I have an issue with swallowing pills, and we were trying to get my medication in another form, but it's way too expensive. And she was telling me how I was "allowing my fear to paralyze me" and that it was important for me to learn to swallow pills if I wanted to get better. And I got so angry at her word choice, and I felt like my feelings were being invalidated. Because I've tried over and over again and I can't make myself do it and she kept pushing it. I just looked at her with complete contempt and argued with her and I couldn't control it and said something along the lines of "you hate me because I can't do anything" something along those lines. And she looked at me like I was out of my mind and said she didn't hate me. I get so angry with her a lot of the time. It's like she'll be telling me to think positive and how my thoughts about myself are wrong and I just feel so annoyed and it's like I'm pushing against her trying to help me and I can't seem to see things any other way. Is that weird/normal?

sounds like she got frustrated and goofed up.

we all goof up...... i hope you do not let that one error cause a lasting rift between you two.

[trying2survive]

Originally Posted by nevergoodenough

I have an issue with swallowing pills, and we were trying to get my medication in another form, but it's way too expensive. And she was telling me how I was "allowing my fear to paralyze me" and that it was important for me to learn to swallow pills if I wanted to get better. And I got so angry at her word choice, and I felt like my feelings were being invalidated. Because I've tried over and over again and I can't make myself do it and she kept pushing it. I just looked at her with complete contempt and argued with her and I couldn't control it and said something along the lines of "you hate me because I can't do anything" something along those lines. And she looked at me like I was out of my mind and said she didn't hate me. I get so angry with her a lot of the time. It's like she'll be telling me to think positive and how my thoughts about myself are wrong and I just feel so annoyed and it's like I'm pushing against her trying to help me and I can't seem to see things any other way. Is that weird/normal?

i think your t may have handled this situation the wrong way, maybe she could have cut the pills up smaller, this would have been an inconvenience for sure, but it may have helped with any issue swallowing them, can you chew them? i know most pills taste awful that way but that's what i used to do, cause i always had a problem with that too, and your response is to be expected, nobody wants to hear "think positive" when the **** hits the fan, so i don't blame you. i'm guessing i would either try to start chewing the pills or have your t cut them up smaller..hope this helps!

[Frankbtl]

Hi nge, I've got to agree with what you said about her word choice. It's sounding as if she's saying you're just making the choice to/or and "sitting back" and letting "your fear paralyze you. She's not letting it sound like the fear is paralyzing you, if that's the case.
And you know if the fear is the cause, is she actually giving you any constructive tools when she's recognizing that, to actually help you in taking control of that?
Of course, maybe it is just an unfortunate choice in words and what came across might not be what she actually meant. Maybe it's worth reflecting back to her how you're interpreting what she's saying when she says something like that and ask her if that's what she meant or if not what she did actually mean.
But this: "It's like she'll be telling me to think positive and how my thoughts about myself are wrong" sounds as well, just like you said, to be invalidating your feelings.
Your thoughts are your thoughts, how can they be "wrong", they're real, you think/feel them??!!
OK, maybe she's thinking that you could see things from a different perspective but that's down to her to try to help you actually come to see some real evidence (evidence that's going to mean something to you) in how/why you should be seeing things differently and supporting you in that process.
And sure positiveness can have it's place, but it can be a lot easier said than done doing that, it's not a "click your fingers" and ............I'd say she should be supporting you in trying to feel more positive (after she's tried to understand your feelings!!).
I'm thinking that she's starting the therapy from a different stage/level than you need though? Missing out the bits where you need more to express how you're feeling, the effects of things on you, recognize/understand your feelings, and feel understood, gradually try to take a hold on things..........................and instead she's jumping straight to.............which might be helpful to some, but...............
Maybe explain to her how you would like the sessions to run, what she could do to be more helpful, how certain parts of the sessions are making you feel...................
Anyway, the pills?........Would the pills soften/dissolve if left in water (although check with your doctor first as this can alter the dosage hitting your blood stream) or could you take them with/in something like yoghurt/mousse? Maybe you could crush them and put them in something like that (but again check with your doctor!)? Or could you "shop around" to find cheaper versions of the alternatives to pills you've looked into?
Alison

[HD7970GHZ]

Hi Goodenough,

I am sorry that you feel your therapist isn't validating your feelings.

I think it's vitally important for you to tell her what you have told us. I think you need to be assertive and tell her how you feel. Don't concentrate so much on what you think. Our thoughts can be so easily distorted - and people, (let alone therapists) always seem to respond more genuinely to how we feel rather than how or what we think. Any therapist will respond much better to emotion and feelings compared to what we may think about their agenda's or therapeutic style.

