Interesting Text Exchange

[desiderata310]

Ok... Sorry @joeylittle
After the Ativan helped with my sleep and we determined that my suicidal ideation was actually from the other med I was on a few weeks back, my therapist said he didn't think it was necessary for me to go to the psychiatrist for meds.

I gave the GP the assurance that I was going to a psychiatrist so that I could get that tiny prescription filled.
When I ran out my therapist wanted me to go back to the GP. I said, not without him calling. He indicated that he would.
He didn't
I indicated last week that this was why I had not been back at our meeting last week.
He still got pissed.
He said last week he would call the GP.
I said that I was still waiting for him to actually make that connection.
As of today he has still not made that connection with the GP
As of today I suppose that it is my responsibility to go to the GP without his backup first.

 

[joeylittle]

yes, the detail about surfing was unnecessary. My therapist does this sometimes - I truly think he forgets himself briefly and tells me information about his schedule that I really don't need to know. I don't need to know that you are cancelling in order to go to your son's graduation event. Sometimes I don't mind, but most of the time, I do - in my case, it just reminds me of the gulf between his normalcy and my freakishness.

 

[desiderata310]

OH! and the therapist was the one that decided that I did not actually need to go to the psychiatrist. Not me. He had made a call and had tried to get me in. When things cleared up he indicated that he did not want me on meds

 

[desiderata310]

@joeylittle Actually, I feel like because of the way that he said it, that it was really a slap in the face.
Desi, YOU are not important enough to give more warning that about 14 hours that I am canceling so that I can go surfing with my kid.

That was a big f*ck you.
No: truth be told I feel very abandoned.

 

[joeylittle]

Thanks, @desiderata310 - that makes so much more sense now.

Ok, take it or leave it - but I think the point where both you and your therapist made an assumption was at that point where your therapist said he didn't think you needed a psychiatrist anymore.

Your therapist wasn't really allowed to say that - in the sense that you are the one who made the deal with the GP about the ativan, not your therapist. The GP wants you to see a psych.

So your therapist didn't have the authority to say that, and then I'd say (and I mean this totally constructively), you probably could have taken responsibility for finding a psych anyway, if you knew you wanted to continue the ativan - or, gone back to the GP sooner and explained the situation.

I hold him more responsible, because he never had the right to say you didn't need to see a psych because the ativan fixed it all. The GP, for reasons of his own (probably just personal policy, he likes to leave the psych situations to the psychiatrists), was requiring that you see a psych if you wanted that prescription to continue.

From your therapist's perspective - he went over the line talking to your GP in the first place (which he offered to do, I remember that). And he went over that line again saying in session he would call the GP about the ativan refill. Somewhere in his mind, he knows he's being inappropriate. And it came out inappropriately, as "I'm picking up the pieces".

Definitely not awesome professional behavior. But also understandable as human error. I think it would be worth it doing a session with him to either clear the air about the whole thing or close things down.

Although, given the boundary-crossing, it's a question as to whether the therapeutic alliance can be rebuilt.

 

[desiderata310]

I'm kind of no longer interested because of the " I'm going surfing." I just haven't quite figured out what to say that isn't just ugly.
I'm shaking pretty hard. I still have to ride home.

 

[joeylittle]

truth be told I feel very abandoned.

I understand that. I would be as well, in your situation.

 

[anonymous]

Well, I think a lot of this is due to your own personal error.

I'm in the USA, and yes, this is how it works.

Doctors can indeed refuse to give you medications for whatever reason. It happens ALL the time. They may say "I won't prescribe XYZ, you need to see a specialist." Actually, this IS indeed how it should work given that certain medications are so specialized that they should only be prescribed by a specialist! In your case, your GP was doing you a courtesy with the understanding that you would see a specialist, ie Psychiatrist to manage your medications.

So you knew that your GP was just doing you a courtesy, but you didn't want to listen to him. You went to your therapist and figured that your therapist could "convince" him to continue filling your Ativan. Uhm, stop me now, but your doctor told you NO MORE and now you're attempting to get your therapist to undermine his medical expertise and manipulate him into prescribing something he doesn't feel comfortable in managing!

Long/short, your GP told you to find a psychiatrist to prescribe a controlled, (YES, CONTROLLED) substance, and you know what you need to do in order to get said controlled substance. Find a psychiatrist....

Your therapist is only human. I think everyone is jumping on his case because we only know your side of the story. I have a feeling that he is getting frustrated with you for a number of reasons, the latest of which is this medicine fiasco.

So, find a psychiatrist. If you don't like this guy, find a new therapist, too. But honestly, given all of your recent posts, you're nowhere near being able to function without a therapist. JMHO.

 

[desiderata310]

ANON I get what you are saying; I do.
My beef is with the therapist who said "do this" and then changed his tune, several times.

The THERAPIST said he wanted me to see a pyschatrist and then changed his mind saying "I don't want you to see a psychatrist, I don't think you need anything more than an aid to help you sleep." He suggested that I go BACK to the GP for more. I pointed out that this was problematic and he said they would talk and clear it up. When they never spoke, I never went. Now, since I took it for granted that my therapist was going to follow through and do what he said, you can kind of understand my surprise when this was thrown back in my face last friday.

Not being especially Dr/pyschatrist/therapist savvy I was relying heavily on the advice of my therapist to point me in the right direction. The DR didn't reccomend that I see a pychatrist, either initially or even after our consultation. I TOLD him that I was going to see one because my THERAPIST had reccomended this and was arranging it only to change his mind and say not to go.

In our recent conversations, it has NEVER entered the conversation that I should seek a psychatrist. Even in his frustration last week it never came to light just that I should 'go back to the GP' . I'm not interested in manipulating anyone into anything. Actually, I don't necessarily relish the idea of getting on sleeping aids. It's something I did as a last resort. I would be just as happy doing without them.

 

[desiderata310]

Also, I'm certain that he IS frustrated with me. I AM a difficult patient and I HAVEN'T made any serious progress.
That being said, his text was completely inappropriate.
A. for cancelling so close.
B. for the manner in which he chose to do it aka telling me he wanted to go surf and is cancelling tomorrow and he would only see me once a week from now on.

Neither of these things are text message items.
Both leave me feeling abandonded.
Both leave me not feeling like I can't trust him

It was going to be my suggestion tomorrow that we go back to once a week. I was feeling pretty good this weekend all things considered.

Now, I'm not so certain that I want to continue.

 

[Chosen]

I'm so sorry, desi. He's seemed so nice for so long. I think that was harsh for him to talk about surfing.

Perhaps a simple text saying "you canceling 14 hours prior to go surfing leaves me feeling hurt and trust is broken."

Legally, ethically, morally, human nature-wise, business-practice wise, cancelling with only that much notice is not good. Maybe a reminder of that...say the APA ethics code 3.04 "Do no harm" for one.

 

[darrenS]

Today I got a text that said that for the first time
first time he had been mad. But he wasn't anymore.

im sorry but as much as i really like my therapist , i do not in any way encourage communication outside of the session, and certainly not to hear their feelings on anything i may have done or said. They can tell me in session so we can work it out, once the boundary that incorporates professionalism is broken its a really slippery slope, sure in really bad times i have had to leave messages to let them know im ok, but the whole purpose of therapy is to get you functioning on your own two feet, once they offer things outside of the session ,it can turn very unhealthy very fast