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Posted by alexandra_k on October 9, 2013, at 16:31:02
In reply to Re: p-doc said... » alexandra_k, posted by Twinleaf on October 9, 2013, at 6:34:06
thanks. i'm not sure about the inter-personal trauma thing. i mean... i was traumatised, for sure, but a lot of other people suffer worse without it affecting them. and i guess that people with asperger's etc can get traumatised, too.
i think more particularly... he read like a couple pages from file notes and met with me for half an hour. that doesn't exactly position him for specific insights. he told me he specializes in autism / aspergers. which of course primes him for seeing it everywhere. he said that there is no treatment for it in nz. i did say on the way out 'so, uh, how do you get to specialize in something you don't even get to treat' (JOKE - I'M JUST MESSING WITH YA) except i wasn't joking, particularly.
i think... this is more about the possibility of benefits. assistance with earphones. with accommodation. people taking seriously how much the noises affect me. a diagnosis of trauma or DID or borderline or anxiety or depression etc etc etc won't enable the same level / degree of support. neither will railing about the poor fit with my current sh*tty environment and how i fit right on in to certain other environments that i can't presently manuouver myself into...
in a way... i feel that he could perhaps have helped me additionally with the ADHD thing and the provison of medication which is clinically proven to improve *everyone's* ability to concentrate. i suppose it might be that such meds are addictive... in which case i would prefer to avoid them. ADHD isn't his pet... i think it is more about that.
i think... community mental health will look at me / view me / treat me / interact with me very different in virtue of thinking of me as aspergers than thinking of me as borderline. i mean... if i tell them i'm overwhelmed and need time out (for example) they are more likely to listen to my particular complaints and less likely to brush me off 'go practice your skills dear'. which is horrible... but perhaps true. they will be more respectful / gentle about my reaching out for help. perhaps. i don't know.
Posted by alexandra_k on October 9, 2013, at 23:18:10
In reply to Re: p-doc said... » Twinleaf, posted by alexandra_k on October 9, 2013, at 16:31:02
well... today was... crappy.
she seemed...
disappointed?
on my take that p-doc read a couple pages of my file and already made up his mind to see his favorite dx before meeting with me...
on my reinteration that a dx label is just a dx label and doesn't help so much... that it supports a bunch of assumptions which might not be so helpful. e.g., how p-doc thought i must have food allergies - and i do not. on how... people see me as not being socially skilled.
that bit a bit, actually.
and so i spent much of the rest of the session ranting on how i actually think a lot of my problem is that other people lack social skills to (for example) back the f*ck off when i'm sending that signal out loud and clear.
at the end she... said something about how we didn't manage to get much done this session...
well...
i guess she has an agenda.
the agenda seems to be that she is currently doing a (slower) dx assessment of me.
of course she is.
she seems UNABLE to relate to me without categorizing me. that would require... flexibility.
she seemed annoyed at my ranting. she was getting this urge for me to stoppit... she didn't quite crack her knuckles but...
she can't handle me. she can't even see that process might actually be the point.
f*ck*ng useless.
i feel sick.
Posted by alexandra_k on October 9, 2013, at 23:19:42
In reply to bad t, posted by alexandra_k on October 9, 2013, at 23:18:10
why can't people just let me talk?
why?
why can't people just shut the f*ck up sometimes?
Posted by alexandra_k on October 9, 2013, at 23:20:31
In reply to Re: bad t, posted by alexandra_k on October 9, 2013, at 23:19:42
i mean... who is being paid to help who again?
and what is helpful? oh, surprise, it must be whatever it is that YOU want to do. of course... of course it is...
Posted by Dr. Bob on October 10, 2013, at 0:54:03
In reply to Re: bad t, posted by alexandra_k on October 9, 2013, at 23:19:42
Posted by Twinleaf on October 10, 2013, at 10:30:15
In reply to bad t, posted by alexandra_k on October 9, 2013, at 23:18:10
You are just at the very beginning. Whether you choose to "rant" or explore how you might work through some of your most uncomfortable feelings is up to you, and it's up to HER to stay with you , whatever you say, and help build a strong relationship. I hope you can do that with her.
