When Psychiatrists Try Talk Therapy...

Alright, not sure where to put this exactly, but it kinda involves sexual health.

Anyway, a few months ago I was in need of a psychiatrist, and I wanted to be sure I was going to get an LGBTQ-friendly psychiatrist who I would feel comfortable being open with.

I asked the mental health coordinator at my LGBT center for a referral to an LGBTQ-friendly psychiatrist. (I've had lots of negative experiences with her, see my http://emptyclosets.com/forum/general-support-advice/123270-borderline-rape.html#post1861814 thread for some mention of them). Probably a mistake.

I was shocked when she referred me back to a psychiatrist I had seen years before whom I had found really lousy and totally lacking in bedside manner. (I was deeply closeted then so sexuality never came up, but he always had a tendency to blurt out offensive comments like "You have no friends" every time I met with him.)

It turns out she referred me to him because she works in the office right next door to him and is apparently friends with him. I see her walk in and out when I'm in the waiting room for four hours for each psychiatrist appointment, getting into the room at like 8pm for a 4pm appointment. (And sitting in that office all those hours really gets my anxiety up.)

Anyway, I've been seeing him the past few months, I'm on his medications so I'm kinda stuck with him.

Since I was referred by the LGBT center mental health coordinator, he knew I was gay even though I never actually came out to him. In fact I never discussed my sexuality with him.

Even though I never bring it up, he always discusses my "gayness" as the first topic he beings up when I'm in his office.

The last session I had with him was the worst though. I'm seeing 3 talk therapists, he should stick to his job of writing prescriptions.

But he evidently feels the need to try some talk therapy when I see him.

Now I mentioned that I've been having issues with not getting along with my mother and family. Right away he jumped to the conclusion "that must have something to do with you being gay". Since he brought up the sexuality topic, I mentioned that it's true I don't feel comfortable being open about being gay around my family in whose house I live, and that does contribute greatly to my depression.

He said "okay so it's like don't ask, don't tell?" I said "yeah I guess so".

He said "alright well that's a good thing. 'Don't ask, don't tell' is the way it should be, it's a good compromise, because your parents have a lot of troubles of their own having to accept your problem with gayness too".

I said, well I don't feel comfortable like even just having a relationship or anything because of my parents not accepting me.

So his next talk therapy was "Well I've dealt with a lot of clients who had problems with gayness. The solution that I would recommend to you is to tone down the gayness, don't be flaunting it in front of other people. People don't ask me whether I prefer blonds or brunettes, so nobody should have to know your sexual preference".

I said again well that means I can't even have like a normal relationship unless I just completely hide it from my family whom I live with, I don't consider just openly having a boyfriend as part of my life like any straight guy has a girlfriend to be "flaunting" my sexuality.

He said that's fine, "again keep it don't ask don't tell, your parents have a lot to deal with being faced with losing their son to gayness".

So he said again "tone down the gayness when you're around your family. If you want to have a relationship with a guy, just do it while you are out of the house and go over his place, and tell your family you're just like spending time with a friend across town, you know, something like that."

I was left pretty speechless by his attempts at "talk therapy", and needless to say it left me feeling pretty worse about my "problem" of "gayness". His whole "talk therapy" consisted basically of telling me to be ashamed of who I am and thus needing to hide who I am.

Again, I NEVER even bring up the topic of being gay when I'm in session with him, and yet he accuses me of "flaunting" my gayness and being "obsessed" with being gay, so my solution is to "tone down the gayness".

I told my social worker about it and she was shocked that a psychiatrist would say such things, she said his job is to deal with medication, not talk therapy. So I've just tried my best to completely ignore anything my psychiatrist says that is not related to the medications he is prescribing me.

I'm seeing 2 social workers and a PhD psychologist for talk therapy. I don't get people who say they want a psychiatrist who talks to them, I really wish my psychiatrist would say as little as possible, just talk about my med routine, and then just hand out the prescriptions that I need. (Maybe if he did that with all of patients, I wouldn't be waiting anxiously in his office waiting room for over four hours, seeing him at 8pm when my appointment time was 4pm.)

