We do not have power in therapy.
You guys will love this
I had another session with my psychiatrist/therapist in which I brought up the question of the notes again.
If you are just tuning in to this story you can go to this post, I’m Calling Bullshit on Them..Where is Our Voice?
I had gotten it into my head that maybe I did want to do some “therapy”…that maybe it would be a good idea to process some of my story with one of them.
I actually had high hopes that he would consider what I had to say.
If you remember…I like my Pdoc (he also does therapy). He is smart and respectful and knows his meds. He is a very good very respected Doctor and it took me a long time to find a good one.
I thought maybe we would chat about it and then I would ask him why he won’t take insurance (huge eyeroll here) and then my roadblocks to feeling comfortable with treatment would be removed and maybe I would let him therapize me….
Let me clarify what my request was before going into his response to it…
my basic request was to be shown the notes at the end of the session. Just a quick run down…..so if there was something off…something that was not true..that he misunderstood…the wasn’t what I meant…then that could be noted…
before it went
I am going to tell you what he said…..
I took notes
The base of it is that he does not feel like he can provide effective quality treatment if he has to show me the notes at the end of the session.
So there you go.
I am legally allowed to see my records
but if I see them
I forfeit my right to effective treatment
I think that merits a repetition
We are legally allowed to see our records
but if we see them
We forfeit our right to effective treatment
That’s real nice
That’s real fair
I am unsure at this time whether he was saying that he would not treat me if I wanted to see the notes…but I believe that he is in fact saying that he will not show me the notes…
maybe that is the same
I’m not sure
So do you want to know WHY he is unable to provide his service if I get to sign off on what goes into my permanent record?
Apparently, my request is unusual
I think it is the natural decent way to operate.
but he said he it has never had this come up before…..
THINGS NEED TO CHANGE
I said I thought it was a small request
He said it was not a small request…that it had a tremendous impact on therapy.
(okay maybe it does…..is that bad????
THINGS NEED TO CHANGE)
(Show of hands again of people who have been helped by therapy????
oh yeah….you three over there.)
Okay he said
The therapeutic relationship is not equal
The therapeutic relationship cannot be equal
(I don’t really think I’m asking for “equal” but okay so we are less than them moving on….)
He said that there has to be a boundary
(I agree completely. I’m not asking for closeness. I’m asking for a voice in what goes into my permanent record)
He said that what I am asking for blurs a line…..where is the line
(The line I see is a line between what is decent and just and what is old protocol that holds stigmatized, discriminated people down and disempowered)
He said what he writes is his opinion…..
(yeah I know. That’s the point. His opinion isn’t my truth. His opinion can have tremendous ramifications in MY life. Why should their opinions be granted so much reverence and power?)
He said that therapy requires a huge amount of trust from the patient.
(So yes you are supposed to hand over control, hand over power, hand over your voice, and tell a stranger all of the most crazy of the crazy most personal most intimate frightening inner workings of yourself……
and have them write it all down….and then make speculations and interpretations about you……
put it in a permanent record
And not let you see it?
And if you can’t do this
That is what therapy takes.
And we really sort of get strong armed into therapy.
If we see a psychiatrist, which most of us just need to do for the meds, they inevitably push therapy on us.
Please don’t anybody blame me for people not going to therapy.
I am not saying we don’t need and shouldn’t go to therapy as a general group. Some of us can benefit tremendously.
What I am saying is…
Things NEED to change!
The “mental health system” is not finished evolving…
I mean obviously!
Look where it was 40 years ago!
Appalling horrendous inhumane cruel
Why should we assume that a mere 40 years later everything is fair and humane?
It isn’t over
Things still have to change.
This isn’t cancer or multiple sclerosis or Parkinson’s or Diabetes or Hashimoto’s thyroiditis….
THIS IS MENTAL ILLNESS
and society and the system do not hold an accurate view of us
in fact it is a damaging view
People really DO NOT think that we are on the same level as they are….
and it is FOOLISH to think that this attitude does not exist among the mental health professionals.
We are entirely too stigmatized and mistrusted and feared to be comfortable handing over all of our control and power and
trusting so profoundly.
Seeing what is going into our permanent record could never undo the power imbalance.
The power imbalance is strong as strong can be….
We will forever be crazy, diagnosed, ill, a “patient”
and they will forever be
So if they write that you’re depressed
and you say
I’m really not depressed
Who is going to be believed?
or the Bipolar girl?
If the doctor writes down that you are delusional because you want to write a book (true story)
and you say “I’m not at all delusional”
Who is going to be believed?
The Doctor? The Expert?
Or the guy with the diagnosis of Bipolar Disorder, a symptom of which is being delusional?!?!
