topic Not sure psychologist is going in the right direction with me in Treatments, health professionals and therapies

Not sure psychologist is going in the right direction with me

corbeau — Sun, 01 Feb 2015 07:35:23 GMT

Hi all.

A couple of weeks ago I had my first ever appointment with a psychiatrist. I went to him wanting help with controlling my moods. Based on my answers to his questions, and information I had volunteered myself, he said I have borderline personality disorder, but a mild form of it. He also said I have social anxiety and mild depression, and he prescribed me some anti-depressants. He also referred me to a psychologist in his clinic to go to appointments with.

I had my first appointment with the psychologist last week, and I don't know if he is taking on-board what the psych doctor said and what I want help with. He is focusing on me having anxiety, and wanting to treat that first. Whereas I don't think I have a huge issue with anxiety. He said I am not clinically depressed, which I already knew, but it is a milder depression that is pretty much always there. After him not mentioning any therapy at all for the borderline personality issues during the hour-long appointment, I asked just before I left if we would start something for that soon. He said he is not convinced I have bpd and that he wants to make his own decision on that, and that you can't do that in one session.

So here lies my confusion. A psych doctor, one that is in the same office as him, believes I have mild bpd. Mood swings and bursts of furious anger are a major reason I have sought out psychological help. Yet this psychologist that I need to have weekly appointments with might not even help me deal with those issues because he's not convinced I have it. Getting help with my social anxiety and self esteem issues would be marvellous, and that is what he is focusing on first. But social anxiety doesn't affect my life in the way that my constant mood swings and taking out my anger (over nothing or something tiny) on my partner does. If this psychologist is going to continue treating me for anxiety that I don't believe is a huge problem, do you think I should try find someone else? Is it normal for a psychologist to disregard what a psychiatrist has found in their appointment? Thanks in advance.

Not sure psychologist is going in the right direction with me

CrashCoyote — Sun, 01 Feb 2015 13:12:14 GMT

Hi corbeau,

It is always an option for you to see someone else, but make sure it is for the right reasons. Not liking the message isn't a good reason. If you think your psychologist knows his stuff, you need to trust him to do his job. I think one session is not enough to write him off, it takes time to bond with any health professional and you are one of many patients. He will need time to get to know you.

The psychiatrist is a doctor, the psychologist isn't (unless it is in another field). Think of it as the difference between your GP and your physio. The GP has superior medical knowledge but the physio treats more knees in a month than the doctor will see in a year.

Kind regards, John.

Not sure psychologist is going in the right direction with me

geoff — Sun, 01 Feb 2015 14:14:28 GMT

dear Corbeau, well not all doctors or psych's agree on a diagnosis, only because they may have had more experience in particular field than the other person.

He maybe treating your anxiety as a way of getting to know you, and edging his way into finding out what you are suffering from, so see if you can relate to him and vice-versa and let us know. Geoff.

Not sure psychologist is going in the right direction with me

Kemiri — Sun, 01 Feb 2015 16:36:59 GMT

Hi Corbeau,

Up to a point I agree with the previous two answers: no doubt it is true that doctors and other health professionals disagree about diagnoses and treatment programs and all that, and it's also true that you need time to build a relationship with your psychologist. BUT if you are uncomfortable or doubtful about the direction the psych is taking, I certainly think you should mention this to him. I assume he knows about your problems with mood swings and anger, and how you take that out on your partner, so I'm amazed he doesn't see that as a priority. In any case, I would have thought a psychologist (unlike a doctor) is not there to diagnose you but to work with you in identifying what is causing problems in your life, and to help you work through them. If you mention to him your doubts about his approach and he still insists on proceeding the way he wants to, I would suggest that you seek out someone else who is more responsive to your needs.

With best wishes, Kemiri.

Not sure psychologist is going in the right direction with me

corbeau — Mon, 02 Feb 2015 03:19:56 GMT

Thanks for your replies guys.

I had another appointment with him today, and after getting me to fill in some worksheets about exposure to phobias, he straight up said he doesn't think I have borderline personality disorder. He hasn't asked me any questions regarding why the psychiatrist thought I had it, no questions about my mood swings, no questions about bursts of anger, no questions about episodes.

I am not a forceful person (apart from with those I am close to) so I think I wanted to think it over and didn't say anything to him in the session about it. I personally feel that, if I do not have full blown bpd, that I certainly display traits of it. And they have an impact on my life, otherwise I wouldn't have sought help.

But I am not a psychologist and I know he knows more than me, obviously. I feel like if he's already said he doesn't believe I have it then he won't be looking to help treat those symptoms. I know that treating my low self esteem is at the root of a lot of my problems.

But he is really pushing the anxiety thing and talking about exposure therapy and honestly, I don't have anxiety that is bad enough to warrant that.

I feel as if he has formed an opinion on me already in his head and that's it. He talks a lot during appointments and it kind of feels like a class. I'm hoping that I will get the courage to mention my thoughts, or I hope that all this is some round about way of treating the bpd issues.

Not sure psychologist is going in the right direction with me

Beltane — Mon, 02 Feb 2015 08:10:39 GMT

I have a few issues with whats been going on with the psych...

1. Psychologists aren't qualified to diagnose. Your psychiatrist IS. Now, if after a while of treating you your psychologist has an opinion on diagnosis, he will let the doctor know, but its still the doctor/ psychiatrists job to diagnose- not the psychologist.

2. You need to trust your medical professionals. Simple as that. This is the person you're relying on to help you fix your issues and deal with your symptoms.

At the end of the day, it seems your current psych just wants to quibble over the labels given to your symptoms and decide FOR YOU what symptoms hes gonna work on treating. Uh, how-about no? At the end of the day, the label isnt so much important as just focusing on what you feel are the issues.

