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My Very Confusing Psychiatrist Appt...i Am Lost

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Laura 2

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I had a second appt with psychiatrist and a 'senior practitioner' (whatever that is) today.

I was going to write about it in a sensible, sanitised way. But I decided to cut and paste the email that I sent to my dear friend who accompanied me (but didn't come into the meeting). We didn't have too much time to talk about it after and I am filling her in with more of the details. This email is more immediate and more descriptive than a tidy version.

Why post? Well, I'm really at the end of the line, I'm out of ideas, plans, hopes. Please don't feel that I'm dumping on you...it's that I just don't know where to go or what to do next and would very much appreciate your opinions and support. Thank you for reading....

Thank you for the picnic lunch – it was nice to sit out in the sun and not be rushed. Thanks as well for coming with me to the appt. I should really have asked you to come in - I didn't because they were going to ask you to do even more supporting and, as I said, you've been amazing and gone way beyond anything that could be expected.

Both of them are genuinely nice women and seem keen to do what is possible from their perspectives, within their resources. Even said they wished they could "rescue" me (whatever that means) because I’m nice or whatever and they both feel well-disposed towards me, though it’s not what I want.


The whole appt was so seriously confusing and all over the place – from why isn't my sister supporting me, why is she bedridden, to why don’t you go and live in [400 miles away] near your son, to you have to get blood tests and you must get a GP (apparently local GPs are so much better now, they have been trained to work-with patients now, and nothing happens without a GP), to (yet again) the details of the people involved in the stalking and – mega-trauma - CCTV, to ‘there’s three people in the room: the doctor, the patient and the illness – the patient has to decide what side to join forces with’ (huh?), to (yet again) how did the stroke happen: recount the event, to [a local charitable agency] as a signposter and tenancy supporter and me saying to the effect of 'been there, done that, they're not helpful', to you have so much to offer, not in [this city] of course because it’s [something negative] but somewhere else... to “everyone” is “terrified” of your intellect/intelligence, to a bunch of things they could offer (but only the drugs, Brief Therapy and ‘reflecting’ is all I caught of it)....to selling the house, to you could take drugs for depression ...but they don’t work for you, to the sheer mess of my medical records/misdiagnoses, to why were you let down by former GP and the hospital consultant took advantage of your deficits according to one of the previous therapists, to me being the big, strong supporter for ALL my family and some of them blaming me when I just couldn’t, to why have you had all these bad experiences of negligent doctors/therapist (like how should I know what’s in their minds! It’s the NHS), and so much more...


Any one of those could have/should have taken at least 20 mins to discuss and set in context. We had Ihr 10mins in total. Yet their Qs and opinions all came at me in a completely unstructured way, higgledypiggledy; I tried my best to answer but as soon as I got a short sentence out then they were on to the next thing or off at a tangent. At the end, when I endeavoured to herd-the-cats, so to speak, the doc told me I am ‘stuck’. Well, duh. With the implication or words to the effect that I have to want to unstick myself (If only I knew how....) and choose [something, I don’t know what it is I am supposed to choose, it wasn't explicit].


Then there was the opinion that I “think too much” – though what does that mean?? Doesn’t it presuppose that there is an ‘optimum’ amount of thinking that a human should do? I didn’t even get a chance to say that I do the greatest amount of my thinking on paper/screen, that I don’t sit around over-thinking anything of the past because it’s all just too painful, complicated, terrifying and overwhelming to think about, so I don’t: I just do not ruminate, I avoid. No appreciation whatsoever of how much I’ve worked – with your immense help – to get as far as I have now...


Your immediate reinterpretation along the lines of my creating analytical frameworks (instead of "thinking too much") was most accurate - thank you! It's what I believe I really only do on paper, as accurately as poss for the sake of accuracy and fact. The ‘thinking too much’ thing/analytical frameworking is just the same, uses the same tools and techniques that e.g. [central gvt depts, statutory bodies and local authorities], etc.etc. gladly used to pay me c£500/day for....how is it somehow wrong, unnecessary or unwanted when I become a patient/service user and try to use such skills to frame the problems here and seek solutions?


[My friend] it was all so impressionistic and almost random, leaping across time and space from the mega-horrific to the most minute irrelevances. For me it felt like scores of tiny, chance, transitory pinpricks on an inside out, upside down version of their rather sketchy one dimensional map of one decade of my life. But there was not one fixed point or compass bearing from which to set out and no way points to follow, no logical sequence whatsoever.

I know their intentions are good, but they were overwhelmed (and articulated that - both in words and in body language). I know they haven’t understood how utterly terrified and traumatised I was (to be fair, no one did) in the first two years alone of the stalking which set the foundations for all the rest of the crap. Nor do they get how my brain just doesn’t do such randomish complexity in the moment. I just could not follow them nor get much of a word in edgewise. And, as I said, I know they’ve not grasped how very scared I am of people now and how barely I function and avoid everything I am frightened of – which is just about 90% of life. I know they’re not getting it. How can they with such impressionistic, random bits of snatched information?


