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Dr. Bob is Robert Hsiung, MD,
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Posted by Dinah on November 22, 2003, at 21:17:22
In reply to Re: Another question » Dinah, posted by Elle2021 on November 22, 2003, at 21:04:48
Sounds like we came to therapy via the same route. I came in with panic attacks and OCD too. Over time, he came to think of me as schizotypal.
Now I'm afraid to get a receipt for insurance from him because he's hinted that he'd give me a diagnosis code I don't want to have, have never gotten, and don't think is accurate. I guess I need to talk to him about it.
We use borderline terminology a lot in therapy, though I don't meet the DSM IV criteria. It helps me a lot in explaining myself to myself.
Posted by Elle2021 on November 22, 2003, at 23:07:38
In reply to Re: Another question » Elle2021, posted by Dinah on November 22, 2003, at 21:17:22
Hi Dinah,
What is a diagnosis code? How will it show up on your receipt? Do you think your Schizotypal? Your lucky you don't meet the criteria for BPD! :)
Elle
Posted by DaisyM on November 23, 2003, at 0:54:08
In reply to Another question, posted by Dinah on November 22, 2003, at 20:35:47
<<Is your therapist likely to startle you by thinking you're far better off than you think you are? Or by thinking you're far more troubled than you think you are?
>>>Good question. We've kinda just talked about this in two different ways -- the first in the way I entered therapy: Mid-life crisis/depression and then after 4 months, huge "confession" about childhood issues, which takes us totally in a different (PTSD) area. So what looked like "standard" therapy has actually gotten much harder. I worry that it is too hard for him 'cause I know how hard it is for me! Plus, this isn't exactly what he bargained for, is it?
He has also mentioned that sometimes clients start getting better but because you are afraid that therapy will be terminated because you begin to recover, you resist sharing the good things that are happening. I don't know if that applies to me yet. I do think that this statement was meant to encourage me to look at how often I am OK, to focus on what coping techniques have worked in the past. I feel like I'm falling apart sometimes, but I'm never sure how "bad" he thinks I am doing. We use the word fragile alot --and he did move Thursday's app't to Wed, even though he'll see me Monday too...
I've actually been thinking this weekend that I feel more hopeless and I don't know what I want from therapy anymore. I don't feel better - I mean, who gets near tears just grocery shopping?! Other times I think, I just need to buck up and deal with my life. *sigh* I drive myself crazy.
Posted by Dinah on November 23, 2003, at 7:06:46
In reply to Re: Another question » Dinah, posted by Elle2021 on November 22, 2003, at 23:07:38
I suppose I need to check it out again with him. It's possible he's since come to a different conclusion.
Is it being borderline or being diagnosed borderline that distresses you more? There is unfortunately still a stigma attached to the term among some practitioners, I fear. That's why I'm so happy to see the good work of Nikki and others lik her. I wish more practitioners would see it as a source of pain to the people who have it, rather than a source of pain to themselves.
Looking through the borderline criteria again, I think I could easily fit five, depending on interpretation. Yet I never get diagnosed, because I'm usually very far from impulsive, have relationships and a lifestyle that's almost too stable, and don't freely show anger. My therapist also read the descriptive rather than clinical criteria, and I don't fit those. I guess that's what comes from self diagnosing. Although he thinks I do have some borderline qualities. Hmmm... It might be interesting to get him to read the descriptive criteria for schizotypal.
Posted by Dinah on November 23, 2003, at 7:12:19
In reply to Re: Another question » Dinah, posted by DaisyM on November 23, 2003, at 0:54:08
> So what looked like "standard" therapy has actually gotten much harder. I worry that it is too hard for him 'cause I know how hard it is for me! Plus, this isn't exactly what he bargained for, is it?
It sounds like a lot of us got to therapy this way, so perhaps we shouldn't worry so much about it. Maybe therapists are used to simple presentations turning complex. Or simple CBT becoming long term therapy of a different sort.
>
> He has also mentioned that sometimes clients start getting better but because you are afraid that therapy will be terminated because you begin to recover, you resist sharing the good things that are happening.I worry about that too, so just on the off chance it was true for me, I had him agree that therapy wouldn't be terminated anyway unless I wanted it to be. I think that also reassured him a bit that I wouldn't resist getting better.
>
> I've actually been thinking this weekend that I feel more hopeless and I don't know what I want from therapy anymore. I don't feel better - I mean, who gets near tears just grocery shopping?! Other times I think, I just need to buck up and deal with my life. *sigh* I drive myself crazy.
>
Sounds familiar. :( But every once in a while I look over my "journals" and see that yes, I am getting better. Do you have any old notes or posts that you can use to help you see how far you've come (and I forget how long you've been in therapy?).
