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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by cubic_me on January 7, 2007, at 6:24:03
I'm wondering who's done therapy with their psychiatrist, and was it much different to therapy with a T?
It's pretty unusual here, but I've heard it's more common in the US (although I don't know if that's true).
Posted by madeline on January 7, 2007, at 8:58:12
In reply to Therapy with a psychiatrist, posted by cubic_me on January 7, 2007, at 6:24:03
I see a psychiatrist and he is both my T and pdoc. I think it is really nice to have the same person that handles your therapy handle your meds as well. It just feels to me as though they know you better and aren't as quick with the meds.
Also, I saw several therapists (social workers etc) before I landed in my T's office and none of them worked out for me.
However, I'm really not sure that there is much of a difference as far as therapy is concerned. I think it is all about the fit between the therapist and client.
Posted by wishingstar on January 7, 2007, at 9:41:47
In reply to Therapy with a psychiatrist, posted by cubic_me on January 7, 2007, at 6:24:03
I had therapy with a psychiatrist for about a year as a teenager and didnt like it at all. She really had no skills to speak of and wasnt very supportive or understand. But shes probably not representative of all psychiatrics.
I think there's probably more variance within the field of psychaitrists doing therapy maybe than within other therapists, not in terms of technique but in terms of comfort with it, skill level, etc. I'm sure there are some who are wonderful, but then there are some like mine. My understanding is that here in the states, pdocs go through the regular medical school sequence and just choose to specialize in psychiatrty, and most do not receive much (if any) training in counseling techniques or any of that. Of course some pursue it, but not all I'm sure. I dont know if that is the same where you live though.
Posted by caraher on January 7, 2007, at 10:16:24
In reply to Re: Therapy with a psychiatrist, posted by wishingstar on January 7, 2007, at 9:41:47
I've done it both ways... I think it really just comes down to the individual. If I have someone else as a T I'm less concerned with how I "click" with my pdoc. There is a certain convenience to having one person do it all. There also can be financial reasons to have different people; psychiatrists may bill at a higher hourly rate than some psychologists or others who may do psychotherapy.
Posted by cubic_me on January 7, 2007, at 10:46:00
In reply to Re: Therapy with a psychiatrist, posted by caraher on January 7, 2007, at 10:16:24
Thankyou for all the replies so quickly. I've been to this pdoc for meds before (and from what I've seen so far I think we'll click), and she's suggested therapy since my current T isn't working out for me. The main thing I hope to find with a good pdoc than the current T is that they're on the same wavelength intellectually and in a career aspect.
Do you go for 'meds appointments' and 'T appointments' or is it all mixed in together?
Wishingstar - I can totally see where you're coming from about the variation. I'm currently at med school and perhaps half the people who do psychiatry do it for the love of it, and half because it's one of the 'easy' jobs to get.
Posted by peddidle on January 7, 2007, at 11:46:14
In reply to Re: Therapy with a psychiatrist, posted by cubic_me on January 7, 2007, at 10:46:00
I did therapy with my first pdoc. I did not like her at all, but maybe we just didn't "click". However, after going to a second pdoc, I have come to the conclusion that pdocs, in general, are more serious and straight-laced (maybe that's not the right word...). I always feel like I'm sitting in the room with a doctor, whereas with a T, regardless of whether or not I like them, I feel like I'm having an actual conversation. Does that make sense?
I agree with madeline that it's helpful if the pdoc really knows you, but I feel like pdocs, for the most part, are all about meds. One time I completely refused to go to an appointment with my first pdoc-- I locked myself in my room and fought with my parents when they tried to pick the lock (that's how much I hated her). I finally agreed to talk to her on the phone, and the first thing she did was tell me to increase my zoloft. Again, maybe I just had a bad experience with my pdoc.I haven't seen my current pdoc in about 2 years, but my T checks up on the meds intermittantly and asks me if I think they're still working, etc. It may just be a matter of personal preference, but from my experiences, I'd rather keep the meds and the therapy separate.
Sorry if I'm rambling, but to answer your last question, the therapy and the meds were all sort of mixed together when I did therapy with a pdoc. Of course she always had to check-up on the meds, but sometimes it was as brief as "how are you doing on the zoloft?" When I first started seeing her though, sometimes I would go for half hour appointments just to deal with meds.
Posted by madeline on January 7, 2007, at 12:21:21
In reply to Re: Therapy with a psychiatrist, posted by peddidle on January 7, 2007, at 11:46:14
I'm sorry about your experience with your pdoc.
However my pdoc/T is very warm and caring. We rarely discuss meds at all, but I think that is largely because my meds are okay for now. He is also very conservative with the meds, which I like.
He started out as a child psychiatrist and maybe that is why he is so good (at least with me).
He is also older (50+) and did his med school, residency and fellowships prior to the psychopharmacology became all the rage. I don't know how I lucked into him, but I certainly went the rounds with every crackpot there was out there I think (one chic even had me hold a tea bag - that T will live in infamy).
