Late last month I saw my shrink. It was one of those days where I woke up drowning in self-loathing. As I wrote about in this post, I showed up to my appointment about ten minutes late and was a sloppy incoherent mess of emotions. I mostly just cried and rambled before leaving in an admittedly abrupt and tantrum-y way. My frustration was not with my shrink, it was with myself and how dysregulated I felt at that time.
She called the next business day and left a voicemail saying she wanted to check in. She also offered a couple of times for our next appointment and said we should talk about “how you want things to proceed from here.” She mentioned that my medication seems to be more or less “squared away” and she’s wondering how this would “work best for me.”
It was a nice enough voicemail but I had a bad feeling about it. I mentioned this whole scenario to my therapist who suggested I schedule a follow-up sooner rather than later and suggested that my shrink was simply trying to open a dialogue about our work together.
Perhaps.
But today I had that follow-up. I was two minutes late and I couldn’t get the door open with her buzzer so she had to come let me in. We sat down and she asked how I was. I told her I was okay and she launched into the hypothetical conversation she’d referenced wanting to have in her voicemail.
She essentially said that I have a therapist and that is not her role. Her role is medication management. She told me that she doesn’t believe it would be healthy for her to do therapy with me and that it seemed like she “had not been helpful” last session.
She doesn’t want me to be bringing up issues that are destabilizing when we don’t have the regularity or solid relationship to tackle those issues. She said we could check in about how my medication is working, if I’m experiencing any side effects, and if I need an adjustment.
I don’t even know what that means.
But what I think it means is that she is just like every other psychiatrist I’ve ever seen – she just wants the bare minimum.
I was in and out of her office in 8 minutes today. That’s the relationship she wants with me. Short, simple, easy.
Shocking.
I have one appointment with her where I am authentic and uninhibited with my emotions because it just happened to fall on a particularly crappy day and now she’s drawn a fucking fortress around herself.
She clearly doesn’t want any part of that nonsense and has relegated that full responsibility to my actual therapist, a woman who is also currently feeling the limits of her own boundaries and compassion around our relationship, and for similar reasons.
I am so fucking tired of clinicians who can’t handle my reality. They don’t need to save me. They don’t need to be perfect. They don’t have to have all (or any) answers. They are allowed to disappoint me and upset me and be not what I need or less than I need. But I am also allowed to be disappointed and upset and emotional.
What I loved the most about this psychiatrist is that she allowed space for me to talk about my whole life, rather than chopping it into these weird disconnected pieces that only allowed for the least amount of information possible to continue prescribing medication. I thought we made a great team in that way and I felt really comfortable adding and modifying medication with her because it seemed as though she was genuinely interested in my entire experience, rather than just symptoms and side effects.
This feels like a rejection. And it feels like the rug was pulled out from underneath me. I would love to be able to process and repair this with her, but that would require space.
And space is the very thing she took away from me.
So many crappy mental health professionals out there. I swear psychiatrists are the worst.
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Agreed!
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Wow, that is sloppy psychiatry.
psychiatry
sʌɪˈkʌɪətri/Submit
noun
the study and treatment of mental illness, emotional disturbance, and abnormal behaviour.
Since when did Psychiatry become a pharmacology dispenser? I’m sorry this happened. No wonder you feel rejected. What will you do?
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Right?! So ridiculous. I really thought she was NOT one of those shrinks that only cares about pills. So disappointing.
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That is pretty lame. I am sorry. I think you should send her a letter/email explaining how lame she is (probably use different words then lame) because you weren’t asking for her to be your therapist. Even if you were, it should’ve been handled better! It is not easy to go to these appointments. It is never easy. grrr I am pissed for your sake.
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Thanks, e. I’m gonna try to draft some sort of letter that I could read to her next time I see her. I really wished she had handled this better.
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On my phone, hence the brevity – that is shitty. Real shitty. I’m ticked.
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Shitty, indeed.
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I wanted exactly what you got – a psychiatrist who would just do meds, no therapy, leave that to my psychologist – and I haven’t been able to find one. I expressed that exact sentiment to my last psych and he said that ethically, he just couldn’t do that because he has to know about what’s happening and what I’m struggling with to be able to prescribe accurately. I think that shows just how shitty she was.
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Yeah this shrink was all “I want to be in contact with your therapist so we can be a team and I know what’s going on with you” blah blah blah. SHE initiated our relationship in a way that allowed for me to talk more openly about how I was experiencing my life, but then got pissed when the reality was more than she apparently bargained for. Sucks. I hate just having script-writing robot docs.
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It’s so frustrating when they make declarations like that and then freak out when it actually happens. Like…I’m sorry, what exactly were you expecting?
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Exactly!!
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I wish you had a psychiatrist like dr. Barry. This one sounds just so shitty. I’m so sorry she made you feel so rejected, not. professional. Very bad practice if you ask me. XX
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Yeah, totally unprofessional and very disappointing.