I learned that the diagnosis only matters so much. yes it can help with finding the right treatment. But what if the diagnosis doesnt quite fit your symptoms? then everyone argues over it, and throws different treatments at you. When really all they have to do is what you suggest- just listen to your symptoms, listen to your issues, get to know you as a person over a few weeks. I had a similar issue, switched GP's and psychologists to find people who wanted to treat me as a whole person than as a medical diagnosis. and you know what, after a few weeks getting to know me, they actually figured out the correct diagnosis when no-one else had. And the treatment worked liked magic!

So your psych should care less about insisting you have (or dont have) whatever, and more time just listening to your issues!!!

you should feel free to find another one. Infact you can do a search on google and find websites for psychologists in your area, often they show photos and give a bit of info about the psychologists they have on staff. You could find one that you like the sound of (or one with experience with BPD), ring up and make sure they can see you as regularly as you want to go, and then go to your doctor and ask for a referral to that person.

Not sure psychologist is going in the right direction with me

Pergatory — Mon, 02 Feb 2015 11:15:53 GMT

When I was first diagnosed with bpd 15 years ago it was quite foreign to me. I listened to the professional advice given and immediately felt I should take responsibility to get to know me, the disease, and how I could prevent future 'attacks'.

I started with a very detailed diary every day, and then as I monitored the symptoms, I realised I was being too detailed and jumping at shadows. It's like monitoring your weight on a daily basis, where deviations are to be expected but are not indicative of suddenly ballooning out or shrivelling up like an anorexic.

So the diary stretched weekly and, as one Psychiatrist said - Don't tell me what your symptoms are - how do you feel?? That was my turning point. And I said I actually feel OK. But I kept up the symptoms in my diary, and although I had to have the episodes I had to do this, I now have a checklist from whoa to go to keep me out of involuntary 'confinement'.

Starting at a baseline of quarterly confinement, I can now 'nip' my episodes in the bud, take double my dose in the 'bad' times, and now 18 months down track I am episode free, have a full time job, and 'trained' my partner with the earliest symptoms and full list, which I keep on the fridge door.

You are the best judge of how you feel, and everyone is different. Keeping a diary, like a food diary, will not only give you insight into any condition you may have, you can also discuss this diary with a mental health professional.

All the best with managing your condition.

Not sure psychologist is going in the right direction with me

corbeau — Mon, 02 Feb 2015 11:33:50 GMT

Thanks for your replies Beltane and Pergatory.

I did think it was a bit weird how in my first appointment with him, the psychologist didn't ask me a lot of questions or ask me to tell him about my life at all. He'd read from the referral about me and what I had explained to the psychiatrist that was given to him and for some reason zeroed in on anxiety as THE issue. I've barely said boo during the 2 appointments, it's mainly him telling me about anxiety and worksheets and the treatment for it, which may just be his style. I think if I don't feel more optimistic after another appointment I will look for someone else.

And Pergatory, thanks for the tip on the diary. I've attempted these in the past but didn't keep it up so may actually do it now that I'm seeing a psych!

Not sure psychologist is going in the right direction with me

Beltane — Mon, 02 Feb 2015 12:23:36 GMT

To give you an idea, I soend at least half my appointment doing the talking. Like usually I arrrive with a particular issue or problem I wish to discuss, maybe something that's bothering me, and I'll talk about it. Then we'll have a discussion about what we think is going on and some solutions. she says something, I say something. We work together to fix stuff. She obviously has tonnes of ideas, that's her job, but she often seeks my thoughts and opinions, I guess she's trying to teach me how to sort through my own thoughts so eventually I can be my own psychologist, if you know what I mean. But she always asks me what I think, and if she gives me something to take home to try like a technique, or even a book to read, she always asks me how it went and then responds appropriately.

so no, I really don't think you should have to sit there and be talked at all day. You're supposed to be talking- getting out all your thoughts so they can help you deal with them. Sounds like hEs barely heard anything from you and is just treating you like an illness, not a person.

yep I definitely reckon a new psychologist is a great idea.

as for Pergatory's idea about a diary- fantastic!,, there's lots of ways to do this, there are iPhone apps if that's more your thing.

I myself have two diary type things.

Pone is an iPhone app called "optimism" designed to keep track of mood, triggers, symptoms and stay well strategies. You can go in and edit literally every single thing to set it up so every ting suits you. it keeps a chart of your mood, sleep, energy, exercise etc so you can see really easily if say a bad nights sleep affects your mood. you can list all your symptoms, mood triggers, and what keeps you feeling good and then every night at bed just check "yes" or even rate on a scale of 1--10 on everything that allies for that day.

I used to use it a lot when my mood was unstable, now I'm stable I usually don't need it, as I've learned more about myself from the app.

my other thing is a beautiful journal I have. Every night I write on the right page, and on the left page I glue in printed photos of the day. Not every day has photos obviously, but Im trying to get photos of family and memories etc. the rule is, the journal is full, of good things- lovely memories of each day. If something bad happens, I mention it but not focus on it- I focus on the good, it makes me focus on the good, and is getting full of memories of each day 🙂

Not sure psychologist is going in the right direction with me

CrashCoyote — Mon, 02 Feb 2015 13:20:32 GMT

Hi again corbeau,

Beltane is right, I think. Normally it is the patient that sets the agenda for the session. I have been seeing the same psychologist for three years and we may talk about a myriad of things on my mind but it always starts off with her saying, "How are you?" and I respond with, "Well, I am really........." and so it goes.

She did accept the diagnosis made by the psychologist and that is the template we work from.

If you have given your's a chance and are not happy, look elsewhere! Sessions are not cheap and can't be squandered!

Kind regards, John.