![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6 to 30 of 32. Go back in thread:
Posted by noa on April 16, 2003, at 9:42:24
In reply to Re: Misdiagnosed?? » sedona, posted by Dinah on April 16, 2003, at 3:52:54
DINAH???? SCHIZOID? that's a laugh! (And a cry!) How could anyone think you are schizoid?
Posted by Pfinstegg on April 16, 2003, at 13:11:23
In reply to Re: Misdiagnosed??, posted by noa on April 16, 2003, at 9:42:24
Dear Sedona,
It is very painful to feel that you are at an impasse with your therapist, and at the same time to get hit with tests and a diagnosis of borderline personality disorder; there is a punitive aspect to this which is not at all helpful. I would agree completely with Noa's assessment, and his suggestions.
Some mental health professionals now feel that all of these terms, such as "borderline" and "schizotypal" are inaccurate and out of date. They originated at a time when psychiatrists thought that they indicated a continuum into psychosis and schizophrenia- something that no-one thinks now. They also carried a connotation of untreatability- the reason why anyone would dread to hear them. This is wrong, too; with new techniques developed over the last 20 years, they are commonly treated successfully.
Many psychiatrists now think that the term "limbic dysregulation" more accurately reflects what the underlying situation is, and they use the term "PTSD" to indicate that a range of childhood neglect, trauma and abuse situations are the underlying causes.
People can definitely be treated successfully for these conditions; you do need, and have a right to, a therapist whom you feel is warm,cares about you, and feels hopeful and confident about your capacity to get better, and about his/her capacity to see it through successfully.. They are definitely out there.I hope to hear that you have gone out and interviewed a number of therapists, and found a great one. Keep in mind that you deserve the best in therapists- you are clearly willing to do your part. Once you find the right person, life will seem so much more hopeful and promising to you- and you will have the strength to weather all the extremely tough times that do come with therapy.
Pfinstegg
Posted by fallsfall on April 16, 2003, at 13:21:45
In reply to Re: Misdiagnosed??, posted by noa on April 16, 2003, at 9:42:24
About 6 months into my therapy I ended up in the hospital, and when I returned to my therapist she said that I was Borderline. As is my trait, I started reading. One of the first books I read was "Cognitive-Behavioral Treatment of Borderline Personality Disorder" by Marsha Lineham. (This book is for therapists) As I started reading her description in the beginning chapters I was amazed. Finally, someone understood me! And I am not a typical Borderline - I am not impulsive, but I do have enough of the traits to know that it fits.
I've been with her now for over 8 years. Things were great until a couple of months ago. I did a bad thing and she got angry (justifiably), then we got into this thing where she is saying I'm too dependent (which I am), but I don't dare talk to her anymore because she might get angry again. It it excruciatingly painful (I'm dependent, remember?). I'm hoping that at this point we are talking together towards the same goals, but I'm not sure. Nothing like this happened in the first 8 years. She is warm, and I love it (usually).
So. A little homework on Borderline might be helpful. Your therapist should also be willing to go through the DSM-IV definition and tell you why she thinks you have which symptoms. The diagnosis was very helpful to me - I went to a DBT class (highly recommended - see Linehan's book), and reading about it gives me better perspective on why I feel certain ways. I think that you have to feel comfortable with your therapist. Warmth is very important. You should be able to talk to your current therapist about this. She should give you her assessment of the "fit". She should also give you names of people to go to, if you decide to do that.
Good Luck
Posted by Dinah on April 16, 2003, at 15:32:05
In reply to Really Borderline, posted by fallsfall on April 16, 2003, at 13:21:45
Ouch, that must really hurt! Years of a good relationship changed because of one action...
You really have my sympathies. I'm always afraid my therapist will say that I'm too dependant. So far his attitude is that it means therapy is working, and I'll grow past it. But I'm afraid that one day he'll think it's past time I grew.
I just wanted to send some warm thoughts your way. I think I know how much you must be hurting.
