![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Racer on May 18, 2004, at 1:38:04
OK, you all know that I cancelled that appointment with the REAL psychiatrist, because of the money angle. 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. 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. (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?)
Now here's my dilemma: our marriage counselor has a therapist she supervises who will see me -- IF I'm medicated. 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. Whichever it was, this therapist will have an opening for me in early June. 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.)
Here's the question: the therapist I'm seeing now at the same agency as Dr EyeCandy isn't close to gaining my trust. 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. And she's just not a good fit for me, period. I'd like to go ahead and cancel therapy with her -- NOW -- rather than waiting until the new one opens up.
Again, I do feel as if I've failed in all this, and I feel as if I need to be doing everything I can to do something about my state. 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. 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? 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?
Thanks.
Oh, and while I've doped myself to the gills on Xanax all day, it was much better than on the drug. Again, I feel as if it's my fault the drug didn't work, etc, but I'm glad I stopped it. Thank you all for your support through all this.
Posted by finelinebob on May 18, 2004, at 6:27:18
In reply to Seeking advice, posted by Racer on May 18, 2004, at 1:38:04
If cancelling means saving a few $$ that you can put away to defray costs for a consult with a pdoc, do it. And while you are at it, tell yourself how successful you are -- cutting loose from a situation that is not helping you and making positive steps toward finding something better.
If cancelling doesn't mean saving a few $$, then use the time to come to some sort of closure (particularly one that affirms what progress you have made ... and DON'T say you haven't made any because, at the VERY least, you have found out what doesn't work for you and knowing a negative is better than not knowing anything).
If you don't think you can bring it to any sort of closure, then cancel anyway and treat yourself good -- vacation time! Heck, we've been announcing vacation time for lots of people (or so it seems) lately here on Babble: it MUST be your turn, Racer!!
flb
Posted by NikkiT2 on May 18, 2004, at 7:31:21
In reply to Seeking advice, posted by Racer on May 18, 2004, at 1:38:04
I think if you're gonna be seeing someone in a few weeks anyway, then you can go ahead and drop Dr EyeCandy and have a few weeks "vacation" from the stresses that she obviously causes you. She's on your mind ALOT, and you stress about her ALOT.. a holiday from that would be a good thing I think..
And, you have mine and FLBobs say so.. so you have even been given persmission to have this holiday from worrying about therapy!
And.. as for meds.. I always felt guilty for having side effect after side effect with them..
Nikkixx
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...
Posted by Racer on May 18, 2004, at 11:05:34
In reply to Re: Seeking advice » Racer, posted by SLS on May 18, 2004, at 10:07:01
For thinking that I'd be anything other than grateful to you for taking the time to write all this, and to write honestly, when you thought that I might be offended or upset. Scott, you're a good guy.
I'm late for a dentist's appointment -- like I don't already have enough pain in my life -- but I do want to respond to a few of those things just to give you a fuller picture of the situation. I can either do it here, exposing my whole sordid tale, or I can do it via email -- your choice. Depends, I guess on how invested you are in this, but either way, I promise to respond to it all later.
Scott, from the bottom of my heart, thank you. I know how hard it can be to write something you don't think the other person wants to hear, and you did that for me. It means a lot to me.
Posted by shar on May 18, 2004, at 18:50:45
In reply to Re: Seeking advice » Racer, posted by SLS on May 18, 2004, at 10:07:01
Racer has responded positively to your post, and I'm thrilled about that, because I have some of the same questions. I'm so happy someone could word them in a way that is ok with Racer. I especially agree with the following:
> 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.
>I think, coming from you, this will help make more sense of things. I appreciate your ability to phrase things, and hope Racer will respond.
I seem to get into 'mom' mode, which I don't think is all that helpful. So, again, thanks.
Shar
Posted by Racer on May 18, 2004, at 19:09:25
In reply to Thanks, Scott, posted by shar on May 18, 2004, at 18:50:45
I'm just back from the dentist, medicated, groggy. The full response has to come later, probably tomorrow.
Two things I want to get out now, though, are these:
1. Shar, it really doesn't matter how you phrase things. I know that you're writing out of concern and caring, and that does matter. Thank you.
2. The problem with this therapist is that I really and truly do not trust her enough to tell her ANYTHING. We're not talking about me holding back something important, because it's hard to say -- I don't trust her to hear anything I say. It has to do with the whole agency thing, which I'll explain about tomorrow, when I've got access to my brain, 'K?