But my next appointment with the psychiatrist is coming up this Monday, I'm really dreading it, sitting in the waiting room for hours upon hours with all sorts of crazy characters, my nerves and anxiety running high, and then fearing what he is going to open his mouth to blurt out when I finally see him.

 

Yeah the 'mental health professionals' I've worked with have really fucked over my mental health worse than it was before, I'm starting to doubt whether I'm getting any help by dealing with them.

Unfortunately, it's not that easy. There are a lot of really bad psychiatrists out there. When I asked the mental health coordinator at my LGBT center for an LGBT-friendly psychiatrist, she said "oh it's hard to find because so many psychiatrists around here are so bad", so then I was kind of floored when she recommended me to this guy who I had already seen- and a guy whom I had thought fit the description of one of the "bad psychiatrists" she was talking about.

I ended up going to this guy because he was literally the only psychiatirst to finally pick up the phone after multiple attempts calling him.

She also had given me a few other names, I called them and either got a rude secretary telling me their schedule is full or got a voicemail that was never returned.

I had also asked my psychologist for a list of psychiatrists. I called all of them repeatedly, left multiple messages, and never heard back.

The guy I'm seeing I called originally, left a message and never heard back, a few calls later, I was leaving a message and mentioned that I had treated with him before and he finally picked up mid-message and was willing to give me an appointment.

And part of the reason I did go back to him is that I figured he at least knew my history going back to my teen years. He had me on 200mg of Zoloft for years which never did shit for my anxiety and depression.

Later I was on Paxil which was even worse with the side effects, and the withdrawals coming off of it were horrible. (Or "SSRI discontinuation syndrome" as they like to call it, to pretend SSRIs are perfectly safe to hand out like candy and don't cause withdrawals like coming off an addiction)

So I figured he would at least know that my anxiety was severe and genuine going back to my teen years and anti-depressants never fixed it and that I would need to go back on the stronger stuff. I was afraid going to a new psychiatrist would mean he or she would just put me on anti-depressants and wait a few months or years for it to do nothing before being willing to prescribe the stronger stuff.

I don't know, he is a very intimidating figure, he's like 6'6 with a very deep forceful voice. And I'm afraid if I question him or piss him off in any way he won't give me the scripts I need.

He doesn't have a nurse. In fact he doesn't even have a business card with a phone number that I could call in case of emergency. At the end of each appointment he just hands me a scribbled piece of paper with my next appointment date and time without ever even asking me whether that date or time would even work with my schedule.

And yes, it's normal to wait hours upon hours in his waiting room. The waiting room is always packed with people sitting there for hours. Some of them are obviously crazy or unstable and start getting loud or obnoxious, my anxiety is sky-high sitting in that waiting room for four hours. He seems to book appointments every 5 minutes, while each appointment takes at least half-hour in the office.

Again, all these things are easier said than done. I don't feel at all comfortable being assertive with him or saying anything critical of him or even questioning him.

And again, finding a good psychiatrist- hell, finding any psychiatrist- is a lot easier said than done around here.

I'm on high doses of both anti-depressants and benzos, I couldn't risk just stopping going to him while trying to accomplish the Sisyphean task of finding a good alternative psychiatrist.

So right now I'm just putting up with the long waiting-room hours dreading what he is going to say, just to get my scripts while trying my best to tune out anything he says that is not medication-related.

 

Well I think he really is just an ignorant old man who doesn't realize that just using the word "gayness" in any sort of clinical context is ridiculous and inappropriate.

And of course the contexts in which he used it, referring to the "problem of gayness", and repeatedly telling me to "tone down the gayness" make it worse.

The most ridiculous part though I found was when I said I didn't feel comfortable having a normal relationship with a boyfriend that I could be open about with my family... and his advice was basically to keep having a boyfriend a secret from them, just go out with my boyfriend in secret, just go over his place in secret and lie to to my family saying I'm "spending time with a friend across town".

That was just like a total WTF? moment.

 

Oh, well I think I've already reached that point. In fact I think I reached that point way back when I was sitting in his office at age 16. He would always remind me "You have no friends" at every appointment. I remember back then he asked me if I had ever been on a date, when I said no, his eyes widened and a look of genuine shock came over his face and he said "Ever?!" That just made me feel like shit.

