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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Karolina on July 16, 2006, at 23:14:11
Hey everyone
I'm sorry I haven't been around so much lately. This is random but still a constant worry of mine: what kinds of things would make a T want to make a referral/stop working with you? Has anyone ever had this happen?
Also would anyone please mind telling me how to turn on my babble-mail?Thanks,
-Karolina-
Posted by Adrift on July 17, 2006, at 1:38:06
In reply to get kicked out?, posted by Karolina on July 16, 2006, at 23:14:11
I'd think this was very rare. Wouldn't it work the reverse? I'd think it would be more likley that they would be tyring to keep a patient on, since they work for the patient.
don't worry about it, we are they salary. They want patients, without patients, they'd be broke.
Posted by jammerlich on July 17, 2006, at 2:37:30
In reply to get kicked out?, posted by Karolina on July 16, 2006, at 23:14:11
It happened to me. She terminated me because I refused to take AD's. And she did it by phone. It was horrible.
Sorry, I can't help with the babblemail. Mine is on, but I can't remember how I did it.
Posted by Dinah on July 17, 2006, at 9:35:12
In reply to get kicked out?, posted by Karolina on July 16, 2006, at 23:14:11
Go to registration
https://dr-bob.securesites.com/cgi-bin/pb/signup.pl
and update your registration. Check the box to turn on Babblemail.
Posted by ElaineM on July 17, 2006, at 20:48:23
In reply to get kicked out?, posted by Karolina on July 16, 2006, at 23:14:11
Hey Karolina: I'd guess that there could be a couple of reasons. 1- No progress is being made, and the T suggests that they are not able to work to your benefit. They concede that your diagnosis may be out of their range of expertise. 2- You develope new symtpoms suggesting more specialized treatment. (ie. I've had to switch from regular therapy to ED treatment professionals) 3- Client developes a strong erotic transference that the T cannot manage. Or, T developes a strong counter-transference that they cannot manage, and feel referral is necessary to protect the client. 4- T is retiring, or moving. 5- I suppose a T could refer out of frustration if a client is non-compliant (though I'd guess that that wouldn't be common, unless they had a waiting list of new clients)
That's just me brainstorming. I could be wrong. I could've missed a few. Just rambling.
Most of my endings were because I was either going into treatment, or my follow-up sessions ended. I usually go T, to hospital, to T. The first lady I parted with, was really traumatic - meds were a big deal. The first time we met, she told me what pills she wanted me on, before a full history was taken. Back then, I was adamant about never trying meds. She would get so mad. Then when I stopped eating she kept threatening to certify me. She was always telling me I was "Such a silly little girl", "You're so stubborn", "Stop trying to rebel against me. You think I'm your mother?" and "Stop worrying about the same stuff month after month. You're the exact same as a year ago!" I used to sit in the chair shaking, afraid to speak. When I would, she'd cut me off to tell me I was wrong -- she was always saying that. At one point she forced me to drink a protein shake in her office, and had the forms signed on her desk ready to go, if I didn't. My anxiety was through the roof, and I was becoming suicidal (mostly due to the An). I told her I needed help right now, something anti-anxiety, because nighttimes were becoming dangerous. She kept saying no way -- only the original pills she wanted a year earlier.
A few more sessions, I let her know that I was having severe SI urges. She started yelling at me saying she didn't know why I bothered coming, and that I shouldn't ever have come. I remember begging her to not give up on me, and help me control the panic. Then she took out her prescription pad, quiet-yelled "Is this want you want? Here, take it then and go! I can't do anything else with you". Then she threw a 30day prescription for Ativan at me. I started bawling, picked it up, and stumbled out her door. I never went back. I never filled the prescription. And it took over a year for me to even take regular medicine - like antibiotics. My doctor (the one I just finished with) picked up the slack and "baby-sat" me until my name came up on the waiting list for ED inpatient.
I always think of that as her terminating me, in a way, for refusing ADs. It was terrible. It took a long time for me to realize that, if she could treat me like that, I was better far away from her. All I new at the time though, was that my world had been turned upside-down, and I was missing the person who I had grown so used to.
One other time, I was kicked out of ED outpatient treatment for refusing anti-psychotics. Another round, it was because I refused a colonoscopy!
Are you still concerned that you could be referred elsewhere? Is he still talking about you seeing an ED person?(that was you right?) Would you ever ask your T, "Out of curiousity..." what would all his reasons be for terminating a client.
EL
Posted by Jost on July 17, 2006, at 21:41:14
In reply to get kicked out?, posted by Karolina on July 16, 2006, at 23:14:11
Karolina, this is a rare event-- and unless a T doesn't understand how to handle their responsibilities, certainly wouldn't happen out of the blue.