If this were me and my analyst, it would be an example of a "rupture", where my feelings seem misunderstood or judged. We would then work on a "repair" so that the relationship is once more comfortable and helpful.
Posted by Poet on October 10, 2013, at 17:34:07
In reply to bad t, posted by alexandra_k on October 9, 2013, at 23:18:10
> well... today was... crappy.
>
> she seemed...
>
> disappointed?
>
> on my take that p-doc read a couple pages of my file and already made up his mind to see his favorite dx before meeting with me...
>
> on my reinteration that a dx label is just a dx label and doesn't help so much...My first pdoc thought I had borderline, I didn't find out until years later. He had called my T after I told him I was done seeing him and he told her my dx a/k/a label, which she and Dr. Clueless both disagreed with.
>
> at the end she... said something about how we didn't manage to get much done this session...
>Honestly, does she expect an "ah hah" breakthrough made for TV movie therapy session? I didn't get much done in therapy today, either, it's how the process works.
> she seemed annoyed at my ranting. she was getting this urge for me to stoppit... she didn't quite crack her knuckles but...
>My T is tired of my ranting that I am a failure, she doesn't crack her knuckles, but sighs and says, stop sending negative energy out into the universe. Here, I though what I said in therapy stayed between the two of us, I guess the universe must be listening in. Sometimes you need to rant and if you can't rant to your therapist, who should we rant to?
I'm sorry she's frustrating you.
Poet
Posted by baseball55 on October 10, 2013, at 19:26:38
In reply to Re: bad t » alexandra_k, posted by Poet on October 10, 2013, at 17:34:07
Sometimes you need to rant and if you can't rant to your therapist, who should we rant to?
Therapists are people too. An hour of listening to someone rant is frustrating to them as it is to anyone. I mean, once in a while, okay. But they want to feel that you are working with them to try and change and learn about yourself. That's what makes their job worthwhile, because it sure doesn't pay a lot.
When I was seeing my p-doc for therapy, I used to ask him how he thought of me and he would say -- you're willing to work very hard.
I guess I wanted him to say -- you're really smart and funny and likable or something. But this is how it worked for him. I was willing to think about myself, to try and change, to take his reactions and suggestions seriously and not explode in anger or be constantly distrustful. This made it gratifying to work with me. That's what therapy is -- work.I understand this from teaching. My favorite students are always those who try their best, who come to me with problems rather than bad-mouth me and complain about their grades. Their job is to work on building their skills and knowledge and mine is to facilitate that work. I think this is exactly how therapists see the relationship.
Posted by Poet on October 11, 2013, at 15:55:59
In reply to Re: bad t, posted by baseball55 on October 10, 2013, at 19:26:38
I agree that an hour of listening to someone rant is frustrating. It's not like I rant nonstop every session, just sometimes I need a place to let it out where I can't get in trouble if someone hears it.
Poet
Posted by alexandra_k on October 11, 2013, at 18:54:17
In reply to Re: (nm), posted by Dr. Bob on October 10, 2013, at 0:54:03
lol. thank you. it helps to feel like you are there. all the way across the other side of the world.
:-)
Posted by alexandra_k on October 11, 2013, at 19:00:21
In reply to Re: bad t » alexandra_k, posted by Twinleaf on October 10, 2013, at 10:30:15
I think we have similar ideas of what we are looking for in therapy.
The issue for me is that all the clinical psychologists over here are primarily trained in cognitive behaviour therapy.
This thing they do of saying they are psychodynamically oriented comes more from their attempting to make affiliative noises in my direction than from any cognitive or even emotional understanding of how psychodynamic therapy might offer them differences in approach or execution...
I suppose she did ask me a little about how I thought my last therapist helped. I said about the 'experience near' thing - but then also said that I thought perhaps it was traumatising... But then I said that my narrative was coming together so perhaps I'm more integrated than I used to be... I'm not sure that any of this made sense to her even though she smiled and nodded...
