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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Tamar on July 7, 2006, at 6:19:43
Things have been so hard for the last week. My diabetes has been out of control for no apparent reason. I’ve been doing a LOT of sleeping. But I managed to go to therapy yesterday morning.
Then today I spoke to my GP. About a month ago we’d discussed the possibility that I might reduce my dose of Prozac. So I spoke to her today and asked if I could do just that.
She said she had spoken to my therapist about me and he had told her I was struggling with my demons. I agreed that I’d been having a hard time in therapy a couple of weeks ago but I said that I was now coping fairly well. She then asked me if I was still seeing my therapist.
I’m very angry because he never mentioned talking to my GP. I don’t mind him talking to my GP, but I’d like to have been informed. I’m pretty sure I told him at the outset that he could talk to my GP about me if necessary, but I don’t quite see how this was ‘necessary’. Convenient, perhaps. Useful, perhaps. But necessary?
Of course, it’s possible that she talked to him since I saw him yesterday, but if that’s the case it’s a little odd that she asked me if I was still seeing him.
I also think that if he was going to talk to her about how I’m coping, he should have told her that he made a mistake in therapy that I was struggling to deal with. Omitting that rather significant fact makes it look as if I’m simply struggling with the usual pressures of everyday life.
I just don’t think it’s fair. I don’t think it’s fair for him to give my GP an assessment of my mental health without (a) informing me of the fact, and (b) informing her of *his* role in my current struggle.
His professional decisions impact on my life. It’s not a trivial matter to me.
Am I being unreasonable? I desperately want to phone him and ask *when* he talked to my GP about me. But I’m afraid of the consequences.
Posted by Annierose on July 7, 2006, at 7:15:39
In reply to Here we go again, posted by Tamar on July 7, 2006, at 6:19:43
I think that's a fair question - very fair - and he should be direct about answering it. I would have been upset too. I think upset enough to probe my GP about the conversation as well - "When did you talk to my therapist?" - "What was the context?" - although I say that now but I can be stunned into silence at the most inconvenient moments.
Posted by Poet on July 7, 2006, at 11:23:33
In reply to Here we go again, posted by Tamar on July 7, 2006, at 6:19:43
Hi Tamar,
I don't think it's unreasonable to ask your T why he called your GP. You can be honest that you don't understand why he felt he needed to: it's not like you are in a crisis.
Has your T done this in the past? Does your GP call your T? I gave my T permission to call Dr. Clueless, but only because I felt I needed her to try to explain something on my behalf. T knows that I would be mad if she called her again (unless it was a crisis.) I would expect her to tell me first why she thinks it would be a good idea to talk to Clueless. Then ask me if it's okay.
I haven't given Dr. Clueless permission to call my T. I have a real issue with people talking behind my back even if they think it's for my best good.
Poet
Posted by Dinah on July 7, 2006, at 12:55:30
In reply to Here we go again, posted by Tamar on July 7, 2006, at 6:19:43
I don't know what the rules are there, but here he'd be in trouble, unless you gave him permission. Maybe he has to check in with her to get extra sessions authorized? Which is no excuse not to tell you.
I'd tell him how I felt about his talking to her, and see if he has a reasonable enough explanation.
I'm sorry it's so hard, Tamar. :(
Posted by Tamar on July 7, 2006, at 15:08:49
In reply to Re: Here we go again » Tamar, posted by Dinah on July 7, 2006, at 12:55:30
The impression I formed (and I could be wrong) is that my GP called my therapist to ask him how I was doing.
Now that I've calmed down a bit I've realised that she might have spoken to him this morning. They sometimes work in the same building on Fridays. She might have asked him informally about me before my appointment, knowing that I wanted to ask her about reducing my dose.
But STILL! I don't think they should be discussing me, however informally, without my prior knowledge, unless there's a very good reason.
Grrrrrr....
Actually I'm somewhat ashamed to admit: another thought also came to me... There have been times when I've imagined my therapist in a relationship with my GP. I always found that idea a little startling and wondered where it came from. After this incident, I suspect the idea is a transferential reference to my parents: my therapist and my GP know eachother and they both have similar relationships to me. I think today's events triggered feelings of danger based on my memories of my mother calling my father at work and telling him I'd been a bad girl, which inevitably led to him coming home from work and punching me.
But STILL! I don't like it. I just don't like it...
Posted by sunnydays on July 7, 2006, at 15:47:18
In reply to Re: Here we go again (**possible trigger**), posted by Tamar on July 7, 2006, at 15:08:49
(((Tamar)))) I don't have anything to add other than what people before me have already said, but you seem to be going through a hard time and I wanted you to know someone is thinking of you, even if I don't know what to say.
sunnydays
Posted by Jost on July 7, 2006, at 20:19:45
In reply to Re: Here we go again » Tamar, posted by sunnydays on July 7, 2006, at 15:47:18
Tamar, I too agree with what everyone's said.
It's great that you've thought of the possible transference meaning, which could be why it upset you more than it might have.