The psychiatrist is really tall and large in size and has a deep voice, a very intimidating figure. He has both an MD (medical) degree as well as a JD (law) degree (MD, JD, being prominently displayed after his name on his nameplate on his desk), so apparently he must have some degree of intelligence...but something about him just makes him seem like an idiot. The way he speaks, the way he pronounces his words makes him seem well, like a big dumb oaf. That's the best way I can think of to describe him.

So he has no bedside manner, but I really do think the things he says, like "tone down the gayness" are said out of genuine ignorance and stupidity rather than malice.

Thanks for the advice, and yes that's pretty much the mindset I have adopted. I mean, due to my anxiety, I pretty much always answer in short monosyllabic answers anyway.

But I just hate the fact that the gay thing is even an issue in that room. He knows I am gay because the mental health coordinator at the LGBT center, who is friends with him and works right next door to him, told him I was gay from the outset before I even first met with him, without ever even asking my permission to out me to him.

(This mental health coordinator at the LGBT center who has caused all this grief in my life is a LCSW social worker, for the record)

But I would never have felt comfortable coming out to him and I really wish the issue were left out of that office. I'm there to treat my anxiety and depression, not discuss my sexuality.

Like my very first appointment with him, he starts off by saying "_______ (mental health coordinator at the LGBT center) tells me you are gay". I said well I guess so, I've been through a lot of questioning, I'm still kinda confused and questioning about who I am, I'm not really comfortable discussing it too much. And his response was a forceful "well either you are or aren't, if you're attracted to men that means you're gay".

So that pretty much set the tone for "gayness" to be the predominant issue this doctor talks to me about, even though I only wanted to treat with him for anxiety and depression, not talk about my sexuality.

I don't really have a GP of my own. Up until age 21 I was still seeing a pediatrician when I needed to have a physical done (including HIV test) in order to be allowed to travel to study abroad in Russia.

I went for one physical early last year with my mother's doctor, who I guess would be the family doctor I would go to if I needed one.

At the end of the physical, I told her well I suffer from severe social anxiety that really interferes with my life, I was on 200mg of Zoloft for years that never did anything for me, and my psychologist had suggested going on Ativan or Klonopin for the time being until I am able to work out my issues with him. She said "oh those will only treat anxiety at specific times where you have anxiety, I'm going to give you something that will stop your anxiety all the time", so she gave me Paxil (Paroxetine).

Of course in my case, my anxiety is 24/7, and Paxil, like Zoloft did absolutely nothing for my anxiety at any time, it made me feel worse, like a zombie. The side effects of Paxil were even worse than Zoloft (which were pretty bad to begin with), for months I was pretty much anorgasmic and had no sexual functionality, and coming down off the Paxil even after only being on it a matter of months was even more painful than coming down off of years of Zoloft. (And again, doctors don't even warn you that there is "SSRI discontinuation syndrome", she didn't give me any advice on what the side effects would be or how hard it would be to come off it.) After about three weeks of hell, feeling dizzy and disorientated and getting headaches all the time, I felt so much happier and less depressed having gotten off of that awful "anti-depressant".

She had told me to arrange an appointment to meet with her in a month, but I said screw that.

It was at that point that I decided to seek out a psychiatrist, who at least thankfully took me off the Paxil and put me on a different, non-SSRI anti-depressant.

Well I guess it's a worth a try, I've never looked into it. I guess at the end of the day if I'm going to be prescribed addictive and potentially dangerous medications, I'd prefer to be under the supervision of an actual MD rather than a nurse practitioner, but maybe that's just an irrational bias of mine.

But yeah I've had plenty of experiences with bad psychiatrists before. This one time, I went to this psychiatrist who advertises on TV all the time around here. On my very first meeting with him, his first question to me was "alright so how's the 50mg of Zoloft working out for you?" Yeah I'm not on Zoloft, this is the first time I've ever met you, what kind of shitty doctor are you?

 

Oh well at this point I've accepted the fact that I am addicted to the medications. So I will need to be under a doctor's close supervision in coming up with a plan to taper off of them. It scares me quite a bit, and I really don't want to be on them too long.

