![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by sunny10 on May 11, 2005, at 14:00:22
I'm not sure if it's going to be a problem from an insurance coverage standpoint, but I have started seeing two T's.
One is a behavioral mgmt guy who will help my SO and I with individual anger mgmt and then see us together for couples counselling when he feels we are ready.
The other is a T just for me. There has been so much stress in my life lately and I'm becoming more and more paralyzed by feelings of low self-worth. I've thought about ending it all a few times lately.
But the new "personal T" really wants me to shell out money on a pdoc assesment because she feels that in order to correctly start a "long-term therapy relationship", she needs "a proper diagnosis" for me. I have to admit to some confusion as to exactly what my diagnosis is because at one point, many years ago, a pdoc prescribed me with Desipramine and Depakoate. A pretty well-known Bipolar med cocktail. And it worked for as long as I needed it (about a year) and I didn't have a buch of side effects when I came off them, either, like I did later with EfexxorXR.
But the other side of me is saying, "hey, wait a minute. Aren't you going to be providing ME with therapy? Does a label matter? Will you be treating ME or some DSM IV category?"
Can someone provide some insight? (Oh, and just so you know, I DID tell her that I had recurrent Major Depressive Disorder and that my cycle is extremely long... I can go 5-7 years without needing a year's worth of meds to "right" my chemicals again.... I am not currently on meds...)
Anyone?
-sunny10
Posted by pinkeye on May 11, 2005, at 14:30:41
In reply to Starting with a new T (or two)...(triggerish), posted by sunny10 on May 11, 2005, at 14:00:22
It is not a label, it is a diagnosis. And I think your T is right in asking you to see a pdoc first - because you don't want to be treated for a wrong diagnosis right? If you shell out lot of money on your T for a year, and then if she realizes that she was all wrong about you, that you had some thing which should have been treated with medicines, how would that be? I think she is very sensible.
She would still be treating YOU and not the LABEL. It is like a teacher teaches physics, but still she would be teaching the physics lesson applicable to that grade. But she atleast needs to know that she needs to teach physics - I think that is what she is asking for, and I think your T s request is quite fair.
>But the other side of me is saying, "hey, wait a minute. Aren't you going to be providing ME with therapy? Does a label matter? Will you be treating ME or some DSM IV category?"
Posted by LadyBug on May 11, 2005, at 14:55:00
In reply to Re: Starting with a new T (or two)...(triggerish) » sunny10, posted by pinkeye on May 11, 2005, at 14:30:41
IMHO don't think a therapist should give you a DX as I have heard it can confuse the work. I may be wrong but I have read this several different places.
If your not sure about your insurance covering both, have the other one turn it in for your SO.
Good Luck!LadyBug
Posted by Tamar on May 11, 2005, at 15:31:38
In reply to Starting with a new T (or two)...(triggerish), posted by sunny10 on May 11, 2005, at 14:00:22
I dunno. I can see it both ways. Maybe having a diagnosis would help your new T get an idea of where to start with you. Or maybe she always asks new clients to get a pdoc assessment. I can understand your reservations though. But is it the case that insurance companies sometimes insist on a diagnosis before they'll pay out?
Posted by sunny10 on May 11, 2005, at 15:36:41
In reply to Re: Starting with a new T (or two)...(triggerish) » sunny10, posted by Tamar on May 11, 2005, at 15:31:38
that I have been dx'd- about 2 yrs ago???
I COULD have the records TRANSFERRED, but she would prefer that I go to this particualr pdoc that she likes to work with and trusts...
so the insurance covering the T is not an issue in terms of having a diagnosis for billing purposes...there already IS one that can be transferred.
Does this change anyone's response?
(sorry, I thought that when I mentioned earlier pdocs and meds that it would be clear that I have proir dx, but I am feeling so confused that the confusion no doubt made it into my posted question..... sorry again....)
Posted by Tamar on May 11, 2005, at 16:02:27
In reply to Re: did I neglect to mention, posted by sunny10 on May 11, 2005, at 15:36:41
> that I have been dx'd- about 2 yrs ago???
>
> I COULD have the records TRANSFERRED, but she would prefer that I go to this particualr pdoc that she likes to work with and trusts...
>
> so the insurance covering the T is not an issue in terms of having a diagnosis for billing purposes...there already IS one that can be transferred.
>
> Does this change anyone's response?
>
> (sorry, I thought that when I mentioned earlier pdocs and meds that it would be clear that I have proir dx, but I am feeling so confused that the confusion no doubt made it into my posted question..... sorry again....)Do you have a gut feeling that she is not being entirely straight about this? If so, you should listen to it.
I understand that professionals can have good relationships and rely on the judgement of people they particularly trust, but it shouldn't be a requirement that you spend money to see her pdoc pal when you could get the records transferred.
So yes, it does make a difference to my response. If I were in your shoes, I'd be a bit skeptical. Unless you think there's any possibility that your diagnosis could have changed in the last two years.
But I also have to admit that I really don't know how the pdoc system works, so maybe I'm speaking out of turn...
Tamar
Posted by pinkeye on May 11, 2005, at 17:04:32
In reply to Re: did I neglect to mention » sunny10, posted by Tamar on May 11, 2005, at 16:02:27
I would still think you can see the pdoc maybe once and decide later if that is what your T thinks would be good for you
I am usually not a person to suspect a T of a mishandling - and my experience with Ts had been extremely good. My ex T didn't even charge me any money for all the support he gave me for 2 and a half years, and my current T does charge me, but I think she is pretty straightforward and honest.