I'm not sure how much of what I say she understands, honestly. She managed to say what was on her mind last time. What was on her mind was this: 'I know some people who have done their PhD and I admire you for it'. I think if I had have said 'I know some people who haven't done their PhD and I respect their decision not to' she would have felt... How I felt. I think I have enough empathy to see that...
?
You don't comment on something... Normal. I don't know what I'm saying. There is a fundamental disconnect.
I freak her out. She seems to be trying to persuade someone that she is like me that she can empathize with me. I'm not entirely sure who she is trying to persuade... But it is the fact that she is trying... That shows me she is having difficulty...
Posted by alexandra_k on October 11, 2013, at 19:09:09
In reply to Re: bad t, posted by baseball55 on October 10, 2013, at 19:26:38
She is having difficulty.
I think...
I'm supposed to help her, yes.
> Therapists are people too. An hour of listening to someone rant is frustrating to them as it is to anyone. I mean, once in a while, okay. But they want to feel that you are working with them to try and change and learn about yourself. That's what makes their job worthwhile, because it sure doesn't pay a lot.Yeah.
It is our job to look after them.
Or... Perhaps it is more... That sometimes people freak out. If you take a couple minutes to soothe them... Then they can sometimes calm down... And actually rise to the occasion. If you write them off... You miss out on that. Even from a purely selfish perspective... It can pay to take the few minutes to reassure them...
If you can.
Perhaps this is true. I guess I don't know... Because I don't know her very well.
I think ideally I wouldn't need to do this. Ideally... Ones therapist is in therapy oneself which takes care of their need... So they don't need their clients to do this for them. Or perhaps super ideally... Ones therapist can get this from relationships in their outside therapy lives... Or whatever. But... Well... I suspect the ones who function at this level partly get to that level by carefully managing their caseload... And they are perhaps not likely to be found in community mental health. Even if they were... Doing 1 year competency check upon emigration (for example)... You would not have them at their best.
Such is life.
I need to give them something. Yeah.
I've got a mission now: Accmomodation. Then they can say goodbye to me. ANd they reallyr eallyr eally really want to . OH yes, I know tis true.
Dare I say it... My best students were the ones that wrote the best essays. That had good ideas or nice ways of putting things. It is easiest to answer the essay question after reading what everyone else has said then telling your own version stringing together all the 'best' ideas you found in the others work... The ones who... Participated effectively. I always... Thought my job was to coax that out of people and reward it. Trouble was... I wasn't particularly good at rewarding it. I think... People tended to respond the way I did to praise: It paralysed one with fear that one couldn't keep it up.
Posted by alexandra_k on October 11, 2013, at 19:14:52
In reply to Re: bad t » alexandra_k, posted by Poet on October 10, 2013, at 17:34:07
I don't know what she thinks. I guess I'll try and say something next week about how I felt hurt that she said we hadn't really got anything done. That I realized that she had an agenda - of doing a dx assessment. Of how that upset me because I don't feel like she heard what I had been saying about how dx doesn't actually mean anything to me. About how there is a LITTLE F*CK*NG SPEEL AT THE START OF THE DSM ABOUT HOW THE DX CATEGORIES ARE NOT TO BE USED TO DETERMINE TREATMENT ffs.
How... I was trying to share with her stuff that actually was hard for me. I did... Slightly raise / touch on stuff that was very very hard for me (e.g., I told her that I had been having trouble working - this is a very sensitive issue because I think she needs to see me as being extremely productive the only thing holding me back is this autistic thing I'm not at all sure she can handle anything to do with how I get blocked and figuring out how to free those up). I told her one of the helpful things my past t did was LISTEN TO ME and then SOMETIMES make comments on patterns he had observed...
I should tell her that one of the things I like about psychodynamic therapy is how the therapist is a little better at the SHUT THE F*CK UP strategy.
I...
I sometimes do things I later regret. I will approach the next session with an open mind and see what she has to say. She was looking a little... Harrassed? Last time. Maybe I got her on a bad day.