Maddie
Posted by Deneb on January 7, 2007, at 12:51:11
In reply to Re: Therapy with a psychiatrist » peddidle, posted by madeline on January 7, 2007, at 12:21:21
I do therapy with my psychiatrist. I think she's really good. About 43 mins of the session are used to do therapy. The last 2 mins are for meds management.
She's really great. She never gets angry at me. She's always professional. No matter what she's always calm and collected.
I see her once a week to once every two weeks. She knows almost everything about me.
Deneb*
Posted by JeffSmith on January 7, 2007, at 13:43:39
In reply to Re: Therapy with a psychiatrist » peddidle, posted by madeline on January 7, 2007, at 12:21:21
(one chic even had me hold a tea bag - that T will live in infamy).
>
> MaddieOMG, please elaborate... Im dying to know. : )
Posted by Dinah on January 7, 2007, at 15:09:26
In reply to Therapy with a psychiatrist, posted by cubic_me on January 7, 2007, at 6:24:03
I did it when I was a preteen. I think it was more common then. He wasn't particularly awful, but definitely not particularly skilled. I didnt' help, I'm sure, being determined not to talk.
I don't think he much liked it though. A few years after he saw me, he went into management, and has been there ever since.
Posted by notfred on January 7, 2007, at 19:25:15
In reply to Re: Therapy with a psychiatrist, posted by wishingstar on January 7, 2007, at 9:41:47
" My understanding is that here in the states, pdocs go through the regular medical school sequence and just choose to specialize in psychiatrty, and most do not receive much (if any) training in counseling techniques or any of that. "
Yep, no training in psychology. They are, afterall, medical docs. Insurance will only pay for so many/long med management sessions so docs have to code visits differently if they want to get paid.
Posted by madeline on January 8, 2007, at 6:06:18
In reply to Re: Therapy with a psychiatrist, posted by notfred on January 7, 2007, at 19:25:15
Interesting, my insurance company would only pay for a small part of my therapy with a psychologist, but pays 90% of my visits with my psychiatrist and I meet with him every week.
I think it depends on the company.
Also, FWIW, the psychiatry residents at my institution have to spend 2 precepted years in the outpatient therapy clinics.
Posted by madeline on January 8, 2007, at 6:13:24
In reply to Re: Therapy with a psychiatrist » madeline, posted by JeffSmith on January 7, 2007, at 13:43:39
well, she was really into breathing, meditation and stuff like that, so in one session she handed me a tea bag and told me to hold it for five minutes.
She wanted me to feel every texture, smell of the tea bag and then to focus my all of my energy on the tea bag.
Frankly, I just think she had to go to the bathroom, or wanted to take a small nap.
At least it was a new tea bag.
I asked her if i could keep it, that I liked that kind of tea.
Posted by JeffSmith on January 8, 2007, at 8:31:49
In reply to Re: Therapy with a psychiatrist » JeffSmith, posted by madeline on January 8, 2007, at 6:13:24
> well, she was really into breathing, meditation and stuff like that, so in one session she handed me a tea bag and told me to hold it for five minutes.
>
> She wanted me to feel every texture, smell of the tea bag and then to focus my all of my energy on the tea bag.
>
> Frankly, I just think she had to go to the bathroom, or wanted to take a small nap.
>
> At least it was a new tea bag.
>
> I asked her if i could keep it, that I liked that kind of tea.
>
>Thanks for sharing. : )
Maybe she was on to something... but I just dont see it! : D
A "Craziest therapist story" thread Im sure would turn out some pretty funny stories.
Posted by notfred on January 8, 2007, at 13:43:03
In reply to Re: Therapy with a psychiatrist, posted by madeline on January 8, 2007, at 6:06:18
> Also, FWIW, the psychiatry residents at my institution have to spend 2 precepted years in the outpatient therapy clinics.
That is not the same as studing psychology.
Sitting in on thearpy sessions is not where you learn psychological theory. I would think this be enough to deal with short term problems and crisis. Few here have short term problems.
Posted by LlurpsieBlossom on January 8, 2007, at 18:24:06
In reply to Re: Therapy with a psychiatrist, posted by notfred on January 8, 2007, at 13:43:03
Some of us may have short term problems. Some of us may not.
Some of us may view our neurochemistry as a series of short-term problems, while thinking of our psychology as a long-term project. (and vice versa)
I have benefitted from short-term therapy (about 15 sessions) and maybe 3-4 appts with pdoc was enough to get me out of a suicidal depression.
Now I have graduated to working on long term problems with T and getting psychopharm support to help my fragile brain deal with the trauma of stirring up the past. Not everyone is ready for that, or needs that level of work.
Once or twice my T was unavailable, and I had a pdoc appt. scheduled anyways, and so I vented to pdoc. Many doctors, nurses, hair stylists, etc are very good at supportive listening. Sometimes that's just what we need. Life experience (even pdocs get to have life experiences) are also a very good source of inspiration for helping clients. I think that many of the respected therapeutic techniques and theories are natural extensions of an acute observer watching how life unfolds for different people. At what points can the therapist step in an provide some subtle (or overt) cue that will help an individual reconceptualize their trajectory or gain control over their situation... well, lots of people are really skilled at giving good advice.
give it a try. if you cannot open up to someone and work with what they are trying to tell you, then it will be hard to get the hard work done.
