I have a hard time trusting my therapist these days. For example, a few weeks ago, she secretly called up my pdoc and told him that I stopped taking one of my meds. I only found out about the secret call when I went to my pdoc appointment the next day and he said to me, "So, your therapist left me a message..." I don't understand why she even ratted me out, ESPECIALLY since we had both agreed that I would tell my pdoc I stopped taking the med. She didn't even give me the chance to tell him. (We made this agreement the day before my pdoc appt, mind you...) I've never had a history of betraying my therapist when she's asked me to tell my pdoc something. So now I'm afraid that she'll secretly call the cops on me for something I say and then I'll get arrested or put in the hospital because she assumes the worst of me.

I never actually gave her permission to contact my pdoc, btw, but I'm guessing she has the right to talk to him because they work in the same office, and well, I probably signed a waiver that said they can talk to each other.

But seriously... why rat me out? If I'm not a danger to myself or others, then what's the point of doing that? And even if I WAS a danger to myself or others, wouldn't that require the hospital to get involved and not my pdoc? I already said I would talk to my pdoc, but nope, I wasn't given the chance to. She also obviously divulges therapy secrets. And this isn't the first time my pdoc has "known" things that I never told him.

I don't know how I can trust her. How can I have more faith in her? I want to give her a chance, but if she's going to operate behind my back, then idk...

[WishfulThinker66]

I am pretty sure you would have had to have signed a waiver at the time of your initial therapy session authorizing the exchange of information and communication between your psychologist and psychiatrist. My assumption is supported by the fact your therapist knows who your psychiatrist is.

Secondly, these individuals work together as a team looking after your mental healthcare.

Finally, it is your therapist's obligation to take swift action when you endanger yourself. She is not going behind your back.

How can you have faith in her? I would take these actions as her demonstrating you can. She is acting with your best interests in mind. That is enough for me to have faith in my own mental healthcare team.

[Salmon77]

It sounds like part of the problem might be that, when she called your pdoc, she acted like she didn't trust you. So it makes sense that you would be hurt and angry about this. Have you asked her why she didn't leave it to you to tell your pdoc, or talked to her about how this makes you feel? You have every right to be angry and ask for an explanation, but hopefully if you address the issue with her you can start to repair the damage.

[Rive.]

Yes, it seems your T messed up by not giving you the chance to inform p-doc.

I would discuss it with T (as well as your concerns re her ratting you out) and give her another chance. But T's actions showed she did not trust you, so I think it really needs to be addressed if *you* were to be able to trust her i.e. what T did would not inspire trust in me, as a client, either. Trust is a two-way street. T messed up here

[SalingerEsme]

This would be a really big issue for me too, old waiver or no waiver. If you step back, does your T have a reason to be very worried about you? If not, you have a decision to make between letting her repair the relationship with you and both of you working on that or terminating. If a new T did this to me, I wouldn't stay. If this is a poor judgment call in an otherwise steady good relationship, I would roll up my sleeves and get to work saying how I feel. My T makes mistakes, and they spook me, and set me back trustwise. They also make me examine the level of my own dependency/ attachment, that I cannot leave even if I think I should.

[Ashleypenwren]

I understand why would would be hurt by that. My therapist and psychiatrist also work in the same office. I was just stopping medication when I started therpy with her and complained about withdrawal symptoms. She asked if I wanted her to discuss it with the psychiatrist and I said no thanks and that was that. I would expect for her to ask unless it was safety issue. Maybe your therapist thought stopping the med was a safety thing? That being said they have access to each others notes from sessions (and so do I, and anyone in this healthcare network ) so I assume they read each others notes if there is a need.

[stopdog]

Can you find a new one who is not in the same office? I would find the therapist talking to anyone a deal breaker for me. For me, there would be no desire to give this one another chance.

[BudFox]

Therapists should have to earn trust, just like everyone else. And if something underhanded is done, then trust has been undermined. I dont see why special faith should be required. In fact since they are being paid, and since they tend to be manipulative, therapists should be given even less leeway than others.

Also, this idea that you are not allowed to stop meds of your own volition... makes it sound like you are an inmate (the MH system often sounds like a system of incarceration and coercion) or dependent child.

Psychiatrist and therapist talking also evokes parent-child, or supervisor-subordinate. It's creepy on many levels. It probably makes them feel like doctors, but I can't imagine they'd be discussing much of substance. If the concern is the possible impacts of suddenly stopping a drug, then that should be for patient and psych to discuss. Or, there is abundant info online about how to come off psych drugs, if you want to take your care into your own hands.

[susannahsays]

Why should you have "faith" in this therapist? Either there was a miscommunication or she didn't trust you would follow through AND felt justified in going behind your back. Even if she didn't technically violate confidentiality in an illegal way, what she did is shady. I'm not really sure how there could have been a miscommunication, as it seems unnecessary for her to have told your psychiatrist if she heard you say you were going to. Maybe she thought you would forget, and it wasn't about not trusting you per se, but infantilizing and micro-managing you. I guess that's possible, but it would be overstepping for her to do that. You guys made a plan and she should have respected that. In fact, I don't think she should have spoken to him at all if you told her not to, regardless of agency agreement. You have the right to revoke your consent at any time. That may mean you can't obtain treatment from multiple providers at certain places, but you always have the right to withdraw consent.