Posted by Dinah on April 16, 2003, at 16:13:40
In reply to Re: Misdiagnosed??, posted by noa on April 16, 2003, at 9:42:24
Well, I present differently in real life than I do here. I have some sort of expressive aphasia, I think it's called. I'm not sure. But I've always come across as schizoid (even schizotypal), even as a kid.
It hurts to find out that your therapist thinks you have an odd appearance, though. (Said the forty someodd year old "woman" in braids or pigtails who owns only a few outfits, but in several colors each, and who wears bandeau swimtops as bras, and slouch socks used as kneehis with tennis shoes while wearing casual dresses - schizotypal? no, not me. :D )
Posted by Dinah on April 16, 2003, at 16:48:46
In reply to Re: Misdiagnosed?? » noa, posted by Dinah on April 16, 2003, at 16:13:40
Oops. Not expressive aphasia, that's got to do with verbal communications. I've got problems with nonverbal communications. Expressive dyssemia has been proposed to refer to problems with sending nonverbal social communications. "Helping the Child Who Doesn't Fit In"
Posted by sedona on April 16, 2003, at 18:07:29
In reply to Re: Misdiagnosed?? » sedona, posted by Dinah on April 16, 2003, at 3:52:54
Hi Dinah-Betrayed is exactly how I feel. She always tells me that I seem to hold things back from her and I am assuming she is using the test to figure me out. I have read a lot about Borderline and though I do identify with maybe 3 traits, I also identify with traits from other disorders and I don't feel as though I fit into any. Even though I don't think this is me, since she said it, it is in my head always. I worry about maybe eventually going to another doctor and as soon as they see the notes from my last appointment and they see the word "Borderline" then I again am stuck with the label.
I wanted to get a second opinion, so I went to see a psychiatrist at my college. I tried to tell him that I had been seeing someone and that I felt we were at a standstill and I wanted a different pespective on the situation. He immediately wanted to know who I was seeing. I reluctantly told him and of course it turns out they know each other, in fact "very well" as he put it. Then he wanted to know what our problem was. I told him I felt uncomfortable talking about her since they knew each other, but he told me not to worry about it. He said that if I wanted to seek treatment from him, thus releasing my records from her, that it wouldn't be taken personally. Later, I started thinking about it and the more I thought about it the weirder it seemed. I personally would never want to go see a psychiatrist who was friends with my last doctor. Does that seem right to you?
Posted by sedona on April 16, 2003, at 18:07:35
In reply to Re: Misdiagnosed?? » sedona, posted by Dinah on April 16, 2003, at 3:52:54
Hi Dinah-Betrayed is exactly how I feel. She always tells me that I seem to hold things back from her and I am assuming she is using the test to figure me out. I have read a lot about Borderline and though I do identify with maybe 3 traits, I also identify with traits from other disorders and I don't feel as though I fit into any. Even though I don't think this is me, since she said it, it is in my head always. I worry about maybe eventually going to another doctor and as soon as they see the notes from my last appointment and they see the word "Borderline" then I again am stuck with the label.
I wanted to get a second opinion, so I went to see a psychiatrist at my college. I tried to tell him that I had been seeing someone and that I felt we were at a standstill and I wanted a different pespective on the situation. He immediately wanted to know who I was seeing. I reluctantly told him and of course it turns out they know each other, in fact "very well" as he put it. Then he wanted to know what our problem was. I told him I felt uncomfortable talking about her since they knew each other, but he told me not to worry about it. He said that if I wanted to seek treatment from him, thus releasing my records from her, that it wouldn't be taken personally. Later, I started thinking about it and the more I thought about it the weirder it seemed. I personally would never want to go see a psychiatrist who was friends with my last doctor. Does that seem right to you?
Posted by Dinah on April 16, 2003, at 19:14:04
In reply to Re: Misdiagnosed?? » Dinah, posted by sedona on April 16, 2003, at 18:07:29
I don't think that under your circumstances I would want to do that. For one thing you would probably feel awkward trying to work through residual feelings towards her, and you really should be able to do that. Although it may not be a problem. I speak negatively about the miserable pdoc I told you about, even though he is good friends with my therapist. My therapist just accepts my feelings while calmly expressing his own liking for the guy. He admits his perspective is different from that of a patient, and acknowledges a personality clash.
