Trepidation--planning to read my therapy notes.

I’m planning to read my therapy notes.

Saw a T for 13 years over a 17-year period—from 23 to 40. 3 years out of town + some breaks = the other 4 years. Went through a hell of a lot.

Had really painful termination in 2004—abrupt termination by her Walked into session, was told that was it; that was it. It’s too long a story, but of the things going on I wasn’t told--initially why she was terminating, other than that it was unethical to keep seeing me She ended up giving a few different reasons—to me and to my p-doc. T said I could call her to help me transition to someone else—she provided references. Talked once about an admin matter of the termination. 2nd time she told me she c/wouldn’t talk on the phone again, but could write. Wrote a couple of things re: more admin issues, then told she won’t read anything else. Though I was crushed and furious, all of that communication from me was polite, balanced—not harangues. I had my p-doc go over it before I sent it.

After a few months I requested my records, initially just for the immediate period—2 months—until termination. The records I got were incomplete, and had my p-doc request on my behalf the rest of that period—rec’d what supposedly was all of them. I then requested everything, consistent with state law, HIPAA, and APA. I was considering taking action with APA and state board—won’t explain the grounds for that, and when she asked why I wanted them, I mentioned that as one reason. She said she’d send them to me. Got a letter sayign she wouldn’t release them to me because it could be harmful to my mental health. T’s here are required to release to a 3rd party mental health professional if requested—with patient permission, so she sent them to him. I didn’t push him to go through them immediately b/c I was so conflicted about reading them and pursuing any action was something I decided not to pursue.

That p-doc released all of them to me in fall 2006 when he left practice. He didn’t see anything that might be harmful to me.

Now I’ve had them since fall 2006 without reading them, and want to read them now.

I’m afraid that I might get really bent out of shape by stuff in there. Who knows what she wrote? I went thru some really, really heavy stuff. I finally feel like I want to put it behind me and finally read them. But I don’t have anyone in my life to talk to about this stuff or lean on if I do get really knocked around psychologically and emotionally.

The fear is about what she might have said, not with the underlying issues or with what I might have said or done back then—that’s cool with me. But due to the horrible termination situation—I was messed up for about 9 months, and it’s kept me from getting a new T—absolute lack of trust in them and the process (though I saw someone for 5 sessions last winter; we just didn’t click and she did psychoanalysis, not what I want/need—that was 3 years after termination with initial T). After having massive abandonment issues with parents, and 17 years with a T who says she’ll never abandon me, she did—in my eyes.

I don’t even know if the records are complete—as she withheld some the first time around.

Any advice from others on reading your records like this? Coping measures? I’m determined to do it—after 3.5 years of lead-up time since originally requesting them and almost 2 years of personally having them. I’m seriously thinking about getting back into therapy, but first I have to move on. Closure. From that earlier stuff. If I don’t, I’ll ruminate about what’s in there forever. That’s the way I am; know thyself, and that’s just how I am.

Been there/done that? Wisdom? Resources?

Thanks

Hey. I went through a period of requesting and then reading my notes, too. Then... Requesting again as they didn't send me the complete notes the first time etc etc.

After a time... I wondered if there was some repetition compulsion or something like that going on from my part. I would feel upset in reading them. I'd think 'oh my god! they interpreted what I did there in that way?' and 'but that wasn't what i was trying to convey at all!' etc etc. A lot of it was fairly distressing / hurtful to me.

So... The million dollar question really was: Why did I keep putting myself through that with reading them?

I'm not quite sure on the answer. Partly... It was that I wanted to know what they thought of and about me. I wanted to know. The non sugar coated, upfront version. Part of it was that I thought that if I looked hard enough into how they saw me then maybe I'd see myself. Maybe I'd find me in there somewhere.

Only... I didn't really. I saw their interpretation... And while it is one take, they certainly don't have unmediated access to some objective truth (I'm not actually sure that there is such a thing).

I'm not quite sure what to say. I'd kinda know this... Know that reading them would hurt... But I'd still feel compelled to read them. At the moment I have them stored in another country. If they were here... I'm fairly sure I'd still be reading them at times. Hang in there. Maybe... If you can resist... I'd suggest... Don't do it. I'm not at all sure you will find closure in there. I think it is more likely that a wound will be reopened with careless words that were written in haste when a clinician was in a bad mood...

imapatient, I can really understand your need for some closure. Do you have any idea why your T terminated and why she felt it was unethical to see you anymore? I feel she owes you an explanation and it is unethical to terminate without giving one. I too would want to look at the records to see if I could figure out why. Do you think she had fallen in love with you? I hope you can find out what you need to know.

I've read mine once. Ouch. My strong recomendation would be to shred the whole pile. Put it in the past. Get a new T. Process what happened, grieve the loss. The termination process still needs to occur since it sounds like you have not been able to let go (and who could without a proper termination?). That work needs to happen - within the safe structure of therapy. I know the difficulty of trying to trust again. But try to put aside emotion just a bit to know that this was one T. Just one. They are not all like her. You can read here about many, many good, kind, gentle Ts. I hope you will find one to process your loss with, and find a way to move ahead!

It's possible. I know it is.

Slippers.

