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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 justjustine on June 3, 2004, at 10:25:06
i am in our city's mental health program and receive treatment and meds for free - for which i am most grateful.
however, i was forced about 1 1/2 months ago to switch doctors - authorized for 50 minute sessions every two weeks. i don't feel like i'm getting along with this new guy very well. i'm a substitute teacher faced with a summer of god knows what, and yesterday he just kept hammering away at me, trying to make me make "plans" for the summer. i kept saying "i don't know" and he got more and more frustrated. finally i said "i see myself in my garden." he considered this some breakthrough momentarily then went back to "what else? what else? what are you thinking?" "self-esteem," he explained, "is related to the ability to make plans for yourself, it shows you believe you are worth it. you need to break it down, i'm not trying to upset you."
great. how can i go to this guy and not feel like it's just some crap i have to sit through to get my meds? i feel sooo much worse walking out of his office. i don't even know him, and i'm just supposed to open up and he's just supposed to know what i need? now that is nuts!
what should i do?
Posted by pegasus on June 3, 2004, at 11:29:39
In reply to new therapist troubles, posted by justjustine on June 3, 2004, at 10:25:06
Wow, that sounds so hard. Your description really concerns me. I don't know if I have any useful advice, but here are the things that come to mind:
Is there any chance that you could tell him that the way this therapy is going is not working for you? Maybe you could tell him that you always feel worse when you leave his office, and that it feels like a type of persecution that you have to endure in order to get your medications?
That sounds like a tall order, even for me who's writing it. But maybe you could find some way to communicate to him that you're feeling hammered? Could you tell him to check out your post? Or print it for him? Or maybe write out in some other words a description of how this approach is making you feel?
I'm assuming here that you don't have the option to ask for a different therapist at this organization. If you do, it really sounds like you should consider using that option. You've seen this guy for several sessions, now, right? So, you're probably getting a pretty good idea about the potential for work with him to lead to anything helpful for you. I think it would be valid for you to ask for someone else if they allow it.
And anyway, in the meantime, I hope you have some way to take care of yourself. This sounds like very difficult therapy to put up with. I don't know what orientation this guy has, but I've never heard of that type of approach before, and I have a hard time understanding how it's supposed to be helpful. Please post here if you're getting overwhelmed. And keep us updated on what's going on with therapy and all of it, if you can.
pegasus
Posted by Racer on June 3, 2004, at 11:45:18
In reply to new therapist troubles, posted by justjustine on June 3, 2004, at 10:25:06
I've been in a very similar situation lately, getting meds and therapy through the county program. They haven't been able to get me onto any med successfully, and the therapy situation became such a nightmare that I quit entirely. (I'm actually a lot better in some ways since quitting, and I did find another option for therapy which I'll be starting soon.)
My experience sounds to be a little similar to yours. First of all, the therapist who was first assigned to me was promoted out of practice, so I had to change. That change was the beginning of a real downward spiral for me. The new therapist was trying to force me into shapes that didn't fit me, largely because she never explored my needs in the first place. My condition got a lot worse, and it became impossible for me to get into the doctor's office during that time, largely because of her reaction to anything I tried to say about having trouble talking to the doctor.
Then they changed me to another therapist. She wasn't as bad, but again didn't identify my needs. She also did a lot of the "you must do this" stuff, apparently without any recognition that those things she was suggesting were not only beyond my capability at that time, but that the "suggestions" were putting so much pressure on me that I was withdrawing even more. The final straw was when she started into "you have to trust me, you have to open up to me" talks. My personal favorite, maybe because it finally helped me make the decision to quit, was when she asked, "What do I need to do to make you trust me?" Um, if I have to tell you how to be trustworthy, how can I trust you? Besides, since she never felt genuine to me, if I'd told her how to start working on my trust issues and then she'd changed her approach, that would have felt even more insincere, thus reducing my trust even further.
So, if I were in another similar situation, what would I suggest to myself? First, I'd keep in mind that I can A) quit, or B) request another change of therapist. That would reduce the pressure I felt, and possibly allow me to do something positive to improve the situation for myself.