Cutting an extremely confusing episode short, I came out feeling that the only thing that's crystal clear is that I’m far too f*cked up and way beyond help, irrevocably broken somewhere, unwanted on voyage, end of the line. I don’t have the energy any more to keep on explaining and asking for help. I’ve done nothing wrong, ever - and I’ve always done my best even though it may not look like anything great. I’m so sorry.

PS. Using my feverishly overworked brain (sarc/), I just did a back of the envelope calculation. There were about 30-35 separate topics or questions raised by the psych and the senior practitioner in 70minutes. That gives a total of 2 to 2.3 minutes per topic.
 
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I've had an app similar - there is so much to cover in a very short space of time. I left feeling a bit shell shocked and disorientated and it affected me quite a bit because to talk about such intense things for a few minutes before moving onto the next thing left me feeling a little dismissed - ie. my pain dismissed.

HOWEVER - the role of a psych dr is very different to a T. There isn't the time to go into things indepth. It IS very quick, wham, bam, out the door. The Dr asked you all the things they needed to wanted to know in terms if how to treat y (meds usually). It helps to remind yourself of that before an during an app. It's a hard transition to make when you're so used to seeing a T where you go focus on your FEELINGS - Psych Drs are more focused on SYMPTOMS - and what medications can help with those.

What I found helped build a better relationship where I felt the dr actually knew me a little was to see her more frequently in the beginning. I go private so while it costs me a lot, I don't have to wait a whole month to see her like in the public system.

Another idea - ask if you can send an email to her with all the things you think are important for her to know. A timeline of significant life events and a short paragraph about how it effected you then and does now. That enabled her to have a reference, and saved time IN our sessions also. If she doesn't have an email address / you don't have her email address (I don't have hers), email reception with ATT: for Dr xxxxx and she will get it. Doing so also helped me feel heard even though we haven't ever talked about the email I feel better knowing she knows the key things now.

It's really not personal - it's just the nature of psychiatry - hope that helps.
 
@NovemberStar
Thanks for reading my post and for your response.
It's very interesting to get your perspective and the way you've handled your treatment.

Thing is that neither of them asked anything about symptoms, nothing, zero. It was mostly all about circumstances - about which they got a very scant and garbled 30 seconds on each topic, if that - and who the hell they could find to support me instead of the NHS basically.

I had already sent a history I'd written on the whole thing and a few other documents. Which she fleetingly referred to. I'm not sure how much good that did because I am a writer (many times published), my skill seems to present me in a far more functional light than is the day to day reality. I think I'm damned if I do, damned if I don't sort of thing. But there were obviously glaring and important omissions of information.

Yes, I know it's not a personal thing, though I came out feeling that it was all such a confusing waste of time.
 
I hear you. Would it help if next time you took in a list of things YOU need to talk about / discuss. Perhaps worth it also to say how today's app left you feeling; that you find it too much to talk about so many things in a short space of time, and need to focus on one or two things instead.
 
You are on the mark, with your experience-of letting it inform you a truth; the assessment of your situation was not conducted in relational manner that would've been, respectful to your subjective needs, of needing to attach emotionally to someone who was safe, after having exposed who you are, and what your needs are. This the fault of the system, not you.

You are a person, and hence, you will take it personally, it involved you. It is good to relate to your feelings about it; just know that, unfortunately, the practitioners were not taught to be sensitive to your position, and were not taught to extend a personal connection.

There is another viewpoint in psychology that I favor; it believes that any interviewing or testing experience should be conducted relationally, to give the touchstone of safety, that provides the framework, in which to feel safe. If you don't have this, a person walks away, feeling treated like 'a thing' , rather than a person.

Just imagine, being offered, the time to elaborate on a few of the items of your choice. With that interaction, the practitioners would've been understand you more deeply, by getting a fuller experience of you. And imagine, at the end of the session, to sit and process and wind down, from the experience, with one of the professionals.

I would hope that this mechanistic approach will lead to a professional, who will be able to give you the space to represent the troublesome concerns that you want to address, and that are overlooked. It is a drag that practitioners can't see beneath your intelligent presentation.

Sad to say, I have suffered from the same situation, many times. I've finally found a psychiatrist who believes me. It helped that I have happened to come to his office, immediately after being triggered. In fact, today, since I came to the session fresh from a trigger, he was able to see how I was not able to comprehend a rather simple analogy that he made. He graciously slowed down, phrase by phrase, until I could follow the sequence of words, and extrapolate the intended meaning of his story.

I hope talking about the experience on this forum gives you the support to work through a rather disintegrating experience, and move into integration.
 
