Thursday, January 24, 2008

Something finally clicked

Obviously something finally clicked and I found a tag line that I liked. The cold & brutal came not only from the deep freeze we're currently in and having to shovel snow in the subzero temps nearly every day this week, but also from a lovely email comment I received from someone who was displeased by my post on addiction. Their comment involved more than just the words cold and brutal. Ignorant was also thrown in, as was retarded bitch, and a few other very descriptive adjectives.

I knew I'd catch flack for it, but I didn't care. The thoughts were in my head and I voiced my opinion on my blog. I never once said that addiction isn't a very serious problem with devastating consequences. I merely stated that at this point in time, based on what I've read, I don't believe it's an illness unto itself. In no way is that "deluding myself to the truth". Why would I need to delude myself about it? I'm not an addict. I have no need or reason to be in denial over anything involving addictions.

Anyway, I saw the pdoc today. He had a med student working with him who came and got me from the waiting room. I was incredibly anxious and pissed as hell so as we approached his office and she asks me if I mind if she sits in on my session, I said "yes actually, I do mind" and proceeded to close the door on her before she could say anything further. Rude? Probably. But it felt good to speak up about how I felt and didn't allow this strange person to be in the room with me, which I knew would only make me more anxious.

I told him about being off the MAOI since the 13th, which he didn't have a problem with. It made his job easier in that he didn't have to wait to prescribe me anything new. He wasn't too thrilled that I also took myself off the Cytomel, but oh well. It's not his body he's playing chicken with. After I again explained the various reasons why I didn't want to be on it, he was a bit more understanding, but still didn't seem happy that I made the choice on my own without consulting him. I voiced my concerns last month when I saw him that the Cytomel was making me fatigued and increasing my rage, but he dismissed them.

Other than severe anxiety and rage, the depressive symptoms have held steady at a tolerable level. I think that is mostly due to the fact that for over a month now, I didn't have to put any focus on the fact that I'm mentally ill. I was busy with Christmas and all the fun surrounding the kiddie's birthday, and while stressful, it kept my mind occupied. I did have that one moment where I completely lost it two weeks ago when the new therapist cancelled on me, but I put it out of my mind after about 24 hours when I finally calmed down.

Given how I'm feeling, the pdoc decided against the Celexa and put me on Buspar. He said it should help with the increase in anxiety, and may help with the rage, since I told him I did not want to increase the Valium. Valium is one of the few meds that truly works for me and I'm not willing to risk raising the dose, becoming addicted to it and rendering it ineffective.

He wanted me to make an appointment to see him in a month. Problem with that is I will only go to his office first thing in the morning because otherwise it's way too crowded for me to sit in the waiting room (it's a rather large practice with at least 10 pdocs and probably 20 therapists). Thursdays are the only day of the week when he works in the morning and I guess he'll be out of the office for several weeks in the coming months. So I had to make an appointment for two months out. I didn't have a problem with that, but the receptionist did.

"Are you SURE you can't come in the afternoon?"

"I'm SURE that I don't want to be stuck in a full waiting room with all the noise having a massive panic attack. I can wait the extra month. If I have any problems before then, I'll call him."

He also asked that I sign a release so he can talk to my therapist "if he needs to". Just the way he said it made me feel like he's fishing for a reason to stop treating me. I conveniently left without signing one. If I had asked at the receptionist's desk, they would have wanted me to fill in the woman's name, address and phone number, none of which I had with me, so it would have been pointless. Plus I already know from past experience that they won't even let me take the form home, fill it out and bring it back. It has to be filled out in front of them so they are witness to the fact that I am the one giving the authorization.

Speaking of therapists, I never did write about what happened with the appointment I went ahead and attend on Monday. I made sure to show up with everything asked of me...and then some. In addition to the med compliant letter and a list of goals, I brought in copies of the emails from the first time I walked out on the ex therapist, as well as a history of the problems I had with her (such as the details of our 5th visit when she turned on me for no reason).

Since so much was being expected of me in order to be treated, above and beyond the normal expectations of a patient, I also brought along a list of expectations that I have of a therapist. If they're going to make me jump through hoops, why not make them? It's only fair. I know that I'm not the easiest patient in the world to work with, but not everything that's gone wrong in therapy is completely my fault. I'm not always the bad guy and I made sure that this new chick was well aware of that.

We didn't get far in discussing the goals, since we started with my expectations of her as my therapist first. Her only comment about the goals was that everything sounded like stuff I could learn in DBT. I explained my past experience with DBT and said I didn't find most of it useful. So my homework, which I assigned myself since she seems to be on the DBT is the perfect cure-all bandwagon this whole mental health center seems to be on, is to go through the materials I have and write down what I thought was helpful and what I thought was crap. I'll probably spread it out over the next several visits though and do it by section since so much info is provided in each one.

She did like that I was the one that offered to do this homework. She certainly can't say I'm not interested in trying to make therapy work for me. Even the expectations I had of her as a therapist mostly leaned towards making therapy work for ME. I don't fit the nice little mold that so many others in therapy seem to fit in. The treatment guidelines need to be flexible and I clearly explained why. Of course I explained that to the ex therapist as well and she didn't get it. Hopefully this one will.


Anonymous Borderline Crazy said...

Bummer about the mean e-mail. I hate those. I get them from my blog too. I'm like, it's MY blog. The point of a blog is to voice MY opinions. Sigh. I hope you have success with the BuSpar. Some people say they can't even notice any difference from it because it's so mild, but it has a spectacular effect on my anxiety. Perhaps you too will have the necessary lucky biochemistry!

6:29 AM, January 25, 2008  
Blogger Polar Bear said...

It's great that you seem to be taking steps in getting your needs met and not being afraid to stand up for yourself. I wish I had been there to see the face of the student when you closed the door in her face! LOL.

I hope things work out with this new therapist. You deserve to get the help that you need, and it's true that borderlines generally don't fit the "mold" and may be more "difficult", but I believe that good therapists should be able to negotiate a safe and secure environment and provide their patients with the best care possible and provide a basis to build a trusting relationship.

1:41 PM, January 27, 2008  
Blogger MB said...

I know med students have to learn, but the pdoc should have asked you personally if it was ok prior to the meeting. And what is it with receptionists? When you say you're unavailable on a day or afternoon, that's exactly what you mean. It gets me really ratty when I explain everytime I see the dr or dentist that I can't make a certain time or day because of work committments. It's as though they don't believe you, or that you're being awkward, it's really irritating. I'm not coming out of work simply for a check.

And good for you with setting boundaries with the new therapist. At least you will both know what to expect from each other, and from the therapy!

4:04 PM, January 27, 2008  

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