I tell you though, under the circumstances you have explained, I wouldn't even want to forward my records. At least not for a while. When I left that pdoc, I went to a very highly regarded psychopharmacologist, and had my records forwarded. He obviously built his impression of my diagnostic picture from my former pdoc and continued on an ineffective meds strategy. After I left him, I did not forward my records to my new pdoc. Nor did he ask for them. In my first visit, he prescribed a mood stabilizer, and that proved to be the key in my med regimen. Because with no baggage coming with me, he was able to correctly diagnose me.
Do therapists usually ask for records to be forwarded? And what do they do if you request that at least they wait a while to get to know you for themselves first?
Posted by noa on April 16, 2003, at 21:06:48
In reply to Re: Misdiagnosed?? » sedona, posted by Dinah on April 16, 2003, at 19:14:04
I don't think you have to forward records. And I would also want to go to someone who is unconnected to the first therapist.
Posted by likelife on April 16, 2003, at 21:21:06
In reply to Misdiagnosed??, posted by sedona on April 16, 2003, at 1:18:05
Sedona,
I'm sorry you've had to deal with this--it can be so hard/disconcerting/confusing/frustrating to disagree with a therapist, especially after building a 2 year relationship.
I've recently had a similar experience--with borderline pd as well. I have been seeing my current therapist for a little over two years and about six months ago I began talking honestly with my her about how I felt about her, which was basically extremely attached, pretty dependent, and somewhat frustrated by these feelings, and because I felt like she was and continues to be somewhat cold and uncaring. Being, of course, terrified of abandonment, this was a difficult thing for me. She was somewhat receptive to hearing about this, but I was thrown completely by the amount of emotion that I was having, and after having spent the better part of two sessions talking through it, the issue was dropped (mostly because I felt like she wanted me to drop it).
So, anyway, in short order I became quite depressed after this, which was probably caused in part by my disappointment, inability to talk about it, and an enormous amount of stress from beginning grad school.
I am having difficulty making this make sense.
Somewhere in here, my pdoc, who works at the same clinic, asked me if I thought I have borderline personality disorder. I knew a little about it at the time, but his question came completely out of left field for me. I told him no, and we moved on (pretty much I already couldn't stand this guy, but felt stuck with him). Later, I confronted my therapist, and asked her why he had asked me about BPD (I know they regularly consult with each other). She admitted that she thought the diagnosis fit as well, and I was (not in order) pissed, confused, terrified, miserable--mostly because I had a lot of misinformation about the disorder, and felt it was being used as some kind of sentence, rather than as a useful tool (as noa was talking about).
I am one of the most passive people I know, and one of my "characterological deficits" is that I will believe almost anything someone else tells me about myself. So my therapist and I discussed her use of the diagnosis (at my insistence), and whether she would have told me had I not asked. I have come to believe her, but wonder occasionally about how my need to please and not make waves has brought about this agreement. When sharing this information with my husband (much later), he was shocked and angered that someone would "label" me with that group of traits. (For the record, I do fit somewhere around half of the diagnostic criteria, but only when I am quite depressed).
You could say I have made progress in therapy since this point, as I have been handling stress much better, most importantly staying away from cutting (the defiant child in me wonders if I'm not doing this in part just to spite her--see, I'm not what you say I am). But as far as the relationship with my therapist, I feel like I have been trying very hard to distance myself from it, and make it not matter so much to me, since I am finding that it is much more painful to allow myself to think and feel about it.
The point I think I'm trying to get to here is that after reading your message, Sedona, I wonder if I shouldn't agree with my therapist so readily. When I told her I found her cold and uncaring, she turned it back around to me and labeled it as one of my many cognitive distortions, and asked me how I could reframe that perception. I halfheartedly told her something about the necessity of clinical distance, but I didn't believe any of it. She also proposed that perhaps she is reacting to my often apparent lack of emotion in sessions. But what didn't even occur to me then was that I *did* have a previous therapist who was much more warm toward me.
