tag:blogger.com,1999:blog-26666124.post4217718384651016687..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: How Do You Switch Docs?Unknownnoreply@blogger.comBlogger15125tag:blogger.com,1999:blog-26666124.post-45010545971706400992011-01-20T15:28:20.411-05:002011-01-20T15:28:20.411-05:00I sure wish I could leave my psychiatrist. If I e...I sure wish I could leave my psychiatrist. If I ever become more sure of my medicaid (it's unsure right now for complicated reasons) or ever get insurance I'll leave her the second I can.<br /><br />http://sarebear.typepad.com/blog/2011/01/my-psychiatrist-is-completely-insane.htmlSarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-39364498101912943622011-01-17T22:25:44.734-05:002011-01-17T22:25:44.734-05:00I hear that. But what about the point after the ag...I hear that. But what about the point after the aggressive medical approach, whether post hospital or ECT or not, if that wasn't quite needed - or rather, the continued, I guess, assuming continued compliance with medication - where it seems something more is needed then pure medication maintenance? i think the treatment options there seem to become murkier. If the depression is responding to medications, what role does psychoanalyticaly-informed treatment have - seems clear there's a major, primary medical component - especially if there seems to be no other "movement." Does that make sense?Katenoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-56100542642860918052011-01-17T20:10:21.554-05:002011-01-17T20:10:21.554-05:00Perhaps the murkier the disorder, the more amenabl...Perhaps the murkier the disorder, the more amenable to an analytic approach. But I would not equate severe with murky, and severe usually demands aggressive intervention which usually means a biological approach: meds or brain stimulation like ECT, often in hosp.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-49425221629458417232011-01-17T15:56:05.766-05:002011-01-17T15:56:05.766-05:00I think what I was trying to say is it is possible...I think what I was trying to say is it is possible for there to be no indication for psychoanalytic/dynamic based treatment, while there is indication for other treatment. i guess not believing in the former as an effective treatment answers that question! :) <br /><br />fyi, wasn't talking about analysis, but about psychoanlytic-based treatment (eg psychoanalyst providing 1x wk treatment, etc). also not talking about something as clear cut as panic disorder, but th ever murky severe depression.Katenoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-45862017543256483552011-01-17T00:39:08.471-05:002011-01-17T00:39:08.471-05:00Kate: Your two sentences don't seem to match, ...Kate: Your two sentences don't seem to match, but the second one is very interesting: I don't believe psychoanalysis really treats anything, but if during a course of analysis you wanted to try CBT for panic disorder, I see no reason you should have to stop the analysis. Come to think of it a psychoanalyst, Ivan Rohr, trained me to do biofeedback. He told me he occasionally used it with colleagues' analysands who seemed to be stuck. Go figure.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-20664439391553772922011-01-16T22:20:33.824-05:002011-01-16T22:20:33.824-05:00could it be possible that there's no indicatio...could it be possible that there's no indication for continued psychoanalytic/dynamic-based treatment, yet still an indication for non-psychoanalytic based treatment? meaning, are they mutually exclusive?Katenoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-17096027423026739232011-01-16T21:40:33.413-05:002011-01-16T21:40:33.413-05:00Very possible that a psychoanalyst would interpret...Very possible that a psychoanalyst would interpret almost anything as an indication for more treatment, Kate. That's one reason I reject psychoanalytic theory.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-12170681433173213042011-01-16T20:55:14.697-05:002011-01-16T20:55:14.697-05:00Is it possible that a psychoanalytic based doctor ...Is it possible that a psychoanalytic based doctor might feel that the lack of movement, to take your turn, is just part of the process? what happens when the patient is pretty sure that it's just not movement - that there being no movement is no more or less then being no movement. Yet psychoanalytic based theory dictates that as part of the process, no? And, that by definition, the patient won't be accurate if they feel there's no movement....Katenoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-9168282258733327022011-01-14T19:12:42.688-05:002011-01-14T19:12:42.688-05:00This comment has been removed by the author.Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-70961124357229256602011-01-14T19:09:14.558-05:002011-01-14T19:09:14.558-05:00This comment has been removed by the author.Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-19761926822019372172011-01-14T19:07:51.175-05:002011-01-14T19:07:51.175-05:00To mean fit means chemistry. To expand on the idea...To mean fit means chemistry. To expand on the idea of treatment that "isn't working," if the psychiatrist doesn't see sufficient movement, he should suggest the patient consider pursuing treatment elsewhere.