Reading Session Notes of Psychiatrist

I asked for copies of session notes because insurance denied std claim. So I am debating whether or not to hire a lawyer to fight it. Just seems so exhausting at the moment.

Anyway, lawyer said she would need session notes, so I got copies yesterday.

Reading them made me sad. I don't remember many parts of session, I knew that already, but didn't realize how much I don't remember.

Plus to see all the dx in writing, just seems so overwhelming...Complex PTSD, ED, Major Depression with anxiety, depersonalization.

So much to work on, yet doesnt seem like am making any progress. Might not have been such a good idea to read notes on my own.

Sorry you had to see the session notes. It all sounds so clinical, doesn't it? I've been seeing my T for 7 months and I've never asked him for his dx. I know he had to do them for insurance, but I really just don't want to know. I'm sure it would upset me like it has you.

You don't say if this is was your first session. If you feel like you're not making progress, maybe it just needs more time? It can be a slow process to undo what years of God-knows-what have done. It does sound like it's overwhelming right now. Hope you feel better, and that you'll post more here when you feel like it.

That sounds like a frustrating place to be. I have a lot of curiosity and expectations about what my T has written about our sessions, but I think I'd feel very much in the same place as you if I ever saw them.

Is your psychiatrist generally optimistic with you? It could be that those are all things he or she is confident in working with you on and progress has been made, you just can't see it from the notes alone since they're technical by nature. Sometimes we're too close to the situation to see changes or improvement. Our minds are quite dynamic and we often have new setpoints that hide significant progress in hindsight.

I hope you can get to a good resolution with your insurance company.

I remember how upset I was when I was first told my diagnoses (they had to share them with me because at that point I was unable to work, and I had to explain why to the DSS for benefits.) First one that upset me was "Major Depression with Psychoses" (I'd known I was depressed, but psychosis freaked me out) then bipolar disorder (that freaked me out) then schizoaffective disorder and high functioning autism (I'd been diagnosed autistic as a child, but my family kept that diagnoses from me for years.) To have that diagnoses confirmed as an adult was almost as much of a shock as being diagnoses with schizoaffective disorder. I'd always assumed that I was socially awkward, but not so much so that anyone would notice. According to my pdoc I've learned to compensate for the autistic tendencies, but still manifest them in unusual ways (because of my IQ, gender, life experience and mental health diagnoses.) I come across okay on a one to one, but the more people are involved in a conversation the harder it gets for me.

I felt like a freak, like a bundle of symptoms that nobody would ever care about again. I still sometimes feel like a freak, but I am still me.

In the end I realised that I'm still the exact same me I was before all these diagnoses took over. The labels aren't me, they're just descriptions of aspects of my mental makeup. I'm still in here, the labels haven't taken that away.

That sounds hard--reading the session notes. I would not want to do that. I hope it works out with the insurance and you don't have to use a lawyer. Do you know insurance turned down your claim?

Yes, this sounds very difficult. I would feel so exposed. I'm glad you came here, as we can all relate, whether or not we have seen the dx. I have the opposite problem. In my therapy, my T was unwilling to tell me what was wrong.

How on earth can I help myself if I don't know, from an expert, what is wrong? apparently, I have an adjustment disorder....WTF???

Please look beyond labels. You are so much more than these words..your history, your future, your talents, your experiences....everything. The world is not one-dimensional and neither are you.

Hang in there....blessings, MCL

I would suggest talking to your doc about your reactions to the session notes. That way you can ask him what he meant in specific places and tell him how reading them made you feel.

I read notes once and found out why specific clinicians treated me a certain way. They had gotten information from another clinician of mine who didn't have the whole story as I had never disclosed everything to her and so they trusted her word and didn't listen to me. Though them not listening to me was their fault, it did give me some insight into why they acted the way they did. On the other hand it was hard for me to read what they wrote, especially on some of the diagnosis parts.

I think if I ever read my session notes I would need a course of therapy just to process all the emotions that would stir up. Yuck.

I'm sure that my T would give me a diagnosis if I needed it for insurance, but she wouldn't do it otherwise. She says every patient is different and labels are unhelpful.

What you have there is what your T had to write to get your insurance approved. He had to lay it on thick and use the buzzwords the insurance company wants to see. I'm not saying he's lying, but he is writing for a very definite purpose and a very specialised audience.

