Interactions with Mental Health Professionals

AngelThis topic stems from an idea that I had in relation to the post Be Your Own Advocate.

It’s something I occasionally allude to on my personal blog and in my comments on others’ blogs. Over the last two and a half years (has it really only been that long?), I’ve learned a lot about how to compose myself when discussing matters with other mental health professionals.

First, let’s go over my successive period of interactions with mental health professionals. I’ll start with therapists, then mention psychiatrists:

Therapist #1: The only male therapist I’ve ever seen. I saw him from about fall 2009-spring 2010. He had a home office. It often seemed to me that he didn’t remember what we’d talked about before. It disturbed me that he didn’t take notes, and I wondered if that was normal. Sometimes he wouldn’t have any shoes on, just socks. I understand why you might walk around like that in your own house, but I found it irritating and unprofessional. During the first few months, I thought that I didn’t see any benefits because therapy took time. Then I realized that he would never be helpful for me. Still, I kept going because I was petrified of telling him that I didn’t want to see him anymore. Finally, I canceled an appointment and never called back. Maybe not the best course of action, but it was all I could do.

Therapist #2: I saw her for a couple of months. She was on a list of people recommended by the school where I was pursuing graduate studies. I got my Master’s in May 2010, which is why I saw her for a short period. This time, armed with my other therapist experience and tips from people on a depression forum, I called a few therapists and asked some questions. I felt unsure about the one I chose, but I’d asked her so many questions and spoken so long to her that I thought it would be misleading not to become her client. I was afraid of telling her never mind, so I tried her out. Sometimes therapists just sit there and wait for you to talk. She did that all the time. It was not useful in the least. Although she did teach me breathing exercises to calm anxiety. Not that I ever use those.

Therapist #3: She was a recommendation from a GP. She was headquartered in my hometown. My first meeting with her freaked me out because she said she believed I would commit suicide one day if I didn’t get help. She gave me an assignment to write my life story, and I wrote 10+ pages. I was excited to finally be given homework by someone. But apparently people usually wrote only 2-3 pages, and she would ask them to read it aloud. Good thing I wrote too much to do that. I don’t think I would’ve been able to do that without shaking, blushing, and freezing up. So she read it before our next meeting. Now, I am a stubborn person, especially when it comes to thinking for myself. Unless I understand and agree with a thought process, I won’t follow it. I ask people questions and argue with them a lot so I can understand what makes their line of reasoning valuable, not for argument’s sake, as some people in real life seem to think. I won’t go along with anything unless I understand the logic; I’ve been that way my whole life. This therapist told me I would have to give up that way of operating because she’d seen others like that stay miserable because they weren’t willing to do so. I told her that giving that up was like asking a Christian to give up their religion. I felt that was a blasphemous example, but true. At least I was honest and not just going along with the therapist as I’d done with Therapist #1. I’d learned to express my needs, even if I felt panicked and guilty for my ideas.

Therapist #4: My current therapist. There was a five month or so gap between the previous one and this one. I’d moved. I was afraid of having to assert my needs all over again and exhausting myself in looking for another therapist. It wasn’t until I got a referral during my trip to the ER that I found her. She works well sometimes, but not at other times.

Psychiatrist #1: The one I saw in graduate school. At first, I was afraid to do anything but just take whatever he prescribed me. I think he’s probably the best psychiatrist I’ve had. I went through a period during which I intensely disliked him and thought he did nothing but throw pills at me. Compared to my other ones, he’s done that the least, however. He was good about explaining the particulars of what he was prescribing me and why. To this day, I’m on a low dose of Wellbutrin. The one I started with, in fact. I wrestled a while with the Wellbutrin because it miraculously helped me to think again, but it heightened my anxiety, especially its physical symptoms. When he wanted to increase my dose, I was adamant about not doing that because I was afraid a higher dose would give me a higher level of anxiety. He listened.

Psychiatrist #2: Hometown one. He weighed me, which I’d never done with a psychiatrist. He prescribed me Prozac and Klonopin. He was rather young and listened to me, but it didn’t seem as thorough as my first psychiatrist.

Psychiatrist #3: A composite of three people I’ve seen at the place I currently go to, actually. The first one just threw Abilify at me. With the second one, I had a harrowing encounter during which I felt attacked. I was able to get a bit of usefulness from his appointments, though. Not because of anything he did, but because I would tell him as much as I could about my issues. This was not easy. Oftentimes I had to dissociate in order to be able to do it. But I’d learned that it was the only way to receive any benefits.