Posted by alexandra_k on October 11, 2013, at 19:15:21
In reply to Re: bad t, posted by alexandra_k on October 11, 2013, at 19:14:52
Posted by alexandra_k on October 17, 2013, at 15:39:29
In reply to above for poet sorry (nm), posted by alexandra_k on October 11, 2013, at 19:15:21
she is hopeless. i was like 'do you think you might be able to say something in support of my application to live independently because they told me the more they have in support the more likely it is to go through'.
and she was like 'i haven't finished assessing you yet'. and i was like 'they don't care so much about dx as they care about my current level of functioning. they want to know about shared vs independent living. they want to know why i can function at uni but not out of uni. and 'you can ask me whatever for the rest of the session. i understand if you can't write anything in support... but can we at least try and do this and you write something if you feel like you have something you can say?'
so she got to ask me anything... and she didn't ask me anything about how i function outside uni (e.g., about my employment history). she didn't ask me anything about what i find hard about my present living environment and how i've functioned in different ones...
she was like 'chronological' and we went through primary and intermediate and high school (again). last time there was a 'drug use at high school' theme but this time she didn't even pull out a theme... there wasn't any pattern to her questions... and she would say things like 'that was a tangent' and i was like 'i was answering your question' and she was like 'i did ask, yeah'.
what was she trying to do? does she even know how to conduct a psychology assessment?
i am reminded of Grice on speaker's meaning... an example familiar to any philosophy major... a professor is asked to write a letter of reference for one of his students who is applying for a job as a philosophy professor. in the letter he writes that the person is punctual. the (unstated) conversational implicature is that the person is useless at philosophy and has no ability to teach. why conclude this? because the professor has violated conversational implicature rules like BE RELEVANT, BE INFORMATIVE, BE TRUTHFUL, etc. if the most relevant and informative and truthful thing he could say on a letter of reccommendation was that he was punctual... it implies that he couldn't honestly speak to these other (obviously more pertinent) things.
Of course things like relevance etc do require a basic intellectual capacity to focus on what is relevant etc etc. I don't think she understands her task.
I worry that Work and Income will read it as a case of conversational implicature because of (what looks to me) like her inability to focus on what is relevant here. Or even to conduct an organized assessment. Or even (based on past sessions) her ability to conduct an unstructured assessment (she was only full of judgement for the way I freely wanted to tell my story - that my doing so was not particularly relevant to wherever the f*ck it was that she thought we should be)
oh dear god. how do i get put with these people?
(answer: i strayed too far from the university).
please put me back lady. i know it is hard for you... supporting me to do something which involves us never seeing each other again. please look out for my interests. just this once. then you can go back to business as usual with all your other clients. oh yes, indeed. whatever the f*ck it is that you think is productive work.
i suspect she was wanting me to switch.
she is not a safe person for me to be around.
Posted by alexandra_k on October 17, 2013, at 15:48:11
In reply to Re: i think..., posted by alexandra_k on October 17, 2013, at 15:39:29
okay...
what got me was that i am not able to function outside the university. i do function quite well inside it, though. i am not able to function living with other people (who are not similarly introverted and focused on their own things). i am able to function living by myself.
these are facts. they can be seen by considering my life history.
i'm not asking her to lie. i'm not trying to have the system on.
i'm not asking her to do special favors for me. i'm not required to be all friendly and gregarious and flirty and pleading. i'm not asking her to do anything that isn't part of her job description.
i'm just asking her to do her f*ck*ng job. to focus on the task.
and right from the start when i made it clear that i was asking her to write something in support... she got this smile on her face like i was asking her for favors.
because she has some power now.
and how will she use it?
will she do her job and be professional?
or will she punish me for not sucking up in a way she considers appropriate? this responsivity to reason vs responsivity to people who suck up seems to be the university vs the 'real world' difference. i think it is one of the main ones, acutually. because if you don't understand reason... what else is there?
i don't play that game.
if she was trying to see whether i would then well done. i suspect that would be giving her a bit much credit... but we will see.
she left the room for 10 minutes to copy something... left a big file with my name on it 'assessment' on it or whatever. i suppose most people would look reasoning 'it is mine - it has my name on it'. actually... i know that the person writing it owns it. or actually the public health system does since it paid for it... whatever. i'm not deceptive. i didn't look. i wouldn't do that. unlike most of the world i do respect privacy.
just do your job lady. tis all.