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Oh gosh, @NovemberStar and @change : what you've written is so useful. Thank you both .

@NovemberStar - your suggestions are spot on...and great minds think alike: actually, I had already written to her that I am not able to handle/process too many topics in a short space of time (this goes for anything, it's not just trauma-related). AND, because I know my cognition in-the-moment is somewhat deficient (aftermath of the stroke), I had prepped really well AND had a list of a few topics I see as priorities (rebuilding my family, finding a place to live/housing issues, finding a purpose for living - which are all interlinked). All flew out the window as I became entangled in their quickfire questions which went all over the place. :-(

I don't think there's another appt on the table though. I believe it's just to be a letter outlining what I called the bunch of things on offer. (Even that I'm unsure about what next is a sort of indication that the appt was sort of messy.) I did have a thought about actually giving/sending them a copy of the email to my friend, as you've also read. It's from the core and uncensored so may have more impact. What do you reckon?

@change - "a disintegrating experience" is an excellent way to describe the appt. Although I know logically it's a fault of the system, not me, I appreciate your pointing it out. It's affirming.

Yes, absolutely: "relationally" - that's what I meant about lack of context and not being able to see a fixed point, way markers and compass bearings. It was all scattergun.

But although it felt like I'd been shredded and inspected for flaws, the practitioners' saving grace was that they were genuinely warm and sympathetic (not empathic though) towards me and open about their quite strong feelings about wanting to help and 'rescue' me - both leaned towards me and even though they were quite far away in a large room I could feel their professionally stifled impulse to hug me almost. Just as openly they both flopped when they talked about how overwhelmed they felt by the problems I've been struggling with. (The psych even got into a muse about how professionals are taught and learn to protect themselves.) So that was relational.

Still, the interviewing/assessment bit wasn't at all. And I wonder, especially as no symptoms were even mentioned (apart from a passing suggestion of depression), how useful their information gathering was. Particularly in terms of it all turning into practical, positive results for my needs.

Thank you for the info about the relational interview/assessment model. (Is there some more info online about this that you'd recommend?) You're right, despite the saving grace of genuine warmth and sympathy, I felt unsafe and, as you know I came out feeling useless, untreatable, broken beyond repair (and a dork for being so confused and apparently not able to fit in to their treatment models). A real disintegration of my logical and feeling brain bits.
 
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This is what I've encountered time and time again, barely able to get a word in edge ways and if I'm lucky enough to my words are either so incoherent - I'm obviously too ill and therefore unable to contribute helpfully to my treatment, or was logical and rational therefore I'm not ill enough to warrant treatment. It's frustrating and devastating for me, it has left me in hospital multiple times and when I was in there I encountered more of the same treatment. I find, I am essentially disbelieved and invalidated in every possible way until I give up and pretend to be ok again.

Recently I had one different experience, but I had to fight tooth and nail to be listened to and nearly ended up in the hospital AGAIN because of them. Honestly, I never self-harmed before I was under the NHS mental health teams, now I'm scarred for life from wrist to shoulder and over all of my legs. It's so frustrating and to know you're not the only one helps and doesn't all at the same time - at least you know it's not personal, even if does mean the whole system is flawed.

And in the mean time :hug:
 
And in the mean time
:hug:Back at you! And thank you so much for your experience.

to know you're not the only one helps and doesn't all at the same time
Absolutely right - it's important to know though because we need to know it's NOT us.

This is what I've encountered time and time again, barely able to get a word in edge ways and if I'm lucky enough to my words are either so incoherent - I'm obviously too ill and therefore unable to contribute helpfully to my treatment, or was logical and rational therefore I'm not ill enough to warrant treatment.
Exactly. Crazy, And crazymaking...which leads to this:
I never self-harmed before I was under the NHS mental health teams,
Like you, I never self-harmed in any shape or form in the whole of my life until I had been terrifyingly stalked for 3-4 years with no one doing anything to stop it. I was totally terrified to the point of wetting myself every time I heard a noise etc and literally hiding behind the sofa. Then the MH team grudgingly came along and the one chap (a MH nurse type?) actually said, "We can't do anything to help you because it's real, it's really happening to you, we can't play with your mind..."

Then a good but monumentally clueless friend told me to, "Pull yourself together!" (Yes, yes she did, those exact words.)

It was the first time ever that I'd hurt myself. Thus began a year of self-harming literally in response to MH and similar others' , at best, utterly useless pontifications. (The at worst was a professional trying to seduce me whilst keeping me trapped in her disordered, manic scenario, and the everyday sheer cruelty and mindbending/gaslighting of our most trusted institutions and some family members and friends.)


I am essentially disbelieved and invalidated in every possible way until I give up and pretend to be ok again.
Ditto.
This cannot be right in any civilised and intelligent universe.
 
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