I'm reeling all of a sudden. It has been my therapist's mission to make me realize that my perceptions and cognitions can be very distorted, and I agree--BUT, I have agreed to the point that I don't trust my own emotions or appraisals of situations. Have I helped in my own brainwashing? OK, that's probably a bit too extreme, but why do I suddenly feel like I'm not sure which way is up?
Posted by white rabbit on April 16, 2003, at 21:48:34
In reply to Re: Misdiagnosed?? (way too long) » sedona, posted by likelife on April 16, 2003, at 21:21:06
I believe that a therapist has no business giving you a "diagnosis". A diagnosis is made by an MD,
period. Unless your therapist happens to be a doctor, I would ignore this label.Go to www.nami.org (formally the National Alliance for the Mentally Ill, an educational and support group) for more information, they have a terrific website.
Then find another therapist. I have a wonderful therapist, I ALWAYS feel MUCH better after talking to her, and I believe that this is what a good therapist does.
-Gracie
Posted by sedona on April 17, 2003, at 0:20:49
In reply to Re: Misdiagnosed?? (way too long) » sedona, posted by likelife on April 16, 2003, at 21:21:06
I know how you feel. Whenever I am in her office I often feel overpowered which makes me either react in a defensive way or a passive way. When she told me she thought I might be borderline I told her that I disagreed but not much else. Later, that night I got mad-at myself for not saying what I thought about it and at her for just laying it on me as if it were nothing. I have had many days when I feel doubt about myself and think she must be right.
I can relate to your story about about trying to tell her how you feel, only to have it thrown back at you. That's happened to me too. You shouldn't feel more confused about your emotions after seeing this therapist.I mean isn't that what they are supposed to be helping us out with in the first place. I am also very confused about my situation, but I think that maybe it's time we both found a new therapist
> Sedona,
>
> I'm sorry you've had to deal with this--it can be so hard/disconcerting/confusing/frustrating to disagree with a therapist, especially after building a 2 year relationship.
>
> I've recently had a similar experience--with borderline pd as well. I have been seeing my current therapist for a little over two years and about six months ago I began talking honestly with my her about how I felt about her, which was basically extremely attached, pretty dependent, and somewhat frustrated by these feelings, and because I felt like she was and continues to be somewhat cold and uncaring. Being, of course, terrified of abandonment, this was a difficult thing for me. She was somewhat receptive to hearing about this, but I was thrown completely by the amount of emotion that I was having, and after having spent the better part of two sessions talking through it, the issue was dropped (mostly because I felt like she wanted me to drop it).
>
> So, anyway, in short order I became quite depressed after this, which was probably caused in part by my disappointment, inability to talk about it, and an enormous amount of stress from beginning grad school.
>
> I am having difficulty making this make sense.
>
> Somewhere in here, my pdoc, who works at the same clinic, asked me if I thought I have borderline personality disorder. I knew a little about it at the time, but his question came completely out of left field for me. I told him no, and we moved on (pretty much I already couldn't stand this guy, but felt stuck with him). Later, I confronted my therapist, and asked her why he had asked me about BPD (I know they regularly consult with each other). She admitted that she thought the diagnosis fit as well, and I was (not in order) pissed, confused, terrified, miserable--mostly because I had a lot of misinformation about the disorder, and felt it was being used as some kind of sentence, rather than as a useful tool (as noa was talking about).
>
> I am one of the most passive people I know, and one of my "characterological deficits" is that I will believe almost anything someone else tells me about myself. So my therapist and I discussed her use of the diagnosis (at my insistence), and whether she would have told me had I not asked. I have come to believe her, but wonder occasionally about how my need to please and not make waves has brought about this agreement. When sharing this information with my husband (much later), he was shocked and angered that someone would "label" me with that group of traits. (For the record, I do fit somewhere around half of the diagnostic criteria, but only when I am quite depressed).