Why would a T suggest you see a pdoc if she thinks you don't need it? It doesn't make too much sense to me.
Posted by Dinah on May 11, 2005, at 20:32:52
In reply to Starting with a new T (or two)...(triggerish), posted by sunny10 on May 11, 2005, at 14:00:22
I had one therapist I almost started seeing who insisted on that. But I think it was because I was mid Wellbutrin meltdown and obviously a handful.
My current therapist didn't, and I'd have to have a pretty compelling reason to do it.
Mind you, I thoroughly enjoyed my psychological testing, but that was a psychologist, not a psychiatrist.
Is her idea that you need meds?
I dunno. I think I wouldn't feel easy with someone with someone very dogmatic from the beginning. It wouldn't bode well for future flexibility.
But again, that's me.
Does each therapist know about the other? My therapist only allows me to have external therapists for limited specialized purposes. He thinks it can confuse therapy otherwise.
Posted by Shortelise on May 12, 2005, at 1:19:08
In reply to Starting with a new T (or two)...(triggerish), posted by sunny10 on May 11, 2005, at 14:00:22
I'd feel funny with someone who felt they couldn't figure out what I'm about by getting to know me.
I mean, if you see a pdoc a couple of times for a diagnosis, is that going to be more accurate than the diagnosis that your T might come up with over a couple of months of getting to know you?
And exactly what it the use of a diagnosis? It seems to me that point in therapy is to deal with the issues at hand. Who cares what the diagnosis is? If you get a few months into the therapy and your T finds that you need some other interventions, like meds, then maybe that's the time to venture into the world of pdocs.
There, my opinion, maybe not as humble as it should be, but clearly stated at least. Do keep in mind that it is nothing but an opinion, and that I have no education in these matters.
Hope this helps.
ShortE
Posted by alexandra_k on May 12, 2005, at 4:45:21
In reply to Starting with a new T (or two)...(triggerish), posted by sunny10 on May 11, 2005, at 14:00:22
If she wanted you to see a p-doc because she wanted to make sure that you were on the best meds you could be on then I could understand that.
But not for dx.
If she can't figure that one out all by herself then IMO you would be better off finding someone else.
Besides which dx ARE labels.
IMO they are (mostly) a crock.
Posted by alexandra_k on May 12, 2005, at 5:13:36
In reply to Re: Starting with a new T (or two)...(triggerish) » sunny10, posted by alexandra_k on May 12, 2005, at 4:45:21
I'm sorry.
I'm feeling disgruntled and cynical.IMO dx ain't worth sh*t
They are too easy to come by
Too cheap
Too easy to get
Too easy to lose
They are a description of your SYMPTOMS anyway
And if she can't figure out those from her interactions with you then something would be a bit wrong there...But I am disgruntled and cynical.
Sorry
Posted by sunny10 on May 12, 2005, at 7:53:44
In reply to Re: Starting with a new T (or two)...(triggerish), posted by alexandra_k on May 12, 2005, at 5:13:36
okay, I'll try to reply as best as I can...
First- yes, the T knows about the other T and that the other T is for a specific purpose, not general therapy (although if I wanted, other T would do it...)
Second- yes, I think she is wondering if I need meds.
Third- I do think she is being a little dogmatic; I gave a general idea of the stresses that I've been going through in the last seven months (the ones I posted to Dr. Bob to let him know how you've all helped me deal!). I think ANYONE would be a bit scattered and anxious after all that- not everyone would need meds...
Fourth- I can't help but feel that she would be administering therapy "by the book", if the DSMIV dx is so important to her. I would rather have someone help ME because we all know that known of us are ever "textbook examples" of the dx's... We all have things that are similar to some of what's listed; but not all, and some of what's not listed!
BUT- Fifth- she is the only person in the PPO insurance world who has ever suggested that I would benefit by longterm analytical therapy and agrees with me that coping skills only work for some people, not all people. And that if they actually worked for me, I would've been stable years ago- having been "taught" coping skills first when I was seventeen (I am 38 and have had even more "lessons in coping skills" since then that just have not done anything for me).
And the first four would leave me automatically cancelling the appointment that I've made with her for next week.... but the fifth one intrigues me.
So, all points taken in together, I am paralyzed in indecision... If point number five is only applied with point number four, is it even really that intriguing after all?
I am torn...
Posted by Shortelise on May 12, 2005, at 11:05:32
In reply to Re: Starting with a new T (or two)...(triggerish), posted by sunny10 on May 12, 2005, at 7:53:44
Talk to her about all this. All points included. If she's any good, she can take it.
Just my opnion, I can't stress that enough.
Hugs.
ShortE
Posted by sunny10 on May 12, 2005, at 13:36:22
In reply to Re: Starting with a new T (or two)...(triggerish) » sunny10, posted by Shortelise on May 12, 2005, at 11:05:32
here I am, talking to cricket - saying the exactly the same thing to her and didn't see it was also true for me...
Why is it we do that, do you suppose??? Figur it out for others and not ourselves??
Thanks for pointing out the obvious that I didn't see... like the huge elephant in the living room that no one seems to notice....
Posted by alexandra_k on May 12, 2005, at 15:00:31
In reply to Re: gee, why didn't I think of that » Shortelise, posted by sunny10 on May 12, 2005, at 13:36:22
> Why is it we do that, do you suppose??? Figur it out for others and not ourselves??
It is much harder to be objective about ourself and our own situation.
This is the end of the thread.
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.