You have every reason to ask your T to be extremely careful about talking to your GP without discussing it first, even if you've given general permission.
I'd feel very uncomfortable, and probably get quite indignant if my T did that---he never would-- There are definitely issues with what people may or may not be saying about me and the consequences of that, esp. compounded by my not knowing it,
Jost
Posted by muffled on July 7, 2006, at 22:23:31
In reply to Here we go again, posted by Tamar on July 7, 2006, at 6:19:43
I had a similiar situation. My gp phoned mental health behind my back. I told her it pissed me off, and I also said to phone my T, NOT mental health. So then she phones my T, again without telling me! I rationalized it by figgering that she was just watching out for me , or more likely worried bout my kids, so thats why she phoned.
But I was supposed to go to gp this week and I didn't. Guess I'm still mad despite myself....
I think they ought to tell you b4 they call, and why.
Fortunately, as far as I know, my T always tells me when someone has called.
This whole trust business is a stretch isn't it?
I'm glad your going down on the prozac. Mebbe you could try something else. How is SI? Less?
Do they have ANY idea why your blood sugars are wacky? That'd be challenging too. Wacky blood sugars affect people emotionally too.
Tamar, are you ok with your T, really?
I dunno. I guess I a little worried bout you somehow.
I REALLY hope your ok and that your people are on the ball helping you. Its so very hard to help yourself when you all screwed up.
Glad to see you posting.
Your special Tamar, take special care of yourself.
Muffly
Posted by caraher on July 8, 2006, at 0:32:31
In reply to Re: Here we go again (**possible trigger**), posted by Tamar on July 7, 2006, at 15:08:49
What was the verdict on cutting back the Prozac?
I do know that here the T and GP would need written permission to discuss your case with one another. But I think it's all or nothing in practice, unless write a series of very narrow consent forms. So either they would be risking censure or worse by breaching confidentiality, or they would have freedom to discuss your case in whatever level of detail they chose.
I certainly understand why this would be upsetting...
Posted by Emily Elizabeth on July 8, 2006, at 1:15:17
In reply to Re: Here we go again (**possible trigger**), posted by caraher on July 8, 2006, at 0:32:31
In case this is informative, I thought I'd post abt my experiences being the T in such situations.
When I would need to talk to an MD, the client would sign a release authorizing me to talk to the MD for one year. The release was in effect for 1 yr unless the client specifically asked to have it removed. 1 yr is pretty standard in my understanding. So, hypothetically, if an on-going client's GP called me w/ a concern, and I had previous permission to talk to the GP, I would speak to him/her. I would not disclose specific statements, etc. but I might give my impressions of general functioning. Perhaps something like, "She has been experiencing some therapy-related stressors, so she has been struggling more lately." Of course, if the client had specific issues around the issue of disclosure, I wouldn't do it. The way you are talking it sounds like your T would have known that you needed something other than the norm here.
The only time I called an MD w/o specifically telling the client 1st was when I knew that she had an appt coming up and I thought of something that would be helpful to relate (and I had prior general permission).
MD's should understand the dynamics of this just as well as T's, but sooooo much in the medical profession is done behind the patient's back. Part of that god complex, you know?
I hope that something here is helpful. Please take care of yourself and keep us posted.
Best,
EE
Posted by joslynn on July 11, 2006, at 15:00:26
In reply to Here we go again, posted by Tamar on July 7, 2006, at 6:19:43
> he should have told her that he made a mistake in therapy that I was struggling to deal with.
>
> I don’t think it’s fair for him to give my GP an assessment of my mental health without .... (b) informing her of *his* role in my current struggle.
>That brings up an interesting topic. I once had a therapist make some classic T mistakes regarding excessive self-disclosure and other stuff. It triggered a bad reaction in me. I realize that I am the one who has to deal with my own emotions, but the T errors definitely contributed to the situation. Anyway, the person did apologize and change behaviors.
But afterwards, when that time of my life happened to come up in conversation about my history or whatever issue was at hand, ther person's role in it was erased. I felt like the T simply erased their mistakes in their mental landscape of that time. And I didn't think it was helfpul to say "but remember, part of that was because YOU kept saying blah blah and did XYZ" but it was interesting how the big mental eraser came out. Or maybe, the person remembered, but thought they were protecting me by not bringing up again.
I guess my point is, if Ts and pdocs have trouble admitting their mistakes to themselves and their clients, it's probably unlikely they would admit their mistakes to another professional, especially another doctor.
I wonder if anyone has had an experience where a T has said to another professional, "part of this was my fault, I made some mistakes." I sometimes make that kind of statement at my job, and it always seems to clear the air, but it seems tabu from one T-type professional to another.
Posted by Daisym on July 12, 2006, at 1:21:28
In reply to Here we go again, posted by Tamar on July 7, 2006, at 6:19:43
I'm sorry I'm late to this thread. Have you seen your therapist and told him how you feel? Are you doing any better? I think you have a right to be furious. I'd be upset too.
But it does sound like they are both looking out for you. So the intention was good.
Hugs,
Daisy
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