<br />Transference is a term of art based on psychoanalytic theory and assumptions about modernist notions like the unconscious. It is too often used as short hand (psychobabble) for how the patient feels toward the psychotherapist. At behavenet.com you will find the term in glossaries of Gestalt and Jungian psychotherapy, but not others. Sometimes a feeling is just a feeling.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-48482890480731941332011-01-14T17:57:46.646-05:002011-01-14T17:57:46.646-05:00This is a great topic! I liked my last pdoc as a p...This is a great topic! I liked my last pdoc as a person but thought he would not accept me because of his fundamentalist religious views. (I never saw any evidence of this but nevertheless felt I could not be fully open with him about my sexuality, for example.) I couldn't bring myself to tell him I was changing doctors as I knew he was very sensitive and would be hurt, so I just told him I was taking a break from therapy and never went back.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-13961153387949669212011-01-14T10:38:30.908-05:002011-01-14T10:38:30.908-05:00Interesting post. I have a few thoughts. What does...Interesting post. I have a few thoughts. What does seeing a covering doctor mean - is it possible that in some cases, it might be arranged that the patient was regularly seeing the covering dr (weekly, etc) during a medical leave? I have a friend who did that with a maternity leave therapist for a few months, I think. <br /><br />I guess my question for the poster would be what does a better fit mean. I'm probably projecting my own experiences onto this but I would have thought a better fit might mean not just more comfortable, end sentence - but more comfortable talking, listening, thinking about what's being said. Or, what if the second doctor is more knowledgeable, has a stronger arsenal of medical knowledge, or different theoretical orientation, etc. If the treatment is longstanding, it makes me wonder if the patient knew there were other sorts of treatment modalities even available. We all know it can be easy to be trapped into the familiar - especially if you're a patient.<br /><br />I agree with movie doc's point - If the treatment is long standing, it might not be working. If the poster is worried about hurting the drs feelings, that might be a factor in keeping the treatment "long stnading" when maybe it shouldn't have been. Of course there could be other reasons, too. <br /><br />Dinah and moviedoc (would like both your views!) - can transference really only apply in analytic/dynamic methods? (not asking as a sarcastic question, a genuine one.)Jessnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-28404885675301914322011-01-13T18:20:21.218-05:002011-01-13T18:20:21.218-05:00I find myself constantly looking for reasons to fi...I find myself constantly looking for reasons to find flaws with my psychiatrist, to find reasons to leave her. I'm pretty sure I know the reason, or at least the main one; I was hit by my mother as a tween and teenager, and so I expect to be hurt by female authority figures; I'm in a constant state of wanting to protect myself.<br /><br />This may not be the ideal situation to be in as a patient but it's not like I was swimming in choices for psychiatrists, and besides it's likely good for me in some psychological way to try and deal with this. It's just, she's never addressed the issue, although as part of the very comprehensive history I filled out, on the major life events timeline, being hit by my mother was on there. Big red flag about female figure issues, I would think it would be obvious, but maybe it's not.<br /><br />My fear of her is going to come up next appt. anyway since another side effect I've identified is enormous amounts of anxiety. At the moment, I'm afraid of just about anything, everything. Will I even hit post on this comment?<br /><br />Then again, I was afraid of her before the anxieties from this med became an issue; too afraid to even mention it. I was hoping she'd be astute enough to pick up on my history, but I see now that I need to just outright say, "I'm afraid of you in part because my mom used to hit me." and just get it out there.<br /><br />So this post has helped me bring my thoughts together on this. Thanks for puttin' up with me, again.Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-21897933102612196912011-01-13T00:47:28.456-05:002011-01-13T00:47:28.456-05:00Two heads are better than one. Professionals want ...Two heads are better than one. Professionals want what is best for the patient. <br />#1 If the treatment is "long standing" maybe it's not working. "Transference" doesn't apply except to analytic/dynamic methods.<br />#2 is key<br />#3 is good advice<br />#4 is well said.<br />Manage those expectations.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.com