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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Elizabeth on April 21, 2002, at 13:10:38
Hi. It's kind of you to take the time to come here. Thanks!
I'm seeing a new psychiatrist (I moved recently) who seems intent on believing that I'm abusing my medication. I think she's being irrational. Maybe she sees a lot of drug abuse in her practice. Maybe she doesn't like the fact that I take three different controlled medications (Ambien, Xanax, and buprenorphine, the first two in fairly high doses). I'm sure that part of it is an overreaction to my running out of Xanax that month. (The amount she prescribed was barely enough for an average month; for a month when I'm more anxious than usual, it's not enough.) Whatever the reason, at our last meeting (my third or fourth appointment with her, I think) she kept making these comments that I found quite offensive. (She hadn't said anything like this any of the previous times I'd met with her.) Some things she said:
* She said that I had been "overusing" the Xanax in the past month because I'd run out. (She gave me enough for ten doses, and I had to ask her to call in a refill before the month was over.)
* When I told her that increased anxiety and associated musculoskeletal pain were the reason I'd needed more Xanax, she accused me of abusing it, on the grounds that Xanax isn't indicated for pain.
* I told her that I'd been having some problems with early-morning depression, perhaps because the buprenorphine was "wearing off" too soon [overnight]. She took this to mean that it had stopped working altogether, and said that if I was becoming tolerant it must be because I was using it to "get high."
* When I told her that 10 mg of Ambien doesn't work for me but that 20 mg dose (this has been apparent since I first took it in 1996), she didn't believe it, even though I told her she could call my former psychiatrist and ask him. She insisted I "try" 10 mg.
* She said, towards the end of the session, that she thinks I have an innate tendency to experiment with/overuse/abuse drugs. (I don't remember the exact phrasing, but that's the general idea.)
I'm concerned about this. I want her to trust me. I don't believe I've done anything wrong. I've been honest with her. I've told her I'm not abusing any drugs. It seems that she doesn't believe me. Why is she behaving like this? Is there anything I can do, short of finding a new doctor?
-elizabeth
Posted by pedr on April 22, 2002, at 13:13:17
In reply to Dr. Goldberg: how to deal with closed-minded doc?, posted by Elizabeth on April 21, 2002, at 13:10:38
Hi Elizabeth, I've only had a few psychiatrists in comparison to many people on this board but what-the-heck. I've generally found the easiest solution to a psych with a fixed, irrational attitude is to find another. For example, I was told by the first psych I was referred to [he was highly recommended by my GP here in the UK] that because I'd tried SSRI, Tricyclic and a "novel" AD [i.e. effexor XL] that no other drug would work. End of therapy, grin and bear it, goodbye, next please. This was before I'd found PB and I was devastated.
Fortunately I'm in work and can afford to see a private psych who's really helped me out. It makes me soooooo fecking angry that there are almost certainly lots of people in the UK without internet access, or without the funds to go private, who are in a deep depression that they will not get out of. A saddening thought indeed.
Sorry, that's not very helpful information but it does make rather shocking reading I feel.
I hope you get some good replies and keep your posts coming, they're great.pete.
Posted by Bekka H. on April 22, 2002, at 22:12:47
In reply to Dr. Goldberg: how to deal with closed-minded doc?, posted by Elizabeth on April 21, 2002, at 13:10:38
Hi Elizabeth,
I don't know too much about you other than the fact that you are one of the most intelligent, well-informed, articulate people on PB. I don't know what size city you moved to, but if it is a fairly large city, perhaps there are other doctors available to you? In years past, I would stay with doctors who weren't right for me (just as I used to stay with boyfriends who weren't right for me), and I would try to change them into the perfect doctor or perfect "parent" instead of seeing them for what and who they were. This only made matters worse. If you can, I really think it's best to try to find someone else. A long term doctor-patient relationship has to work. It has to feel right. It has to "click." The mutual trust that is required for the long term relationship will take time, but if you continue to feel uncomfortable with that woman for more than a few more weeks, then you have to leave. It's clear that you are having enough pain and enough difficulty in other areas of your life, and you don't need her to be the source of yet another problem.
