My psychiatrist does some psychotherapy with me and it's really ineffective and I've expressed concern that he should stop. All he wants are quick fixes. I understand that this comes from him wanting me to be well, but I've been through a lot and I deserve the time to heal. So this ends in him pushing me to do stuff I don't want to.

Yesterday he told me that I am 23 and most people my age are going to movies, going out on dates and going out with their friends and that I SHOULD too. But I'm not into that stuff. I haven't been to a movie theatre in 4 or 5 years and if going out with my friends involves "bars" like my friends do, then I'm not into that either. I'm very artsy and I'm sort of a loner. I would appreciate for him to tell me express myself in those ways. Go to an art class or join a book club. Something more quiet and reserved. I didn't really think of all this till after the session or I would have told him how I felt. Although I have told him in the past with other things.

He'll tell me things like "you need to move from your apartment, because it's too isolated, move into town, so you can do more". I'll tell him that even if I moved into town I would just be more scared to walk outside. That me and my dog have fun where we live and we don't need to be in the middle of a large town. That just because a majority of the society likes it doesn't mean I am comfortable with it. I like it here. But he'll continue on about how that's part of my problem and we need to fix it.

It's like he's not listening at all and doesn't really want to. After every hour I spend with him I come home much more upset then I was before, because he's attempting to control me in some way. I don't need him to counsel me, because I do have a therapist. But am I allowed to just not talk when he asks me questions? Wouldn't that make me look like a brat? Like he's my psychiatrist and OF COURSE I have to trust him he signed the hippocratic oath. And if I told anyone otherwise they'd label me unruly or "lacking trust". I used to not talk all the time to psychiatrists and some would become very angry about it. One even stood up and screamed at me "WHAT IS WRONG WITH YOU!? DIDN'T MOMMY SPOON FEED YOU ENOUGH!?"

[Sannah]

I think it would help if you told him how you felt. When he says something and you have thoughts about it - tell him, right then and there.

[sunrise]

Originally Posted by LydiaB

My psychiatrist does some psychotherapy

What you described is not psychotherapy. It sounds more like he is giving you advice. (And you don't want it from him.) Is he charging you for psychotherapy?

If he again raises questions about your isolation, living situation, activities to do, etc., you could thank him for his concern and tell him that you are working on building your social resources and support with your therapist, and things are going well now in therapy, and so on. Try to draw a line with him on the topics he gives input into and reassure him your therapist is doing a great job with you.

Originally Posted by LydiaB

I've expressed concern that he should stop.

What does he say when you ask him to stop? It can be confusing for a client to receive psychotherapy from two different people. You might mention that also. Perhaps your therapist could phone him up and reassure him that you are making progress and that she is following these issues with you.

Originally Posted by LydiaB

After every hour I spend with him

The length of time you spend with him tells me he probably is billing you for psychotherapy services. He may even think you want psychotherapy from him since you are paying for it. You could tell him that you noticed you were being billed for both medication management and PT and you would like to focus on meds with him, since you have a T. And next time you schedule an appointment with him, choose a 20 minute appt. Then he will focus on that and bill for med management only.

Originally Posted by LydiaB

But am I allowed to just not talk when he asks me questions?

No, use your communication skills! Don't just sit there and say nothing. Tell him you don't want PT from him and if he pushes, that his approach is ineffective and you have a T. Nothing will be solved by sitting there and saying nothing. He would probably consider it just more sign of dysfunction. Be assertive and communicate your wishes. Might not be a bad idea to ask your T for advice on this. Good luck.

Originally Posted by sunrise

What you described is not psychotherapy. It sounds more like he is giving you advice. (And you don't want it from him.) Is he charging you for psychotherapy?

If he again raises questions about your isolation, living situation, activities to do, etc., you could thank him for his concern and tell him that you are working on building your social resources and support with your therapist, and things are going well now in therapy, and so on. Try to draw a line with him on the topics he gives input into and reassure him your therapist is doing a great job with you.

What does he say when you ask him to stop? It can be confusing for a client to receive psychotherapy from two different people. You might mention that also. Perhaps your therapist could phone him up and reassure him that you are making progress and that she is following these issues with you.