I can't imagine any T calling and ending with someone over the phone. I guess it can happen. That T (of jammerlich's) must have have some own her own problems, to handle it so badly.
You've said you're very afraid your T might do this-- But maybe you can see this more as a fear, maybe of abandonment, or of your not deserving respect and concern, or-- of other issues from your life.
A fear is not a reality: even though you can scare yourself a lot, it's part of what you're going to learn from this relationship: why you have this fear, and how to know within yourself that you're okay-- and will be okay, even if challenges arise.
Keep talking about this with him-- and if you feel that he's being inappropriate, maybe you need to reevaluate. Have you been able to ask about the way he looks at you? and some of your other uncomfortable feelings? Or in some way allude to it, so it can begin to be straightened out?
Jost
Posted by Racer on July 17, 2006, at 21:44:36
In reply to Re: get kicked out?, posted by ElaineM on July 17, 2006, at 20:48:23
That's a good point -- asking is a very good idea.
And I'm so sorry about your experience. I have had similar experiences, and know how much damage they can do. Heck, my latest AN episode started with a lousy T a couple of years ago. The damage that occurred then is still with me, and it feels sometimes as though nothing will ever be OK again. Amazing, isn't it, how much effect Ts can have on us, good or bad?
Good luck to you.
Posted by Jost on July 17, 2006, at 22:04:55
In reply to Re: get kicked out? » ElaineM, posted by Racer on July 17, 2006, at 21:44:36
>
>
> Heck, my latest AN episode started with a lousy T a couple of years ago. The damage that occurred then is still with me, and it feels sometimes as though nothing will ever be OK again. Amazing, isn't it, how much effect Ts can have on us, good or bad?
>That's very true. I've had a couple of bad experiences-- so I'm not going to say they aren't out there. But We're all kind of groping, unguided-- and have to sort of crash forward, despite that--
How's your day been?
Jost
Posted by ElaineM on July 17, 2006, at 22:50:15
In reply to Re: get kicked out? » ElaineM, posted by Racer on July 17, 2006, at 21:44:36
R: Yes, I really don't know if I ever would've been able to trust a therapist again, if my doctor hadn't stepped in to see me weekly. The fact that she was treating my body AND my mind, and then, I guess, my heart, was the thing that allowed me to give the staff at inpatient a shot. She was like damage control. But I do find that, ever since, I've been hyper-sensitive to avoiding triggering my T's -- even when the worry is unfounded.
I'm sorry that you've gone through similar stuff. You said that a T sparked an AN episode. Do you find that you react to your T's mood, words, or what you think of your relationship together, with symptoms? I can't seem to help it - I assume it was connected to the first lady. I mean, I'm getting better at not reacting that way, but it is still hard for me to think of a "seperate-from-hospital" T as an ally, when it comes to ED stuff (even when they genuinely are). [I don't want to get too into ED stuff here, but I've always wondered if others are similar]
Thanks for sharing about identifying.
EL
Posted by Racer on July 18, 2006, at 0:41:22
In reply to Re: get kicked out? » Racer, posted by ElaineM on July 17, 2006, at 22:50:15
>
>
> You said that a T sparked an AN episode. Do you find that you react to your T's mood, words, or what you think of your relationship together, with symptoms?No, I don't think that's ever happened before. That's part of what made it so horrible -- I had been doing pretty well, mostly, for nearly a decade! Within weeks, with this babe, I was hardly eating, had lost about 25 pounds, etc. I'd never had that happen before, nothing like that. She didn't listen to me, contradicted everything I tried to tell her about my own experiences, and tried to convince me that I had a personality disorder -- "if you insist you're not Borderline, maybe you're Narcissistic!" Hello? That's pretty much a no-brainer: I spent years working very, very hard to convince myself I was Good Enough, and worthwhile in some way.
I'm working now to try to get some of it back.
What happened, really, was a recreation of the basic trauma of my childhood -- not being heard, being told that I was Wrong, that my feelings were Wrong, etc. My anxiety went through the roof, I felt trapped in a corner -- the woman had me in an L shaped office, in the little tiny nook at the bottom of the L, in a tiny corner between a counter and a desk, with her between me and the door. I felt trapped both physically and emotionally. And reacted by turning to a coping mechanism that is awfully compelling for me. I *like* being thin, I get so much more done, I have so much more energy, etc. But I hadn't done that in YEARS!
Whoops. Bad T post or not, this is turning ED, and triggering me a bit. Not something to write after dinner -- I feel too disgusting and fat.
>
> Thanks for sharing about identifying.
> ELSure, I'm sorry for the identification, but at least we're not alone, eh?
Oh -- wanna hear my Teenage Therapist Trauma story? It might beat yours, or come close...