Bekka
Posted by Iago Camboa on April 23, 2002, at 5:25:13
In reply to Dr. Goldberg: how to deal with closed-minded doc?, posted by Elizabeth on April 21, 2002, at 13:10:38
Hi Elizabeth,
I'm also a (distant) admirer of your intelligence, vast culture and sensitiveness and would like to contribute (although modestly) with some advice. Perhaps I have the 'right' to do it, being probably old enough to be your father and having myself a 21 y.o. daughter which is perhaps as bright and as sensitive as you are and whom I really admire too...
I think Bekka is right, yes. If I were you I would 'give' your pdoc a second fresh chance for her to start behaving more 'correctly' toward you and in case she kept being arrogant and intractable I would 'dispatch' her straight to ... hell.
Wish you all the best,
Iago
Posted by omega man on May 3, 2002, at 0:55:15
In reply to Dr. Goldberg: how to deal with closed-minded doc?, posted by Elizabeth on April 21, 2002, at 13:10:38
Psychiatry tends by the analytical nature of the profession to attract slightly intellectuall convergant thinkers...
I've practically made it three years work to get to know why this is and that would be a neurology discussion...
if you introduce a change or bend the rules or add something new to your relationship/dialouge..they will usually react in a negative..questioning..pull back way..but perhaps be more enquiring the next time you see them if they have some motivation to do so.
Convergant intellectuals like psychiatrists will only accept something
A) after it has happened usually in a pattern..
c) if its corroborated by their training or peers..which is difficult when this can be vague and out of date quickly in the ever changing and highly theoretical complexities of biopsychiatry.
it can get quite fraught between an im-patient who sees ways to skip the procedures or customize them..
if your Pdoc is the type I mentioned above they can send out signals that they are understanding people because the nature of the relationship ...... knowing how to seem understanding is not the same thing as being that by nature....Pdocs are professional and need to follow rules which they are accountable to..god forbid anything goes wrong..
her offensive remarks.....she probably has little idea the effect they have on a sensitive individual and it seems like she has no respect for you..
I hate arguments myself..but convergant thinkers work things out thru that way then retreat and think about it...
in this case state your problems in writing.
Strange how we ended up having to understand the psychiatrists is'nt it ?
> Hi. It's kind of you to take the time to come here. Thanks!
>
> I'm seeing a new psychiatrist (I moved recently) who seems intent on believing that I'm abusing my medication. I think she's being irrational. Maybe she sees a lot of drug abuse in her practice. Maybe she doesn't like the fact that I take three different controlled medications (Ambien, Xanax, and buprenorphine, the first two in fairly high doses). I'm sure that part of it is an overreaction to my running out of Xanax that month. (The amount she prescribed was barely enough for an average month; for a month when I'm more anxious than usual, it's not enough.) Whatever the reason, at our last meeting (my third or fourth appointment with her, I think) she kept making these comments that I found quite offensive. (She hadn't said anything like this any of the previous times I'd met with her.) Some things she said:
>
> * She said that I had been "overusing" the Xanax in the past month because I'd run out. (She gave me enough for ten doses, and I had to ask her to call in a refill before the month was over.)
>
> * When I told her that increased anxiety and associated musculoskeletal pain were the reason I'd needed more Xanax, she accused me of abusing it, on the grounds that Xanax isn't indicated for pain.
>
> * I told her that I'd been having some problems with early-morning depression, perhaps because the buprenorphine was "wearing off" too soon [overnight]. She took this to mean that it had stopped working altogether, and said that if I was becoming tolerant it must be because I was using it to "get high."
>
> * When I told her that 10 mg of Ambien doesn't work for me but that 20 mg dose (this has been apparent since I first took it in 1996), she didn't believe it, even though I told her she could call my former psychiatrist and ask him. She insisted I "try" 10 mg.
>
> * She said, towards the end of the session, that she thinks I have an innate tendency to experiment with/overuse/abuse drugs. (I don't remember the exact phrasing, but that's the general idea.)
>
> I'm concerned about this. I want her to trust me. I don't believe I've done anything wrong. I've been honest with her. I've told her I'm not abusing any drugs. It seems that she doesn't believe me. Why is she behaving like this? Is there anything I can do, short of finding a new doctor?
>
> -elizabeth
This is the end of the thread.
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