyeCandy isn't close to gaining my trust.
Fuck trust. (This should earn me my first PBC)
What is there to trust? The only trust you need is the belief that the therapist wants to help you get to where you want to go. Perhaps you have yet to discover where it is you want to go. I don't know. Spill your guts. You need to accomplish full disclosure. That which is most personal is most general. I masturbate, do you? It is the job of a female medical doctor to examine my penis and determine if the appearance of a mole warrants a biopsy. I didn't hesitate to drop my pants. Psychotherapists are professionals just like medical doctors. They are trained to hear anything and everything. That is their job.
IF YOU WANT TO GET WELL, YOU WILL TELL YOUR THERAPIST EVERYTHING. PERIOD. ONLY YOU CAN DETERMINE THE RATE AT WHICH YOU WILL HEAL AND GROW.
> In fact, I feel as if I'm just passing messages around to the rest of the agency when I'm in session with her.
I don't understand what you mean here.
> And she's just not a good fit for me, period.
Great! It's great that you have discovered this now rather than later.
> I'd like to go ahead and cancel therapy with her -- NOW -- rather than waiting until the new one opens up.
Great! Now that sounds like a positive and constructive decision.
As I asked before: What would happen if you were to stop seeing a personal psychotherapist temporarily?
> Again, I do feel as if I've failed in all this,
You have not failed. Not at all. Indeed, you have successfully survived a devastating and painful disease. THAT is an accomplishment. Don't let anyone tell you different. For you, the word "heroic" is more applicable than "failure". Your efforts to win the war against the undeserved pain and frustration that are beyond your ability to control is nothing less than heroic.
> and I feel as if I need to be doing everything I can to do something about my state.
Step #1. Now that sounds like a plan.
> But I don't feel as if this therapist is getting anywhere near helping me, and often I leave there feeling much worse than when I went in.
Find a therapist whom you are convinced wants to help you get well. Then, tell them everything - personal and private. Let the therapist know what a tangled mess you are. Tell him about your most bizarre and warped thoughts and feelings (if you have any). If the therapist is dedicated to his profession, you are safe to do so. Safe. You are safe, I promise you. Safe. Go for it. Get the job done. Everything. Full disclosure. I know this will not be easy, but you should make it your goal. The therapist is a clinical and objective professional who specializes in thoughts and feelings. Show him yours so that the two of you can treat them. Kick ass.
Oops. Another PBC
> Not in the 'wow, that was a draining session because we really got at some roots,' but in the 'damn it all, there really is no hope for me, and she didn't understand a damn thing I said' sense. Can anyone come up with a compelling reason for me to continue on with her?
Start fresh with someone new. First, evaluate the new therapist. Discover whether you feel he is competent. If you come to believe that he is competent and genuinely wants to help you, trust him. You are safe. Let him do his job.
> Or do you think it's OK to go ahead and cancel therapy now, knowing that I'll be able to be seen by someone else in a couple of weeks?
That sounds like a good plan to me.
> Oh, and while I've doped myself to the gills on Xanax all day, it was much better than on the drug.
As I suggested before, attacking the anxiety at this juncture might be critically important. Things should make more sense now.
> Again, I feel as if it's my fault the drug didn't work, etc,
I know. You know that I have felt this way many times in the past. I have, on occasion, actually apologized to doctors for not responding to their treatments. Of course, the adult and logical me knows that it is not my fault at all. Perhaps you should apologize. You can if you want. It will relieve you of the misplaced guilt, and reinforce to you the truth that it is indeed NOT your fault. The doctor will tell you so. You'll see.
> but I'm glad I stopped it.
From what you described, that seems like a reasonable decision to have made. I'm sorry Remeron didn't work out for you, but my guess is that you have plenty of alternatives yet to explore. You just need a psychiatrist who is equipped to find them.
> Thank you all for your support through all this.
If you decided to read this post in its entirety, I hope you will eventually forgive me for trying.
I don't have time to proofread this, as I am already very late for an appointment. However, I elected to write this because I thought it was the best investment of my time.
With much care and affection,
Scott
PS. I decided to proofread it anyway. I hope I haven't missed anything. Ok, here we go...
poster:SLS
thread:348038
URL: http://www.dr-bob.org/babble/2000/20040501/msgs/348133.html