So why wouldn’t they dismiss you as
NOT KNOWING WHAT YOU ARE TALKING ABOUT BECAUSE YOU ARE BIPOLAR (or whatever else you are my dear readers)
They want us to TELL them when we feel depressed or manic or delusional or suicidal or sad or whatever!
Thanks for making us so comfortable mental health people.
So I really thought he would maybe make some concession….
I am just baffled because my desire seems so
But you know what it IS NOT?
It isn’t “how it’s done”
Yeah I know….
THINGS NEED TO CHANGE
If therapy won’t work if we aren’t stripped of our power and voice and rights…….
THEN IT DOESN’T WORK
He said that he would be “hindered” in therapy if he had to show me my notes.
I said that I would be “hindered” in therapy if he could write down anything he wanted and I would have no say or knowledge what was permanently recorded about me.
“Who is losing?”
Good thing I am so used to losing.
That is what we do guys
We lose over and over
We lose jobs
We lose friends
We lose children
We lose disability insurance
We lose apartments
We lose when we have to list all of our meds for judgmental nurses
We lose when we have to cold call a list of providers trying to get help when we are so depressed we can’t move
We lose when we are ignored when we go to the ER and say we are suicidal
We lose when Urgent Care doctors treat us rudely
We lose when people dress up like “mental patients” for Halloween
We lose when people make jokes about mental illness to our face…assuming of course that …..
“the mentally ill can’t really be among us”
We lose when we have to be anonymous
We lose when we have to brave the dangers of the internet in order to get real help and understanding.
We lose when we have to pay extraordinary amounts of money out of pocket in order to see quality doctors who can’t be bothered with paperwork.
We lose when we are forced to find new providers when we move without any support or structure to help us.
We lose when they prescribe meds we can’t afford….
We lose when we have to wait forever for appointments with psychiatrists
We lose when we experience damaging therapy where we are told we said things we did not say and then patronized
We lose when we subject our bodies to the side effects of the medications…everything from insomnia, to permanent tremors, to death.
here is just another way we lose.
But he followed that up with the statement that I am losing because
I am “making it conditional”
Does he mean that I am making therapy conditional on being treated fairly?
Then Yeah I guess I am
that is NOT why I lose…….
We lose because….
We can’t get the help we need and deserve unless we give up our power….
we have to say all of the really crazy shaming embarrassing personal stuff we have in us….
and take the risk
that some day
it may blow up in our face…
that everything you say could be used against you.
Am I being somewhat extreme? I do not know the exact number of cases that blow up and damage the individual.
But the world is crazy and anything can happen
I could give a few examples….(this is too long we will do it later)
He basically said the same thing over and over again….
That if I knew what he wrote….
That he would be hindered…
that it would limit therapy
that it might kill therapy (for him I guess)
that it would keep things reined in
That if the dynamic changed even a little bit it would impair his ability to help me therapeutically.
That it would become a slippery slope….where would it end….
(I kept saying I am just asking for this one normal natural thing but he kept acting like if I got to know what went in my permanent record that next thing he knew….I’d show up on his doorstep looking for a hug. puhlease.)
He said that his interpretation of the notes (that he would be hindered in making) are important and sometimes lead to a breakthrough in therapy.
But there can’t be a break through if I’m not sharing?
Isn’t that obvious?
At the end I said…..
“So You’re saying that it is more important for you to make your speculations without me knowing them than it is for me to actually tell you things?”
“Are you telling me that if I get to see and sign off on what goes into my permanent file that you cannot treat me effectively…that it would have a tremendous negative impact on therapy?”
The answers unfortunately are yes.
he did leave me with a little bit of empowering knowledge….
“The control you have in therapy is to share or not share”
I’ll let that sink in
The problem with that statement (well one of them) is that if WE DON’T SHARE then…….
There is NO THERAPY to BE IN.
WE HAVE NO CONTROL IN THERAPY
and to top it all off….
he coded me depressed….
Well even better
Bipolar and Depressed of course
Did he tell me he thought I may be depressed…?
Am I depressed?
not at all
But he wins.
His opinion wins
Their OPINION wins
Their opinions become our personal MENTAL HEALTH records
And so now…he can write down whatever he wants from our session and put it in my file and it can be matched up against the insurance codes and what does it look like then????
Like a depressed Bipolar girl made this big weird fuss about seeing her records.
I do trust him. I don’t really think something bad could happen someday.
But the principle
is what I am talking about.
I’m talking about
What is RIGHT
not what is convenient
So he wants his power…
I want my voice
Apparently, they cannot coexist.
I find this extremely disturbing.
and I am disappointed and discouraged because we are stuck…..we need Pdocs…some of us need our therapists.
I am not being all anti-therapy. I am saying.
It needs to change.
The Mental Health System needs to be more of what WE need and less of what THEY want.
We need rights. We need protection.
So remember guys
“The control you have in therapy is to share or not share”
What do you think your therapist would say?