This was at Langley Porter in San Francisco, by the way. Prestigious, but apparently that doesn't stop it happening even there...
So, I was 13, on my way to the therapist's office, which was horrible anyway. She would tell me I was evil, my mother deserved better, I was ruining her life, etc. (Mother saw the same T, and then we'd see her together, too.) It wasn't a good situation, but I kept going -- I was kinda obedient. One day, a guy followed me off the bus, and grabbed me -- I was sexually assaulted, but someone chased him off. Someone else took me to the campus police, who took a report and took me to my appointment.
The T yelled at me for being late, and then told me that I *hadn't* been sexually assaulted, I was wrong about that, because I was only 13, I was a child, and no one would see me as old enough to be assaulted!!!
The good news is that that was the last straw, and LP finally transferred us to another T...
Scary thought for us all: that woman may still be practicing somewhere...
Posted by ElaineM on July 18, 2006, at 10:25:54
In reply to Re: get kicked out? » ElaineM, posted by Racer on July 18, 2006, at 0:41:22
Oh my god, that's a horrible thing you went through. It's no wonder that you're still working through it. Actually, I think it says alot about you that your willing to keep trying with new T's. It's so baffling that there can be such amazing T's and such bad ones. But I guess that's how life is. I sometimes forget that T's are part of the same species. As though, once they become T's they should be perfect people -- if only because their flaws could injure another. Unfortunately, it doesn't seem to work that way.
Sorry about triggering you. I thought about that after I posted, and wanted to take it back. Hope it didn't upset you too much. I wasn't thinking.
EL
Posted by Racer on July 18, 2006, at 17:17:59
In reply to Re: get kicked out? » Racer, posted by ElaineM on July 18, 2006, at 10:25:54
> > Sorry about triggering you. I thought about that after I posted, and wanted to take it back. Hope it didn't upset you too much. I wasn't thinking.
>
> ELThanks for your response, Elaine. It's still hard for me to realize that it wasn't my fault, something I'd done wrong. Hearing it from other people kinda helps with accepting that something bad happened to me.
See, that last phrase is the problem, I think: "...happened to me." At least if it's my fault, I wasn't powerless, even if I felt that way. Does that make sense?
And as for triggering, that's not a problem. I really and truly wouldn't have written about any of it if I thought it was too much for me, I do stop when I get too upset by something, and I don't read if I get the feeling that it's not good for me. I try very hard to take responsibility for my own reactions, is what I guess I'm trying to say. Therefore, you can write anything. ;-)
Thanks again for caring.
Posted by Karolina on July 18, 2006, at 21:48:25
In reply to get kicked out?, posted by Karolina on July 16, 2006, at 23:14:11
Thanks so much everyone for your responses.
Racer and ElaineM - I am really sorry to hear about your experiences with your T's. That is terrible, I can't believe how unprofessional and insensitive they were being.
When I was younger I had a T who had a major crush on my pediatrician, who was still handling my prescriptions at the time (I didn't have a pdoc yet). She would push so many medications at me and make me take these lame tests to see if I had ADD and stuff like that. Then she would get on the phone with him to discuss medications and attempt to flirt with him...it was awful, like she was using me as an excuse to try and talk to him or something.
Anyway I agree that maybe I should bring up my fears about him terminating me; I guess my main fear is that I'm freaking him out by talking about/writing about my attraction to him and what it means. But I really am trying to look at everything from a therapeutic viewpoint.
I really do forget that Ts are human too so maybe I am overreacting, but he seems to go back and forth between: being flirty with me, giving me those long deep stares, using explicit language or sexual terms, encourage me to talk about my relationship with my ex-boyfriend, etc *or* looks away when I look back at him while he's talking, looks down at the ground and plays with a pen or takes out one of his buisness cards and folds it over and over, and tries to change the subject to anything but sexual. And rarely, he will just be completely blank, like he is numb to everything or maybe has other stuff on his mind and is much less responsive than usual.
I really don't get him and I guess that's why I'm so hesitant about bringing up these feelings with him, I never know how he's going to react. And for some reason his reactions make me feel guilty like I'm doing something wrong.
Posted by ElaineM on July 18, 2006, at 22:19:30
In reply to Re: get kicked out?, posted by Karolina on July 18, 2006, at 21:48:25
> When I was younger I had a T who had a major crush on my pediatrician, who was still handling my prescriptions at the time (I didn't have a pdoc yet). She would push so many medications at me and make me take these lame tests to see if I had ADD and stuff like that. Then she would get on the phone with him to discuss medications and attempt to flirt with him...it was awful, like she was using me as an excuse to try and talk to him or something.