-Ll
Posted by madeline on January 8, 2007, at 18:35:37
In reply to Re: Therapy with a psychiatrist, posted by notfred on January 8, 2007, at 13:43:03
that's why the years are precepted (taught, monitored, discussed). It includes theories as well as practice.
You are right though, most psychiatrists hate this part of their residency.
Posted by notfred on January 8, 2007, at 23:45:58
In reply to Re: Therapy with a psychiatrist » notfred, posted by madeline on January 8, 2007, at 18:35:37
> that's why the years are precepted (taught, monitored, discussed). It includes theories as well as practice.
>
> You are right though, most psychiatrists hate this part of their residency.Yep, they are, after all, medical docs. But still
a T is schooled in thearpy and gets far more than 2 years training in it. say a MSW or a PhD. For these 2 precepted years they are covering many facets of medical practice, so it is not 2 yrs of just psychlogical studies.
Posted by cubic_me on January 10, 2007, at 8:24:47
In reply to Re: Therapy with a psychiatrist, posted by notfred on January 8, 2007, at 23:45:58
Thanks for all your experiences, it's really interesting, and some of your stories are pretty awful.
I'll let you all know how my first appointment goes in a few weeks.
I've got to attempt to end therapy with my current T today - scary!
Posted by B2chica on January 10, 2007, at 12:04:40
In reply to Re: Therapy with a psychiatrist, posted by cubic_me on January 10, 2007, at 8:24:47
HI CUBIC_ME!!!!!!!!!!!!!!!
LOOOOng time no speak.i'm so glad to see you here. i'm basically a lurker these days. i pop in about every other week or so.
to quick catch up. my Best T moved away last year about feb., but few months later i found another T, yes a female (big for me). i am very pregnant and due in about a month. off meds and feeling great as pdoc thought i would.
have concerns after delivery but covered. also my FAB pdoc closed his practice, i miss him SOOOO much...he was SO good and well, kinda cute :)
-now i have another one...only seen him once...still trying to plan an appt for late feb (after delivery to watch for PPD and such). so i'm not really happy bout that.but overall, doing well.
and though i've never officially seen a pdoc for therapy, my FAB pdoc and i got along very well, and he would ask me at times about what's going on...if i would describe a new symptom and such, i would tell him why my anxiety would skyrocket and i would tell him about flashback memories and fears and such. although it wasn't thorough, i also had my T call him and keep him up to date on EVERYTHING (this way i wouldn't have to re-live things but that way he would know). i did feel that if he knew the extent of my emotional problems he could use that with deciding about medication. i think it worked REALLY well.i hope that you have the same luck.
BEST WONDERFUL WISHES
and SO glad to see you!
((((((((((((((cubic_me))))))))))))))b2c.
Posted by cubic_me on January 10, 2007, at 14:09:58
In reply to Re: Therapy with a psychiatrist » cubic_me, posted by B2chica on January 10, 2007, at 12:04:40
> HI CUBIC_ME!!!!!!!!!!!!!!!
> LOOOOng time no speak.
>
> i'm so glad to see you here. i'm basically a lurker these days. i pop in about every other week or so.
> to quick catch up. my Best T moved away last year about feb., but few months later i found another T, yes a female (big for me). i am very pregnant and due in about a month. off meds and feeling great as pdoc thought i would.
> have concerns after delivery but covered. also my FAB pdoc closed his practice, i miss him SOOOO much...he was SO good and well, kinda cute :)
> -now i have another one...only seen him once...still trying to plan an appt for late feb (after delivery to watch for PPD and such). so i'm not really happy bout that.I just saw you in another thread and was so excited to see you again. And pregnant! wow, things have defintately moved on for you. Good luck with all that.
>
> but overall, doing well.
> and though i've never officially seen a pdoc for therapy, my FAB pdoc and i got along very well, and he would ask me at times about what's going on...if i would describe a new symptom and such, i would tell him why my anxiety would skyrocket and i would tell him about flashback memories and fears and such. although it wasn't thorough, i also had my T call him and keep him up to date on EVERYTHING (this way i wouldn't have to re-live things but that way he would know). i did feel that if he knew the extent of my emotional problems he could use that with deciding about medication. i think it worked REALLY well.I've seen this pdoc for meds (or lack of them, on mutual agreement) twice and we really get on well, so I'm hoping things continue in the same way through therapy (a 16 week semi-structured course)
>
> i hope that you have the same luck.
> BEST WONDERFUL WISHES
> and SO glad to see you!
> ((((((((((((((cubic_me))))))))))))))
>
> b2c.
(((((((((B2C)))))))))))) I hope your sticking around for a bit ;)
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