Re-starting Therapy Or Continue?

[scout86]

But even so I have been hiding from my current T. Not everything. But important things yes. It's not intentional, but I just have never NOT done it.

Do you think the psychiatrist is going to be able to read you any better, if you're hiding stuff?

I think that maybe you underestimate your T a bit,

I know there have been a number of times when my T has mentioned something that he'd figured out and I thought I was doing a pretty good job of hiding. You may not be as good at this as you think you are, she just may be waiting for either you to bring it up or it to somehow come up in the conversation.

 

[HappyJock]

I understand, but you said you are NOW for the very first time trying NOT to hide. That's a majo...

You're right. She's amazing. She's always very, very kind and complementing my improvement. But I've never even brought up these core issues -- every time I go and try, she's so kind, then I feel too vulnerable and appreciate the kindness and then would be ashamed or frightened to tell her that maybe part of my 'symptoms' are improving but overall, I think I am not improving and different parts that I'm not working up or haven't brought up, yes, they are worsening. I just can't get myself to admit it -- I've written it, have planned showing her, I never can once I'm there.

I don't underestimate her, of course not -- but even on the intake I never brought anything up and in general I always pull off a good mood and she sees only what I want her to see -- improvement -- when there's more not, than there are 'improvements.' But yes also parts are improving.

 

[expectingbetter]

I need to say that I see so much of myself in your words!
We are dealing with similar struggles.
Although I don't try to convince my T that I am making progress when I am not actually.
But I also can't force myself to share three crucial things, bcs I am so frightened how I am going to live through my days after it, I am scared of here reaction too, and much more.
And mine are also getting worse.
So I agree that you have a problem with sharing stuff, that's for sure, but please don't try to add a new one to everything by trying to change the people you are working with on resolving your difficulties, it could only lead to a bigger mess.

 

[joeylittle]

Couple of questions - have you asked the psychiatrist what billing codes they are using? Even if they have not given you a complete formal diagnosis, they are required to diagnose you with something on your insurance paperwork. Maybe finding out what that says will help.

And, what is the psychiatrist medicating you for? Is it working?

Finally, have you allowed for co-ordination of care between your psych and your therapist - do they talk with each other? From the way you describe your psych it sounds like they might not be interested in that, but I'm just wondering if that notion has ever come up.

My gut response is that you should just stay with your current combo, as long as everything else about your psychiatrist is working. Ultimately, they are there to treat symptoms. If they are treating your symptoms, and your therapist is really working well for you, and you don't feel like something is missing from your care besides having the words be right, then it's probably OK to keep going as you are.

 

[seedling]

I've had issues with hiding. I think it can be a progression to let go of that.
It's been an important and life-saving coping strategy for you in the past. Let it ease it's way out a little at a time. You don't want to cut your defenses all at once.
Your intention to let go of it is what matters the most right now. As the trust builds you will see the shifts.

When I first went to therapy it was my therapist, a psychologist (Phd), that diagnosed me. My psychiatrist was there to prescribe.
I'm a little confused about how yours can bill the insurance company without a diagnosis. I was told that diagnosing was something they had to do to get payment. They had to be treating me for something.

My psychologist went through all the steps and testing to make an accurate diagnosis. He was very methodical about it - of course, that was just like him :)
I was relieved to have the PTSD diagnosis at the time.

It sounds like your new T is wonderful. I think you can make a lot of progress with her even if you still feel that your psychiatrist's approach is not ideal. The therapeutic relationship is paramount.

 

[expectingbetter]

she's so kind, then I feel too vulnerable and appreciate the kindness and then would be ashamed or frightened to tell her that maybe part of my 'symptoms' are improving but overall, I think I am not improving
.

From this sentence I think that you are hiding the fact that you actually don't improving for the simple reason that you assume you are going to offend her if you are not good enough despite all her kindness. I think that someone who is that kind and caring can only be hurt bcs you are not honest enough so she is not able to help you, and she is not able to help you only for the fact you are not telling her that you suffer more and that has nothing to do with your psychiatrist or with the diagnosis.
Please don't take my words as something too harsh or similar, I only want the best for you as much as I want that for myself.

 

[Sideways]

I talked to my T directly about this issue about a year ago. "My doc says I've got this, but I'm not sure that's the whole picture..."

My T openly communicates with all my therapy team. But he told me that my doc's disgnosis wasn't much more than "an interesting opinion", and said "I'm treating the person in front of me, not a diagnosis".

That was really helpful. It came out that even if my doc's 'certified' diagnosis changed, my therapy probably wouldn't, because me & my T already saw eye to eye on what my problem was, and that's exactly what we were working on.

Your T sounds great - airing these concerns with your T directly might be an easy way to deal with the issue without chopping or changing anything.

 

[HappyJock]

Thanks for all the input, folks! Really eye-opening and something to think about; I'm leaning more towards sticking with my psychiatrist simply because my T. is that amazing. But one of the users, @expectingbetter is also accurate and makes me think -- part of the reason it's hard to tell her is BECAUSE I think I'll offend her and it's just so hard to be honest with someone so, so, so caring and someone who sees so much positive in you that you may not see yourself, it's hard to really be honest and you don't know what to believe anymore, whereas if she weren't so, so, so, kind, I may not have been as vulnerable and may or may not have thrown it out there. But maybe also I've made so much progress because she's so kind. No clue. Having a good therapist is new to me.

As for the other mentioned things, yes, she's great and maybe I'm starting not to hide is a sign that she's doing so many great things that it's working and if I brought my other concerns to hand, that'll also improve. Who knows? I just don't know the other aspects of maybe my psychiatrist isn't good or medicating me right. Previous one said I had this diagnosis, gave me several meds and this one said 'Complete garbage, this illness does not exist. I'll just put Depression. Here are meds. Go to therapy three times a week. You'll feel good."

Another issue arises where I may not be able to be honest with her about any of this here -- and perhaps I have symptoms of a disorder like BPD or DID (just an example) and they are worsening the more I avoid talking about these symptoms, the worse it is for me and my own metal health because I'm too frightened or defensive to be honest. In this case, even if she's so amazing is it really the best option if I'm not being honest? And I don't know what'll happen if I search for a new T, will the same thing eventually happen?

 

[expectingbetter]

The same thing would certainly happen, because it is not likely that you are going to change yourself.
I would start working with my lovely T on the one particular issue, the reason why you are afraid of sharing some stuff with her. I strongly recommend you this. Don't bother yourself with anything but that particular problem right now. Until you solve it. And work on finding the solution with her. No matter how much time it would take, you see her three times a week after all, lucky you :)
and that is the main step you need to take just to be able to continue your recovery.
Good luck!

 

[Sideways]

You're in therapy for a reason. If your T is as good as she sounds, she probably has more insight than you realise. But my experience with T's is that building trust comes first.

So she's waiting. Waiting for you to trust her enough to tell her how it really is yourself. She's compassionate & accepts you as you are, right? A compassionate T isn't going to confront you with "You're wasting my time. Out with it. Tell me what's really happening..."

It's ok that you can't just give her all the gory details straight away. Trust takes time. Try being honest in little chunks at a time, see how it goes. My guess is that she won't be surprised, and her compassion won't falter.

 

[mary1979]

I feel like a diagnosis is only really important to get the right medication.

And for me, my relationship with my social worker was much more meaningful and helpful than my relationship with my psychiatrist.

Also, I've learned in my short time here that most of us are not able to be labelled clearly any one single disorder.

I was diagnosed as PTSD 20 years ago.

Now I see myself in symptoms from depression, border line personality disorder and anxiety.

 

[Suzetig]

My psychiatrist, although caring, is a little blunt and doesn't believe in BPD, Borderline or DID. Basically, more of the personality types of disorders. My therapist does, but obviously she's not at liberty to just diagnose me.

Why is your therapist not able to diagnose? I know in the UK they don't because diagnosis isn't part of their training but I thought that in the U.S. therapists did give a diagnosis at least for billing purposes? It would be worth asking what she is treating you for/what she thinks your issues are. If she's any good she'll be happy to talk about it.

It's not necessarily the case that different conditions need different treatment. Things like EMDR and DBT aware good for trauma but other modalities do work with the person and whatever comes up in session. My experience is that the work can be slower but relational therapies do work for people dealing with trauma. I'd say if she works for you and you're able to see progress, stick with her.