Posted by Partlycloudy on October 17, 2013, at 18:44:24
In reply to Re: i think..., posted by alexandra_k on October 17, 2013, at 15:48:11
Goodness, she does not seem to be qualified to do the job at all from what you are saying.
Makes you wish there was a buzzer and intercom so you could say, "sorry, this one is a dud, please send the next one in." Because it's THEM who are failing the system, Alex, that is clear enough.
I hope this fool sees you through to what you're looking for. So frustrating.
Posted by alexandra_k on October 17, 2013, at 21:55:05
In reply to Re: i think..., posted by Partlycloudy on October 17, 2013, at 18:44:24
thanks for your support. i feel a bit bad now... it is of course possible that i am underestimating her significantly because i am scared.
i got scared about the social worker... but she actually came through for me. i got scared about the doc and he did the same with his report... so... we will see...
i don't think we are a good fit. but it is possible there is some kind of reason behind her action...
based on past experience with psychology in this country... i wouldn't count on it, though.
i went and had a look at where i'm meant to be moving to, today. so i have a mental image. it is... a dump. from the outside... there is a wall of one way glass (which is actually cool, because i'm paranoid about two way glass, and it is nice to have more light in). the view is totally uninspired. street. cars. car parking buildings. diffuse light (and it was a sunny day today). big *ss hill.
it is just one block back from uni but damn if that block isn't down a big *ss hill. there is another building back on the uni street (where they have the apartment style options). apparently there is some kind of internal accessway... i couldn't see it, though.
so it is basically down a dark valley. there is a big *ss bar on the corner advertising (actually) cheap meals and drinks. i ate there once on conference, actually, and their breakfast was actually quite good, i thought. grungy. no chain stores. i guess... grad students are likely to take the studios since scholarship makes them affordable but they are just out of the price range of most undergrads...
fingers crossed... the last place i lived it was politic to complain about what a dive it was... and i suppose in many ways it was... but it was my home. i think... this will suit me. i'll complain, of course. but i think this could work. i would rather have that part of town then the macdonalds etc of the main street... i'm a bit sad to be off the ridge... but the price of the ridge is a teeny tiny little room with shared kitchen and bathroom and no guarantees of a view anyway so...
i think it will suit me quite well.
:)
fingers crossed.
Posted by Dr. Bob on October 19, 2013, at 23:29:42
In reply to Re: i think..., posted by alexandra_k on October 17, 2013, at 15:48:11
> I've got a mission now: Accmomodation.
> I realized that she had an agenda - of doing a dx assessment.
> i'm not asking her to lie.
>
> i'm not asking her to do special favors for me.
>
> i'm just asking her to do her f*ck*ng job.
>
> and right from the start when i made it clear that i was asking her to write something in support... she got this smile on her face like i was asking her for favors.Maybe her agenda (what she sees as her job) fits with one agenda of yours, treatment, but you also have another agenda, accommodation. If so, might it be an option to find someone different for that explicit agenda?
Bob
Posted by alexandra_k on October 20, 2013, at 0:59:55
In reply to Re: i think..., posted by Dr. Bob on October 19, 2013, at 23:29:42
i guess what i wanted from her was something along the lines of a GAF assessment. I was working under the assumption that she was a clinical psychologist who was qualified in diagnostics.
i think i read that wrong, though, and she isn't a clinical psychologist after all. community mental health does sometimes employ other people (former nurses or crisis team workers or whatever) as counselors. when they really have run out of clinical psychologists... i'm starting to suspect that she may well be one of those... which is why she is more... enamored with the DSM than most... and why she doesn't seem to be conducting any dx assessment like i've ever had before... even though i have in fact been through quite a few of them over the years... and why she does a lot of nodding and smiling and i've been having concerns about whether she understands me (i was assuming graduate level psychology vocabulary and some background in psychodynamics).
accommodation trumps treatment because if i get the accommodation i'll move to a different region so she won't be my clinician anymore.
and dx doesn't make a damn for treatment. says so in the initial blurb of the DSM. and not just the newest one, neither.
