Sad but so fucking true ...

Rebuttal to Conflicting Agendas

ANONYMOUS said:

I totally disagree with you. I have a wonderful therapist and a very professional psychiatrist ... and believe it or not, they consult with each other about the best treatment plan for me. Sure you have to shop around for the right fit (sort of like dating) but the search is definitely worth the wait. If you have a therapist who won't consult with your psychiatrist (or vise versa), time to find new doctors. The search is worth the wait. Don't just pick someone out of the phone book. There are plenty of great doctors out there you just have to look. I am better off than I have ever been in my life and I thank both my doctors for that. Instead of slagging off all doctors, maybe you should do some research first to find the best fit for you. I knew my psychiatrist was the right one from the very first appointment -- she asked a lot of good questions and was very thorough. Same goes for my therapist. And no I don't think they're just after my money. They really care and I wouldn't be where I am today without them.

Conflicting Agendas?

ANONYMOUS said:

Whenever I've gone to a therapist/social worker (someone who cannot prescribe medicine), I'm told I just need to process my feelings by talking about them endlessly until it's out of my system. Whenever I've gone to a psychiatrist (who can prescribe medicine) I'm told I have a personality disorder or some other psychiatric disorder that will require medicine. It's really that black and white between the two. And even though your therapist is supposed to talk to your psychiatrist about you to come up with the best plan, that never happens. This is because psychiatrists view themselves as "the real experts" who shouldn't lower themselves by consulting a lowly therapist. The whole industry just seems very fucked up and contradictory, if you ask me. I think both therapists and psychiatrists are full of shit, making money off of people's problems, and not really wanting you to get better. That's just my honest opinion y'all.

Finally, a Positive Story!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Anonymous said:

I have a psychologist and a psychiatrist who actually talk to each other and respect each other. This is somewhat rare, although that is what the protocol is supposed to be! Anyway, after 15 years of seeing less than satisfying or knowledgeable people, I think I finally got the right combination. Yeah me!!! I would also recommend to anyone who is searching for a shrink to turn to a group practice or clinic where shrinks are monitored and have paperwork to turn in to show they actually care and are on the ball. The ones who are in private practice just do whatever they want and it's usually not much. They're not accountable to anyone and don't have any direction or purpose. At a clinic, the shrinks are expected to have a direction that they are to set with the patient and this direction has to be documented. Keeps 'em honest and purposeful IMHO.

Let's Talk About George

I once saw a shrink who let the sessions go completely unstructured and directionless. I kept trying to talk about things substantive, but somehow she always managed to get the conversations into the "irrelevant" zone, bringing things up that didn't really matter or making issues out of things that weren't. Basically she was just faxing in her appearance, nodding her head, and going "And how does that make you feel?" It became obvious to me that she only wanted "easy" clients with self-absorbed lifestyles, not anyone who was proactively trying to deal with specific issues. On one of my last visits, we spent the entire session talking about the life and careers of British gay pop star George Michael. -- Anonymous

Clueless and Outdated

This one shrink I saw was so outdated (I think she got her degree in the 70s) that I, the patient, had to explain to her that adults can have ADHD just as kids do. She was like, "Really? I never heard of that." She just wouldn't believe me. Finally, exasperated, I said "Do you have a tv? well are you watching it? Haven't you seen the commercials for that new drug for adults with ADHD?" She looked at me like I was making it all up. -- Anonymous

Most Unprofessional Shrink (so far)

When I first started college, I went to our school's psychologist to attempt to deal with childhood trauma issues. Since I was not in immediate danger of any kind, he had to pass me off to another agency – luckily we had an outstanding graduate program in social work and a counseling center where the near-graduation grad-students honed their craft. And, I could afford their $5 per session fee.

At my first session, the counselor announced that given my issues, I needed someone who would be around for a while, but she was so intrigued with my description of my mother that she thought she'd meet with me this one time before her graduation.Great. I'm a curiosity. Umm, how about my reason for being here??

The second counselor was definitely longer-term. However, it became increasingly clear as time went on that anything I wanted to talk about, she wanted to stay far away from. We tried a relaxation exercise since I had great difficulty keying down. Instead of calming me, I immediately started to get a flashback. Rather than discuss it, the whole episode was quickly shunted off as a "let's never do that again."