Be extremely open with her - otherwise I cannot see how your therapeutic relationship can foster growth and acceptance for you. And perhaps you need to remind her of your mutual goal: that your goal is to get better, and that you're more than willing to do what it takes to get better - so long as it is 100% in line with that goal.

And given that you are not (I am assuming that you are not) fearful of taking medications in pill form - you wouldn't be allowing fear to conquer you - instead - you would merely be doing what your body is telling you is best for you.

Keeping this in mind - it is obvious that your therapist is truly on your side. Perhaps she may conclude that you're against taking medications altogether, perhaps she thinks you're making an excuse to not take the medications... Maybe you need to clarify with her that you're willing to take the medications as prescribed - but you would prefer to take them in another form. It is not a fear so much as it is a preference. Perhaps she would understand if you worded it as such. From the sounds of things - you've been taking these medications for a nondescript amount of time. Perhaps reminding her of that fact could help her to understand why it is you're asking for the change in the first place. (Evidence that you've taken the medication by pill form could push away her belief that you have fears around it.)

If she doesn't seem to understand - try not look at it as a black and white scenario. Just because she may not understand and comply with your request of medication form change - does not mean that she doesn't have your best goals in mind. She can still be your psychiatrist despite the small differences of opinion. After-all, all you need to do is go to a medical doctor and get a different form of the medication. (If it even exists)

I think you've got a good therapist. For one she isn't afraid to disagree with you. Having a therapist disagree with you is often times the best way to receive a gentle push in the right direction - and perhaps there's something to be said in your current predicament. Maybe you do have a fear of taking medications in the pill form... There's nothing harmful about delving into that possibility for yourself. If you do have a fear, maybe telling your therapist that you have a fear - but you have much more important things in life to deal with first - could set the fear of taking pills on the back-burner for later. There's no sense adding to your list of goals if you're already bombarded by more vital things in life.

Wish you the best,

thanks,
HD7970ghz

Thank you for your replies.

I have never swallowed a pill. I take Paxil in a liquid form, and have been for over a year, but that's all I take. They want to put me on Wellbutrin, actually I have it here at my house, and I tried to but was too afraid to swallow it despite it being a small pill. I have a fear of choking to death and can't seem to force myself to get over it. And unfortunately it's a time release pill, so I'm not supposed to crush it. The doctor decided that I can crush it, since my dose is a small dose, but if I were to ever take any more, then I shouldn't crush it. But then I'm just wondering to myself, why even take it if I can't ever take any more? What if the dose is too small to do any good? Liquid/tablet form of medication are a lot more expensive, which is why she was pushing for me to "get over my fear." I hope that clears things up.

Originally Posted by Frankbtl

Hi nge, I've got to agree with what you said about her word choice. It's sounding as if she's saying you're just making the choice to/or and "sitting back" and letting "your fear paralyze you. She's not letting it sound like the fear is paralyzing you, if that's the case.

Yeah, that's how it felt to me. But I'm really sensitive about a lot of things people say and find criticism in almost anything.

And you know if the fear is the cause, is she actually giving you any constructive tools when she's recognizing that, to actually help you in taking control of that?

She suggested for me to put it in peanut butter or something to see if I could get it to go down, but I told her I tried that and that it doesn't make a difference. And she just kept going on and on about it and wasting our session and I was getting really upset. I almost had a panic attack in her office and felt something that was almost rage and I don't know how normal that is...

[trying2survive]

Originally Posted by nevergoodenough

Thank you for your replies.

I have never swallowed a pill. I take Paxil in a liquid form, and have been for over a year, but that's all I take. They want to put me on Wellbutrin, actually I have it here at my house, and I tried to but was too afraid to swallow it despite it being a small pill. I have a fear of choking to death and can't seem to force myself to get over it. And unfortunately it's a time release pill, so I'm not supposed to crush it. The doctor decided that I can crush it, since my dose is a small dose, but if I were to ever take any more, then I shouldn't crush it. But then I'm just wondering to myself, why even take it if I can't ever take any more? What if the dose is too small to do any good? Liquid/tablet form of medication are a lot more expensive, which is why she was pushing for me to "get over my fear." I hope that clears things up.

i would try to cut it up into 4 pieces and use a whole lot of water, that's what i did a lot, worked ok for me i'm not one that likes to swallow pills either



She suggested for me to put it in peanut butter or something to see if I could get it to go down, but I told her I tried that and that it doesn't make a difference. And she just kept going on and on about it and wasting our session and I was getting really upset. I almost had a panic attack in her office and felt something that was almost rage and I don't know how normal that is...

peanut butter? i think that would make it worse, i don't think that was a good suggestion at all! wtf, peanut butter as thick as that **** is? no way!

