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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Racer on January 20, 2006, at 14:24:14
My T and I talked about how awful things have been for me lately. She says that she thinks it really is much worse now, because we're just allowing me to feel, encouraging me to feel. And that, since I've spent so much time working on NOT feeling, it's all much more extreme than it would otherwise be.
This came after the second visit to the new pdoc she recommended. The first time I saw her, I was not really able to get a feel for her. Mostly, I was just so far gone, I just wanted to stop all medications, because I was so very sick of doctors. This time, though, I can safely say: I'm not getting a good vibe off her. And this second time, I was very argumentative, which I suspect will make things worse for me. The thing is, this pdoc is VERY CBT, which is very common these days, and KEPT doing the whole, "And that's why you need to practice The Skills you should be working on with your T..." Hello? How many different times and ways do I need to say that CBT is NOT the right modality for me? And of course she seems to assume that's because I'm Not Doing It Right.
I kept telling her, "that's not helpful for me." And I finally tried to tell her about what I do, and how the CBT stuff makes it worse. She maybe heard part of it, because she said something like, "Oh, you use CBT to berate yourself." Yes, as I tried to tell you last session and this one.
She also kept trying to tell me what to do about situations that are upsetting me right now. I don't need therapy from her. I have a good therapist. But the problems were relevant to whether or not the meds were working.
So, I'm feeling pretty lousy about the whole thing. I'm afraid she'll just write me off as BPD and decide that there's nothing she can do to help me, so why bother to break a sweat? Of course, this is where I shut down, and why I go through these "it's not worth the problems trying to find a medication to help." Ugh. Thank you, Modern Medical Science.
Anyway, in talking about all this with my T, she said that she was glad that I was able to tell the doctor that what she was doing wasn't helpful; that there was a pretty good chance the doctor would indeed come back to BPD; and that the bottom line was that I needed to feel all the yucky things that I was feeling, because of all the years of NOT feeling them. I needed to do that, and CBT stylers wouldn't agree with that. And that it was much worse while I was getting it done with.
Back to my abcess analogy, right?
I hate this. I want it over with. I want it to go away. I want to go back to NOT feeling. I want to go back to feeling in control of myself and my emotions.
I want to go back to bed. I told my husband this morning that I didn't want to get out of bed. He just told me to get up. So, I'm up. It's overrated.
Has anyone made it through this? Managed to get through the hell of feeling? And been better for it? Or am I doing this for nothing?
And could someone tell me that there are decent pdocs out there?
Posted by fallsfall on January 20, 2006, at 16:26:25
In reply to It's not my imagination., posted by Racer on January 20, 2006, at 14:24:14
You are not doing it for nothing. I believe there is life on the other side.
CBT is not helpful for everyone. I have had a BPD diagnosis. I did DBT for 6 months, and that was helpful. But CBT only brought me so far, and then I got stuck. I have made incredible progress with a psychodynamic therapist. When I started talking about finding a new therapist with my original CBT therapist she strongly warned me not to end up with someone who I would be seeing 3/week. She absolutely believed that immersing myself in therapy would be the end of me. 3/week is what has saved me. 3/week has let me give therapy LESS of an emphasis in my life.
If you believe that CBT is not going to help you, then don't be afraid to act on that belief. It sounds like your therapist is able to do non-CBT things, and that it is helping you.
About the pdoc. I think it would be worth switching to someone who has more faith in the type of therapy that you are getting. I have really hated when I felt caught between my pdoc and my therapist (in order to please one, I would have to disappoint the other).
My pdoc (whose office is across the hall from my old CBT therapist) has analytic training. So I have been able to stay with him even though I switched therapies. There are pdocs who will give you the support you need at this time.
You KNOW what kind of therapy you need. Trust that.
Posted by madeline on January 20, 2006, at 17:36:28
In reply to It's not my imagination., posted by Racer on January 20, 2006, at 14:24:14
I have been through the hell of starting to feel again. In fact, I said the exact things you do. I used to (and sometimes still do) feel like I was inside-out. Everything hurt and rubbed the wrong way.
It sucks and I'm so sorry. There is no way out but through it because emotions and hurt really are pandora's box. You can't put them back in.As a general rule, pdocs suck.
Take good care of yourself, and remember - you get to feel happy now too.