Through these encounters, I’ve learned that one must be assertive while talking to mental health professionals. Otherwise, I’ll get thrown prescription after prescription, many of which may not be just unhelpful but also a bit harmful. Otherwise, I’ll sit in therapy skirting around the issues. (I still haven’t fully resolved that problem. That might be because I don’t yet fully understand my needs. But some of it is also fear of asserting myself. I’ve learned to do it more often, but that doesn’t mean I’m perfect at it by any means.) Otherwise, I’ll sit in therapy listening to irrelevant suggestions.

But when so many of us are bashful about our issues, how can we be assertive? Especially if you’re someone like me, for whom social anxiety is a strong daily presence?

I’ve found that my stubbornness is what personally helps me. I’m determined to be as self-sufficient as I possibly can. I believe that’s an innate trait of mine.

There’s also dissociation . . . which perhaps isn’t healthy, but perhaps if it’s the only way I’m able to communicate my needs, it’s a necessary evil?

The bottom line is, we’ve got to lay all of our cards on the table (or as many of them as we can) so that we can get the help we need and deserve. This would make most of us uncomfortable, not just those with social anxiety. Our issues are private matters. Many of us try so hard to hide our issues from others that it feels awkward to be forthcoming about them. We’re sensitive about our issues. We fear that the professional may call us inadequate.

But those are all risks we have to take. No matter how scared it makes us, we have to be frank about our issues. Maybe it makes sense. After all, the professionals aren’t in our heads to see what it’s like in there. We have to share the uncomfortable, the private, the downright terrifying, with people who are pretty much complete strangers. That’s a hard leap to make. Attempting it can trigger our issues, but not attempting it can keep us from getting better.

So how can we make this leap?

It’s probably different for everybody. You’ve got to try various tactics until you find what works. After you’ve found it, it still might not be enough. It might take years to chisel through and find the right way to do it, a way that both doesn’t trigger you and ensures the professional knows enough to help.

I’m still not there. Yet through it all, knowing that I have the ability to think helps. Somewhere in me, I know precisely what’s going on. One day, I will discover it. Then another day, I will learn how to express it.

As long as we stay true to our selves, our instincts, we can learn to cope. We can use that to assert our needs. We can use it to reject what may not help us, and we can use it to understand ourselves and our needs. In doing so, we can eventually guide professionals to the path we require.

And for people like me with social anxiety, we have to believe in those things so much that it endures, it evinces itself, amid the social anxiety.

This seems to be the best course, at least to me.

© Angel Fractured and A Canvas Of The Minds 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Angel Fractured and A Canvas Of The Minds with appropriate and specific direction to the original content.

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19 thoughts on “Interactions with Mental Health Professionals

  1. This is very interesting. I’m a retired mental health nurse – and I’d agree, professionals aren’t mindreaders, you have to tell them stuff.
    Also, the relationship is one-sided – professionals shouldn’t disclose their own stuff – except for carefully considered self-disclosure designed to help the client.
    I used to try to keep this in mind when trying to encourage 1:1 sessions on the ward.

    • Good points. It’s that much harder for people like me to share such intimate details with someone when it’s one-sided. In life, I usually have a quid pro quo way of operating . . . I tell people only as much as I feel they’re telling me. I can’t use that to gauge my interactions with mental health professionals.

        • In my experience, they’re not. I feel like they should be more aware of what the appointment is like for someone with social anxiety. My last pdoc (during what I termed the “harrowing encounter”) got mad at me for freezing up and not saying much. I was panicking inside, my social anxiety running big time. And his behavior only increased that.

  2. Interesting post! I could probably write a novel (perhaps a series?) on the things I’ve learned from various therapists. but it’s interesting to see someone else’s take on it.

  3. It can be so hard to find a therapist that will be supportive, helpful, but also willing to do the hard work. I also saw many, many therapists, each for a few months before you realize it just isn’t helping, and yes, the guilt of *breaking up* with them is hard to overcome as well. But once you find someone that clicks, and the process begins, there is nothing like the journey of healing. Great post! Everyone needs to know this process is difficult and not to give up.

    • Yeah, I need to remind myself not to give up sometimes, too. I haven’t found a therapist that clicks one hundred percent . . . or even for the majority of the time . . . I feel like the latest one is always the best. But I also have noticed that I tend to be more forthcoming with the latest one than with previous ones. I want to get down to working on my issues, and the only way we can do that is if I try to keep myself from evading topics that I’m not comfortable talking about. It seems probable that there must be a therapist out there who can help me, but the more I see them, the more discouraged I get sometimes.

  4. Pingback: The Therapist Saga « The Life You Save May Be Your Own

  5. Good round-up of the challenges of trying to get mental health issues addressed. Every time I have to switch providers I feel like it’s negative progress, even when it’s an improvement in quality of care.

