I have an appointment with my psychiatrist tomorrow, this will be the third time I have seen this particular doc. I really don't want to go, but I promised my primary care physician I would at least give this psychiatrist an honest try. I don't exactly have the greatest opinion of psychiatrists, both from a professional and personal perspective. My last appointment didn't exactly go very well, which wasn't particularly unexpected. I didn't score any points with her and she didn't score any points with me. Here's an unnecessarily long exposition on why I'm not really fond of psychiatrists.
Let's start with a little backstory. I am a clinical laboratory scientist and I work in a hospital lab performing diagnostic testing. When someone draws your blood, I'm the guy on the other end who runs the tests on the specimen and/or looks at it under the microscope. I am very, very good at what I do. Clinical laboratorians, as a whole, are a very intelligent lot, we are extremely analytical and we have an ungodly amount of knowledge about disease processes and the tests we are performing. Here are some of the subjects that I have expert knowledge in: Hematology, clinical physiology, immunology, microbiology, immunohematology, endocrinology, genetics.....the list goes on and on and on. The medical director of our lab (she's a doctor, by the way) has said to me numerous times that she believes that the smartest people who work in any hospital are the clinical laboratory scientists. I'm not exaggerating that statement and I will admit that I am in complete agreement with her (hubris, is that you?). This next statement is going to sound arrogant and boastful, but it is not intended to be so in any way, shape, or form. If you were to ask most of my peers who the most intelligent, practically experienced, and knowledgable tech in our lab is, my name would be probably the one that came up the most. I'm not bragging, I'm just very good at what I do.....because I make sure I'm very good at what I do. It's a unique balance of aptitude, drive, knowledge, and predisposition to the subject. It should also be noted that I love what I do for a living and I can't see myself doing anything else. As a counterpoint, if you were to ask who the most volatile and most likely tech to get in trouble because of something he said, my name would be very near the top of the list, if not at the number one position. You have to take the bad with the good, people.
More backstory. I grew up in a mine field of mental illness, abuse, substance abuse and addiction. It runs on both sides of the family. While I am fortunate to not have any substance abuse issues, I am very mentally ill. The extent of my diagnoses are not of any import to this narrative, at least at this point. My sister was an end stage alcoholic with borderline personality disorder and she took her own life 5 years ago. My mother most likely had Complex PTSD coupled with an unspecified personality disorder. She continually used increasing doses of benzodiazepines for over twenty years. To say I'm intimately familiar with mental illness would be an understatement. I have been hospitalized numerous times for suicidal ideation over the years and I spent 6 weeks at in intensive outpatient treatment facility in Seattle. The outpatient treatment center helped to expand my knowledge on the subject of mental illness exponentially, though I found their methods to be naive and somewhat counterproductive for me since it was a faith based program (I made more than one of the staff members' heads explode while there. Talking about turning a wolf loose with the sheep.) and I am a too much of a free thinker for a lot of the programs that were offered. I understand the principles behind how a lot of therapy approaches work though. During my time around other people with addiction problems, I gained a far greater appreciation for depths of suffering and hardships that my sister suffered before her suicide. Most importantly, I came to a much greater appreciation and awareness of myself and my illness. It was almost like having an epiphany of realization. Things that I wasn't even remotely aware of became crystal clear almost immediately. I came home and began the task of integrating all of my new knowledge and experiences into my daily life. Naturally my clinical knowledge and professional background contributed to this process and I began to draw many new conclusions about my perceptions, motivations, and reactions to everything in my life.
So, between my clinical knowledge from my career and my experiences with mental illness, I have a very unique perspective and understanding of the complexity of my situation. I can't emphasize enough just how much my intelligence factors into this equation (once again, I'm not bragging or stroking my ego). I seek knowledge and understanding of almost everything and anything I encounter in life. I look for patterns, I look for causes, I look for effects, I look to see how things fit together, I look at minute details, I look at the big picture. I'm always observing. My life is about logic and trying to figure out the "why" to everything. I never stop. I'm watching people right now as I write this post. If there is one thing my sister and I have in common, it most definitely would be our intelligence. Carly was so smart, smart in such a beautiful and charming way. Our intelligences manifested themselves in different ways, Carly was creative, I'm analytical. One of Carly's biggest problems was that she could never stay sober for more than few months at a time, effectively "work" the AA doctrines, or utilize the various counselors and therapists that she saw for help over the last 15 years of her life. I firmly believe this was partly due to how smart she was and she was too skilled at talking her way around her problems and sore spots when confronted with them. She was too hard to read. I honestly believe that I was one of the few people on the planet who could actually read her and not be manipulated by her..........because I'm exactly the same. If anyone even comes close to a difficult subject, my true feelings, or a sore spot, I will deviously (and frequently unconsciously) find a way to distract or divert the person in a way to not draw attention to the subterfuge. I show exactly what I want to show and only what I want to show. To be honest, I frequently take pleasure in doing this to people who I know I absolutely cannot trust under any circumstances. It's just too much fun and I'm just too good at it..... and Carly was too. I touched on this idea in this post. Some individuals have suggested that I have "tipped my hand" by bringing these things to light. Here's the rub; I wouldn't volunteer any of this if I weren't confident that I can continue the subterfuge and diversion, even when other parties are armed with foreknowledge of my behavior patterns. Yes, that is fucked up.......and I don't care. There are individuals who can see through my "smoke and mirrors" routine and naturally, I view them to be extremely dangerous entities. It has been three years since I last encountered one of those individuals and it just so happens he was a mental health professional at the intensive outpatient treatment facility I was at. He was the ONLY staff member I couldn't manipulate at will and he took me to task immediately. It was like getting slapped in the face, but I am one to admit when I am bested and we set upon making some changes in my thought patterns. Those changes still persist today, but an old force has returned and has done so in an overwhelming fashion. Cynicism is running the show now, folks, and to be honest, I currently have no intention of opposing or overwriting it's influence.