The length of time you spend with him tells me he probably is billing you for psychotherapy services. He may even think you want psychotherapy from him since you are paying for it. You could tell him that you noticed you were being billed for both medication management and PT and you would like to focus on meds with him, since you have a T. And next time you schedule an appointment with him, choose a 20 minute appt. Then he will focus on that and bill for med management only.

No, use your communication skills! Don't just sit there and say nothing. Tell him you don't want PT from him and if he pushes, that his approach is ineffective and you have a T. Nothing will be solved by sitting there and saying nothing. He would probably consider it just more sign of dysfunction. Be assertive and communicate your wishes. Might not be a bad idea to ask your T for advice on this. Good luck.

Hmm I don't know if he's charging me for psychotherapy? He goes over his time with patients a lot. Not just me. They say "your appts at 10" but really that means noon. Sometimes my morning appts turn into 3 oclock appts, but I just ignore it because I figure that there are some people out there who can't even see one at all and I should be happy for what I have. If he charges me, it goes to my insurance company. I never see it.

My therapist and psychiatrist work in the same office, and they're very much buddy buddy. Which makes it even more difficult to explain to one that I don't prefer the other. I have mentioned it to T and he tells me "I'm having a hard time trusting".

But I guess I could be more upfront about not wanting psychotherapy to him directly. I'm just worried because he insists that medications don't treat PTSD and I just need therapy. So why am I seeing him?

[Perna]

Lydia, if you "agree" with him pleasantly, he'll run out of things to say. When he says something you don't like, just reply, "Thanks for the suggestion, I might try that!" and go about your business with your actual therapist :-)

[anilam]

Originally Posted by LydiaB

Hmm I don't know if he's charging me for psychotherapy? He goes over his time with patients a lot. Not just me. They say "your appts at 10" but really that means noon. Sometimes my morning appts turn into 3 oclock appts, but I just ignore it because I figure that there are some people out there who can't even see one at all and I should be happy for what I have. If he charges me, it goes to my insurance company. I never see it.

My therapist and psychiatrist work in the same office, and they're very much buddy buddy. Which makes it even more difficult to explain to one that I don't prefer the other. I have mentioned it to T and he tells me "I'm having a hard time trusting".

But I guess I could be more upfront about not wanting psychotherapy to him directly. I'm just worried because he insists that medications don't treat PTSD and I just need therapy. So why am I seeing him?

Well he is right. PTSD cannot be treated by meds. However they can help with anxiety/depression that most PTSD patients feel.

From your description I think he is trying the CBT- seems like it. I used to received the same crap from my exT, plus that I should exercise more, eat more to gain muscle mass, spend time with my dad, less time with my dog.... Ive done it all and became suicidal. The more I went out with my friends the more I hate that and I hate myself for feeling that way.
Long story short CBT is not for everyone. Personally I think it is not suitable for PTSD , it could help people with OCD and maybe depression (not secondary though)- see Im trying to be fair although Im mad just hearing about it- reading your post actually made me register on this board to write my opinion:-))

So my advice to you is to simply told him that you do not need and want PT from him, just the meds.
If you will not listen I would find a new psychiatrist. Do not waste your energy on him.
Also I would not like my T to be friends with my other docs. I need him to be on my side.

[WikidPissah]

Sounds difficult. Your insurance company should send you regular statements, you should always review what they have paid because a provider can bill wrong and it screws everything up. Those statements will tell how many "units" or types of sessions (med management; therapy).

My advice would be to try harder to let your T know how much this is bugging you and have him deal with pdoc, especially since they have a good relationship.

BTW...my son is 23 and very much a loner. He doesn't like the bar scene and picking up girls...which is what his friends do. So he spends a lot of time with a few MUCH older guys occasionally. I worry about him sometimes, but I can see that it is a choice he has made, and I don't push him. Not every 23 yr old should be living in the city and bar hopping.

[nannypat]

Many pmd don't even have time to do therapy. Mine does a very good job with it but I have dealt with some that should just stick with the meds and find a therapist for themselves!

[elliemay]

Sometimes you have to be open to suggestions, sometimes you have to actually do what they suggest and sometimes you just have to lean back and say to yourself "This guy is totally full of crap".

My favorite saying is "yeah!......no, not really"

Cheeky!