Posted by Dinah on November 23, 2003, at 7:12:55
In reply to Re: Another question, posted by Dinah on November 23, 2003, at 7:12:19
Posted by karen_kay on November 23, 2003, at 9:38:20
In reply to Another question, posted by Dinah on November 22, 2003, at 20:35:47
> Is your therapist likely to startle you by thinking you're far better off than you think you are? Or by thinking you're far more troubled than you think you are?
><<Well, at first he really scared me. Within the first three sessions he basically diagnosed me as Borderline. After doing my homework, I realized that I do in fact fit the criteria. And I hate it. But, it is also a sense of relief, because I feel that knowing is so much better that not. But, the only thing that we are focusing on at this point is the "black and white thinking." And I'm coming around, SLOWLY.
But, he does such a good job of reminding me of the progress I've made at this point. And when I complain that I'm not getting anywhere he reminds me where I was when I first started seeing him. I don't think he tries to tell me that I am doing better than I actually am. Nor does he make me sound as if I am worse off either. I think he tells me like it is. And I love his accuracy and consistency. We used to argue from time to time, quite a bit actually, because I was jealous that maybe his other clients were healing faster than I was. And he would just tell me that maybe I just wasn't ready to let him start helping me. Well, I trust him now and I'm so ready!!! I'm actually excited!
Karen
Posted by Dinah on November 23, 2003, at 10:08:11
In reply to Re: Another question, posted by karen_kay on November 23, 2003, at 9:38:20
Posted by fallsfall on November 23, 2003, at 10:49:47
In reply to Another question, posted by Dinah on November 22, 2003, at 20:35:47
My therapists think I'm doing better than I think I am - almost all of the time.
But since my first therapist told me on our first visit that she expected to see me 6 - 8 times, and I ended up seeing her for 8 1/2 years (and am still not "well"), I think that maybe my view is more accurate.
My new therapist said something in June about getting me back to work (i.e. fulltime software engineer) "well, maybe not by September". And he really did see "the real me" falling apart when I first met him.
I feel like I know how sick I am, and they know how to fix sick people. Somehow we have to get together on this and accept each other's knowledge.
I hate it when they say "You are more competent than you think you are". It makes me feel like I'm not trying, but in reality I think that there is something getting in the way of that competence that they don't understand yet.
Posted by karen_kay on November 23, 2003, at 10:58:38
In reply to Re: Another question, posted by fallsfall on November 23, 2003, at 10:49:47
I really become afraid though, because I only have a year and a half before I leave this town and my therapist. That is my time limit. And I have a lot to work on. I try not to think about it, but not thinking about things IS my problem. I tend to honestly believe that if I don't acknowledge my problems, they don't exist. And, I forget them. But, other people don't, no matter how much I wish they could. But it really worked in the past. But, that is why I had to start therapy, so I guess it didn't really work as well as I had hoped. But, it got me through some rough times when I needed it to. And, I can't imagine seeing another therapist. So, I have to work twice as hard. But, I can't make memories come that just aren't ready, you know... Oh, dilemmas!!
Posted by DaisyM on November 23, 2003, at 17:44:31
In reply to Re: Another question, posted by Dinah on November 23, 2003, at 7:12:19
Just a little over 6 months. Which I think is soooo long and he says we are just beginning. :(
At least I started out looking for a psychotherapist and did not mess around with a CBT. Since I have so much experience and education in the developmental realm, and we use behavior techniques with kids, I knew I would resist if they were being used on me.
yeah, it is a control thing.
Posted by DaisyM on November 23, 2003, at 17:56:08
In reply to Re: Another question, posted by fallsfall on November 23, 2003, at 10:49:47
<<I hate it when they say "You are more competent than you think you are". It makes me feel like I'm not trying, but in reality I think that there is something getting in the way of that competence that they don't understand yet.
>>> See, I wonder all the time about this competent thing. I am totally competent, doing my job, being the mom, etc. (OK, so the wife thing has gone down hill a bit, a person can only do so much). But being TOTALLY competent was what sent me into overwhelm last April. It is the motivation and joy that I am missing. And self-confidence. I can't get excited about anything, or sustain a good mood. And I started having suicidal dreams, which scared me. But you would never know it to look at me: suits on with stockings and heels, makeup, hair's done...it is all automatic.
I don't know whether to SAY this to my Therapist or not. I don't know how to prove that I am an emotional wreck yet intellectually OK. How can this be?? I was thinking today about how many times I've had a melt down and told him in the past few months. Prior, I wouldn't have told anyone, I would have just moved on. Arrggh.