The kicker, though, was when she began pushing me to be involved in video-taped sessions for her grade. I have serious issues with my image on film or my voice recorded … issues that directly relate to the childhood trauma, which she was aware of. She kept pleading with me that I would be a great case, and besides, this was for her grade. I gave in for a while, but we got very little done in those sessions.

Finally, frustrated and cranky, I decided to skip an appointment. I reasoned it all out, but really I wanted to wake this woman up … that it was time she take what I said, my feelings, seriously for a change. The message on the answering machine was pleasant, but she still obviously missed the point. I skipped the next session as well – highly unlike me. This time when I returned her phone call, she immediately began with: "You're doing so well in school. This is for my grade … don't you want me to do well in school?" A good five minutes of this emotional blackmail. I never went back and I hope her instructor explained the error of her ways to her – I should have reported exactly what happened … but I didn't have the fight in me at the time. -- Anonymous

Hippy Chick

One social worker I saw (she was cheap) was a real basketcase. A former hippy from the 60s who went on and on during my paid time about what a difference she and her friends made back in the day. She was just lost in that era and hadn't updated her views to match the modern times. She looked and dressed pretty normal but as soon as you started trying to talk to her you could see was stuck in another time. For example when she found out I didn't have any African-American friends she accused me of being racist. What?!

When I did try to talk about the my problems she'd just sit their chainsmoking her Virginia Slims and feed me talkshow style expressions I could have gotten for free by watching tv at home. She had no wisdom to impart and never really heard what I was saying, it was all filtered through her idealistic 60s lens. I finally stopped seeing her and not returning her phone calls when she did the most inappropriate thing and CALLED ME AT WORK saying, "I just couldn't let the Christmas season go by without seeing how you were doing."

I was very short with her and furious, to which she responded, "Oh, you must have coworkers around your desk and can't really talk." I replied, "Actually, I'm sitting here by myself perfectly alone." She got the message.

I'm no Republican but I know a dumb liberal when I see one now. -- Anonymous

Dumping Ground?

I had inquired in yesterday's post if the patient misdiagnosed (rather arbitrarily) by a male psychiatrist as having Borderline Personality Disorder (BPD) was a woman. Here is the response:

Anonymous said...

Why yes, I am, in fact, female. Which apparently is a symptom of Borderline Personality Disorder. It really does seem a dumping ground for difficult to treat female patients, too. I'm difficult to treat because I consistently respond to doses about twice as high as the doctor expects.

A good friend of mine works in a practice specializing in personality disorders, and she tells me how frustrating it is for them that BPD has become such a dumping ground. She gets quite upset at the numbers of women walking into their practice who don't meet ANY of the criteria for BPD, who've been given the diagnosis by male psychiatrists after one drug trial has failed. She also says that these women generally have a history of abuse -- whether child abuse, rape, domestic abuse, or some combination -- and fit many criteria for PTSD, yet that diagnosis is NOT made. (I wonder if that's because they're middle class, and don't "look" like abuse victims to the doctor?)

I do feel fortunate, after hearing these stories, that my former doctor didn't stop trying to help once he made his diagnosis. And profoundly grateful to him for admitting his error.

Let me guess, you are/were a female patient...

Only guessing because my impression is that Borderline Personality Disorder is considered primarily a "woman's" disease. Or at least most diagnoses are made when the patient is a woman. Tell me if I'm wrong.

Now on with the story:

Anonymous said...

Years ago, I saw a psychiatrist who prescribed Paxil to me. I was severely depressed at the time, and the Paxil didn't do much of anything for me. The doctor diagnosed me as having Borderline Personality Disorder, his explanation for why the Paxil didn't work. Then he raised the Paxil. Lo and behold! Depression gone -- and he told me he removed the BPD from my diagnosis, because he could see he'd been wrong. I've thought about that since then. Isn't it lovely, for the psychiatrists, that if they can't find an effective drug treatment for depression, it must be because of a personality disorder? And, with the new research saying that PDs improve with age and drug treatment, they never have to say they were wrong -- only that age and drug treatment have improved the patient's condition. Kinda makes you wish you'd gone to medical school, doesn't it? You'd never have to rethink your diagnosis, and if your treatment plan fails, it's the patient's fault anyway.

Come On People ...