i have 2 p-docs who are supporting this. i thought support from a clinical psychologist would be icing on the cake (a panel would be convinced any independent assessment would likely concur). three out of three would have been pretty good evidence in my favor (especially given that they are randomly assigned community mental health practitioners and not private assessments i paid mega-bucks for).
if she isn't qualified in diagnostics (isn't a p-doc or a clinical psychologist) then her opinion doesn't mean a damn, though. i wouldn't have asked her if i'd have known that...
actually... that isn't quite fair. support from her is support from the community. like how it helped (probably) that the social worker came with me last time... that i'm bringing a known advocate (who seems smart and relevant etc) with me this time...
but 'three out of three qualified health professionals agree' was the kind of evidence i was going for.
wanna write a letter?
i jest.
:)
Posted by Dr. Bob on October 20, 2013, at 15:08:15
In reply to Re: i think..., posted by alexandra_k on October 20, 2013, at 0:59:55
> i have 2 p-docs who are supporting this.
>
> but 'three out of three qualified health professionals agree' was the kind of evidence i was going for.
>
> wanna write a letter?I'm hopeful that two out of two psychiatrists will be good enough. :-)
Bob
Posted by alexandra_k on October 21, 2013, at 1:34:56
In reply to Re: i think..., posted by Dr. Bob on October 20, 2013, at 15:08:15
i think you are probably right. she wrote a letter anyway. i'm not sure how much it is supportive, exactly, but whatever.
the bond got paid. so looks like i'm moving in. or that work and income has sort of committed to it...
but the panel needs to assess it / decide.
i'll see how soon i can move tomorrow. they offer summer contracts (and i don't think many people want them because they reduce the rate) from december. but hopefully they may have a room before then, even. usually someone doesn't have exams or has early exams.
i should feel happy but i just feel exhausted. i thought i was done with grading, too, then got told that no... there is another batch... we'll see tomorrow...
sleep will help.
Posted by alexandra_k on October 21, 2013, at 21:21:38
In reply to Re: i think..., posted by alexandra_k on October 21, 2013, at 1:34:56
I actually got to look around the place today and someone showed me her room. The building is a lot bigger than I thought. I think there is even a hole in the middle with trees etc so a lot of the rooms look out on that aspect instead of the road. The sun was coming in the windows... There was enough room to stretch out lengthways along the windows on the floor (I quite like to work like that). And she had a studio... I think the deluxe ones are a bit bigger again... It would need to be kept tidy... But it didn't feel cramped.
It was a bit of a rabbit warren inside... Heaps bigger than I thought it would be. Spacious. Felt solid the way older buildings feel solid (not like the brand new made of paper crap that passes for construction these days). Some weird softish concrete block look alike internal stuff... Felt like it was an attempt at internal soundproofing... There was a study room but she didn't have access to it... Communal areas looked deserted...
I'm so happy. So very very very very happy.
Figuring out how soon I can move in...
I think... I signed something to the advocate person... So she can access my information and act on my behalf. She was casual about it so I just signed it... I think... Maybe... She has contacted the Uni Accom people about me... They did something so I had to go in and see them today (meeting me again) basically... I think they kept a few different options open for me in case different things happened with Work and Income. And when I went to the place... There was something about how I couldn't move in early because I wasn't an enrolled student
HERE WE GO AGAIN
But then - oh, no, It is okay...
Whatever.
I will work as hard as I can. I swears.
And I will find this post later when the going gets tough.
I am so very privileged to be given this opportunity to just focus on my studies... How many years of civilization was required for anybody to have this opportunity? MOst still don't have it. I am very privileged indeed.
Posted by alexandra_k on October 21, 2013, at 22:20:09
In reply to Re: it's perfect, posted by alexandra_k on October 21, 2013, at 21:21:38
Though of course I can also remind myself that many students do get this kind of opportunity and piss it away. So. Anyway. Whatever.
Posted by Dr. Bob on October 21, 2013, at 22:52:54
In reply to Re: it's perfect, posted by alexandra_k on October 21, 2013, at 21:21:38
This is the end of the thread.
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