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Is my doc not asking right questions?
Jul 6, 1998

I get awful panic attacks sporatically every day due to issues I feel like I have no control of since I've been diagnosed with HIV/AIDS. I tend to lose faith in my ability to solve problems and become deeply depressed. A fault of mine is that I'm too proud to let it show, even to my psychiatrist. When I can't communicate to him how I feel, I feel like even if I tried, he would not believe me, thus getting nowhere. My sessions with my psychiatrist seem to last only five minutes with him asking me questions like what my parents do for a living, if I have any siblings or what I do for a living. Any new sessions, he just confirms what he's already asked in previous meetings, and I feel rushed to get out rather than spill my guts and bear my soul like I thought I'd be able to do. The only time I thought we were getting anywhere, he prescribed wellbutrin for me to quit smoking. The wellbutrin never helped me quit smoking, and for months, each session was just him asking me if I ever quit smoking, I'd say no, and he'd write another prescription for wellbutrin. Should I see a different psychiatrist?

Response from Dr. Young

Who referred you to the psychiatrist you are now seeing? Do you have any evidence that he is experienced in working with people with AIDS? From what you write, it does not seem to be the case. Have you told this psychiatrist that you have AIDS? Before trying out another psychiatrist you really need to ask him if he has worked with many other people with AIDS. If he does not give you a direct answer than tell him you are going to leave him to find someone who definitely does have this experience. The fact that you are unable to talk to him about your feelings is another thing that you really must tell him before you decide whether or not you need a new psychiatrist. If he makes this your problem rather than exploring what within the relationship between you two contributes to this difficulty, than again tell him you are going to leave treatment with him. Do not let him tell you that this is just "your resistance to treatment" or that you are "sabotaging" the treatment.

In order for nay psychotherapy to work there has to be a solid relationship of trust between the professional and client that THE PROFESSIONAL HAS EARNED BY TREATING THE CLIENT RESPECTFULLY, SENSITIVELY AND IN A CARING MANNER. So far it does not sound like the person you are working with has figured out how to individualize the way he works to meet your needs. But until you take the risk of confronting him with how you are feeling about the sessions, and why it does not seem to be working for you and why it does not seem to be helpful to you, it is premature for you to leave treatment with him. The first step is to tell him all of this, and unless you are satisfied with his responses do not be afraid to shop around for another therapist. Doing this will help you to regain a sense of control in your life and treatment.

Michael Shernoff, MSW



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