And I did hear back from our marriage counselor -- who does hear me. The policy is that patients need to be in treatment with a pdoc first, but she's waiving that because she trusts me to speak up if I'm a danger to myself. I'll start therapy with her supervisee mid-June. And I do promise a fuller explanation when I have my brain back.
Posted by SLS on May 18, 2004, at 20:32:01
In reply to Re: Thanks, Shar -- and Scott (above was joke), posted by Racer on May 18, 2004, at 19:09:25
Posted by Racer on May 19, 2004, at 16:02:29
In reply to Re: Thanks, Shar -- and Scott (above was joke), posted by Racer on May 18, 2004, at 19:09:25
Ugh. Yesterday was a really lousy day, ending in the ER after getting really, really sick. After a couple of hours without being seen, and hearing that they had a 10 hour average wait, I decided that I'd either die comfortably at home, or live through the night more comfortably at home. Obviously, I lived. Dunno what caused it, but I didn't argue when my husband suggested we might want to go to the ER. The suggestion came, by the way, as I collapsed while trying to crawl back to the sofa after being sick again. I was too sick to walk, which was bad enough, but when I was too sick to crawl, well, seemed like a sign, eh?
Anyway, here's a story that illustrates why I'm having trouble with this therapist. Gotta give you a little background, first, though.
I'm not paying for this treatment -- if I were, I would be paying SOMEONE ELSE -- it's all through an agency contracted through the county to care for those of us who are uninsured and without resources. I ended up in this system after a suicide attempt last year. The agency coordinates services with a case manager as point person, and I've also got the therapist and Dr EyeCandy, the pdoc. There was a problem with the first case manager I had, so my husband requested a change. The change was by far for the worst, but I won't bore you with details. Here's where the therapist gets into the story.
In session one day, she brought up something that would have required the services of a case manager. I told her that I would do without services in order to avoid having to have contact with that man. Mind you, I'd already told her what happened with him -- keep that in mind. This time, I don't know if she finally heard what I was telling her, or if it was just my absolute, flat refusal to have anything to do with him, but she sounded upset by what I told her. She said that she understood, she didn't blame me, and gave me the name and number of the person to contact to be reassigned a new case manager. That afternoon, there was a message on our voicemail from the case manager, saying that the therapist wanted him to call me, that we'd do that thing that she wanted, and here's what I needed to do and then call him. I know, there are all sorts of things that can be miscommunicated, but this sort of thing just makes it so hard for me to speak up. For one thing, I had to tell her several times what happened with this guy before she even seemed to hear what I was saying. Then, I felt boxed into a corner by his call. On top of it, I don't even really feel as if she believed me when I said that I didn't think I was being unreasonable. I don't think I was being unreasonable, thank you very much, but I don't think that there's any way in the world that these people are ever going to believe me when I say anything.
Yes, I know I'm supposed to be open, to hold nothing back. The problem is that I'm afraid. It seems as if everything I say gets around through the treatment team meetings, usually in a distorted form. At least, I think it's distorted based on the responses I get afterward. It includes the pdoc, too, which is a real problem. I've heard now through three other people that there was a drug that worked for me, but I unreasonably refuse to take it again. That's not exactly true. I've also heard that I'm unreasonably hypervigilant about side effects. He swore, when I brought it up to him, that these people were getting it from my chart. First of all, two of the three said, "Dr EyeCandy says that..." And then there's the idea that anyone in there can read my chart. It's just not a good sitaution for me right now.
The agency that our marriage counselor works through is not out of reach financially -- assuming my husband's job lasts -- so I will be switching over there. It feels as if I've failed with the main agency, of course, no matter how much I look at what's gone on and try to convince myself that it's at least not *entirely* my fault. All I see, though, is all the things I couldn't do right to get help there. {{sigh}} That's the sort of thing I guess I should bring up in therapy...
I left a message for Dr EyeCandy yesterday, because he was on call Saturday when the Remeron crisis really hit hard. He said to stop taking it and call Tuesday, so I did. No word yet. The nurse who called back said she'd ask him today what he wanted me to do, whether he wanted to move up my appointment, or what. I can't wait to hear this one.
So, that's a story. Tomorrow, if you like, I could paraphrase the Hungarian legend of the wives of the sons of Adam...
This is the end of the thread.
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