[TheRealFDeal]

For the second time in my (now) 5-month fruitless search for a T, my pdoc offered to do t with me. I like my pdoc and I'm able to share with him during my 20-minute med checks. Well, they're really not med checks now, they're mini monthly t sessions, where I just cry and he says really empathic, understanding things that make me sometimes cry more because he's so nailed my situation. The thing is, I have this deeply held bias that pdocs make terrible Ts. I've always felt that their training and bias is more towards the medical and much less toward psychotherapy. And I've always believed that you should keep your pdoc and your T separate just because they have different roles and different specialties that are both important to one's mental health. And I like checking with one about the other occasionally.

And what if it doesn't work out or he helps me till he can't or I use him as a bridge until I can deal with a "real" T, can we go back to the pdoc/patient relationship?

What do you think? Has anyone had successful psychotherapy with a psychiatrist?

[Ike McCaslin]

I developed transference for my PDOC and she agreed to see me for therapy. It worked well, at times she seemed to forget she had agreed to see me for 30 minutes a session and would try to give me the bum's rush. But once we got that settled, it worked OK, then I lost my job and had to move 3 hours away.

[Sometimes psychotic]

My pdoc is trained in psychoanalysis so could be a T also...we do 30 minutes every couple months. However having had a really good T there is no comparison she was so much better. Still the pdoc fills a void for me. I don't really need a T long term I need someone to verify my meds are working so that is why we talk, not about the meds but about life. I have psychosis so I could slip into another break and he just checks that I am sane, interacting with people, leaving the house etc.

It is only because of the insurance industry that psychiatrist do very little psychotherapy these days. Some psychiatrist really like doing therapy, and some that choose to not take insurance do therapy more ofte

[wotchermuggle]

I like having my T and Pdoc separate. They have really different ideas, and it's helpful.

[The_little_didgee]

My psychiatrist does psychotherapy. She has really helped me. I appreciate her honesty and openness. She has a way of getting me to think. After my appointments, I always think about our discussions and try to learn from them.

If therapy does't work out, I think you can return to the patient/doctor relationship, as long as you communicate with him and don't have expectations he cannot fulfill.

I asked my pdoc to be my T on my third or fourth visit with him, which was a year ago now, and I see him twice a week for therapy. He is a really good T, and definitely no pill-pusher; in fact, the first thing he did when I saw him as a pdoc was take me off my medication since it didn't work. (I am all for taking medication, but in my particular case those meds didn't work and T and I have decided together that I won't start with another kind of med right now.) So my personal experience is a very good one, and I think an experienced pdoc/T can have a perspective that Ts without medical training may lack.

But of course it always comes down to the individual, if it's a good T, and a good fit.

[anilam]

Originally Posted by Mastodon

I asked my pdoc to be my T on my third or fourth visit with him, which was a year ago now, and I see him twice a week for therapy. He is a really good T, and definitely no pill-pusher; in fact, the first thing he did when I saw him as a pdoc was take me off my medication since it didn't work. (I am all for taking medication, but in my particular case those meds didn't work and T and I have decided together that I won't start with another kind of med right now.) So my personal experience is a very good one, and I think an experienced pdoc/T can have a perspective that Ts without medical training may lack.

But of course it always comes down to the individual, if it's a good T, and a good fit.

Exactly right. Id say give it a go and see how you like him as a T.

My pdoc is trained in psychotherapy. I asked him to be my T; I think he would be great at it and I felt an instant connection to him. But my ex-pdoc (who was god awful ) moved to another city, so my now pdoc got all his med only cases...so he has no time to add on T appts (longer appts) to his schedule. So I basically got rejected when he said he could not be my T for this reason.
That felt like crap. Esp. now when I am in there and he throws in his 2 cents worth of psychology re: whatever I tell him in my update...I am getting ready to tell him to STOP because I don't want to hear a "preview" of what I can't get. Just give me my meds and shut up if you won't be my T (not that I am saying he is lying about not having the time...his desk is a wreck of people's folders).

[unaluna]

I think it depends on the pdoc. I saw one for therapy for 3 years, and I have another former pdoc I would see if I could afford him.

[tooski]

When I first had psychotherapy, back in the '60's, it was mainly psychiatrists who did it. Psychologists were for interpreting test results, doing research etc. Things have changed so much that now just about anyone who can do some studying and pass a license exam can call themselves a therapist. (Don't mean to sound denigrating - some of them are wonderful!) Just saying that just because a psychiatrist had to study more physical/medical issues to get their M.D. doesn't mean they can't be a good therapist.

I think bottom line is always the "fit" between patient & T, plus some people just seem to be naturally empathic and good w/therapy stuff, regardless of their education or background.

[Perna]

Originally Posted by TheRealFDeal

The thing is, I have this deeply held bias that pdocs make terrible Ts.

The PDoc is an individual and there's always that exception. My surgeon saved my life acting as my primary care doctor and I had the bias that you didn't want a surgeon to be your doctor (because all they want to do is operate :-)

Think about in what ways you feel PDocs make poor therapists and give yours a try and try to help him with that part? Mine I had to research medications to try online myself and give him a list and tell him to "pick one," right when he was getting ready to operate on me again to see what was wrong. He went along with my "pick one" idea but warned me that if it did not work, he was operating. It worked

[herethennow]

I see two psychiatrists. One is purely for meds, another for psychotherapy. And both are pretty good even though my pdoc is a pdoc purely, she is somehow my second T because whenever I'm in crisis I will arrange an appointment to see her and she's the one who will work it out with me and listen to what I have to say.

But my T is really empathetic and good what she does.. and she will talk to my pdoc whenever she finds that something is wrong. She's senior psychiatrist in the hospital I go to therapy for so I assure you that pdocs make good Ts as well.

(even though I see 2 Pdocs, I like the idea of separate people for meds and therapy hahaha)

[doyoutrustme]

I had the same start as you. I now use my pdoc for therapy. It was great to be able to warm up to him before officially starting therapy.

I also think its great to have the same person do meds and therapy. He treats me on both ends and I feel a lot safer that way, then if he only checked in once a month.

[TheRealFDeal]

Great feedback. I've decided to give pdoc a go and I've made a "real" appt with him for Thursday. I really would like to have a separate T for therapy, but I'm doing this partly because I feel I'm out of options -- there are no more Ts left to call -- so many are not taking new clients. That said, I'm terrified. I'm terrified of the whole relationship changing, of ruining the relationship so that I neither have a T nor a pdoc. And it will be a different relationship, with transference and all that. I haven't expected much of him before, his empathy and reflections were gravy to me. Now I may need him more and have higher expectations, and that scares me.