Interactions with Mental Health Professionals

This topic stems from an idea that I had in relation to the post Be Your Own Advocate.

It’s something I occasionally allude to on my personal blog and in my comments on others’ blogs. Over the last two and a half years (has it really only been that long?), I’ve learned a lot about how to compose myself when discussing matters with other mental health professionals.

First, let’s go over my successive period of interactions with mental health professionals. I’ll start with therapists, then mention psychiatrists:

Therapist #1: The only male therapist I’ve ever seen. I saw him from about fall 2009-spring 2010. He had a home office. It often seemed to me that he didn’t remember what we’d talked about before. It disturbed me that he didn’t take notes, and I wondered if that was normal. Sometimes he wouldn’t have any shoes on, just socks. I understand why you might walk around like that in your own house, but I found it irritating and unprofessional. During the first few months, I thought that I didn’t see any benefits because therapy took time. Then I realized that he would never be helpful for me. Still, I kept going because I was petrified of telling him that I didn’t want to see him anymore. Finally, I canceled an appointment and never called back. Maybe not the best course of action, but it was all I could do.

Therapist #2: I saw her for a couple of months. She was on a list of people recommended by the school where I was pursuing graduate studies. I got my Master’s in May 2010, which is why I saw her for a short period. This time, armed with my other therapist experience and tips from people on a depression forum, I called a few therapists and asked some questions. I felt unsure about the one I chose, but I’d asked her so many questions and spoken so long to her that I thought it would be misleading not to become her client. I was afraid of telling her never mind, so I tried her out. Sometimes therapists just sit there and wait for you to talk. She did that all the time. It was not useful in the least. Although she did teach me breathing exercises to calm anxiety. Not that I ever use those.

Therapist #3: She was a recommendation from a GP. She was headquartered in my hometown. My first meeting with her freaked me out because she said she believed I would commit suicide one day if I didn’t get help. She gave me an assignment to write my life story, and I wrote 10+ pages. I was excited to finally be given homework by someone. But apparently people usually wrote only 2-3 pages, and she would ask them to read it aloud. Good thing I wrote too much to do that. I don’t think I would’ve been able to do that without shaking, blushing, and freezing up. So she read it before our next meeting. Now, I am a stubborn person, especially when it comes to thinking for myself. Unless I understand and agree with a thought process, I won’t follow it. I ask people questions and argue with them a lot so I can understand what makes their line of reasoning valuable, not for argument’s sake, as some people in real life seem to think. I won’t go along with anything unless I understand the logic; I’ve been that way my whole life. This therapist told me I would have to give up that way of operating because she’d seen others like that stay miserable because they weren’t willing to do so. I told her that giving that up was like asking a Christian to give up their religion. I felt that was a blasphemous example, but true. At least I was honest and not just going along with the therapist as I’d done with Therapist #1. I’d learned to express my needs, even if I felt panicked and guilty for my ideas.

Therapist #4: My current therapist. There was a five month or so gap between the previous one and this one. I’d moved. I was afraid of having to assert my needs all over again and exhausting myself in looking for another therapist. It wasn’t until I got a referral during my trip to the ER that I found her. She works well sometimes, but not at other times.

Psychiatrist #1: The one I saw in graduate school. At first, I was afraid to do anything but just take whatever he prescribed me. I think he’s probably the best psychiatrist I’ve had. I went through a period during which I intensely disliked him and thought he did nothing but throw pills at me. Compared to my other ones, he’s done that the least, however. He was good about explaining the particulars of what he was prescribing me and why. To this day, I’m on a low dose of Wellbutrin. The one I started with, in fact. I wrestled a while with the Wellbutrin because it miraculously helped me to think again, but it heightened my anxiety, especially its physical symptoms. When he wanted to increase my dose, I was adamant about not doing that because I was afraid a higher dose would give me a higher level of anxiety. He listened.

Psychiatrist #2: Hometown one. He weighed me, which I’d never done with a psychiatrist. He prescribed me Prozac and Klonopin. He was rather young and listened to me, but it didn’t seem as thorough as my first psychiatrist.

Psychiatrist #3: A composite of three people I’ve seen at the place I currently go to, actually. The first one just threw Abilify at me. With the second one, I had a harrowing encounter during which I felt attacked. I was able to get a bit of usefulness from his appointments, though. Not because of anything he did, but because I would tell him as much as I could about my issues. This was not easy. Oftentimes I had to dissociate in order to be able to do it. But I’d learned that it was the only way to receive any benefits.

Through these encounters, I’ve learned that one must be assertive while talking to mental health professionals. Otherwise, I’ll get thrown prescription after prescription, many of which may not be just unhelpful but also a bit harmful. Otherwise, I’ll sit in therapy skirting around the issues. (I still haven’t fully resolved that problem. That might be because I don’t yet fully understand my needs. But some of it is also fear of asserting myself. I’ve learned to do it more often, but that doesn’t mean I’m perfect at it by any means.) Otherwise, I’ll sit in therapy listening to irrelevant suggestions.

But when so many of us are bashful about our issues, how can we be assertive? Especially if you’re someone like me, for whom social anxiety is a strong daily presence?

I’ve found that my stubbornness is what personally helps me. I’m determined to be as self-sufficient as I possibly can. I believe that’s an innate trait of mine.

There’s also dissociation . . . which perhaps isn’t healthy, but perhaps if it’s the only way I’m able to communicate my needs, it’s a necessary evil?

The bottom line is, we’ve got to lay all of our cards on the table (or as many of them as we can) so that we can get the help we need and deserve. This would make most of us uncomfortable, not just those with social anxiety. Our issues are private matters. Many of us try so hard to hide our issues from others that it feels awkward to be forthcoming about them. We’re sensitive about our issues. We fear that the professional may call us inadequate.

But those are all risks we have to take. No matter how scared it makes us, we have to be frank about our issues. Maybe it makes sense. After all, the professionals aren’t in our heads to see what it’s like in there. We have to share the uncomfortable, the private, the downright terrifying, with people who are pretty much complete strangers. That’s a hard leap to make. Attempting it can trigger our issues, but not attempting it can keep us from getting better.

So how can we make this leap?

It’s probably different for everybody. You’ve got to try various tactics until you find what works. After you’ve found it, it still might not be enough. It might take years to chisel through and find the right way to do it, a way that both doesn’t trigger you and ensures the professional knows enough to help.

I’m still not there. Yet through it all, knowing that I have the ability to think helps. Somewhere in me, I know precisely what’s going on. One day, I will discover it. Then another day, I will learn how to express it.

As long as we stay true to our selves, our instincts, we can learn to cope. We can use that to assert our needs. We can use it to reject what may not help us, and we can use it to understand ourselves and our needs. In doing so, we can eventually guide professionals to the path we require.

And for people like me with social anxiety, we have to believe in those things so much that it endures, it evinces itself, amid the social anxiety.

This seems to be the best course, at least to me.

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