You Have No Power In Therapy except omission and lies

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.

HA

no

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.

So yeah…

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….

maybe

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

ya know

permanent

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?

Okay cool

let’s go

.

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…..

right

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

a distance

(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

tough

.

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?

we SHOULDN’T

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

incompetent

irresponsible

unstable

lesser

.

Yes.

Lesser.

.

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

The Doctors

.

So if they write that you’re depressed

and you say

I’m really not depressed

.

Who is going to be believed?

The doctor?

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)

.

AND YET

They want us to TELL them when we feel depressed or manic or delusional or suicidal or sad or whatever!

.

um ok

.

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

normal

natural

obvious

.

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.

He nodded

I said

“Who is losing?”

He said

“You are”

.

.

.

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.

We lose

and lose

and lose

So

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

but

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?

Right?

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?”

and

“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.

.

BUT

he did leave me with a little bit of empowering knowledge….

he said….

“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.

Therefore…..

.

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…?

no

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.

yep

.

No power

No Voice.

.

I do trust him.  I don’t really think something bad could happen someday.

But the principle

the principle

is what I am talking about.

I’m talking about

What is RIGHT

not what is convenient

or comfortable

or “done”

.

.

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”

.

That’s it

.

.

What do you think your therapist would say?

29 comments

Add Yours
  1. sandracharrondotcom

    He probably doesn’t want you to see his notes because he’s actually surfing porn. I fail to see the logic. If you see the notes then you can’t benefit from therapy? I think the opposite would be true. Seeing his notes allows you to see where his thought process is at and that would allow you to be the judge of whether you agree or disagree. But I’m sticking to my original thought: surfing porn.

    Liked by 3 people

  2. Ava Savage

    He seems more interested in control of the therapy than helping you. What is he afraid you will sue if you don’t like what he says. It seems like you would be limited with what you say now, wondering what the hell he writes he doesn’t want you to see. I’ve been looking back for an article I only skimmed (didn’t have time to really finish) about a new therapy. It had a new concept where patients had people involved who had bipolar etc. as part of a group of five with patients treated as equals involved in their treatment. I’ll try and find it.

    Liked by 1 person

  3. bipolarfirst

    I am wondering and hopeful that perhaps my experience with eight or so therapists is the odd one out and most of the other do offer and show notes and ask to take them…..

    Can you guys say what your experience is?

    Super curious

    Like

  4. AndrewS

    Ha, Blah. I was going to say, sounds like such a GUY. I think dude’s inner monologue goes like: “Well, if she looks at my notes, and disagrees with some interpretation, she might get her feelings hurt and start being all wack job and shit, because A: she’s a she, and B: she’s mentally unstable.” Whereas you are saying, “Hi, I’m a human being, I have the ability to think and speak, I’m sitting here in your office behaving like a decent human being, and so I WANT the fucking right to challenge you if your notes turn out to be a bunch of inane psychobabble. It might actually generate productive dialogue. Who knows? Maybe YOU will have a breakthrough because I will persuade you that something you have written is superficial, incorrect, superstitious, derivative of erroneous theories, group-think shibboleth, messianic nonsense, etc etc.” Fwiw it’s worth, my therapist is strictly a therapist, doesn’t take notes: we just chat, I get bored (I’m doing it for my parents). My psychiatrist takes just the occasional note to remind himself what meds I’m on: he has no organizational skills and apparently keeps haphazard records, bless his bumbling heart.

    Liked by 2 people

  5. Jess Melancholia

    First of all….what the flying fuck?!?!
    He said you lose to your face??!! There are not enough words or exclamation points to describe how angry I am. The man would be on the ground if he said that to me and I’d be in an “insane asylum” with a straight jacket.
    Second….I’m still confused as to why EXACTLY it would hinder your therapy. I’m the kind of person who needs facts and graphs to explain a point.
    Third….my therapist doesn’t take notes and is relatively helpful but my psychiatrist does and she likes to tell me how I feel all the time even when I say yes or no to contradict her….
    So yeah I’m mad and reblogging this.

    Liked by 2 people

  6. lolabipola

    Hmmmm – I do not agree with a single thing he said to you. Maybe that’s the difference between a psychiatrist and a psychologist? The New Zealand Code of Ethics warns psychologists to be aware of the power differential, and to ensure that the client feels empowered. He did not empower you at all in that exchange, and that just makes me so fucking angry, I could in fact shit in my pants.

    “Psychologists ensure that informed consent is the result of an agreement to work COLLABORATIVELY and they take all reasonable steps to ensure that consent is not given under conditions of coercion or undue pressure from them” – that’s from the NZ Code of Ethics for Psychologists – I have no idea what sort of code psychiatrists operate under here, or in the States, but yeah – I always ask to see a Clinical Psychologist if I need help with my head. Meds, I go to the GP (but I did see a psychiatrist to get diagnosed, and then I was sent on my merry way). Psychiatrists suck piles from the anus of Satan

    Liked by 2 people

  7. Leslie

    The only thing that I can think of that makes his attitude make any sense, is that if you see what he thinks, and you don’t like it, than you will stop being real in sessions. You will spend the majority of your time trying to prove his conclusions wrong instead of getting the thoughts spinning around in your head out of your head.

    Liked by 1 person

    • bipolarfirst

      Yes I can see how this would happen but it just seems like at the point at which a patient tells you they can’t tell you ANYTHING if you’re not going to be open with the notes you’d think that it would be worth the risk. ugh.

      Liked by 1 person

  8. dyane

    I wrote this over at Jess and thought it was only right to copy it here, my darlin’:

    “Okay, I think it’s a sign of (EXTRAORDINARY/GIFTED!!!!) intelligence that Claya wanted to see her notes…I honestly think it should be okay and a great point of discussion for the two of them if she wanted anything clarifyed, interpreted differently, etc. I think it’s a sign that the doctor/therapist feels insecure in some way to shut her down like that.”

    Liked by 2 people

  9. Screaming Jean

    Couldn’t agree more, what they don’t like, I’ve come to this conclusion after my blog post last night – they don’t like being challenged. They want us to sit there and nod yes and be good little patients who don’t question their authority etc.

    They make me pig sick.

    Like

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