Tuesday, July 17, 2007

I am so lucky to have the Pdoc I have

The following is what I remember about part of today's session. I know I didn't entirely capture all that was important, and I may have made some mistakes in remembering as I wrote them down 5-6 hours later:

I went into my session feeling apathetic, hopeless...like I will never be well, or have a chance again. I ruminated about suicide almost the whole 45 minute drive to my session.

Last night I printed off my last blog post and this a.m. I asked my pdoc to read it, because , in my sessions, I often feel I get so overwhelmed by my emotions that the message I need him to hear is lost. I often remember what I needed to say when I get into my car to leave. I feel like I can express myself more clearly in writing.

He read it, and then silence. I felt intensely ashamed and embarrassed. Once again he suggested the hospital. I told him I would be willing to go after the 19th of August, when my commitments are complete. I expressed concern and a strange feeling about "planning" a hospital stay.

Dr. X.: Why?
Me: a) What if I show up and my symptoms are no longer there? I know what will happen. I will show up, my symptoms will temporarily disappear(because as I usually seem to manage around strangers I will try to be normal and no one will believe I need help. Also, I do not trust other Pdocs/Dr.'s. In fact I only trust [him]. What if they won't let me out?
Dr. X.: The chronic nature of your illness is understood. Yes, you may show up with no symptoms, but I will do all I can to help you while you are there. (I think he meant he would express to the inpatient Psychiatrist what I've been feeling) and how I am really depressed despite this mask I can often manage to place on my feelings and despite being actually able to enjoy brief and sometimes extended moments in time. (My mood is VERY reactive to the situation sometimes. At other times nothing will bring me up.)
Dr.X.: I really think a hospital stay would be a good idea. I like to think I am a good Psychiatrist, but maybe I am missing something. It would be good to be assessed by someone else.
Me: I have never once thought my not getting better had anything to do with your competence. I believe you are doing all that is possible to try to help me. I know you are a good Pdoc. In fact I would say you are the best Dr. I have ever had.
Dr: X.: I want you to bring your hoarded medications to your next session. I rarely make a direct request to you, but I think the amount of medication, and having it around the house is unhealthy and impeding your mental health.
Me: I see it as a safety net. If I cannot take it anymore I have a way to end it all.
Dr X.: Your safety net is unhealthy. Use the hospital or the health care system as your safety net.
Me: I would never go to the hospital.
Dr. X.: Why?
Me: Because, I would get there and within minutes of talking to someone I would laugh, or seem better and they would send me home. I would feel totally dismissed and feel like my needs were dismissed.
Dr. X.: I will give you my home phone number. If you are headed to the hospital call me and I will call/fax ahead and explain your circumstances.
Me: (at that moment I felt so trusted and cared about) I would not feel comfortable with your home phone number. I am not going to intrude on your personal time. I would not call.

I guess what I'm trying to show is how openness and honest dialogue with my pdoc, (about symptoms, med problems, eg. hoarding for suicide and I've been "sneaking into my stash to try to sleep"), directness, explaining my fears about the hospital and feeling trusted and cared for can be so therapeutic. I left today thinking I can hang on for a while longer as long as I have my pdoc for support.

P.S. I will tell you about the dream I had last night and our interpretations tomorrow.

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