Therapist and GP Conversations

[piratelady]

I have a hard time disclosing that I have PTSD, I asked my therapist for help in disclosing that to my GP as it’s become apparent that it’s necessary.

Therapist took the unexpected route of offering to just have that conversation for me. I signed the release form. He said that his approach was going to be telling him that I have PTSD from sexual abuse when I was younger. We agreed he won’t disclose my self-harm.

So I have a few questions.
1. Once your GP knew, did it change how they treated you? Like I’m scared that it will define me in my doctors eyes.

2. I’m scared Therapist and GP are going to gang up on my to try to make me start taking anxiety medications, which I still don’t want to do.

3. I found that once I knew therapist and GP would be talking I felt less comfortable with therapist. Like I deliberately omitted the suicidal thoughts I’ve been having because I didn’t want my GP to know. How do you get past that worry?

 

[FauxLiz]

Unfortunately @piratelady I don't have any advice for you. I understand why they and many patients believe that it is helpful I have a strict personal policy that prohibits conversations between treating providers. This isn't just mental health and medical I don't allow my P-doc to converse with my T nor do I allow my neurologist to speak with my PCP. Records go between but there is no two way conversations this way I see myself as being in control of my care rather than as you mentioned having two or more gang up to try and persuade me to do something I am uncomfortable with.

 

[Eagle3]

I have to tell every doctor I see about my DX's for various reasons. Some doctors have treated me like a label, but one I have now is still treating me as a person with the added benefit of asking or explaining before touching. It helps a lot.

With that said, I have never had my T talk to my doctors about anything. Not sure I would be comfy with that. However, the meds you take are ultimately your decision alone. They can't force you.

 

[Sideways]

1. Once my GP knew, I got treated differently. They were much more careful about touching (eg to take blood pressure), and started laying off about “when are you gonna have your next pap smear”. It also explained my complex headache situation, so I now have no issues getting the appropriate meds for that. So, all good stuff.

2. When 2 different types of specialists recommend the same medication for different reasons? I wouldn’t consider that “ganging up on me”, so much as “mmm, must be some sound medical advice”. You don’t want to take them? You can still just say no:)

3. I don’t tell my GP about my suicidal thoughts either. Yes, it would absolutely freak them out. But more importantly? That’s what I pay my T for, not my GP. If my GP strays into questions that I’m dealing with in therapy? I tell them, “My T is managing that issue for me”.

I’ve had a bad experience authorising my treatment team to converse with each other just recently. My strong advice would be to make it very clear to both that beyond your ptsd diagnosis, you don’t authorise any other communication between them. If they want the other one to know something? They can tell you to pass the message on. But then, I had a bad experience just recently, so maybe that’s a little paranoid!

 

[Kubash16]

I’m kind of the opposite. Normally I’m a total control freak. With this? I authorize and encourage communication. There’s a part of me that’s like eww they’re talking about me behind my back, paranoia about them acting like middle schoolers. But the larger part of me? Thinks leaving it up to them and letting them have that control makes me feel taken care of, that things won’t get lost in translation if I try to handle it cause umm I suck at referring messages, and I trust them to know what they are talking about. I don’t know why I find it easier to trust med professionals more than others besides I keep telling myself that this person has spent years upon years and buckos of money getting an education. However, if I feel like that person is rushing through/not hearing me, then I won’t return anyway. So I stick with people I trust and allow all communication. I’d rather oversharing and possible ganging up then me not realizing some critical piece is important and not relaying it correctly.

 

[piratelady]

Thank you guys for your input. I really appreciate it.

 

[Chris-duck]

Once your GP knew, did it change how they treated you? Like I’m scared that it will define me in my doctors eyes.

My GP has known since I moved and got this GP so I don't have a T right now, but before my last T. It doesn't seem to have affected how they've treated me though, I've heard people complain that they've had physical issues dismissed as psychosomatic when their GP knows but that's never been an issue IME.

I’m scared Therapist and GP are going to gang up on my to try to make me start taking anxiety medications, which I still don’t want to do.

They can both voice that they think it could help, but they're not gonna gang up to convince you, they might both make a comment like "I think *med* could help.." but it's totally your decision.

I found that once I knew therapist and GP would be talking I felt less comfortable with therapist. Like I deliberately omitted the suicidal thoughts I’ve been having because I didn’t want my GP to know. How do you get past that worry?

Speak to T? Go over what you're giving permission for them to know and what you're not. Say you've been worried stuff might get passed on that you don't want, and assuming your suicidal thoughts aren't ones you're gonna act on, there's no reason for it to be passed on.

IME of these types of phonecalls as a health professional, they tend to be a lot faster and vague than any convo I imagine people have about me as a patient. Usually "P and I think it might be helpful if you knew this" "okay, for any specific reason or just something to be aware of" "something to be aware of (or whatever)" "cool thanks bye". When I'm the patient I tend to imagine it as a massive deal but majority of the time it's really not. Not to dismiss your worries, just for a different view I guess.

 

[piratelady]

Thanks, that’s really helpful

 

[piratelady]

I emailed Therapist. He said he won’t disclose anything without my permission. So if I start having suicidal thoughts, he’s not going to tell Doctor without asking me first. The breaking confidentiality thing, it sounds like he might explain that more next week.

Apparently he thinks of medication as a tool whereas I see it as a sign I’m failing. He thinks Doctor is going to recommend it, so he wanted to talk to me about it first so I was prepared.

All I wanted from this was for the doctor and others in their office to be more careful when treating me and tell me what they’re doing before they do it. Hopefully I at least get that out of it after all this worrying and crap.

 

[Kubash16]

Apparently he thinks of medication as a tool whereas I see it as a sign I’m failing.

I get this. But frankly, medication (at the right dosage/type/etc) can be really helpful in taking the edge off and making therapy more vulnerable. If you choose to take meds- you are not failing. Not one bit. You are doing what you need to do to survive-something you’ve always done. It’s just another tool to do that.

You don’t have to answer this but I want you to really consider it. Do you think I (and the several others on here) are failures because we take meds every day?

 

[Starfire]

Totally understand. I was told to think of it as a care team. Would I not tell my T that I had say a seizure disorder? OK that's the reasonable, sane answer!!! What I also learned was that permission can have caveats. You can limit the topics...T can disclose only PTSD dx, meds. Also can limit time. Give your permission for the 2 to speak once, one week, one month, one year, whenever they need to coordinate meds, treatment, only with your prior knowledge. Just write it in on the permission slip! In the USA that's legally binding.

 

[piratelady]

That’s what therapist said when I emailed him for clarification. He will only discuss what I gave him permission to discuss and if I do start having suicidal thoughts again, he can’t share that.

I didn’t specify the frequency they would speak, but I can’t imagine they would need to often.