Help With Dr./ Patient Relationship

[Samantha_38]

I hope this will be ok to talk about. I have PTSD, newly diagnosed but I know I've had it for years I just ignored it. I'm still not really at terms with it. The doctor I opened up to, about a year and a half ago, diagnosed me with it. He also tried to help by allowing me to email him how I was feeling. Basically I'd send him an email every day or couple of days depending on how I was doing. They would be things like what happened to me that day, what I was struggling with currently. He never really offered advice, he rarely said anything more than supportive statements. They went to his work email and this is all it ever was. He's my family doctor. I don't know why but recently he has said no more messages, stating it is outside the dr./patient relationship. I want to to reiterate the fact that it was never more than what I have stated above. I'm having a REALLY hard time dealing with this. I understand why it may be a problem for him. I was really feeling a lot better because I had the person to talk to though, and now I'm left with nothing. I'm not sure where I go from here and I struggle with daily urges to just want to send him a message. It definitely feels like he no longer cares at all, and that hurts. I don't have a lot of support. I have a really hard time understanding relationships because of the abuse I sustained during my childhood, and I really relied on him to make sure any communication we had was acceptable for us to be doing. I don't know what changed. I don't want him to get into trouble. I feel horrible that I'm at fault for something I don't even understand why its wrong. Any advice would be great. An understanding of what the problem is might help, but really I think I need someone to talk to again too. He is the first person I ever opened up to this much and now I'm feeling left in the dark, alone again.

 

[Julesnaz]

It might be because of insurance issues. Since its not really a "visit" your doc might not be covered by his liability and if anything happened he might get in trouble for it.

 

[Samantha_38]

That could make sense. I just don't understand what changed....and the hardest part of all...what do I do now? I was doing better before opening up than what I am doing right now.

 

[Justmehere]

I'm so sorry you have lost that support. That can be rough even in the best of circumstances, especially when you don't have other support. It was really brave of you to open up to him. I would feel really hurt too. It seems really unusual and uncommon for a family doc to offer to a patient to provide support over email like that. It would make sense for a mental health professional like a psychiatrist or therapist to offer that support, but primary care doctors are typically not equipped to treat a patient with PTSD and provide on-going emotional support, especially in absence of other treatment with a therapist or psychiatrist. It sounds like something he did out of care and concern, and then realized maybe he wasn't the best person to lean on for support for your sake. What I am trying to say is that this sounds like it is more about him than anything you did wrong at all. This isn't your fault. You reached out and leaned to share and that is a sign of growth and maybe you are just ready for the next step on healing, and he's simply not the right person to walk with you on that next step of your journey to heal.

And I know that doesn't really make it hurt any less.

The first person I talked to about my PTSD reffered me in to someone else after several years and I never thought I could open up to anyone else again. But I looked and tried meeting with someone new, and in time, I did start to open up again and it was an even better experience and source of support and healing.

Did this doctor suggest anywhere to go for help and support? Or next steps to take from here? What do you think about trying counseling?

 

[Justmehere]

Oh, and it makes sense to me, a little, that you would feel worse after opening up about this stuff. Most trauma therapists are heavily trained in helping clients "contain" because opening up to someone and risking being vulnerable and dealing with PTSD symptoms often can feel worse before it gets better. That pain has been there and it's super healthy to begin to face it because in the long run, we are way better off than we would be in ignoring it... But most trauma therapists say that dealing with the trauma and ways it impacts us now without proper containment and support can leave a client worse off, even re-traumatized. What I'm trying to say is that much of what you are experiencing sounds very normal for PTSD.

 

[Leanne1]

Maybe you can find a good therapist you can trust and open up to?
Also, it is good you found this forum. It has helped me not feel alone. And some of the input and understanding I have experienced here could only come from people who can relate.

You can tell your doctor that you are wanting to respect his boundary, and ask if he can clarify anything that would be valuable for you to understand. I think this is important if you are to continue having him as your doctor.