>
> You could say I have made progress in therapy since this point, as I have been handling stress much better, most importantly staying away from cutting (the defiant child in me wonders if I'm not doing this in part just to spite her--see, I'm not what you say I am). But as far as the relationship with my therapist, I feel like I have been trying very hard to distance myself from it, and make it not matter so much to me, since I am finding that it is much more painful to allow myself to think and feel about it.
>
> The point I think I'm trying to get to here is that after reading your message, Sedona, I wonder if I shouldn't agree with my therapist so readily. When I told her I found her cold and uncaring, she turned it back around to me and labeled it as one of my many cognitive distortions, and asked me how I could reframe that perception. I halfheartedly told her something about the necessity of clinical distance, but I didn't believe any of it. She also proposed that perhaps she is reacting to my often apparent lack of emotion in sessions. But what didn't even occur to me then was that I *did* have a previous therapist who was much more warm toward me.
>
> I'm reeling all of a sudden. It has been my therapist's mission to make me realize that my perceptions and cognitions can be very distorted, and I agree--BUT, I have agreed to the point that I don't trust my own emotions or appraisals of situations. Have I helped in my own brainwashing? OK, that's probably a bit too extreme, but why do I suddenly feel like I'm not sure which way is up?
Posted by sedona on April 17, 2003, at 0:28:38
In reply to Re: Misdiagnosed?? » sedona, posted by Dinah on April 16, 2003, at 19:14:04
Thanks again for your response. I have absolutely no intention of forwarding my records, or going back to the college psychiatrist. I though it was ludicrous of him to expect me to be able to talk about the psychiatric nurse that I have been having all the trouble with, knowing that they were friends. I kind of feel like it would have been more professional for him to refer me to one of the other psychiatrists.
Posted by sedona on April 17, 2003, at 1:40:02
In reply to Re: Misdiagnosed?? (way too long) » likelife, posted by sedona on April 17, 2003, at 0:20:49
Posted by Dinah on April 17, 2003, at 10:16:06
In reply to Re: Misdiagnosed?? (way too long) » sedona, posted by likelife on April 16, 2003, at 21:21:06
You and Sedona are making me feel so lucky for the relationship I have with my therapist. I feel like I can tell him anything at all. In fact I have.
And while he might get angry occasionally, he always is very careful (eventually at least) to reassure me that anger is part of any long term relationship. And that he is always willing to work out any problems and that the relationship is in no jeapardy. Which is something I need to learn in all my relationships.
Posted by WorryGirl on April 17, 2003, at 17:25:36
In reply to Misdiagnosed??, posted by sedona on April 16, 2003, at 1:18:05
Sedona,
I'm probably not the one who should be answering this, since I still haven't found another pdoc yet for myself.I don't know a lot about borderline personality, either.
I guess I would say that if you feel that this therapist has really helped you so far, it won't hurt to try to work on improving the relationship.
But if you two really aren't connecting well, it wouldn't hurt to try someone else for a few weeks and just tell your therapist that you need a vacation during that time. If after this time you think she was right for you, go back.
Posted by jane d on April 17, 2003, at 19:09:03
In reply to Re: Misdiagnosed?, posted by white rabbit on April 16, 2003, at 21:48:34
>
> I believe that a therapist has no business giving you a "diagnosis". A diagnosis is made by an MD,
> period. Unless your therapist happens to be a doctor, I would ignore this label.
>WR,
This doesn't make sense to me at all but I've seen it stated here before. Why should psychiatric diagnosis be restricted to doctors (and does anyone other than doctors say that it should)? I thought that most of the people working in the field from Social Workers to Psychologists were encouraged to make their own evaluation of the people they treat. Is this not so?
Thanks,
Jane
Posted by noa on April 17, 2003, at 22:20:51
In reply to Re: Who can diagnose? » white rabbit, posted by jane d on April 17, 2003, at 19:09:03
I think psychologists and social workers can diagnose psychiatric disorders, too. But maybe it differs from state to state?
Posted by likelife on April 18, 2003, at 0:14:26
In reply to Re: Misdiagnosed?? (way too long) » likelife, posted by sedona on April 17, 2003, at 0:20:49
Sedona,
Yeah, it's looking more and more like a new therapist wouldn't be such a bad idea. Just need to find the energy to suck it up and (1) tell my current therapist and (2) start looking again. Sigh...