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No way is that good practice! It’s outrageous and unfair. Mental health care professionals are supposed to be able to deal with our issues, which aren’t always nice and tidy. That includes tolerating our distress sometimes. This seems like a basic requirement of the job.
Even though it’s entirely on her, I can see why you would feel hurt. I’m so sorry! You deserve better.
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Right?! I feel so rejected – as a PERSON. I feel like she rejected my fundamental experience of being human and being myself, which really sucks! Thanks for the support, Q ❤
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Wow. I can’t imagine how it would be possible for there to be zero overlap between therapy/psychiatry. I know there’s definitely a Venn Diagram sorta thing going on with my two, for sure. That was shitty, and I’m sorry she did that and hurt you. Sending you support.
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OH there’s definitely overlap, she just got scared. Figures. Typical. Crap. Thanks for the support xo
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Ugh. You really deserved better. I’m sorry that she was so open to having space and talking and then just shut down and drew these hard boundaries. That is all on her, though, and is her issue. I know that’s hard to see, but it’s true. This isn’t on you.
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Yeah it was super confusing. It’s like she completely backed out of the unspoken agreement we had about how we’d interact during appointments. But of course I’m the one who gets screwed on this because she gets to pull the clinician card and I’m just the dysregulated crazy chick. Ughhhhh. Thanks for the support, Alice xo
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I hate it when clinicians act like “clinicians” and behave like we are just a patient, a list of labels and diagnosis and crazy behaviors. I’ve had enough therapists who acted this way. It hurts and is confusing. And you aren’t crazy. Xoxo💜
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Yeah it really does hurt (and it really does make me feel crazy). Thanks, Alice 💗
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That’s so frustrating. I get exactly what you’re talking about. I had a discussion with my therapist the other day that similar to some of your sentiments. I just explained that anyone that you might talk to or open up to doesn’t need to have the ‘right’ response or any response at all. They just have to be there and listen and sit with whatever you’re going through.
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EXACTLY! I was already feeling whatever I was feeling. It had nothing to do with her. Apparently she just isn’t strong enough to handle my reality so whatever screw her.
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I think that your psychiatrist’s reaction to completely shut everything down other than specifically talking about meds is a complete over reaction and mistake on her part.
At the same time, I can understand why she would be concerned about not having enough of a relationship to help you contain the huge emotions, especially when you talk about suicidal ideation and then hurriedly leave her office in a heightened state of distress. I want to be clear that I’m not blaming you and I’m not saying that you should take care of your psychiatrist, but just pointing out that the natural response would have been to be concerned about your safety. From her statement that she felt that she wasn’t useful to you, I suspect that she feared that her interaction with you only made things worse for you.
I really don’t know where the best solution would be between “anything goes” and “nothing but meds talk”. I think that is something that would take time and willingness on both your parts to figure out. I’m sorry that it sounds like she is too worried about what might happen, if she worked with you on it.
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Yeah I see your point and this is what my therapist alluded to – the idea that it would be irresponsible of my psychiatrist to set up a space that allows for me than she is able to respond to. But I just don’t feel like that’s what happened and I wish she had initiated a different dialogue with me that felt more open and less shaming. I’m a very flexible and understanding person. I would have been willing to talk with her about this, but not when she just slams it in my face like that. I was too stunned to respond like an adult and now I feel so humiliated and rejected. Ugh. Thanks for your comment – it really helps 🙂
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This is such a terrible story and it angers me SO much. I’m sorry. I would’ve felt the same way though.
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😡😡😡
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👿👿👿😡
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I have DID, and on a benzo currently. I am curious if you decided to go with the Amphetamines (posted under Dr. Bird). I hate meds altogether; I fought taking anything for a very long time. I was wondering if taking amphetamines really does reduce the switching during the day time. I also struggle with night switching; it leaves me with little or no sleep most nights.
I’ve been reading some of your story, you are a strong and courageous woman!
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I did, yes. I am currently taking Ritalin and it works well for me. It helps my brain stay in “executive control” during moments of distress. Which has the added effect of reducing switching and other dissociative symptoms. Thanks for commenting and reading along! 🙂
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Thank you! Another question…does it help with night switching too? That is one of my hardest times.
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Yes actually. I have to take klonopin at night for sleep and anxiety and the Ritalin helped a lot with the inevitable switches that happen when I am sedated. It’s not perfect but it helps. And i never feel “up” or hyper on it so I like that a lot.
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Thanks so much!! Appreciate you sharing what works.
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How crappy. Honestly, I suppose I’d feel the same way. I mean, I am not a psychologist or psychiatrist but I do counsel other people sometimes. And it urks me when those who work in a counseling field don’t put in the heart to take others seriously when they need it most. Granted it can be dangerous but that’s a part of the experience; they sign up for that possibility.
Hope you feel better soon. Rejection sucks but at least you can vent it out!
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Thanks, dear 🙂
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