 

[Samantha_38]

He had recommended counselling and I did go to a psychiatrist that he referred me to way at the beginning. I'm not into the meds. Again they created more problems than I had. The counselling is a different story. I have issues with them stemming from my past and the way things were handled by counselors I had during the the time of my abuse. They were court ordered and everything I said got twisted, and I got blamed for things. I just can't open up to them. I really don't know how I just walk into a room with someone I've never met and start telling them my life. People I've known for years have no clue. I feel like they'd get irritated with me for not being able to speak. I mean you can't just make an appointment and sit in silence forever. I don't know if I'm just not ready for it or what, but it is so scary for me.

We also live in a rural area and I don't know that there would be anyone who's "good" enough at it for me not to frustrate them. The others always would get frustrated when I didn't get it, and I don't know...I just didn't get it. I didn't try to be difficult, it just didn't help.

Thank you for letting me know this is normal. I always feel like I know NOTHING about life. Everything people just learn growing up, I was never given the chance to learn, and it is definitely an issue now.

 

[Leanne1]

I'm sorry you had such a terrible experience with the councelors you spoke to. For me, I agree, you can't just walk into a room with a stranger and open up to them. It is like any relationship, it takes time to develop trust . For me, a huge first step has just been being honest about the fact that I don't feel safe to talk about the details, so right now we are just working on coping tools, so I can start to manage the anxiety, panic and moments I feel like it is all happening again.

 

[circe47]

Please don't take this as personal rejection. I think the doctor probably ultimately realized that while he gave you a mental health diagnosis, he really isn't qualified to be giving you counsel regarding that mental health diagnosis. He is really only qualified to treat your medical issues. In case of a medical emergency, there is most likely a voice mail or operator directing you to call 911.

As for a good therapist, they will also not agree to email exchanges. This crosses the boundary between the therapist's work hours and personal time. Most therapist's worth their salt keep rigid boundaries so that they do not become enmeshed with, and thus resentful, of their patients. Again, with mental health emergencies like suicidal ideation and self-injury, the voice mail or operator will direct you to call 911.

If any doctor tried to treat or counsel via email, they'd never have a life outside of work. See how it's not personal?

 

[Samantha_38]

How did you find whoever it is you see? I also don't feel like the process of trying out 20 different people is any more appealing. I don't even know if there are 20 people in my area...it is so small.[/quote]

 

[Deleted member 1860]

I understand your fear of reaching out for help, however, I think you should ask yourself if not reaching out for help is doing you any good? I bet the answer is "no".

Healing isn't easy. Actually, it's REALLY tough. I learned early on that I had to force myself into doing certain things that helped me to heal. I hated it at the time, but in retrospect, it was the best thing for me.

Yes, there are people who refuse to reach out for help and work on healing. You'll see some of them here on the forum. It's heartbreaking in a way because fear keeps them paralyzed when the truth is that if you take a leap of faith and actively work on healing, the suffering comes to an end much sooner. Just something to think about.

 

[circe47]

My most current team came by way of crisis intervention in the county mental health system. Before that, when I worked, I usually just entered my desired parameters for a therapist into my insurance's online website and found them that way.

Sometimes it's hard to find someone to connect with. The first time I went to see a shrink, I disclosed that I was in an abusive and neglectful relationship. He looked at me sternly over his horn-rims, took a few pulls on his obnoxious pipe, then said to me, "why don't you do something about it?" Gee......if I had the answer to that one, I wouldn't be here now would I? Stupid guy. Never went back.

The next guy just sat there. Every damn time I stepped into his office, as soon as we were both seated, he would just stare at me. Didn't say anything.......just stared at me. Nothing like being in the hot seat....right? I decided that maybe therapy wasn't supposed to be all comfy cozy with plenty of Kleenex and a nice strong should to cry on. So, I took the bull by the horns and led my sessions. In hindsight, I'm sure it was a technique designed to "empower" me. Anyway I ended up with this one for two years, and figured some stuff out.

Good therapists are kinda like friends, with strong, healthy boundaries. Like friends, though, the right fit is very important. You'll know it when it happens.