I know you're reading this. I know you come back. I have a feeling some of you have even bookmarked this site. I know, for some of you, you've been in or are in therapy. And somebody out there has to have a story to tell. I'm not asking for an opus -- just trying to avoid having to pull a quote from that Adam Phillips article yet again (it gets old). So PLEASE PLEASE PLEASE will somebody send in a story (under 500 words) about their feelings/memories of The Shrink Experience. You can post it anonymously in today's comment section. You can even rant about how you suspect I'm antipsychology or am a Thetan Level 7 in the Church of Scientology. Thanks.

Quote:: Conversation

Picture: Conversation by Mark Takamachi Miller

"Psychotherapy makes use of a traditional wisdom holding that the past matters and that, surprisingly, talking can make people feel better — even if at first, for good reasons, they resist it. There is an appetite to talk and to be listened to, and an appetite to make time for doing those things."

-- Adam Phillips is a psychoanalyst and the author, most recently, of "Going Sane: Maps of Happiness." The quote comes from an article titled “A Mind Is a Terrible Thing to Measure” by Adam Phillips. You may read the entire article at www.iht.com/articles/2006/03/01/opinion/edphillips.php

Been There, Done That

NOTE: The image to your right is not intended for the "patient" but for the "shrink."

I, back in the late 70's, seen a couple of shrinks. Actually I was made to go by my parents and other authoritive figures. It was 1976 when I graduated high school and 4 days after my 18th birthday, I married my highschool sweetheart to get out of my house. My significant other was addicted to both drugs and alcohol when I married him and did became a convict due to his heavy drug use.

Our marital problems, needless to say, were overwhelming. It was a life full of both physical and mental abuse and I began drinking daily to escape my reality. I can go on and on and I'm sure one day I'll even write my own story, but thats not what this is about -- its not about me -- its about those shrinks. I was sent to numerous shrinks for what they called my 'problem' -- I was suicidal... needless to say.

I remember one guy specifically used to just sit there and listen to my woes while every few minutes glancing at his watch. Until, we'd be really entwined in something, and he'd say, "ok, im sorry but your time is up" "we'll continue next time". Needless to say, next time never came - New things would happen in my life and it took me the whole 40 minutes to begin to think I could trust him with my life and then "im sorry, your time is up!!"

As years went by and a few suicide attempts the shrinks would always tell me my problem was "my significant other" --- never was it mentioned that being the child of two alcoholics and having two older brothers following the same path, never was it said that maybe I had a drinking problem. I drank on a daily basis just to take the shakes off. Before I even married my significant other, I was drinking. That's what I did. Blackouts, doing things I never remembered and the list goes on.

I went through a couple marriages, continued to drink and seen several shrinks for my depression. Every shrink told me my problem was my 'Significant other' and many of them suggested that my problems would cease if I would get divorce. 'Alcohol, didn't play a part'. In 1997, after myself 'surrendering' to alcohol, I voluntarilly started an outpatient clinic for alcoholics. After years of many shrinks,and even once being in a mental institutions I kept divorcing my significant others. When I myself figured out what my problem was I again, divorced my current significant other. Because again 'he' was the problem. I took pills, slit my wrists and even overdosed on some heart medication of my mother's all because, THEY said, it was my significant other.

After a 2 year divorce from my current husband, I learned that it was not HIM but my alcohol problem and my running from reality. Today, I am remarried to my last 'significant' other and am 9 years sober. I am happy. Sure, we have problems, usually financial, but HE was never the problem, just as the others weren't -- I had to find something inside of myself that was wrong. I am an alcoholic, now grateful and in recovery. I could have saved a lot of time, money, relationships and self esteem if those SHRINKS would have stopped putting the blame on others and knowing that I was drinking on a daily basis to deal with 'my reality', maybe came to the conclusion that it was 'alcohol' afterall being the child of two alcoholics made my statistics even higher.

I'm not seeing a SHRINK today -- afterall, I figured out what they should have figured out long before. Guess all that schooling is worthless if you ask me. I can go to an A.A. meeting to vent today, and they don't charge me for their time listening. Been there, done that.

