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Questions after my first therapy session


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So I had my first appointment with a therapist yesterday.  I have been told that I may not always like the first person and it may go through a few.  I have never done this so I'm not sure what to rate this on.  She seemed nice and was warm and caring.  We talked about bipolar but it seemed like we were stuck on bipolar I.  It wasn't until the end when she said I sounded more bipolar II.  I felt like I, through all my research, knew more about it than her.  That was scary.  How do you judge a good therapist?  

Also, she said that with bipolar II I will need to see a psychiatrist for meds and her for therapy.  The reviews on the Pdoc is that she is a "pill pusher" and doesn't get to know clients.  This sort of fit with the therapist view of Pdocs over all.  This makes me feel uneasy.  Does anyone ever use a general practitioner instead of a Pdoc?

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Everyone has their strengths and weaknesses. Bipolar II might seem wrong to me but it took me 10 years to even get that far. But you're saying you have BP1 and it saps a little bit of your trust that you don't feel listened to.

As far as pdocs, I think that's how the system is set up. The pdoc is there to give you meds, and meds are something (I think) you need if you're bipolar. I judge a p-doc by how responsive he is to symptoms, etc. Does she change things when the meds aren't working? Or when the side effects get too extreme? Do they ask you enough questions to even know about that? do they coordinate with your therapist if necessary?

Your therapist can help counesel you through what you might need to say to p-doc depending on what's going on. I've had good luck with educating myself and comunicating my ideas with p-dog.

I definitely wouldn't go GP unless they really know what they're doing. I know one nurse who is very good with meds, but most docs don't know much about psychotropics and the good ones among those wouldn't agree to rx without experience/training.

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For my local Pdocs they all only met with me for 5 to sometimes 15 minutes max and mainly focused on prescribing the drugs. They were kind and I could tell they were trying, but they were always over scheduled. This is not uncommon. The therapist is the one that got to know me and would sometimes contact the Pdoc to push things. I finally went to a university affiliated hospital further away where my doctor saw me frequently for an hour, if not that, at least 30 minutes. He knows me very well. I couldn't use a general practitioner because my case was too complicated or difficult. General practitioners often don't know the latest research in mental illness and for me I would rather see a Pdoc for 5 minutes than a general practitioner, but others have had good experience using a general practitioner.

I once had a therapist who on the second visit told me she looked up ideas on Google about how to cope with suicidal feelings since she wasn't sure what to suggest. You would think that a therapist would be better trained. Needless to say there are some pretty ignorant therapists out there. It is hard to really open up and take some advice when you feel you know more than the therapist. 

How I found my latest therapist is by asking a friend who is a therapist (I don't do therapy with friends) if he knew anyone who was competent, experienced with PTSD and bipolar, and who also was very calm and wouldn't freak out no matter what I said. If I hadn't had the friend I would have just called therapists and asked them what experience they had. Sometimes they lie or exaggerate. One therapist advertised she did DBT but I found she was just "familiar" with the concepts but "modified" them. All she did was tell me how I needed Jesus, after I told her I was an atheist. So, it can be hit or miss but your chances are better if you ask if they are experienced in treating bipolar. I saw one person suggest you ask them to tell you approximately how many patients they have treated with bipolar. 

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The ecletic therapist is a scourge on the profession. it would be great if people could say, "I'd like to try dbt, or act, or cbt, or schema therapy, or psychoanalysis..." but if you call one hundred therapists, 95 will say they're "ecletic" and "familiar" with the concepts they "respect" and "incorporate" into their practice. The other five will say they do one thing but are really no different than the other 95.

The result of that is you just have to see a therapist a few times before you know if it's going to work. Same for the next, then the next...

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Personally, in regards to judging a therapist (or a pdoc), I go with my gut.  If I feel like if there is something not quite right, then that probably is the case.  I can usually tell if I can work with a pdoc or tdoc the after first 2 to 3 times.

(I used to think about giving them 5-6 weeks, to give them a chance to see if I felt like it would work, but as time went on I've felt like 2-3 appts is enough to figure it out).

I hope you are able to find a pdoc and tdoc who you can both work with and who can work with each other.  If it were me and I saw reviews that said the pdoc was a "pill-pusher" and doesn't get to know clients, I'd probably consider finding someone else. 

However, reviews don't always mean anything ...

7 hours ago, BatsBelfry said:

The reviews on the Pdoc is that she is a "pill pusher" and doesn't get to know clients.  

I saw a DR before reading reviews ... the DR and I got along well, he was thorough, answered all my questions, etc ... a very good DR.  I happened to read his reviews afterwards, and he had all 1-2 star reviews. I have no idea why anyone would give him a 1-2 star review.  So you might want to meet the DR before basing him/her on the reviews. 

7 hours ago, BatsBelfry said:

This sort of fit with the therapist view of Pdocs over all.  This makes me feel uneasy.

This would make me feel uneasy also.  With this attitude and view of how your tdoc thinks about pdocs in general, this personally wouldn't work for me and I would start looking for another one.

 

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