Dealing with burocracy is not the same thing as dealing with a patient. Some medical people (eg Gregory House) DO tell lies on paper if they think it is in the patient's interest.

not sure how to tell T that reading her notes made me feel worse. I mean there really were no surprises in there, I am aware I dissociate and am anxious. But I thought I hid it well, knowing that she is that observant, I guess makes me feel self-conscious. Plus not sure I want my lawyer to have these notes now. Not sure I want other people knowing how unstable I really am. Also, this is worst time of year for me anyway, just lots of things happening all at same time. so so exhausting, how do i explain to t that am just tired all the time, no matter how much i sleep, just feel drained.

Why did your insurance deny the claim? Did they give a reason? It sounds like you definitely need the therapy.

The reason I ask is because my insurance has done similar things and given reasons that make no sense. I think sometimes they do this on purpose when a person is in therapy for awhile to try to scare that person out of continuing. Sometimes it's just incompetence and confusion, but sometimes I think it's deliberate.

I know that sounds paranoid, but I don't trust insurance companies at all. All they care about is money. They see the cost, they want the cost to stop.

Can you appeal the rejection? My company has a formal appeals form and usually if I appeal they reverse the denial. You might not need a lawyer, just the right form and the right address.

I have appealed twice before. Insurance company is claiming I wasn't totally disabled and should be able to go to work. Doctor disagrees and told me to stay off work, especially because it is toxic work environment and it is making me worse. So doctor and insurance company are disagreeing. In meantime I have no income for 2 months.

I would encourage you to talk to your T. She can probably tell you something like she is trained to see what's wrong, but can probably assure you that the "untrained eye" cannot see what she says. Plus, it's just good to talk about the things that upset you in T.

On the issue of your "instability" however, it seems to me (and I'm a lawyer) that that's exactly what you want to show-- that you need T. JMO.

Anne

I gotta say, reading these notes is something that I would never do. Talk about kicking a hornet's nest.

I'm perfectly happy living in the realm of psychiatric ignorance and bliss.

I hope you and your therapist are able to discuss this fully and good luck with your claim against insurance. If you're able, fight the good fight. My guess is that they are counting on you NOT being able to do it.

Peace.

yeah, i know insurance company does stuff like this because they know most people will drop claim, yet the idea of fighting them just exhausts me. my t is outraged and wants me to fight, but i just barely have energy to get out of bed, how do i fight in court.

Hey Canuck..

I'm really sorry that you had to see those..I'm sure it was a bit shocking and probably the doc in all honesty should have sent them directly to your lawyer. But just remember, that the doc knows that what they write CAN be legally subpoened, and that is in the back of their mind and they are very careful what they put down. Much of it is basically shorthand and in diagnostic terminology that can be backed up. True feelings and gut reactions and appreciation for who you really are would not be included...All the good stuff is not in there. And labels are just for diagnosis and not WHO you are. They are just words to let others know some groups of traits that generally apply to you.

Secondly, you have a lawyer...let him do the fighting for you. The whole reason that you are not working and exhausted is the reason you need his help and why that file is also so troubling. Don't be embarrassed. You are not bad trying to get good...you are ill trying to get well. Let them help you and just support the effort where you can. I know it is hard to let people help you sometimes..but right now, just let it happen and tell that lawyer to fight hard for you for those back benefits and what you need. Often the insurance companies will actually fold when faced with a real lawsuit because they don't want the publicity. BC/BS is famous for that because they have been sued so badly.

Best of luck and relax a little. You are a wonderful person with a big heart that just needs a little help. Don't take those old medical charts to heart. They are just words. Your T and pdoc care very much about you and are trying very hard to help you..

Hugs,

Wysteria Blue

was speaking to a friend today and mentioned the term bone weary....Bone weary is good way to put it . Lots of triggers, this week of november is worse. my family/freinds tell me to just get over it. oh how i wish i could. wish had energy to fight insurance company, but seems so pointless really, any $$$ that would get would go right to lawyer and t for their hours in helping me win fight. kind of ironic sinc t was one in first place that insisted that i take leave from work. i only wanted to take 2 weeks off and she convinced me to take 2 months. and while i did need rest and improve (which insurance company is using against me), now am in much worse position

Ouch! That hurts!

Wow that is exactly how I felt when I found a way to read my dx online thru my insurance claims. And yes you are right I am still me, just with more information on how my mind works.