-- Anonymous

Cartoon Humor

a different world

Years and years ago I had a startling conversation with my sister’s fiance on the nature of psychology. Her then-fiance was studying linguistics at the graduate level and as part of his induction needed to take several psychology courses, of which were a first for him. One of his professors (perhaps several, I can’t remember) posited his notion to the class that in a better world, and as a future goal, there would be no need for psychologists if people were trained to simply listen and speak to one another on a more authentic level. Frankly, I was appalled by what he was saying as I was in therapy myself at the time and could not imagine telling anyone, save my therapist, my secrets and fears. To this day I still cannot imagine this (although I am no longer in therapy). This saddens and intrigues me. Was this professor overly idealistic? Is it possible to attain such a society wherein trust, mutual understanding, and discretion are commonplace – especially within the capitalistic context? I wonder if we are any closer to that ideal today and if not, how we can get there. How do we build community and, even more, deeper friendships? -- Anonymous

quote:: A Mind Is a Terrible Thing to Measure

"If psychotherapy has anything to offer — and this should always be in question — it should be something aside from the dominant trends in the culture. And this means now that its practitioners should not be committed either to making money or to trivializing the past or to finding a science of the soul."

-- Adam Phillips. Adam Phillips is a psychoanalyst and the author, most recently, of "Going Sane: Maps of Happiness." The quote comes from his article titled “A Mind Is a Terrible Thing to Measure.” You may read the entire article at www.iht.com/articles/2006/03/01/opinion/edphillips.php

The above illustration is by Debbie Dreschler.

Ad Hoc Shrink

This is Peter’s Story, my friend who killed himself last October. When he was still alive he told me I could print any of his stories/experiences on my blog, which I did when he was still alive (he was too depressed to start his own blog). I am reprinting it here even though it’s not a straight-out shrink story (but he’d seen dozens of them so that makes it still relevant for this blog). You’ll get what I’m talking about by the end. The story is told in his voice …

I broke one of my rules. If I saw the pharmacist make a phonecall, I would leave. For some reason, this time I didn’t. I was getting careless. It was about 3:00 in the morning. I picked up the opiate script – I bought some shaving cream for my dad too – and left.If this were a big city nothing would have happened, they wouldn’t have cared. But this was _________, a little bumblefuck town where police had nothing better to do.

It was total overkill. There were four police cars waiting for me out in the parking lot. Four. It was unreal. They had the front doors open and were crouched behind them with their guns drawn. They were all going, “Drop the bag! Drop the bag and get down! Get down!” All of them were just screaming this. I couldn’t believe it. I wasn’t even scared. I mean, it was … interesting.So I drop the bag and I’m crouching down and they still would not stop screaming. I’m like, “Okay, I’m doing it, I’m doing it.” And they keep screaming anyway. I could hear one of them on the CB and I’m like, Who are you talking to? Everybody’s here.

I’d never been arrested for anything before. My dad had to post bail and pick me up. That really sucked, having your dad pick you up from jail at 4:00 in the morning.

A week later I went to a different pharmacy. Man, I got so busted. This was when I was working at the bookstore, in the café section. I went up to pick up my script and the assistant suddenly went, “Hey, I know you! You’re Peter from the bookstore!” And I’m like, no I’m not, I’m Steven. And she’s like, “No, but don’t you work at the bookstore? Don’t you remember? You served me coffee the other day.” And I’m like, no I didn’t … and this kept going on for a while. She would not let this go.

I finally leave and just as I reach the sliding doors, the pharmacist’s voice behind me goes, “We need to talk.”We went to this back office and took seats. I just explained it to him, everything. I needed it, it made me feel right. I didn’t know any way else to get it. He just listened. He said this time he wouldn’t call the police, but if he saw me again trying the same thing he would.Then I left. I was really lucky. If he called the police, I would have gone to jail.

Bait and Switch

Anonymous said...

This is a typical exchange between me and a shrink I used to in college. We didn't last too long.

Therapist: You should become a lawyer.

Me: But I don't want to become a lawyer.

Therapist: You have the talent, you have the smarts. I know you could do it.

Me: But I don't want to do that.

Therapist: That's because you're afraid of failure. But you have to take that leap sometimes.

Me: Fine, then I'll leap somewhere else. I just don't want to leap into law school.

Therapist: (sternly now) You're running away from your fears.

Me: I am not running away from my fears. I'm running away from law school because I don't want to be a lawyer.

Therapist: And why don't you want to become a lawyer?

Me: Because I'd rather be a graphic designer! (getting frustrated) I've been talking about this for weeks! I don't care if it's low pay! It's what I've wanted to do since forever! (screaming) And I don't care to argue over this anymore!!

Therapist: (switching gears completely, sensing she's not going to win this one) Good for you! You're becoming more assertive!