You're definitely not going to hear any reasons from me that you should try to "have faith" in your therapist.

[WishfulThinker66]

I think we are missing the point that the OP is endangering herself.

[stopdog]

OP is a free agent - I value autonomy over paternalism

[susannahsays]

Originally Posted by WishfulThinker66

I think we are missing the point that the OP is endangering herself.

Why would you make that assumption? If OP had actually been endangered, the therapist would have been legally obligated to do more than tattle to the psychiatrist. And the therapist would not have agreed that OP would tell the psychiatrist, then turned around and done it herself.

Why are you invested in defending the therapist in this situation?

[ArtleyWilkins]

BlueBicycle, I hope you continue to be honest with your pdoc about your medications. You continual stopping of meds, etc. has left you often very paranoid and psychotic. Your therapist and your pdoc cannot help you if you aren't being honest with them, and the fact that you haven't been may be why your therapist has decided to communicate that information to your pdoc. You pdoc can't make safe and informed treatment decisions based on partial and/or incorrect information. Hope you are feeling better than you were a few weeks ago.

[Favorite Jeans]

If the therapist felt so strongly that she absolutely had to inform the psychiatrist herself, she should have told you that was going to do so and preferably called him while you were present in her office. In general that’s what happens when a provider feels that a client is in danger. Paternalism is kind of inherent in that model of care (and in some cases is a legal responsibility) whereas underhandedness is just shoddy work (and is never best practice though isn’t usually illegal).

If you have a tendency toward paranoia or difficulty with trust, it’s maybe best if your care team is completely upfront and transparent with you? Even when they’re telling you stuff you don’t want to hear.

[BudFox]

Nothing says support like group diagnosis and scolding.

[BudFox]

Originally Posted by ArtleyWilkins

BlueBicycle, I hope you continue to be honest with your pdoc about your medications. You continual stopping of meds, etc. has left you often very paranoid and psychotic. Your therapist and your pdoc cannot help you if you aren't being honest with them, and the fact that you haven't been may be why your therapist has decided to communicate that information to your pdoc. You pdoc can't make safe and informed treatment decisions based on partial and/or incorrect information. Hope you are feeling better than you were a few weeks ago.

How do you know it's not the meds causing problems rather than the stopping? Most likely the pdoc does not know. It's all improvised. They rx one drug, then another to deal with the first one's shortcomings or side effects, then another, then another. It's impossible to predict effects on a given person's brain from this kind of polypharmacy.

I could be wrong, but I imagine she did that to cover her ***. I would find such behaviors intrusive. i also agree with Susannah she shouldn't be talking with your psychiatrist unless she got the ok from you first (regardless of whetheror not you signed a standard form). You're not a minor, right?

My T is not involved in my medical care, so its none of his business what medications I take or don't take unless I choose to tell him. The topic of medications has come up only 2 or 3 times in my therapy over years.

I have no idea how to regain trust. My T would never do anything like that, ever, but I'm having a trust issue now too due to some of his behaviors. Unfortunately, I have no good answer or have seen any other ideas on the threads. I can only wish you luck.

[LonesomeTonight]

In my experience, T's and p-docs handle sharing information in different ways. I used to see ex-T, ex-marriage counselor, and ex-p-doc in the same practice. I did sign a waiver saying they could all communicate with each other. With ex-T, she would ask my permission before she shared anything with either of them. Meanwhile, ex-p-doc shared an incident with them that I would have preferred to tell them about myself (well, I had told ex-T myself). With ex-MC, I didn't think he was really sharing any info. Then later, not long before he terminated, he said that he often shared things with ex-T. Which kind of bothered me, because neither he nor ex-T had mentioned it. So I had no idea what he'd been saying.

With current T, who is in solo practice, I was pretty restrictive in who he could talk to. I never gave him permission to talk to ex-T. I gave him very restricted permission to talk to ex-MC (when I was still seeing him) in that ex-MC could share info with him about me, but T couldn't share info about me with him (there were options on the form). And I eventually let T communicate with current p-doc, but he informed me that he'd be calling her, and he told me afterward what they talked about. And p-doc also mentioned what he said to her. I think much of it for me (now) is about being transparent in how often they're talking, what sorts of things they would share, under what circumstances, etc.

I would let your T know how much this bothered you and request in the future that she tell you if she plans to tell p-doc about something (and you can request the same of p-doc). And at least give you the chance to tell them first. If you don't feel comfortable with her answer, you can always rescind your permission to have them talk (I think you're in the US, right?) If that's an issue because they're in same practice (I still had to give explicit permission for mine), then consider seeing a p-doc outside the practice. I think whether you can have faith in her depends on how she responds to all of that.