The next thing I would do is get a piece of paper and start a list of things that would improve the therapy for me. Applied to your situation, that might look like, "Explain the realities of substitute teaching, the uncertainties of work hours, the difficulty making firm plans because someone might call me that morning to come in to work, so I am more comfortable leaving my plans more vague to accommodate that uncertainty." Or, "Talk about *my* needs regarding making plans, that I'm more/less comfortable making set plans independant of my self-esteem." (By the way, is self-esteem even an issue for you? If it is, is it one of those issues that *you're* ready to work on right now?) Maybe add something in like, "It's hard for me to be open with T right now because I'm experiencing pressure to respond to a set model, rather than feeling as if my own current needs are being considered." You know, a list of the concerns you, personally, have with the therapy as it stands. A day or two before your next session, type up an edited version of that list to take with you and start trying to address them with the therapist. It might not help, but it might. If it doesn't help, then that might be enough to convince you that it's worth requesting a change in therapist.
Another option might be to try to write out a treatment plan with your therapist. Sometimes, if you include someone in the process, they'll respond better and engage more. Writing out a plan, like, "Address these issues in this order, allowing some overlap" might help make your needs more clear. (You know what? That really sounds to me as if I'm suggesting that you have to do all the work to make this therapist work out for you. You know, placing all the burden on you, making you act as a diplomat to gain concessions from a professional who is supposed to be helping to identify and address your needs. That is backwards, and it is unfair that you might have to do it to make it work. Unfortunately, the reality of those public service agencies is that they're not set up to meet the actual needs of clients who fall outside a specific range. That means that, unless you're within their range, it may be very hard to get adequate help from them.)
Here's another option I assume you've already considered: get out your telephone book and make a few dozen calls. I've done this, and I've done it while fighting the urge to lie down and die, and it's harder to start than it is to do. The first few times I called around, I couldn't find any place to get help. We finally found an agency that provides marriage counseling for $15 per session, and that's where I'm about to start individual therapy. An agency that deals with people other than those sick enough to require public agency support might be better able to address YOU, the substitute teacher, who can function within whatever realistic limitations you have. Even if you haven't had any luck before in finding access to better therapy, I'll pass on the tips I've finally learned:
1. Call the closest NAMI office and ask them for referral information for low cost therapy. They'll have some names, and one of them may pan out.
2. Call the city department which oversees your care, and ask if you have any other options for therapy. This one may not help much, but it's worth ruling it out.
3. Check into non-profit agencies that address the concerns of abused women. They usually know where to find good, affordable therapy.
4. Have a nice, calming cup of tea and relax.
Another thought, if you just can't work things out with this therapist, is to request an appointment with his supervisor to discuss the difficulties you're having. It may be impossible to fix them, but the supervisor may be able to advise him on ways to be more helpful for you.
Best luck, and I do hope it works out for you.
Posted by rockymtnhi on June 3, 2004, at 12:00:29
In reply to new therapist troubles, posted by justjustine on June 3, 2004, at 10:25:06
justjustine,
I had a therapist twenty years ago that hammered on me as well. I wish that I would have had the courage to speak up or find another therapist. Needlessly to say, I withheld my true thoughts and feelings because I believed that I was going to be pushed or criticized. I felt victimized almost. It was my fault because when I look back on it now, I think the T would have adjusted his style because he did care about it.
My last therapist has been supportive and understanding and therapy has gone so much better.
Please speak up for yourself. If self-esteem is one of your issues like your T says, then speaking up for yourself will help you to feel better about who you are.
Be well.
Posted by justjustine on June 3, 2004, at 16:36:48
In reply to new therapist troubles, posted by justjustine on June 3, 2004, at 10:25:06
i called the provider and explained the situation. they put me on a waiting list (approx. 4 weeks) to start with a pdoc and a separate therapist, and gave me a referral to a support group too. i guess he was right - i did need to stop being so passive and reactive and make some decisions for myself! ;-)
it's just so difficult and confusing when the relationship between therapist and patient seems to turn adversarial. i suppose he didn't mean it that way, but considering i never wanted to change to him in the first place, i think i've made the right choice.
Thanks!
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