I read a list post yesterday from a good friend, a bipolar, whom
I'll call John. It almost broke my heart:
I went to my second appointment with the new therapist
yesterday and it was hell. I first tried to inform her of the events of the
weekend. I had the worst episode I have ever had. I explained that I could and
would take the anti-psychotics now.
She began asking questions as if to discount what I was
saying. It appeared she was discouraging me from medication altogether.
She carefully turned the conversation to her agenda as she
began explaining "borderline personality traits". She asked if I
knew about borderline personality. I told her some of the things I had learned
but kept back the fact that I knew the prognosis was bleak, and even if some
resolution was possible reoccurrence was likely.
I had a hard enough time hearing the words "bipolar
disorder" (BP), and then she said I have the double whammy of BP and BPD.
Well, I felt that sinking feeling as if I was dying inside forever. I was
silent as the battery of information she selectively read crushed me, in an
apparent effort to prove her theory of a new and more devastating disorder.
I left feeling so empty inside and lost -- not sure if I could
handle another blow to the old self-esteem. I have liked all the therapists I
have ever had, but this woman was without compassion, without any insight as
to how I might react to this.
In group I was asked why I didn't confront her about my
feelings. I was encouraged to go back Monday and explain to her that she was
moving too fast and squashing my self esteem.
John
John, no
therapist has a right to push you around like that. And she is pushing
you around. To go back to her and explain that she is demeaning you is to imply
that she does not know what she is doing. She does.
It's the
same old problem: labeling. Human beings love labels; labels simplify things so
nicely. Fine. But, psychiatrists, please, hold off on labeling people!
OK,
psychiatrists may need to silently label their clients. But they don’t have
beat their clients over the head with the labels. And they certainly don’t
need to try to convince their clients that a particular label applies to them,
as if they were potential religious converts.
Here's a
possible scenario that involves no
labeling:
Psychiatrist: How are you doing?
Client: Last weekend, I had the worst episode I ever had. I'm
ready to take anti-psychotics now.
P: What was your episode like?
C: I had terrible hallucinations . . .
P: Anti-psychotics are effective for hallucinations, but there
are other drugs that may be more effective for your particular hallucinations.
Would you like to read some of the studies comparing the effectiveness of
these drugs?
See how the
psychiatrist was informative without being pushy, suggested treatments without
labeling the client? It can be
done.
John, you
may wonder what will happen if you assert your right to this kind of treatment
next time you visit your psychiatrist. Will she cut off your meds? No. That
would be against the law. The most she could do to you is transfer you to
another psychiatrist.
The best
approach would be to gently explain to her that you really don't care what your
label(s) is/are, that you just want to find the medication that will best treat
your symptoms. If that medication is normally used to treat borderline disorder,
so what? Bipolars often respond very well to medication normally used to treat
epileptics. That doesn't make us epileptics.
.
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