I've spent the better part of the last month trying to get a handle on this very thing: is he still ok treating me? - does he think I need treatment or just support? (LOL - hmmm, 3 visits and 2 phone calls one week, and I still wonder if this is "just" support!)What next?
Posted by Elle2021 on November 24, 2003, at 0:29:03
In reply to Re: Another question » fallsfall, posted by DaisyM on November 23, 2003, at 17:56:08
> I don't know how to prove that I am an emotional wreck yet intellectually OK. How can this be??
My therapist seems to think it is entirely possible. He is always telling me how intelligent I am, yet at the same times recognizing what he refers to as my being "highly emotionally unstable." Hmm... Is that a compliment? Hehe!
Elle
Posted by Elle2021 on November 24, 2003, at 0:38:43
In reply to Re: Another question » Elle2021, posted by Dinah on November 23, 2003, at 7:06:46
> Is it being borderline or being diagnosed borderline that distresses you more?
Thats a tough question! It's a paradox really. In one way, I am comforted by knowing that there is a good reason for my behaviour, but at the same time, scary because I know there is something wrong with me. The borderline moods are a direct source of the majority of my problems. I get my feelings hurt easily, I take *everything* personally (which you may have noticed in one of my other posts to a certain poster you simply said, see you later or something like that in French). Another big problem is black and white thinking. I do not believe I will get past this. I really can't see the grey that other people see. For me it's either right or wrong...very binary if you know what I mean. Sometimes, I think I could easily fit other disorders, particularly PTSD. I have trouble talking to my therapist about anything, literally. Which is starting to make him upset with me. Probably the reason he wants to "cancel" the sessions so often. Probably figures his time is better spent with someone else. Ahh...
Elle
Posted by Dinah on November 24, 2003, at 0:51:05
In reply to Re: Another question » Dinah, posted by Elle2021 on November 24, 2003, at 0:38:43
Elle, we were talking about doing a DBT thread here, where we actually talk about the various DBT ideas and try to put them into action. I still think it's a good idea.
Have you read Linehan's work on DBT? It really is reassuring about the possibility of change. Not perfect total change perhaps, but change enough to make life better. One think I like about her is that she doesn't promise the moon and stars. :)
I think I've gotten a bit better with some of those things, at least some of the time. I think you can too.
And I seriously doubt that's why your therapist is cancelling your sessions. If you can't talk to him about your fears, can you write them down? You write your concerns very articulately here.
You show a good deal of strength here on the boards. I've got the feeling you could turn that strength to good use in your treatment.
Posted by Dinah on November 24, 2003, at 0:53:32
In reply to Re: Another question » Dinah, posted by Elle2021 on November 24, 2003, at 0:38:43
Elle, by the way. I see some shades of grey thinking here on the board. You don't tend to categorize people as all bad or all good, and you are perfectly capable of disagreeing with someone while also showing them that you hold them in good regard.
Posted by Elle2021 on November 24, 2003, at 3:23:27
In reply to Re: Another question » Elle2021, posted by Dinah on November 24, 2003, at 0:53:32
> Elle, by the way. I see some shades of grey thinking here on the board. You don't tend to categorize people as all bad or all good, and you are perfectly capable of disagreeing with someone while also showing them that you hold them in good regard.
That is the best thing someone has told me in a long time regarding my bpd! To be completely honest, this board has really been a help in making me understand the feelings of others without completely seeing them as "all wrong" or "all bad." I am coming to realize that even if I don't agree with someone on one thing, they might still have really good info for me and be nice. For instance, a certain poster(who I will not center out cause he was kind enough not to do it to me) and I have disagreed on something on the Administration board, yet I still find this person very supportive and caring. I guess sometimes it takes other people to point out your progress before you realize it! Thanks!! :)
Yes, an ex-boyfriend of mine also mentioned that I do better expressing feelings on paper than out loud. I can't stand to see people's facial expressions when I tell them personal thoughts and feelings. I always feel like they are going to think I'm stupid or crazy for feeling a certain way. That method of thinking has prevented me from developing strong friendships. I emailed my pdoc, not about his cancelling my appointments, but about a certain medication that I noticed was helping my OCD. I wish I could do therapy via email, or just be able to send him emails and have him write me back inbetween sessions. I think that would help so much. But, I'm too afraid to ask, he might think that I am asking too much of him. Sometimes I feel like I deserve more from him though...I sure do pay him enough! :) Hehe! Thank you so much for your encouraging words, you don't know how much they helped.