    And I get so tired of everyone saying to just switch docs/therapists when things get rough. It’s so hard to do and can take a long time. In between, you’re without a safety net. In some areas there aren’t many options, insurance limits your choices, and when you’re having problems it’s difficult to persevere and keep working to get in to see someone. Add to that the periodic bit of denial/relief from symptoms that makes you think that maybe you shouldn’t be bothering with all this run-around…

    I haven’t had particularly great experiences with mental health professionals, though generally not as bad as I’ve seen some people report. It’s more than a little frustrating, though.

    • I don’t think my encounters with mental health professionals have been as bad as some other people’s also, but many of them have been unhelpful.

      And I agree with you about the switching doctors/therapists thing. In some ways, I find that process more difficult than seeing a therapist I don’t mesh with. It’s exhausting to have to find the right person then go through the anxiety of meeting them and letting them know about me and weighing first interactions to see if we’re settling in well or the person just won’t work.

  6. Maybe it’s because I’ve been in the system since I was little, I seem to have no problem talking about my mental health with professionals? Almost like I’ve been conditioned to it? I understand your social anxiety, because I feel like I can’t talk to “real” people either, but, like I said in my post yesterday, when you learn a behaviour earlier on in life (like the lack of integration of bad and good), it becomes more ingrained? I only ever had problems being honest and anxious with non-professionals, because I feel they judge more.
    I also try to remember that some of these professionals have been doing it for years and there can’t possibly be anything I can tell them, that they haven’t heard before. Also, even if it feels like they are judging us, they aren’t there to judge.
    What you said about the first guy not wearing shoes bothered me though. Ewww. And then I remembered I took MY shoes off in therapy the other day!! I am NEVER doing that again!!

    • It’s possible that you’ve been conditioned to it. I haven’t, and the level of disclosure involved is not something I’m used to. In fact, it’s something I mostly avoid in my everyday life. I’m a very private person. I don’t know why, but I’ve been that way my whole life. Perhaps it’s just another problem I have. Sometimes when a family member asks me what I did today, I’ll retreat and say that’s a personal question. Even if I haven’t done anything personal. I told my brother that while visiting my family, and he became annoyed and confused.

      lol about the shoes . . .

  7. When my son suffered from severe OCD, I thought it was just bad luck that we went from not-so-great doctors to other not-so-great doctors. Your post is a great illustration of what’s out there, and how difficult it is for people to find good doctors/therapists who they feel comfortable with. Thank you so much for sharing. I hope some doctors read this post.

    • Thanks. It’s nice to know that the post resonates with others. As I mentioned, sometimes I despair that I’ll never find the right doctors, but I’m slowly learning how to handle myself to get the most out of them.

  8. You’ve summed it up so well. Thanks. It’s funny because as I was reading I thought it would take me at least 10 pages to list all my therapists and psychiatrists. And like Hellow Sailor I was horrified by the shoes off routine. I see my therapist in his home and I can thankfully report that he has never once had them off. And he better not! 🙂

    • I’m glad I’m the only one who isn’t disturbed by the socks-only choice. I thought that maybe I was being too picky and obsessive about details . . . I mean, he must do that with other patients, too, and I’m sure some of them must like him. Plus, I’m timid, and I’m terrified of offending others, so I didn’t want to bring it up with him. Also, I was afraid he’d laugh at me if I did. And my timidity was so much that it took me months to finally stop seeing him.

      I could probably say much more about my therapists than I’ve said here, but that would involve getting into details about specific moments and, well, that would take forever, so I tried to condense it as much as I could. When I began this post, I mostly wanted to talk about being proactive with mental health professionals, but then I found I couldn’t explain the process and necessity without a little backstory.

      • It’s definitely not just you who gets weirded out by the shoeless thing. My therapist at Riggs would do that occasionally, or sometimes she’d play with her hair. I always wondered if it meant something–Riggs is very neo-Freudian, so everything you do means something.

        The infamous story when I was at Riggs (which I know to be actually true) was a particular patient got caught in a downpour during the walk to his therapist’s office, so he arrived soaking wet. He proceeded to strip down to his underwear and do his therapy in his boxers. I mean, man, if you thought socks were weird…!

        Curiously, my new therapist takes her shoes off, and that doesn’t seem weird to me. Possibly it seems normal because she did it from the first appointment? I dunno. I would go around barefoot most of the time if I could (did it all through high school, including my senior reading), but I wouldn’t do it in therapy. Sometimes I feel awkward even wearing sandals. My mind is full of odd quirks.

        • I don’t think I’d much mind the hair thing. I play with my hair a lot, too, and generally fidget. It probably does mean something, but oftentimes I’m not conscious of doing it, so there’s not much I can do about it.

          Lol, occasionally when I’m in therapy, I wonder if everything I’m doing means something and if the therapist is testing me or not. I like the idea of things having meaning . . . probably because it resonates with my literary critic side.

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