i have a problem with therapy. i don't know if it's my tdoc's style (behavioral "approach" but not CBT strictly) or what. i have several lamentations on the subject.

• big picture. i say i want to look at a big picture and he wants to take it a bit at a time. i think we've had 8 years to look at many bits and examples to refer to. he says they are different. i say they are examples of a pattern i saw long before. i need help with the pattern, not with getting out of an individual instance. sure, getting out in general can be a good thing to learn, but since i create the pattern. i also need to learn to create different (healthier), not keep repeating the same crap where i need emergency meds and emergency escape routes to escape my own prisons after i make them.
  .
• feelings vs. behaviors. i want to work on how i feel about things rather than how i deal with a situation. for instance, i can "deal" with my teasing coworkers... i figure ignoring them will scoot them along to something more interesting. it took us 3/4 session to get here. i still have NO idea what to do about the FEELINGS that are evoked when these ppl tease. the feelings are about ME not about them, and my behavior towards THEM does control MY feelings. i got teased a lot and never ever learned, internally, to deal with it. INTERNALLY.
  .
• lack of continuity between sessions... to my knowledge docs here don't keep files, not even medical. the pts do. that includes xrays, labs etc, everything. so if you think your doc will need your history you gotta lug it all with you. it has good and bad sides. bad is, the docs can lose sight of critical info very easily. this GP rx'd a macrolide antibio first thing when i got here. i was on carbamazapine AND had informed him. had my pdoc in the US not warned me explicitly, i would have taken his stupid antibio and landed in ER or worse - the morg. Welcome to the Olde Worlde. this is how things are done.

those are the big ones. i've tried to resolve the last one myself but other than a few times i seem to go blank. i used to write things on paper till i became afraid of the papers being lost/found. things never got covered anyway... it wasn't working.

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i've had my T/pdoc (same person) for about 8 years now. i like to think he knows me. he is certainly a good guy. he saw me free for 4 of those years because i was broke. i had some issue with this as a boundary violation (i felt and still feel an obligation to continue with him). i did not tell him that because otherwise at the time i was without T or pdoc.

i am not displeased (nor impressed) in terms of his pharmacological management. he is flexible and listens to me so if i prefer one med to another or prefer to try a lower dose etc. also he prefers to lean on the side of caution in terms of adding meds, he's not huge on cocktails though he'll use them, once shown that a single med fails. again on same page as me.

one thing that never fails to freak me out is when i ask for a med report (list) for bureaucratic purposes he asks me to dictate... or he'll say remind me what you're taking again... ????

however pdoc helps me if i need tests scripted through my GP (state) and GP is giving me a hard time. if he thinks the tests are reasonable of course. faced with a request from a specialist, the GP cannot refuse. whereas if i am the requester, not only can GP refuse, but he can get all huffy and puffy about it.

the way i see my pdoc now is via private therapy, with the meds folded in. he practices as pdoc-only in 2 clinics near where i lived before having to crawl back to the folks - too far to juggle with work.

SO if i got a new T, i think i'd have to get a new psychiatrist too and lose him completely. unless i didn't tell him and saw both - which i CANNOTTTT afford.

i get attached to people (things, too!) so i can't imagine changing ... and possibly ending up with ... well, not better, for sure. then again i don't feel like the therapy is particularly therapeutic....

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thank you for reading. sorry for the usual longwindedness... when i write these i always think with admiration of Bizi's short 'n' sweet posts.

~ waves ~ confused