Dear Byzantine,

I'm not any kind of expert, but in trying very hard to understand this article, some questions come to my mind.

One is that with the limited amount of time allotted to the psychiatrist to truly discover what is going on with the patient, how are they supposed to get to know what goes on in our minds well enough to truly even get the diagnosis right. It seems that everyone I know has had multiple diagnosis. I went from Bi-Polar to MDD-severe to now Depression with Dissociative mood disorders and BPD. If I don't write out journals, poems, research articles, letters and descriptives of what is really happening in my mind, my pdoc doesn't have a clue unless I am hospitalized and he gets a chance to actually talk to me for a little while. Also I am very lucky that he knows my T, and they do actually talk sometimes and get a feel for what is going on. Unfortunately, recently, my T asked him to back off any type of therapy with me as to not "cross any boundaries". I hated this and do not feel it is in my best interest.

Secondly, I have been on every medication known to the pharmaceutical industry over the last 10 years. Thus I know I have put my body through a lot of stress and experimentation in terms of the possible long term effects of all these drugs on my liver and other organs in the body, let alone the stress of the anxiety, etc that the illnesses themselves have put on my body. How can we justify all this contamination if indeed we are not sure of the diagnosis because of inadequate contact and relationship with pdoc, and also in terms of the lack of efficacy due to the questions brought up in the article you posted? Is placebo effect enough to truly justify the potential risks?

Third, pdocs are no longer really trained in the interpersonal therapeutic relationship dynamics. My pdoc is gifted and personable but admitted readily that he was in no way a T when he tried to step in while my T was gone. My T confirmed that pdocs are no longer even trained in doing therapy and establishing and maintaining relationships the way that T's are. They are doctors. Most of what they learn interpersonally they learn on the job. How do you/they propose to bring pdoc's back into the equation of really getting into a therapeutic relationship with patients when they are not even trained any more to do so?

I know I'm not very savvy with all of this, but I don't see how to make it work. I feel I have been blessed with a very gifted healer, but I know the difference and what most experience and have been there myself. Most people don't really have much of a "relationship" with pdocs at least in the states as far as I am aware. They are primarily script writers. I don't know what else to do to get better. All my care-givers say that I try very hard in therapy and am med compliant. But I continue to struggle. Whether I "get" something from being ill, I can't be sure. All I know is I still hurt too much. Your article is discouraging to me, and just makes me even more determined to continue efforts to communicate better with my wonderful pdoc.

Most Respectfully,
Wysteria Blue