Posted by Dinah on January 20, 2006, at 17:43:02
In reply to It's not my imagination., posted by Racer on January 20, 2006, at 14:24:14
Yeah. And now I see how much better my life is when I'm feeling. The anxiety used to be overwhelming, and when I get out of touch with my emotions, the anxiety returns at that level.
I can see that it might not be the answer for everyone. Some people probably need to learn to feel less.
But I trust your instincts about what's right for you, your therapist agrees with you, and isn't a pdoc supposed to concentrate on meds when their patients have a therapist?
I laugh sometimes about my pdoc, Dr. Just the Meds Ma'am. But it's probably not such a bad idea. Is there any way that you can deflect any non medication or sympton discussion?
Posted by daisym on January 20, 2006, at 20:16:20
In reply to Re: It's not my imagination. » Racer, posted by Dinah on January 20, 2006, at 17:43:02
I want to say, "run, Racer, run" because you are essentially describing the pdoc I stayed with for 9 months trying to like her. She screwed with my head EVERYTIME I saw her about my therapy. I kept telling myself it was my mother issues and it might have been. But I needed to feel support for therapy in order to want the medications. I like my new pdoc tremendously! He has a practice about an hour south of me, as well as up here. Do you want me to email name and number? It would be a drive for you but manageable I think. I believe he works near one of your favorite yarn shops...
I hate feeling too. My therapist talks about them having been in exile and now that we've allowed them back to the mainland they are like hurricane force winds. So you have to wait for the intensity to die down and then begin to work through it. That is what the cymbalta has done for me. I agree with the above description of being turned inside out and feeling raw.
But you can't stop the storm so you just have to batten down the hatches and weather it. We'll help you. Hang in there.
Posted by Racer on January 20, 2006, at 21:11:27
In reply to Re: It's not my imagination., posted by daisym on January 20, 2006, at 20:16:20
Would that be a 'yarn shop' that actually sells supplies for Another Craft Altogether? lol Scary when someone knows that info, huh? I've been wanting to go there, too. Feeling this nesting thing going on, want to make a new quilt...
Anyway, one of the biggest factors in my choice of pdoc right now is that it be someone who will communicate with my T. Dr CattleProd flunked that one -- I went from Sparkling Bright to a therapist he recommended who did NOT work out. (Although part of me wishes I had stayed with her now. For one thing, I was restricting again after seeing her a time or two...) Anyway, when I fired her, I found a great match for me. I am very glad that I found her, and think she's great. Despite making me feel. Anyway, he would not call her and would not call her. Ignored her messages. I called his office a few times, asking that he return her calls, so that they could cooperate with one another. Nothing. So, shortly before Christmas, I called and left a message on his private voicemail, instead of the front desk. (They "encourage" you to leave the message at the front desk.) I left a very specific message: "one of the main reasons I chose you as a pdoc was your reputation for communicating with therapists. It's been seven months now, and I understand that you still haven't contacted my therapist. I don't know what the problem is, but obviously there is a problem. Can you tell me what needs to happen to have that problem go away?" He did call my T then. And left a message that apparently did not mention me -- only his policy that he didn't talk to Ts, but would communicate via voicemail. Why bother? She called him, left a message. He called back, and she reported some of his message, which was the last straw. Fired him.
So, this pdoc does communicate. If this problem with CBT styling keeps up, I will fire her, but I am at the point of saying that I will NOT continue to take drugs in that case, because I will NOT go though another round of trying to find a decent pdoc. I just can't do it anymore.
Especially since insurance only pays about $100 of any visit, and the initial appointments are something like $250 to $800! I just don't feel like paying another initial visit fee, only to find that I don't quite manage with that doctor, either. And the only other pdoc my T has to recommend is someone I saw when I first moved down here. I will NOT bother with him again. (Aside from everything else, during his MMSE of me, he was asking questions about TV shows -- to test that I was oriented to reality. Sure I was -- but I didn't own a TV! Hello? Cultural factors, Dude, cultural factors...)
And I am still hating feelings. I'm really struggling in a lot of ways, because this does seem like too much for me. Especially since my husband and I have a few problems in our marriage which have a negative impact on my being able to have emotions at home. NOT the best place to be.
Ugh.
Posted by ClearSkies on January 20, 2006, at 21:17:30
In reply to It's not my imagination., posted by Racer on January 20, 2006, at 14:24:14
It sure sounds like your psychiatrist is trying to be your therapist. You're only a few appointments into this doctor, Racer. I'd say that you two aren't starting out on the right foot.