[ChickyHines]

Idonno .. It sounds like you might not be ready

[Frankbtl]

Hi nge, I guess it may be worth checking how confident they are that Welbutrin even just in smaller doses is going to the one that is going to work for you. Of course there are never any guarantees, but if they're pretty confident it's going to work in smaller doses then maybe worth sticking with it? Then perhaps with a lot of support and time you can be working on your fear of swallowing in case at some point way down the line you might need higher doses in pill form.
If they're not so confident though, is there an alternative to Wellbutrin which does come in liquid form they could try first?
I didn't ask though........do you have the same problem with "coated" tablets which may be easier to swallow?? Sorry if the obvious answer is "Yes!!" there. Just a thought.........
Alison

[henrydavidtherobot]

I'm with your T on this one. I find that what has helped me most in my recovery journey from BPD is having people openly tell me when I am being irrational. It may be difficult, but if taking pills will help you, your irrational fear is paralyzing you. Though her word choice may have not been best for you, no one can always say things the way you want them to and you have to accept that. The T doesn't sound like they were being malicious towards you at all.

Irrational or not, I can't do it.

I agree with your premise. If your mind/body will not allow you to do it - then that is our of your control.

So is there ANY way the pills could be crushed and taken with applesauce?

[doglover1979]

There is a pill lubricant available, most pharmacies carry it. They even come in flavors. Do you think it would be easier for you if you tried something like that? That way you would know for sure it will go down easy.

I'll try that, thanks.

The doctor's letting me chew the pills despite that they're time release.

[bataviabard]

Part of my job duties is to pass meds and through the years a few of my "customers" lost their ability to swallow them over time. We use apple sauce or pudding to help them take their meds.

[Perna]

Originally Posted by nevergoodenough

it was important for me to learn to swallow pills

It's a learning thing, not a "belief"/personal thing. Being angry and arguing with T rarely helped me so I started working to do what she suggested and then if I failed after that, at least I knew I had tried and needed to try a different method since that one did not work.

How to get that pill down

Helping kids who have difficulty swallowing pills

Why is it hard for some people to swallow pills? - WSJ.com

No, it's a phobia thing for me. I've tried all of that.

[HD7970GHZ]

Hey Goodenough,

I think you have answered your own question when you said:

"Irrational or not, I can't do it."

Just so you understand where I'm coming from - that alone: speaks volumes in terms of therapy. The fact that you recognize it may be irrational to others - yet you still prefer the other method of treatment - is amazing insight. And it is not irrational. It tells us that you're not against the treatment - and that there is a better more efficient way to go about doing it. That - and you state it in a, "I," statement - which proves to me that you're willing to stand up for yourself and your own needs - and be assertive in doing so. I think it's brilliant!


And in case you missed the bold and italic comment I left earlier, here it is again:

"And given that you are not (I am assuming that you are not) fearful of taking medications in pill form - you wouldn't be allowing fear to conquer you - instead - you would merely be doing what your body is telling you is best for you."

And now that you have realized that you have a phobia around swallowing pills - you have only validated yourself as an individual human being - with your own needs, wants and desires. And that - in my opinion - is the step in the right direction towards self acceptance.

Useless me - also made the comment:

"I agree with your premise. If your mind/body will not allow you to do it - then that is our of your control."

Couldn't put it in any better way.

If your body is telling you that you cannot swallow a pill - then by taking it in another form you will only be doing yourself the same treatment but in a more, 'preferable,' way. There is absolutely nothing wrong with that.

In saying all of this - just remember that this issue came up in therapy - and in therapy it is important to come to terms with our issues and in some way or another - conquer them. In light of this - you have fully conquered this particular issue because you're not afraid to be assertive and get your own needs met, yet you're still willing to commit to a treatment in order to achieve a positive goal of growth.

It is also important to note - that without your therapist disagreeing with you - you may not have come to realize (how much of an issue) there was - pertaining to swallowing a pill. In saying this - it is important for you to recognize that your therapist; truly does have your best intentions in mind - and perhaps seeing it as a positive thing rather than a negative could help ease any tensions in the therapeutic alliance and may allow you two further growth.

I wish you the best,

Thanks,
HD7970ghz