I went through this once with my T. I was contemplating divorce and wanted to see what was in there.

I love this sentence the most "patient is a somewhat overweight white female"... that did it. I couldn't go much further. I did see a comment an eroticized transference and him telling me that boundaries needed to remain firm:..

It was more than I could take, I threw the rest away. However, if your former P-Doc didn't see anything harmful perhaps it isn't then...

After much... going back and forth.. I got my notes.. and.. she had doctored them.. so there was really nothing there... stacks.. of notes... from 4 years.. saying depression up... depression down...

I did get a copy.. of notes from an ENT.. and flipped.. because he said.. I seemed.. to be "all over the place" with my emotions.. I went from.. x.. to y.. to z.. to p...

well... since I am DID... I was switching...

my advice.. is shred.. them... move on...

my T of 4 years had terminated me via e-mail.. of all things... not even in person...
and.. reading.. even the ENT specialest notes.. hurt... though I understood.. the "why".. because of the DID.... but... it still hurt.. and wasn't worth it...

if she terminated you... without an explaination... just perhaps... the notes.. aren't all the valuable.. because they came from her..

and.. I am sorry... it is so so so hurtful to be terminated like that... it has been 2 years for me.. with a good therapist... and I am getting over it...

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lauren_helene said:
I went through this once with my T. I was contemplating divorce and wanted to see what was in there.

I love this sentence the most "patient is a somewhat overweight white female"... that did it. I couldn't go much further. I did see a comment an eroticized transference and him telling me that boundaries needed to remain firm:..

It was more than I could take, I threw the rest away. However, if your former P-Doc didn't see anything harmful perhaps it isn't then...

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Holy moly laren helene... "somewhat overweight white female" somehow doesn't strike me as relevant to a therapy notes. I've read most of my therapy records, and I'm happy to say their isn't anything that really bothers me at all. What would bother me though, is if someone else read them (even though not all that revealing)...

it is fairly standard for them to comment on your weight (it can make a difference for metabolizing medications and also for side-effects and / or complications)

Yup. All the notes I've seen on myself have a physical description at the top of the initial session notes. Some more sensitively and compassionately stated than others. And I've seen it frequently enough in case study writeups to think it must be standard. I sure don't want to see my therapist's notes.

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kim_johnson said:
it is fairly standard for them to comment on your weight (it can make a difference for metabolizing medications and also for side-effects and / or complications)

</div></font></blockquote><font class="post">Doesn't seem like that would matter with a therapist as they are not involved in prescribing or monitoring meds.

I don't think my therapist keeps notes. I'm OK with that. I have ZERO desire to see them if he does keep them. I keep my own notes on some of our sessions in my journal. That is enough for me.

could potentially flag issues with food / exercise (which can of course impact on mood, self image, etc etc)...

I should have been clearer than I was. It’s my first attempt to communicate with other patients/ex-patients, etc. about any of this. It was a really messy situation of what went on with the termination. Anyway, all of that ethics, appropriateness stuff, isn't what's centrally at issue and I should have kept that out of it. I just haven’t' explained it to others than my p-doc and briefly to a friend or 2.

The central driving issue for me--but not the only--relates to a particular, MAJOR issue for me that was addressed in therapy with her over a period of years, including (again) right at the end.

What I want to read about is her side of the issue--to the extent I can--because I questioned her sincerity about her comments and positions. It's my central issue stemming from some sexual abuse as a kid, and I carried doubts about things she said to me about it. It’s a potentially explosive issue—for me—but for some other people, too. She shut down talking about it--at least to the point relating to what she said, thought, etc. various things.

I see now that were at an impasse--more then 10 years before our termination, and that we should have terminated. She refused to talk about it further, and I couldn’t let go of it, leaving aside what “it” is for now.

Anyway, that's my main issue, though for reasons related to the termination and just in general I want to read the records.

I plan on talking about the termination as it happened at some point, and maybe about the underlying issue I'm talking about, but my real issue is the trepidation about literally reading the notes. I'm going to do it, but have concerns about my reaction and state of mind when I do it.

HI Kim, hi Dina---

Most psychiatrists do not conduct "therapy", focusing instead on prescribing medication (most psychiatrists aren't even trained in therapy).

With that thought in my noggin, I have to wonder why a psychologist would want to preface any mental status exam/report etc. with a physical description that goes into such details that are irrelevant to psychotherapy?

Unless the therapist is working w/ a patient with an eating disorder, I can't see the relevance...

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Simcha said:
HI Kim, hi Dina---

Most psychiatrists do not conduct "therapy", focusing instead on prescribing medication (most psychiatrists aren't even trained in therapy).

With that thought in my noggin, I have to wonder why a psychologist would want to preface any mental status exam/report etc. with a physical description that goes into such details that are irrelevant to psychotherapy?

Unless the therapist is working w/ a patient with an eating disorder, I can't see the relevance...

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I don't think it's completely irrelevant for a therapist to make a note of a patient's physical appearance. If the patient goes through a dramatic weight loss/gain it could be an important clue to his or her mental state. The patient could be depressed, using drugs, going through a stressful period, suffering from an eating disorder, not practicing self care, etc. They should try to word it in a more sensitive manner though.