First of all, I can empathize with your challenges. As someone who is in recovery from complex PTSD, I understand that trying to communicate with mental health professionals can be challenging. Part of trauma recovery involves learning to find ways to get one's needs met. It's great that you like your psychiatrist. It's also true that feeling a connection to her (which is also a necessary component of trauma healing) has been challenged by your infrequent visits.
Others have provided some good suggestions here. Whenever possible, it's important to try to express your NEED for good communication. It's your treatment and your recovery. Time to own that by learning to assert yourself with these mental health professionals. If you have specific concerns about your NEED for no additional medication, then this needs to be communicated to your psychiatrist. You could also get additional support from your therapist by discussing your perspective with her, and also getting her views. Good therapists have a sense of someone's relative stability and can provide useful feedback to the psychiatrist. If the therapist agrees that you are stable, that no additional medication seems warranted in her opinion, you could request that she speak to the psychiatrist or write a letter to that effect.
Having said that, you ultimately get to decide whether taking medication or not taking medication is something you feel you need to do. It's your choice. Mental health professionals are there to serve you, to support you and do what they can to facilitate your recovery. While it can feel a bit difficult to assert oneself with authority figures (especially we experienced trauma as children), it's an important step in our recovery. Sometimes we might fear rejection if we do not comply with the wishes of a doctor because it can unconsciously remind us of our relationship with our parents. Sometimes we might feel a need to be liked or please them even if this includes doing things we don't want to do. I do not know if that's part of the issue here.
Steps in Identifying Needs/Communicating & Asserting Yourself:
1. Identifying Need: Knowing and naming what you want and need is the first step.
2. Acknowledging Need: that it's okay to need something from your therapist or psychiatrist.
3. Write down specifically what you need from your psychiatrist and what you want to happen in the session. (Do you want her to listen to your concerns? Do you want to get more information from her about why she sees a need to increase the dose? Do you want to share your perspective or experience with the medication? Write it all down. Create an agenda and bring it to session with you. Tell her you have an agenda and tell her you want to talk about the things you wrote down on your list. The advantage to this strategy is that if we forget what we wanted to say, we can look back at the list). I found this very helpful during my sessions. It’s a way of empowering yourself as the agent of your own recovery.
4. It’s also important to create a space for your psychiatrist to offer her opinion. Maybe she has a reason for her views that you do not fully appreciate or understand. This is why it would be helpful to get communication going between your therapist and your psychiatrist. Asking your psychiatrist to explain her treatment suggestions demonstrates you are actively interested in her perspective too. It also makes her less likely to become defensive and perhaps more open to hearing your perspective. Doing what you can to create a dialogue is one of the best things you can do to create a strong bond between you and your psychiatrist.
5. Communicating Need: Remember that your needs are important. Learning how to overcome fear of rejection by asking your psychiatrist directly for what you want. Writing a note and handing it over to her in session is not direct communication. It’s a way of sidestepping dealing with uncomfortable feelings. It’s a way to avoid feeling possible rejection or an unpleasant exchange. But trauma recovery means learning how to trust. It means that learning how to trust that even if you and your psychiatrist do not end up in complete agreement, the relationship will remain in tact. You will not be rejected. The differences in opinion can be resolved between you. And if a psychiatrist is not willing to discuss your concerns or is not open to your perspective, then this person is ultimately not a good psychiatrist for you.
Good luck.