But the unfortunate fact is that the Klonopin is still the only thing that makes me into a socially functional human being. As my many rants on this forum on this forum for over a year after graduating college indicate, despite meeting with a social worker twice a week, I was basically an unemployed loser afraid to even leave my house before the Klonopin prescription. (Originally Ativan, but switched to Klonopin).

On a few occasions I would work up the courage to go for a job interview, but I would sometimes get panic attacks and go hide in the bathroom and leave, if I even made it into the interview room, I would stumble and mumble and embarrass myself thoroughly (and of course shortly be informed afterward that I did not receive the position).

As soon as I started taking the Klonopin, I was able to get through not one but two job interviews and get hired for two jobs. Not only that I was able to be socially functional, I've been starting to make friends and pursue relationships for the first time in my life... I felt like a normal person for once in my life.

On one big group job pre-screening interview, at the Brooklyn Workforce1 center, for a job at an American Eagle store in Times Square, which I would have loved... I took the meds, and was actually chatting up a storm with the people around me, speaking up more often than anyone in response to questions, and after the interview I went up and had a nice friendly conversation with the interviewers, and I was one of the few to get a call back to meet directly with the hiring director of the store in Times Square.

I wanted to prove to myself that it wasn't the meds that made me do that and that I could do things on my own, so I went for that one-on-one interview sans medications. The interview lasted about 5 minutes, I mangled and bombed it so badly, that the very same day I received a "We regret to inform you that there are no positions available for you" e-mail.

On the medications I even went and signed up for an intergenerational theatre program, presenting sketches on stage to artistically portray unity between queer folk, young and old. For many years I've always loved theatre and wish I would have been involved in it all through high school and college, but my anxiety simply paralyzed me from ever pursuing it.

I've been trying to take the medication less in the hopes of making it easier to ultimately come off of it. I actually take smaller doses than the psychiatrist prescribes me.

But on days where I don't take it, I'm back to my old non-functional self. My work performance suffers tremendously. I don't interact with my co-workers at all, I try to act busy to avoid them speaking to me, if they try to talk to me I mumble one word answers. When I answer phone calls I stumble and bumble them badly, I got yelled at for failing to get the name and phone number of an important official who called.

My job involves a lot of writing, and my social anxiety causes me to agonize over every word I write, afraid that it will be judged negatively. I fear that one of my co-workers will look over at my computer and see what I am writing. I will have lots of writing assignments completed on my computer and ready to print and submit, but my anxiety is so bad that I'm afraid to submit them, they'll sit on my computer for days until I come into work taking the medication and feel comfortable enough submitting them.

I mean, my social anxiety is so bad, that when I'm on a bus or train I won't listen to music with earphones on my iPod, even though I love listening to music, out of fear that the people sitting around me will overhear what I am listening to and judge me for it.

So as much I'm as I'm embarrassed and ashamed and scared to say it, I'm pretty much dependent on addictive medication in order to function right now. My anxiety really is just that severe. I'm fully aware of the dangers and shortcomings of this kind of medication, I just hate the fact that I need to take such pills just to feel like a normal person able to hold a conversation with someone. :tears:

And I feel so ashamed because there is such a stigma involving benzo prescriptions, you probably think I am a junkie and a drug addict, I'm not taking these pills to get high, I'm taking them because I just want to be a normal, functional 23-year-old boy able to hold a job and make friends and have a relationship.

So basically I view the psychiatrist's medication as the short-term solution to making me a functional human being. If it weren't for the meds, my life would still be in suspended motion, I'd be unemployed and rotting away hiding in my parents' house until they kicked me out or I committed suicide. I had no life worth living when I was so paralyzed by anxiety.

I'm just really holding out a lot of hope and optimism that my talk therapy, particularly my work with the psychologist and cognitive behavioral therapy, will one day allow me to wake up and feel like a normal person without needing to pop any pills.

 

Ugh we got a few inches of snow, I made the dangerous trek to my psychiatrist's office at 3:30 for a 4pm appointment to find the gates closed, he just decided not to come in today without notifying anyone, not even a note on the door. I called him up and got some secretary who could barely speak English, I gave her my name and phone number and she said he would call me back, and here I am still waiting 3 hours later, I think I am going to call again.

Last time I ask the mental health coordinator at my LGBT center for any sort of references. :bang: