Six Ways to be The Persecutory Therapist *cue the thunder and lightning*

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Six Ways to be The Persecutory Therapist *cue the thunder and lightning* Link

I am having a very messy ending with my current psychiatrist.

 

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I am really attached to my psychiatrist. I have a lot of appreciation, gratefulness, and TLC for her. It has been a difficult therapy situation as I often felt unheard by her.

 

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My psychiatrist and I have been discussing her retirement since about 2024. She said once her practice building was demolished she would retire. This would be in 3-6 months. I have tried to get a referral from her. Which I finally got this week, when invoking a legal aspect of a fiduciary duty, also known as a duty of care. After delaying for a long time she was able provide two referrals.

The time of her retirement has continuously changed in a confusing and strange manner.

At one point the building could have been demolished within a month or so. The council didn't pass the plans. So that didn't come to pass.

Then she wasn't going to retire but she was going to go in with a couple of mental health professionals.

She said that she would work one day per week from another set of rooms. She said that she would have to change my appointment time. (Which is ironic because she had previously totally committed to changing my appointment time to enable me to attend classes. After four or five months I gave up asking).

After a great deal of uncertainty her time of retirement went back to she's retiring in 3-6 months again.

This week (when, at my wit's end), I sent her an email mentioning a duty of care re a referral, transitioning, a copy of my notes, and a report so I can make a claim on my mother's estate).

She finally sent me an email saying she would retire in about 18 months. This is the first time I have heard her mention that particular time span.

I think and feel that this meets some of the the article's criteria which is linked in the first part of this post.

It meets some of the criteria of "Intrusion," "Derogation," "Invalidation of Experience," "The Opaque," and The Untenable Situation". And all these criteria are met in my overall relationship between my psychiatrist and my self.

 

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My current psychiatrist has been transferring and transitioning her other clients. Two went really well. One went badly in a significant way. She's put a lot of time and thought into managing these clients.

I expressed my concerns to her about transferring to another psychiatrist. She told me that she would do a deep dive. And would find me someone good. That I could trust her. She would take good care of me.

If I brought up my concerns she would belittled me and denigrate my concerns. I tried to say there weren't many psychiatrists here and so forth.

I told her about a good psychiatrist last year. She told me we had plenty of time. I tried to get a referral from her. Last time I spoke to her I told her that psychiatrist has now closed her books.

When I mentioned duty of care indicating a legal framework. My psychiatrist was suddenly able to get referrals sent out over night. One of the referrals she sent me was for the psychiatrist who now has her books closed. That seems petty to me.

 

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My current psychiatrist tried to bully me into going to a GP, telling me I can access medications via her. I am on a complicated medication regime. She has laughed at my GPs lack of knowledge during the last decade. I actually stood up to her and said no. I don't know who was more surprised, me or her.

 

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If I brought up my concerns she would denigrated me and dismissed my concerns.

I tried to say there weren't many psychiatrists here and so forth. She is now citing "a lack of supply" as why she couldn't help me.

 

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My psychiatrist has done this to me before.

She has been delaying and withholding previously.

My psychiatrist kept saying that she would change our appointment day and time. Each time she would say "Don't worry about it. I will take care of it. I will take care of it and find you another time. We will fix this next times". She would say this at the end of each session. So I could attend these multiple Irish classes on a Tuesday. Which could lead some other options and chances.

The classes had the potential to provide me with a range of opportunities.

Progressing with my peers.

Graduating with my peers.

It could have included. a few hours of paid work. And an ability to grow a bigger social network.

I kept explaining this and she kept saying she would find another time and day for me.

After many months I gave up asking. I felt like she sabotaged an important opportunity for me.

I wish I had thought to cancel each Thursday for the Tuesday appointment until she found another appointment.

But I was too intimidated by her. The unequal power relationship left me at a disadvantage. And I felt overwhelmed by her. She would have goes at me that destabilized me.

 

[Movingforward10]

Gosh, I would find all that really destabilising.

I was thinking about the 'opaque' quite a bit when you were writing aboit her retirement plans.
I can understand someone's retirement plans changing as it is such a huge decision. But a mental health professional, I would expect them to know the impact all those changes would have on a client. And to be explicit and acknowledge the change, and invite discussion about how the change is impacting.

I don't see the referral being petty (of the person whose books are closed) but a other sign of her incompetence (that word might be too harsh to describe it but I couldn't think of another one - essentially , it doesn't read as deliberate more careless because there seems to be a theme of carelessness or adhoc-ness about her approach).

There is also clearly a disorganised element to her, which has impacted you . One example is not finding another appointment time so you could do the course. The constant promising and reassurance. And then failing to deliver. That is really very poor. And it sounds like she has never acknowledged that either, or done actions to change that. Of course you will give up asking.

I wonder how you can take your power back in this relationship?
Can you spend the next session making referrals together or something that helps you feel like there is a good plan in place for your ongoing care?

Whilst she now says there is 18 months, do you want another 18 months of this? Or a referral now to someone more able to be consistent and aware?

 

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Is your psychiatrist just prescribing medication? With all the changes in health care and lack of access I asked my primary care provider if she would take over the prescribing of my escitalopram. She said yes.

 

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Is your psychiatrist just prescribing medication? With all the changes in health care and lack of access I asked my primary care provider if she would take over the prescribing of my escitalopram. She said yes.