Finally, something good

This image was taken from PostSecret. If you don't know them by now, you should immediately go to http://postsecret.blogspot.com/

It's not meds, it's you

A number of years ago, when I didn't have insurance, I saw a psychiatrist at the county mental health clinic. When I told her that I was still depressed and anxious after two months on the drug she prescribed, and asked for help, she told me, "No, I'm satisfied that the drug is working fine -- you're just not responding appropriately. The bottom line is, you have too many problems, and no drug will make you feel better."Three weeks later, after a general practitioner at the local medical clinic changed the drugs, I was fine -- although still rather bemused by that doctor's comments and attitude. -- Anonymous

Bipolar Redux

Anonymous said...
And here I thought .... borderline personality disorder was the "when all else fails, just diagnosis the patient as ...."

Refreshing honesty?

I was in an outpatient programme for 3 months and a natural part of this process was family therapy. Needless to say, my family was not exactly chomping at the bit to participate. My sisters arrived drunk and my mother in her true cluster B style had a black cloud over her head and blamed everyone else for any problems. The head shrink who lead this process came to me the next day in the tea room, sat me down and patted me on the knee. He looked me in the eye and said something both highly unprofessional and very kind: "*******, if I were you, I wouldn't get my hopes up about my mother".

I knodded in a sage-like mannar.

-- Anonymous

higher power

Another one was a 12-step grad who crossed me when he started preaching about his higher power. i asked him not to mention his higher power to me any more. i guess i didn't do this respectfully enough. something about the way i said it cut through his professional facade and he flashed. "do you realize," he said, "that you're talking about something that saved my goddamn life?" i felt bad on a basic human level and apologized, but i also couldn't find any way i could continue seeing him after that.

I don't think those guys were bad shrinks, they just weren't the right shrinks for me. and i'm loath to participate in any enterprise to discredit practitioners of psychiatry and psychotherapy, or to persuade people not to look to them for help. to do this is to disrespect a huge community of people who have been helped or are being helped by going there, and to do a disservice to people who could be helped but won't be because their fear and prejudices are bolstered by mischievous enterprises like yours.
-- Anonymous

Cartoon Humor

I think we're alone now ...

I was getting an in-take interview for this day program. The person interviewing me would not believe that I had a nervous breakdown because of an extremely toxic and abusive superior at work. She thought I was exaggerating and kept asking me questions like, "How do you know she meant it to be mean?" and "Maybe it was an accident." I won't go into the details of what my old boss did to me -- but it was illegal and definitely intentional -- and still the intake doctor would not believe me. I could tell she already had an idea of what I was (bipolar, paranoid schizo, whatever) and wasn't really listening to me -- just looking for evidence for a disease she'd already picked out. Anyway, I got so frustrated I started crying and said, "If my old boss could be here now, she'd be laughing her ass off. I can't even get my own shrink to believe me."

To which she replied, "Oh don't worry, I'm sure she can't hear anything we say in this room." Like I was really worried she was somehow in the room! I started to correct her and then just said "forget it," took my stuff, and left.

You're Beautiful

Last summer I took part in the DBT (dialectical behavioral therapy) group that was supposed to help people deal with issues of anxiety, depression, anger, loneliness, etcetera. Our usual therapist wasn't there one day; instead we had the head of the program lead the session. At first she seemed alright, but I think we would all tell she was a little too proud of herself for "launching" the clinics very first DBT program. Anyway, we went around and talked about our problems. This one girl, about 20, was really having it rough -- she was a single mother living with her toxic, emotionally abusive parents, going to school full time and working part time. She was exhausted every day. Oh, and a few years ago she was brutally raped and, naturally, still had issues with that. So the head therapist is listening to all of this and says with a smile, "Have you ever thought of waking up, going to the mirror, and just saying to yourself, 'You're Beautiful'?" The silence afteward was deafening.

Thanks.

Patient: There’s nothing I want to do, there’s nothing I want to be. I’m just depressed all the time.

Shrink: (nods) So how are you spending your time?

Patient: A drive around a lot. Sometimes I don’t even have anywhere to go, I just drive and drive. Then I’ll realize I’m like in a totally different town and I have to drive all the way back.

Shrink: (serious and slowly) Well, I don’t think you’re having a psychotic episode.

Patient: Thanks.

Bipolar: Disease du Jour

There is so much overdiagnosis of bipolar these days (the disease du jour, if you will) that I've come to suspect it's become the label for anyone with an inconvenient personality.