Now to be fair, I've taken some HUGE hits in my personal and career life over the last 15 months and my trust issues are at an all time high. My defenses are dialed up to repel anyone and everyone at this point and my social interactions have moved almost exclusively to Facebook. The darkness came knocking on the door, instead of resisting this time, I decided to wholeheartedly embrace it. There will be elements will who read this and will think I'm completely out of control and some kind of intervention or whatnot. That's not the case though, I know EXACTLY what I'm doing. I'm not depressed right now. I'm not angry. I'm not having anxiety issues. I just don't care right now. Am I bitter? I'm honestly not sure. I will say that I am feeling very defiant at this point in time, but I'm not angry. I'm doing what I want, which happens to mean being dark, brooding, apathetic, and cynical........ and this the is part where my psychiatrist re-enters the picture.
Remember all that stuff I said about being a really smart clinical laboratory scientist and all of the knowledge I have about mental illness? As I said above, I don't have a very high opinion of psychiatrists as a result. In fact, I think I've only met one psychiatrist who I really respected and felt was a compassionate human being. I'm not going to go into specifics as to why I'm very wary of psychiatrists, but rest assured, the list is long and is largely based upon my experience as medical professional. With that out of the way, let's discuss what psychiatrists do. Psychiatrists prescribe drugs in the hopes that said drug will have a positive effect on a person's mental illness. Mental illness is not like diabetes or heart disease, every single case is unique and presents in unique ways. There is nothing definitive or objective about mental health medicine, it's all extremely subjective. When I was at the outpatient treatment facility, we found a particular drug regimen that seemed (?) to help alleviate some of the symptoms of the severe depression and anxiety issues that I chronically suffer from. Here's where things get even more complicated. There are basically two types of mental illness, transient and chronic. Now keep in mind that I am grossly over simplifying all of this for the sake of brevity. Transient mental illness is the kind that the drug companies are talking about when you see their advertisements on TV for the various antidepressants they are schilling for your doctor to prescribe to you. Transient mental illness usually goes away after treatment with a prescription a person responds to. Everything ends all happy like it does in the drug companies' shameless TV commercial and the patient goes back to his or her life, minus the antidepressant and minus the depression. Chronic mental illness is a much, much different story. Chronic mental illness can be something person has the misfortune to be born with, something a person can have a genetic disposition to, created by exposure to stimuli, or through substance use. It's fucking complex and guess what, my is complex as fuck too. Mental health practitioners have been arguing for years as to whether my primary diagnosis is even a real disorder . So let's see, very probable Complex PTSD (if it's even a disease), probable undefined personality disorder, severe chronic and recurring episodes of depression, and an unspecified anxiety disorder. To sum things up, medications are only going to do so much and expecting them to do anything other than support other therapies or relieve certain symptoms is completely unreasonable. To be honest, I'm not even sure meds work at all for me, it's so hard to tell. Now, I had been seeing my primary care physician for my medication needs because I actually trust her and she has been far more helpful and compassionate than any of the psychiatrists I've seen over the last three years. I love my doctor, I really do. She's one of those individuals that helps keep that pitiful, last vestige of faith in compassionate and conscientious medicine in this country alive within me. She's always compassionate, she recognizes my knowledge and intelligence, and treats me as both a patient and as a medical professional. I went and set an impossible task on her plate by asking her to manage my psychiatric issues and like I said, I've taken some really big hits in the last 15 months. It eventually became clear that perhaps it was time to refer me to a psychiatrist, one who is new to the community and that my physician had heard good things about from some of her other patients. So off I went to see this new psychiatrist.....with some trepidations.