Originally Posted by anilam

From your description I think he is trying the CBT- seems like it. I used to received the same crap from my exT, plus that I should exercise more, eat more to gain muscle mass, spend time with my dad, less time with my dog.... Ive done it all and became suicidal. T

Yes that's pretty much the story. But it does just make me more suicidal. It just puts too much pressure on me. I'm such a people pleaser and so when someone tells me "you should be doing this" it becomes a never ending battle to everything that everyone else wants and nothing that I want or need. It eventually feels untrue to myself and I become even more depressed.

Originally Posted by WikidPissah

Sounds difficult. Your insurance company should send you regular statements, you should always review what they have paid because a provider can bill wrong and it screws everything up. Those statements will tell how many "units" or types of sessions (med management; therapy).

I think I do get a statement once every 6 months that says "approved for 1,500 units". Which basically means approved for infinite units and they didn't want to put infinite. But other then that I get nothing. I sign a billing form everytime I get done with someone that says how long I was with them and it assesses me to make sure the provider was mentally present.

Originally Posted by nannypat

Many pmd don't even have time to do therapy.

I feel like mine shouldn't have time. But he does it anyway...

[Snakebit]

Originally Posted by LydiaB

My psychiatrist does some psychotherapy with me and it's really ineffective and I've expressed concern that he should stop. All he wants are quick fixes. I understand that this comes from him wanting me to be well, but I've been through a lot and I deserve the time to heal. So this ends in him pushing me to do stuff I don't want to.

Yesterday he told me that I am 23 and most people my age are going to movies, going out on dates and going out with their friends and that I SHOULD too. But I'm not into that stuff. I haven't been to a movie theatre in 4 or 5 years and if going out with my friends involves "bars" like my friends do, then I'm not into that either. I'm very artsy and I'm sort of a loner. I would appreciate for him to tell me express myself in those ways. Go to an art class or join a book club. Something more quiet and reserved. I didn't really think of all this till after the session or I would have told him how I felt. Although I have told him in the past with other things.

He'll tell me things like "you need to move from your apartment, because it's too isolated, move into town, so you can do more". I'll tell him that even if I moved into town I would just be more scared to walk outside. That me and my dog have fun where we live and we don't need to be in the middle of a large town. That just because a majority of the society likes it doesn't mean I am comfortable with it. I like it here. But he'll continue on about how that's part of my problem and we need to fix it.

It's like he's not listening at all and doesn't really want to. After every hour I spend with him I come home much more upset then I was before, because he's attempting to control me in some way. I don't need him to counsel me, because I do have a therapist. But am I allowed to just not talk when he asks me questions? Wouldn't that make me look like a brat? Like he's my psychiatrist and OF COURSE I have to trust him he signed the hippocratic oath. And if I told anyone otherwise they'd label me unruly or "lacking trust". I used to not talk all the time to psychiatrists and some would become very angry about it. One even stood up and screamed at me "WHAT IS WRONG WITH YOU!? DIDN'T MOMMY SPOON FEED YOU ENOUGH!?"

RE: Psychiatrists getting angry - some (most that I have dealt with) have a God complex. I refuse to see them - I go to an Internist for my meds.

As to your particular issue, I wish I had known myself as well as you do when I was 23. I did go out to bars, etc, and I was miserable. It has only been in the last several years that I realized I was happiest sitting in my own house reading a good book!

Not that it was easy for me to get this across to my T. We spent a whole session deconstructing the word "loner". I thought he had finally gotten it when I went abroad on vacation by myself. But he didn't. He just mentioned in the last session that I was "social". He seems to have grabbed onto my behavior of my talking to my neighbors. This seems to have "checked off the box" to him that I am not a loner! ROFLOL! (He really does crack me up at times!)

The other thing that I realized with him was if he didn't find something enjoyable then he saw it as a chore! I really got into painting things last year and he was always tutting it as just me doing chores. Finally a neighbor (yes a neighbor!) said "he just doesn't like to paint", which helped me explain it to my T. Now when I talk about sewing (or mending as T calls it), he doesn't tut-tut it as a chore, but law it took a long time for him to understand that my enjoyments wasn't the same as his.

Unfortunately with your PDoc, your age is an issue. He's probably 20 years older than you, at least, and sees you as a "kid". You may want to tell him that while going to bars in his twenties was his be-all-end-all, it's not for you. But I expect his God complex will rear it's head, if you deign to talk back.