Posted by likelife on April 18, 2003, at 0:16:24
In reply to Re: Misdiagnosed?? (way too long) » likelife, posted by Dinah on April 17, 2003, at 10:16:06
Dinah,
I do feel envious of the relationship it sounds like you have with your therapist. I definitely don't want the rest of my relationships to look like the one I have with her, but this doesn't necessarily mean that all the fault lies with me. Isn't that a lesson I've been learning forever?
Posted by likelife on April 18, 2003, at 0:17:44
In reply to Re: Misdiagnosed?, posted by white rabbit on April 16, 2003, at 21:48:34
Gracie,
Thanks for your comments. I did check out the NAMI site, though I didn't have much time to cruise. It's a relief to hear that it is possible to *consistently* feel better after talking to a therapist!
Posted by white rabbit on April 18, 2003, at 1:36:07
In reply to Re: Who can diagnose? » white rabbit, posted by jane d on April 17, 2003, at 19:09:03
I'm a licensed and registered x-ray technologist.
Although I can see a fracture on an x-ray film
and I can name the type of fracture, this is not my job. My job is to produce an x-ray film of diagnostic quality for the radiologist, and HIS job is to make an official diagnosis. I have no professional or legal right to make a diagnosis,
even though I can see that fracture just like the doctor. Technologists, nurses and therapists cannot diagnose.
-Gracie
Posted by Dinah on April 18, 2003, at 6:53:12
In reply to Re: hit the nail on the head » Dinah, posted by likelife on April 18, 2003, at 0:16:24
Of course it's not your fault. :)
I credit my therapist with whatever sort of relationship we have. I'm lousy at them and tested him repeatedly. The man has the patience of a saint (overall).
Posted by sueT on April 20, 2003, at 22:29:44
In reply to Misdiagnosed??, posted by sedona on April 16, 2003, at 1:18:05
> Hello- I am facing a dilemma with my therapy. I have been seeing a therapist for about two years and it has been my first experience into the psychiatric world. I guess like any other relationship we have had ups and downs. There have been times when I have felt very grateful for her support and also many times when I have gone home in tears. I have thought of leaving several times. The point is that we don't communicate well. She is kind of clinical and cool, and I think I want someone who is a little more warm. From the very beginning she has told me that I am very resistant, on a couple of occassions she said that she felt ineffective, and most recently she said that when she thinks of me she thinks of impasse. So, I am very aware of the fact that she thinks I am a "difficult" client. I've tried to be more compliant, but I just don't agree with her all the time. Recently after almost two years of therapy after I made a half-serious remark about probably having characterological problems she decided to give me a personality test. One month later she had the results and she found that much to her surprise I showed a lot of Borderline traits according to the test. I know exactly what that means as I have read a lot about the personality disorders- because I am a hypochondriac when it come to psychological diagnosis. The Borderline diagnosis was always the one that I feared most so when I heard it I was shocked. We talked about it and the more we talked the more she thought that not only did I have the traits but also probably the disorder. I feel as though I have now been labelled and there is nothing I can do about it. I do not have most of the common behaviors/beliefs such as self mutilation, angry outbursts, splitting etc. So why did she decide this? Is it because she finds me so difficult that she feels compelled to label me? I am very angry about it and I don't really want to go back,(and I told her these things), and I'm sure from where she stands this looks exactly like Borderline behavior. So I'm caught in a cath-22 and I am not sure what I should do next. Has anybody else had an expereince with getting a diagnosis that you don't agree with? Any expereince with a Borderline disgnosis that they didn't agree with?
> If you have read this you are a saint.
> Thank you very muchHi Sedona,
There is a big difference between having borderline characteristics and borderline personality disorder. No psychologist should diagnose you just based on one test measurement. Ask your therapist to review the DSM-IV diagnostic criteria with you to determine if you really meet the diagnosis.
Best Wishes
Go forward in thread:
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.