Picking a psychiatrist is a precarious situation, one I know all too well. I have bipolar disorder, depressive disorder and anxiety disorder. I have been in and out of therapy for nearly 20 years. And while I have left doctors for a wide variety of reasons—I've moved, I felt better and "been better," I've given up on pharmacology and stopped taking meds—I've only had to fire one.
The reason? She was judgemental and disrespectful. In her office, I wasn't seen, heard or understood.
To help you understand the gravity of the situation, I should give you some context. In the spring of 2017, I was doing well and feeling good, at least for the most part. My family was healthy. I was happy, and life was more or less normal, so I stopped seeing my psychiatrist. I decided I didn't need my meds.
But by the summer, my mood was shifting. I was cycling (which occurs when bipolar patients vacillate between periods of mania and depression) and when I suffered a miscarriage that fall, I plunged into a deep depressive episode—one I knew I couldn't pull myself out of.
I called my psychiatrist to make an appointment. She put me in the books for later that week. But then I got a call back.
"I'm having an issue processing your payment. Has your insurance changed?"
It had. My carrier had changed over the summer, but I didn't think much of it. Insurance providers change all the time. But this change, I learned, was problematic.
"I'm sorry, Kim, but we don't take United Healthcare."
I was gutted. I had worked with the same psychiatrist for years. She knew my family, my story and my backstory. With her, I could be honest. She put me at ease. But now, I needed to find a new doctor—in the midst of depression, while moving through life in a fog, a haze.
I called more than two dozen numbers. Some doctors were not accepting new patients. Others had exorbitant wait times. I was given an appointment four months in the future. But most never called me back. I pled and left messages but my phone never rang—at least not until she called. Not her receptionist or her office manager, but the doctor herself.
To say I was excited would be an understatement. I assumed Dr. W's responsiveness was a sign of her devotion and dedication. She must be very committed to her patients. Plus, she was close by. I had an appointment less than two miles from my home the following week.
But my enthusiasm ended then and there.
During our first session, Dr. W suggested that when my meds were balanced out I would have a more "normal" appearance—and normal hair. My bright pink locks offended her. She said I should consider a more natural color. I should consider going back to my roots.
During our second session, she asked what my husband thought about my piercings and tattoos. Yes, I have a lot, but she asked this in 2017, not 1967. My husband's opinion shouldn't matter. It doesn't matter. Plus, these were my appointments. These sessions were supposed to be about my mental health. And each appointment thereafter was riddled with put downs. She constantly criticized me, my relationship and my appearance.
But that wasn't my breaking point. I decided to fire my psychiatrist when I told her I was having suicidal thoughts and she dismissed them. When she called in (yet another) prescription—one with a higher dose.
Of course, psychiatrists prescribe medication. That's their job. That is what they do. But the problem wasn't medication per say, it was the fact that I thought my antidepressants were causing said thoughts and she wrote me off. She said such side effects were very rare. She also told me it was all in my head. I just needed to breathe. To relax. To "take my meds."
I walked out the door that day feeling helpless and hopeless.
I walked out the door that day and never went—or looked—back.
That said, there are several reasons why you should fire your psychologist, psychiatrist, and/or therapist. Some medical professionals are dismissive, while others are overly supportive. Some seem distant and distracted. They rush you and lack interest in—and concern for—your life. And some relationships are just not meant to be. Comfort and rapport is key.
You also may need to find a new doc if and when you stop progressing because growth is everything. Good therapists challenge you. According to Katie Lear, a licensed clinical mental health counselor in private practice in North Carolina, good doctors support you.
"A good mental health practitioner always makes sure that their client feels safe," Lear says. "You may feel challenged, vulnerable, or even a little defensive, but never unsafe or uncertain about your trust in your provider."
That said, there is also no one-size-fits-all answer for what makes someone a good therapist.
"Studies show time and time again that more than any particular skill set, the relationship and trust between therapist and patient is the most healing part of therapy treatment," Lear explains.
Christene Lozano, a certified sex addiction therapist, licensed marriage & family therapist and the founder of Meraki Counseling providing online sex therapy in California and Oregon, agrees.
"While there are many factors that go into making a good therapist, such as the therapist's training and expertise, one of the most important components is the relationship between the client and their therapist," says Lozano. "While there can be many excellent therapists out there, they all won't be a good fit for the client. It is somewhat similar to dating: There are some awesome people in the world, and all those people may not be the best romantic partner for you."
So how do you find your best match? Through research, trial and error. Getting recommendations can also help.
As for me, I have an excellent psychiatrist today—one whom I trust wholly and completely. One I trust with my life. And the reason is two-fold: He is educated, qualified, empathetic and sympathetic. He also listens. So please know you are worth it. Your life is worth it. Your health and happiness matters, and it's okay to set boundaries, even with psychiatrists and other mental health professionals.
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