Karolina, what you remembered right there may be a part of why you find it so upseting when your T talks about other girls he likes, infront of you.(you know, apart from all the regular valid reasons) It's so similar to what your old T did --flirting with your doc on the phone while you were there. No wonder you question your T's intentions now.I can understand how worried you are about how he will react to you after knowing how you feel about him. I don't have much advice about how to deal with questioning his motives though. But it can't be good for you having to wonder so much. Maybe others will have better ideas.
It's so confusing sometimes.
EL
Posted by Karolina on July 19, 2006, at 23:11:46
In reply to your first T » Karolina, posted by ElaineM on July 18, 2006, at 22:19:30
Thanks El, I had never looked at it like that before. That really explains why I could be having some issues with him, like with what's been going on lately.
I also still just can't seem to get over how cruel he was acting, back in the spring when I had to come home from my internship and he was trying to refer me to ED specialists...I was definitely in terrible mental and physical health during that time, so maybe my perceptions of everything that was going on were distorted, but at the time he was also going through a divorce.
And he's admitted since then, that the divorce was really affecting him right then and he was having trouble dealing with stress and knows he said some things that hurt me. But for some reason I still can't get over how mean/insensitive acting he was. I understand how stressful a divorce must be, but I wish he didn't let his own personal feelings get in the way right then. But maybe he couldn't help it.
There are times I still want to talk about how that made me feel, but I guess there really is no point to go back into it. But something bothers me about how everything is all fine and back to normal, that it's like that whole threat never even happened. It had just caused me so much stress and sick feelings...sorry I didn't mean to rant about all this, I just feel stressed out right now. Thanks for your responses.
-Karolina-
Posted by Racer on July 20, 2006, at 0:02:49
In reply to Re: your first T » ElaineM, posted by Karolina on July 19, 2006, at 23:11:46
If you're still bothered by what happened, then it's grist for the mill. What you wrote, about his not being able to help it, etc, is about HIM, not about YOU -- and YOU'RE the proper focus of therapy.
Truly, bringing up how you feel about what went on is appropriate, and likely to improve the therapeutic alliance.
Good luck.
Posted by Karolina on July 21, 2006, at 10:14:25
In reply to Just a quick perspective » Karolina, posted by Racer on July 20, 2006, at 0:02:49
Thanks, Racer. You are right. It should be about *me* and *my* stuff, not his...I am going to try to bring up those feelings when I see him next time.
-Karolina-
Posted by Karen44 on July 23, 2006, at 23:21:45
In reply to Re: Just a quick perspective, posted by Karolina on July 21, 2006, at 10:14:25
> Thanks, Racer. You are right. It should be about *me* and *my* stuff, not his...I am going to try to bring up those feelings when I see him next time.
> -Karolina-Be careful; my psychiatrist/therapist told me last Friday that perhaps I needed to find someone else with whom to work; He said he would work with me "a bit longer," but we have reached an impasse and so I should in the meantime find someone else. I would not know where to start plus he is prescribing med's, and so what do I do about that??? Don't psychiatrists like psychologists have some sort of ethical responsibility not to abandon patients???
Karen
Posted by Karolina on July 26, 2006, at 16:44:11
In reply to Re: Just a quick perspective, posted by Karen44 on July 23, 2006, at 23:21:45
Hi Karen,
Sorry I'm a bit late responding. I've been doing some research on this since I had my concern come up about getting kicked out, and I definitely think that both psychologists and psychiatrists have an ethical responsibility to not abandon the patient, or if they do choose to do that, that they must give a really valid reason that could be documented. I've heard that they are also supposed to arrange a referral for you, not leave you in the dust to find someone else on your own. I'm sorry he responded to you like that. Did he give an explanation for why he feels that there's an impasse in the relationship? Do you think you could talk to him about how this makes you feel and ask him for some guidance in the process of finding a new therapist? Good luck with everything,
-Karolina-
Posted by Karen44 on August 4, 2006, at 0:10:40
In reply to Re: Just a quick perspective, posted by Karolina on July 26, 2006, at 16:44:11
> Hi Karen,
>
> Sorry I'm a bit late responding. I've been doing some research on this since I had my concern come up about getting kicked out, and I definitely think that both psychologists and psychiatrists have an ethical responsibility to not abandon the patient, or if they do choose to do that, that they must give a really valid reason that could be documented. I've heard that they are also supposed to arrange a referral for you, not leave you in the dust to find someone else on your own. I'm sorry he responded to you like that. Did he give an explanation for why he feels that there's an impasse in the relationship? Do you think you could talk to him about how this makes you feel and ask him for some guidance in the process of finding a new therapist? Good luck with everything,
>
> -Karolina-He gave me the names of some people, none of whom can see me. Does this let him off the hook? And what about med's?? He goes on vacation for two weeks in one week and then I am gone for two weeks. I will have no script if he doesn't give me one???
Karen
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