I apologize. You have a more complex medication regime. I just read your post about this issue. I you have been bullied I would think it has added to your trauma. I am sorry. Is a psychiatric nurse practioner a possibility for you?

 

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I don't know how I am going to make it through this separation with my psychiatrist. And that is okay because I am going to learn a whole lot of new skills along the way.

There was no need for it to end this way.

Maybe she just doesn't know what to do with me? Why didn't she refer me on?

She has said she didn't understand what was going on with me. I just don't understand why she didn't ask a range of questions.

There is the problem as I also did not feel safe with her. I tried to Byng up issues in our relationship and she arroyo old cut me off. Sadly she's really only seen the freeze and fawn parts of me.

She would denigrate when I told her about my parts connecting up. I wish I could have stood up for myself. I couldn't. It was the best that I could do at the time. This is where developing a set of kick arse Self Compassion practises and meditations is going to be so crucial for me to get through this. There are things I can do to really help myself during this difficult and heartbreaking times.

I do have disorganised attachments so perhaps we weren't a good match. Or maybe our main relationship was about me staying in contact.

There will come a time when I know longer think about this. I will have processes it and I will move on.

It is so confusing to me and scary for me and my little parts that it was only when I hinted at a legal/complaints process that I finally got referrals out of her. They were overnight emails. She didn't wait 24 hours to get them to me whew duty of care. This is after me repeatedly sending her emails requesting that our next session be only about getting referrals and working out which psychiatrist could be a good fit for me. I have asked for this many times. Throughout various emails and verbal requests.

This morning I listened to two critics critiquing the work of a singer. I had my eyes closed and I listened to it it a meditative way. It was a good distraction.

I don't want to get to spiralling as around all this. It is difficult given the unprofessional things she said to me.

It is going to be up and down for awhile given I have to find another psychiatrist.

My PTSD cup is overflowing so my expectations are low at this time. I will just do the basics, if I can.

I don't want to be in this process with this situation.

But it was better to be honest, challenge her and bring it to a head. There's no pretence now that she will do any of the things that she promised to do around me transitioning to a new psychiatrist. That was brave given the unequal power balance of our relationship.

It was painful, her unwillingness to do the basics of her professional duty.

 

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I wonder how you can take your power back in this relationship?

Yes I have taken my power back by cancelling my last three sessions, writing her a detailed email and I wrote a blunt email hinting at 'duty of care'. Which invokes legal/complaints processes.

Can you spend the next session making referrals together or something that helps you feel like there is a good plan in place for your ongoing care?

I have written her multiple emails requesting that we spend my entire next session on identifying potential psychiatrists and getting referrals to them.

She has done this with other clients last year. Two went well. One went badly. So she has been providing referrals, names of other psychiatrist's names, copies of notes and reports for her other clients.

I don't know why she wouldn't do that for me. Perhaps because of her heroic prescribing or because she didn't know what was going on with me. (She told me this.)

In further emails to her I have requested that our next session be dedicated getting referrals written (she has a template she uses) and working out which psychiatrist/s in my area, could be a potentially good fit for me.

I have asked her directly for this many times. When I made verbal requests she mocked me, told me that there was plenty of time, she would do a deep dive, she would find me someone good. I was not to worry about it. She said that I could trust her. She would look after me. The longer the months passed the more I would ask. The more she would belittle, mock and denigrate me. That I had nothing to worry about. That we had plenty of time.

Yet she has signed off on other clients.

So I have cancelled my last three sessions because I was having high anxiety and I was getting upset at her mocking, belittling and denigrating me for my concerns around transitioning to another psychiatrist.

It is urgent for me to find someone as if her building was knocked down then I would have no way of contacting her.

I have a complicated and unusual medication regime. So it needs to be a psychiatrist with experience. My body does weird things with medications.

The council denied the most recent building application of the building she owns. All the way along during the talks of her retirement she had said that she would retire in 3-6 months when her building got knocked down. She has been saying this time frame for a couple of years now.

When I last asked her verbally, she mocked me and told me no other psychiatrist would be bothered to work with me given how much psychotherapy that she had done with me. (I don't know when we did psychotherapy - you have to listen to your client and make sure that they feel safe - I don't dare say that to her because she would get very angry). I wasn't really worth her working with as I never got on top of my anxiety. That's her problem and not mine. I really worked hard. I value what we did. She did not.

My current psychiatrist also said a range of unprofessional and unkind comments that I put in my diary. I was very specific in questioning her that session. I asked detailed questions about the comments she made because I did not want to end the session and not be clear about what she was saying. So I did do explicit fact checking. I am proud of myself for being able to do this. It is the work that I am doing with my trauma informed counsellor really paying off.

Recently I sent two respectful but pointedly angry emails to her.

In the second email I hinted at a "duty of care" legal/complaints process and I finally got referrals out of her. The barest minimum of what she could provide. It's a win so I will take it.

She responded pretty much immediately. She didn't wait 24 hours to get them to me when I mentored "duty of care".

She said there was a lack of supply of psychiatrists in my area. One of the reasons that I pushed for a referral which she belittled me for worrying about was a lack of psychiatrists in my area.

I have been proactive in trying to get my situation resolved.