Posted by g_g_g_unit on January 25, 2013, at 6:57:57
In reply to Re: disheartening psychiatrist appt. » g_g_g_unit, posted by Twinleaf on January 25, 2013, at 6:23:01
> I don't see anything wrong with your thinking; you have expressed very clearly how all of us feel when we are in the grip of depression. What one hopes for in a pdoc or therapist is someone who both understands the severity of our illness, but also believes in us and will work with us in every possible way to help us get better. I think you have sized up this pdoc's shortcomings accurately; he is kind of blaming you for your illness - and also seems to have an outmoded Freudian viewpoint that one doesn't see much anymore. Trust your instincts, and look for someone who is hopeful and empathic, and who believes in you and has the skills to really help.
Thanks Twinleaf. I found your message reassuring. It's so easy to doubt myself, particularly in the face of an authority figure (and one I highly respect at that). Regardless of his shortcomings, he is an intelligent, perceptive therapist: As I've maybe iterated already, what hurt the most was that what he said was right -- I do live in denial of my OCD, and have never really come to terms with it, or mourned the loss of the 'ideal', healthy person I see.
That said, I don't see that as grounds to deny me pharmacological treatment, particularly when I am trying to get across precisely how disabling those symptoms have become. I have made him do things that he hadn't done before (prescribed Memantine off-label; used a higher dose of Parnate than recommended) but it's easy to try and frame desperation to get the best treatment as 'pathological'. This has happened to me before; doctors will try a couple of approaches (often monotherapy) and then when I don't remit, or only some of my symptoms are resolved or whatever, they'll accuse me of having some kind of obsession with medication and then act like they're doing me a favor by denying further treatment.
Yeah, the blaming the patient thing has come up once before -- I remember complaining that I was feeling horrendously apathetic on Lexapro and simply wanted to sleep all day, didn't have the motivation to attend to basic tasks like answering e-mails etc. SSRI-induced apathy is a well-known syndrome, but instead he asked what was 'subconsciously' preventing me from attending to these tasks. When Dexedrine didn't improve my ADD or quality of reading, he suggested I had some 'fantasy' regarding what Dexedrine was capable of doing for me.
I don't want to sell the guy short, because he's helped in a lot of ways and often been supportive of my ideas, but I guess it is time we part ways; I've never felt 'loved' by him, and there is probably too much father-transference going on. I just have no idea how the hell I'm going to find another psychiatrist. The last esteemed 'professor' he referred me to was a nightmare. My other option is to simply get a hospital referral from my GP and go inpatient somewhere private (and somewhat reputable) at the end of February, though that might be a gamble, since I have no idea who I'd be seeing for treatment.
poster:g_g_g_unit
thread:1036417
URL: http://www.dr-bob.org/babble/20130124/msgs/1036455.html