You could either - bail and find another p-doc (and yes, there are good ones. Mine listens to me very carefully and does not attempt to therapize me); or make another appointment with the p-doc and put the cards on the table, i.e. feeling like you are at crossed swords instead of having your p-doc on your side. What would it take from both of you to get a good working relationship between caregiver and client, within the structure of your roles as pdoc and person asking for help with medications.
Now, I have gone to my pdoc in the past and said - "the anxiety is excrutiating, isn't there anything else we can try?" to be told that maybe the medication should be a constant for a time but to increase the therapy to deal with the anxiety. I heard it like an Rx with advice dispensed instead of a prescription.
And sometimes, the pdoc gets it right. Sometimes she doesn't, and therapy isn't really at a point where I can address my current Top 10 Complaints, because we're working on the Crap Hidden Underneath The Stairs. In which case, the pdoc will conceed that maybe a tweak of medication is the best thing for now. Why, I believe we actally communicate and have trust going on.The feelings which you and I and a thousand other Babblers have stuffed into our heads and hearts for so many years beg to be released and expressed. To be liberated in a safe environment. Sometimes multiple appointments in a week help; sometimes it's giving me some homework to do that helps me get the next stage in our communication and relationship.
For myself the truth is that if I leave those feeling stuffed inside, then I become an active drinker, to turndown the thoughts; I become majorly depressed and can not get the whole making up the bed in the morning thing going at all. I mean really, why bother when you are going to be right back, in a couple of hours if you can help it? And the anxiety makes another appearance just as I'm whipping the grocert cart around the store, negotiating aisle territory heavily with the stock little boys and little girls who can't get themselves out of the way of the grabby shoppers wanting all their wares....
Never mind the experience of driving during the Snowbird season. It requres wearing blinders so you can't make eye contact with the other driver. If you can see their arms and hands on the wheel, but the head is nowhere to be found, what you got there is a car being driven by QueTips.
After this last experience my appointment was with my dentist, who is trying to remedy my bite so that my teeth don't slide around in my sleep but stay gratifyingly lined up while my teeth attempt to clench,
So the point is that I am better at identifying the things or people who trigger me and I am better at dealing with it: Cancel and apppointment, make another one, talk with your pdoc about it, and talk to your T about the relationship between the three of you.And please let those feelings come out here in a safe place with your good friends at Babble. We want the best care for you. We have many hugs or handshakes or just wan smiles, as needed.
We're here for you, Racer.ClearSkies
Posted by cecilia on January 21, 2006, at 1:33:18
In reply to Re: It's not my imagination., posted by daisym on January 20, 2006, at 20:16:20
I think most pdocs are enamored with CBT because it's a way to blame the patient when their meds fail. Of course T's and pdocs of all stripes are fond of the blame the patient game, the psychodynamic T I saw for 7 years told me, " I can't help you, you obviously need to be depressed". But I think pdocs in particular like CBT because it's supposed to be "scientific" and according to people like David Burns it never fails; if it doesn't work it's because the patient didn't do their homework or practice the techniques. (kind of reminds me of the natural cures gurus who clog the TV screens with their infomercials, take this, guaranteed to cure whatever ails you.) Cecilia
Posted by fallsfall on January 21, 2006, at 8:31:10
In reply to Re: It's not my imagination., posted by cecilia on January 21, 2006, at 1:33:18
> " I can't help you, you obviously need to be depressed".
I'm sorry your therapist couldn't help you with this. My psychodynamic therapist has been able to help me to see WHY I need to be depressed. And we have worked on each one of the reasons. I am better than I have been in 10 years.
There is hope.
Posted by Poet on January 21, 2006, at 16:35:19
In reply to It's not my imagination., posted by Racer on January 20, 2006, at 14:24:14
Hi Racer,
Your pdoc sounds like she's from the Dr. Clueless School of Medication Afterthought.
*No, I don't need a prescription, I need a new chair for my living room, I'll just take yours and be on my way.*
I need to make an appointment with her because I've had major anxiety the last few weeks. My T says I have to be aggressive and just tell her out right that my anxiety is worse and what medication might help me? Maybe that's what you need to do, too? Though we shouldn't have to. Big sigh.
Feeling is hell, though constantly trying to deny those feelings might be worse. Note, I say might be because I don't let myself feel much of anything, I deny the feeling exists. Do not follow my example and keep feeling. You have your T's support, you have our support.
Poet
This is the end of the thread.
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