Elle
Posted by Elle2021 on November 24, 2003, at 3:33:54
In reply to Like music to my ears! » Dinah, posted by Elle2021 on November 24, 2003, at 3:23:27
I forgot to mention that I would be interested in discussing the DBT. I have read a little bit about Linehan's work, my pdoc suggested it to me. Sounds interesting!
Elle
Posted by Penny on November 24, 2003, at 9:49:35
In reply to Another question, posted by Dinah on November 22, 2003, at 20:35:47
> Is your therapist likely to startle you by thinking you're far better off than you think you are? Or by thinking you're far more troubled than you think you are?
>
> My therapist, oddly enough, has managed both. But for the most part I think he more often refers to me as more "troubled" than I think I am. I think some of it may simply be differences in priorities and values. But other times I wonder if I really am worse off than I think if he thinks I am...
Sometimes I think my pdoc thinks I am worse off than I think I am, and sometimes I think he's not aware of how bad I'm really feeling. My T is usually more perceptive.What I have noticed is that if my pdoc seems especially concerned about my mood, it makes me more concerned about my mood, which, of course, makes me feel worse. During one visit he kept asking me, "Are you sure you're okay?" and saying, "I'm concerned about you." and I left feeling like, "Wow, maybe I should be more concerned about myself..."
Posted by Dinah on November 24, 2003, at 19:29:01
In reply to By the way Dinah..., posted by Elle2021 on November 24, 2003, at 3:33:54
I talked diagnoses with him today. I thought it was a relatively innocuous subject, but I still ended up angering him. Come to think of it I anger him a whole h*ll of a lot. At this rate maybe he will terminate me. Terminate....
Anyway, he says he said my prior pdoc thought I was schizotypal and he didn't disagree. But that over time he's thought of me as less so, although still having a lot of traits. But he now also thinks I have a lot of borderline traits, so if he were diagnosing me, he'd give me both Axis II diagnoses.
I still see me as more borderline.
But at this point, I don't think I care one way or another.
Posted by fallsfall on November 24, 2003, at 20:07:52
In reply to Re: Diagnoses, posted by Dinah on November 24, 2003, at 19:29:01
He's not going to terminate you...
Posted by Elle2021 on November 24, 2003, at 22:16:03
In reply to Re: Diagnoses, posted by Dinah on November 24, 2003, at 19:29:01
> I talked diagnoses with him today. I thought it was a relatively innocuous subject, but I still ended up angering him. Come to think of it I anger him a whole h*ll of a lot. At this rate maybe he will terminate me. Terminate....
Why does he get mad when you talk about your diagnosis?
>But that over time he's thought of me as less so,
Thats a good sign, your getting better.
But he now also thinks I have a lot of borderline traits, so if he were diagnosing me, he'd give me both Axis II diagnoses.
ouch...
> I still see me as more borderline.
> But at this point, I don't think I care one way or another.I'm getting to that point too regarding my own diagnosis'. ugh. Thanksgiving is starting to get me stressed...
Elle
Posted by Dinah on November 26, 2003, at 15:52:25
In reply to Re: Diagnoses » Dinah, posted by fallsfall on November 24, 2003, at 20:07:52
I guess I know he won't. But better yet, he called to change the time of Monday's appointment and he didn't sound mad. I needed that. :)
It's all a matter of timing, I think. I'm just not feeling well right now, so everything seems bigger than normal. When the holidays are over, I'm going to try to get a Depakote level and/or call my doctor to complain. Goodness only knows I shouldn't have any effects at 250 mg, but my hair is falling out - complete with disgusting roots (and ending up in my food all the time, yuck), and I just feel awful - depressed and really uncharacteristically angry. Even the dogs think so. I think I'm a medication side-effect hypochondriac.
Posted by Dinah on November 26, 2003, at 15:55:50
In reply to Re: Diagnoses » Dinah, posted by Elle2021 on November 24, 2003, at 22:16:03
Well, I went to the bookstore today, and found a book that was based on the DSM IV but did more than list the criteria. It also gave descriptions of people with the disorder. And I still think I may have schizotypal traits, but my current pdoc is correct. The diagnosis of schizotypal personality disorder refers to a different level of intensity of those traits than I have. Ditto with the borderline. So I'm holding out for personality disorder - not otherwise specified. I'm not going to deny I have a personality disorder. I just think it's a combo plate.
Posted by fallsfall on November 26, 2003, at 16:43:15
In reply to Re: Diagnoses » fallsfall, posted by Dinah on November 26, 2003, at 15:52:25
I hated Depakote because it made my hair fall out. Hair is my favorite body part - so this was not acceptable. I stopped taking it because of that. It took another month before it stopped falling out after I stopped it.
This is the end of the thread.
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