The first appointment is always the "medical history" appointment where I get to try to cram the intricacies and subtleties of my issues to the psychiatrist along with the extent of my experience, knowledge, and intelligence. That lasted an hour and I left her office cautiously optimistic (which is unusual for me). My next appointment was six weeks later, though it was only supposed to be only four weeks later, but her patient load is so large that getting an appointment with her is difficult at, this is not a good particularly good omen, especially if I have an acute emergency and need to see her on short notice. Sigh. I saw her for a whole twenty minutes this time and we discussed the fact that I was still not seeing a counselor/therapist (my previous one "scaled back her practice" and cut me loose during a severe personal crisis at work). I told her that I wasn't really interested in seeking any sort of counseling at this point in time. She then pushed a "You have a poor attitude (which CAN be argued, but it's my prerogative) and I know better than you do.", attitude with me.........which is the absolute last thing you want to do with me, nor should you take that attitude with ANY patient. I have to deal with snotty physicians at work on a regular basis and I absolutely WILL NOT tolerate ANY attitude from ANY medical professional when I am the patient. This woman barely knows me, has little to no grasp of the complexity of my condition, no reference for the severe trauma and anguish I had suffered within the previous three months, AND she was not respecting my knowledge and intelligence. Then she told me that all of my recent tattoo additions were a form of "self harm". I must have been possessed by the spirit of one of my more patient ancestors that day because the normal me would have said, "HOW ABOUT A FRESH CUP OF GO FUCK YOURSELF? JUST BECAUSE YOU HAVE THE INITIALS M AND D BEHIND YOUR NAME DOESN'T MEAN YOU ARE FUCKING SMART OR KNOW ANYTHING." Instead, I think I just blinked several times and thought about how many visible tattoos I would be able to get inked before my next appointment with her. I was summarily told to get a therapist (she suggested one of new age, mindfulness gurus out of the local new age guru institute) and to come back in 4 weeks......which turned out to be eight weeks later because that was the absolute soonest appointment available.......which no longer mattered to me. I kept telling myself that I was doing this for my primary care physician and walked out the door. Now, I've had eight weeks to simmer about this......which is a very bad thing. During that time, conditions at work deteriorated to the point that I had to temporarily reduce my work bid from 5 day a week to four days a week. I went to my poor doctor for that because she understands the fact that I'm VERY wary of any sort of therapists/counselors at this point, she also knows what kind of hell hole the lab tends to be, AND I can get an appointment with my physician within 48 hours of calling her office (yes, my doctor is awesome). Now, I'm off to my psychiatrist's office tomorrow after having stewed for eight weeks in the wake of my last appointment with her. This means I've had eight weeks to prepare my comments on her professional character and let me tell you, I'm pretty much ready to lay waste to her ego with the full resources of my intellect if she even looks at me wrong. Fuck I hate psychiatrists, they can be so damn presumptuous. I'm at least going to try to be nice (be nice, be nice, be nice, be nice, be nice, be nice, be nice, be nice). She's going to be mad that I haven't established with another therapist and even more angry when I tell her I still have no intention of doing so. Seriously. I'm not wasting my money on it anymore. How do you think I've been funding all of my new tattoos? With all of the money I'm saving by not going to therapist. Let's see.... find a therapist or use money for the equivalent to what my psychiatrist thinks is self harm? No contest, I'M GETTING INKED (a subject I plan to address in a post in the future)!!!! Who am I kidding though? My cynical and jaded mind knows exactly what psychiatrists are for. They dispense drugs, that's what they do. They dispense drugs, make sure they don't cause fatal side effects when mixed together, and they hope they made the correct guess. No cynicism here. Nope, nope, nope.
As long as I'm trying to be honest (sort of), I might as well dump this fact on the table; going to a therapist right now is a complete waste of time. I don't want help. Period. My psychiatrist is convinced that I need mindfulness therapy. Guess what? I'm so fucking mindful that it's a part of the problem. Wait, maybe I need to be mindful of the fact that I'm mindful of my thoughts, how the fuck does that work?!? Oh wait, I know...... I don't fucking care. The lab's medical director ( the one who's a doctor and just happens to pretty much be the smartest person I've ever met) knows all of my story and was originally going to med school to be a .............psychiatrist (we have similar opinions on the subject, thank goodness she's a pathologist instead) agrees that not seeing a therapist isn't the smartest thing in the world, but she also knows me........very well. Well enough to know that I'm going to completely break, traumatize, or run circles around all but the best and most intelligent of mental health professionals. I need someone who can recognize when I'm full of shit and tell me that I'm full of shit. I may come around to the idea again at some point, just not now. Like I said above, I've embraced the darkness and I'm finding that it's very much to my liking. I get lots of tattoos and cookies. What's not to like? In all seriousness my life never has been fit for public consumption, I'm tired of trying to be something I'm not and spending all of this energy hiding my true nature. I can't hide it anymore, I have an extreme aversion to people. Scratch that, I'm allergic to shallow and dumb people. The problem is that 99% of humanity fall into both of those categories. Guess where almost all of my difficulties originated? People. People suck. Seriously. I'm trying to play the victim here either, I'm just being truthful. There are those who are going to read this and immediately think I'm completely out of control and that I'm not properly medicated. Hey, you people that I know are going to say that! I take the same meds every day that I've been taking for the last three year, nothing has changed!.......Well, certain circumstances have changed. Well, a LOT of circumstances have changed! You don't know me well enough to know though that and I'm quite busy laughing at your assumptions! Besides, if you ask me about it, I'm just going to lie to you anyway!........that is probably the most truthful thing I've said tonight........or is it?
No comments:
Post a Comment