Saturday, July 18, 2015

How do you know you have a Good Psychiatrist or Therapist

Why seek therapy or medication? I'd say, if you are experiencing intolerable mental anguish that gets in the way of leading a meaningful, productive and happy life.

It's always advisable to try psychotherapy before you get medicated for a mental illness, whether it's schizophrenia, schizoaffective disorder, OCD, depression or bipolar d/o.

All these conditions are seen at New Directions Support Group

For OCD - obsessive compulsive disorder - a variety of techniques can help the individual deal with this extremely painful condition which may include, in part, hoarding, checking, hand-washing, plucking out hair or eyebrows, and cursing (scrupulosity).

When I was on the bipolar med Lamictal, I was obsessive for the first time in my life, so I do understand how acutely distressing this condition is. OCD also hits children. Judith L Rapoport, MD, of NIMH is a pioneer in the field of treatment.

Read her Medscape interview here. 

As a psychotherapist in private practice, I often recommend psychotherapists and/or psychiatrists to both my clients and to members of New Directions.

We maintain a Top Doc/Top Therapist List, based on the experiences of our members.

This is different from professionals - psychiatrists, family doctors or therapists - who recommend treatment "providers."

There's quite a discrepancy between the two.

How do you know it's time to find a new psychiatrist?

One of our members has not progressed at all after seeing her psychiatrist for FOUR YEARS.

Why would anyone stay with someone who is not helping her?

Many reasons are involved including loyalty, not wanting to repeat your history all over again to someone new, and the inconvenience of driving somewhere new.

Dreadful excuses all of them!

When seeing a new psychiatrist, I suggest a patient type up his or her accomplishments and present them at the first meeting. This will help the new shrink know you better.

A member of ND writes, "I write a history of my recurrent depression, my first diagnosis, on the computer. This includes a history of my depressions, what made it better or worse, all meds I'd taken - which worked and which didn't....

Also, all allergies to foods, meds, and environmental conditions. Because it is in the computer I can easily change it or add to it. I can take this w/me to any psychiatrist or psychologist or medical doctor, so I have the details with me then and there at the appointment.

Good thinking!!!

A woman from our group, whom I'll call Natasha, had terrible experiences at the University of Pennsylvania - remember, this is unique to her - and her psychotherapist recommended someone new.

Natasha saw the well-known "Phyllis Brown."

Natasha called me crying hysterically. Remember that her psychologist had recommended Phyllis
Brown to her, not a member of New Directions.When Natasha asked me what I thought of Phyllis Brown, I originally said "Many people like her. You'll see what you think."

I did not want my poor opinion of Brown to prejudice Natasha.

I've known Natasha nearly 3 years, and was shocked to hear that.....

- Brown blamed Natasha for her condition

- Interrogated her about her suicide attempts

- Wanted to know about the relationship between her parents, asking intimate questions about their relationship

- Wanted to put her back on Sinequan, which she'd spent many a month going off. It is a highly toxic med and should NOT be prescribed for anyone who has attempted suicide.

-  When Natasha asked for a refill of her Klonopin and said, "I don't use that much," Brown said, "They all say that."  Brown told her she'd call it into the pharmacy.

After Natasha called me and I listened carefully to her and of course validated what had happened, I recommended several psychiatrists from Our List.

One of the things I usually recommend to my clients is to do writing assignments that will make them feel good about themselves.

Her assignment was to continue writing about the man in her life.

Natasha just called me saying she went to her pharmacy to pick up the Klonopin. There was no prescription, only one for Sinequan (generic doxepin), the toxic agent you never prescribe for someone w/ a history of suicide attempts.

Neither she nor I can figure out the thinking of "Phyllis Brown." One thing is for sure. She is not on our Top Doc/Top Therapist List, and, in fact, never has been.

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