What should I do after telling psychiatrist that today would be our final session?
July 9, 2012 5:01 PM Subscribe
Without fully realizing it, I told my psychiatrist that today was our last session. I feel very sad about this and don't know what to do. Advice?
Today, I had a session with the psychiatrist that I have been seeing since January of this year. I had not seen him for about one month. During the session, he mentioned the idea of me trying a different medication (Zoloft) because it seems like Cipralex wasn't effective after all.
The first time that he asked me about taking this medication, I may have seemed hesitant at first, but then decided that I would like to try it. However, near the end of the session he mentioned the idea again and I said something along the lines of "actually, let's just leave it because today is our last session anyways." I wasn't aware that I even said these words until later on after our session had ended, but I feel like it was such an irrational thing to say. I think I said this because 1) I thought it was later on in the month rather than July 9th so in hindsight, I can still have a couple of more sessions with the psychiatrist even if he stops working at the university two months from now and 2) I was under the impression that this was our last session because it was a "follow up" session and the psychiatrist was going to be shrinking down his practice which is something that he stated a month ago. I was under the impression that I would never be working with him again.
I feel terrible about our session. I think I misunderstood what was happening ever since I was told that he would be shrinking down his practice.
In hindsight, it seems like I was all over the place in terms of my emotions during the session because I was so nervous. I think he realized that and said that the clinic will always be open while I'm still here because I mentioned the idea of me not coming back anymore and just "moving forward as if nothing happened" which is far from healthy... He said that if that's my strategy then to go with it. He also said that it was nice working with me and that he wished me well and I thanked him, then left.
It seems to me like I ended the relationship between myself and the psychiatrist that I was working with and now I feel like it was a poor decision. I feel sad about this decision, but still, a part of me feels defeated by the lack of progress considering that it's been almost a year and I feel so exhausted because of how many professionals I've worked with just within a short span of time.
I really don't know what to do. I don't know if it's professional to call the secretary and book another appointment after what I have done. I feel like it might be worth giving Zoloft a try because it might help reduce the severity of my emotions. I should probably be seeing a mental health professional regularly. But, I also stopped seeing the psychologist that I had only seen twice. I missed the third appointment and now feel like it's too late to go back there...
Sorry this is all over the place, but I could really use some advice.
Today, I had a session with the psychiatrist that I have been seeing since January of this year. I had not seen him for about one month. During the session, he mentioned the idea of me trying a different medication (Zoloft) because it seems like Cipralex wasn't effective after all.
The first time that he asked me about taking this medication, I may have seemed hesitant at first, but then decided that I would like to try it. However, near the end of the session he mentioned the idea again and I said something along the lines of "actually, let's just leave it because today is our last session anyways." I wasn't aware that I even said these words until later on after our session had ended, but I feel like it was such an irrational thing to say. I think I said this because 1) I thought it was later on in the month rather than July 9th so in hindsight, I can still have a couple of more sessions with the psychiatrist even if he stops working at the university two months from now and 2) I was under the impression that this was our last session because it was a "follow up" session and the psychiatrist was going to be shrinking down his practice which is something that he stated a month ago. I was under the impression that I would never be working with him again.
I feel terrible about our session. I think I misunderstood what was happening ever since I was told that he would be shrinking down his practice.
In hindsight, it seems like I was all over the place in terms of my emotions during the session because I was so nervous. I think he realized that and said that the clinic will always be open while I'm still here because I mentioned the idea of me not coming back anymore and just "moving forward as if nothing happened" which is far from healthy... He said that if that's my strategy then to go with it. He also said that it was nice working with me and that he wished me well and I thanked him, then left.
It seems to me like I ended the relationship between myself and the psychiatrist that I was working with and now I feel like it was a poor decision. I feel sad about this decision, but still, a part of me feels defeated by the lack of progress considering that it's been almost a year and I feel so exhausted because of how many professionals I've worked with just within a short span of time.
I really don't know what to do. I don't know if it's professional to call the secretary and book another appointment after what I have done. I feel like it might be worth giving Zoloft a try because it might help reduce the severity of my emotions. I should probably be seeing a mental health professional regularly. But, I also stopped seeing the psychologist that I had only seen twice. I missed the third appointment and now feel like it's too late to go back there...
Sorry this is all over the place, but I could really use some advice.
It seems to me like I ended the relationship between myself and the psychiatrist
It's not like you had a public renunciation ceremony. You made a mistake about whether or not this was the last session the two of you had planned to have together. Call tomorrow and make another appointment and say "Oh, whoops, I had mistakenly thought that yesterday was the last day Dr. X would be able to see me, but as I thought further I realized he might have time for at least one more session. Can you tell me what he has available?"
You're not blacklisted because you made that mistake.
I missed the third appointment and now feel like it's too late to go back there...
Missing an appointment also doesn't put you on a blacklist. Seriously, it sounds like you have a significant issue with this stuff, and you need help. Have you read Facing Codependence by Mellody, Miller, and Miller? This kind of self-disqualification and making a big deal out of missing an appointment or making a mistake about when your last session is going to be is pretty typical of people with codependence issues.
posted by Sidhedevil at 5:09 PM on July 9, 2012 [5 favorites]
It's not like you had a public renunciation ceremony. You made a mistake about whether or not this was the last session the two of you had planned to have together. Call tomorrow and make another appointment and say "Oh, whoops, I had mistakenly thought that yesterday was the last day Dr. X would be able to see me, but as I thought further I realized he might have time for at least one more session. Can you tell me what he has available?"
You're not blacklisted because you made that mistake.
I missed the third appointment and now feel like it's too late to go back there...
Missing an appointment also doesn't put you on a blacklist. Seriously, it sounds like you have a significant issue with this stuff, and you need help. Have you read Facing Codependence by Mellody, Miller, and Miller? This kind of self-disqualification and making a big deal out of missing an appointment or making a mistake about when your last session is going to be is pretty typical of people with codependence issues.
posted by Sidhedevil at 5:09 PM on July 9, 2012 [5 favorites]
Just from how much of a challenge this is presenting to you (as you describe it here) you really need to be seeing someone for talk therapy, because you have a whole set of imaginary boundaries that you think other people have that they really don't. And that you're berating and punishing yourself for having violated when you've made a simple mistake or done something mildly inconveniencing like missing an appointment.
The "it's too late to fix it, I've already fucked it up" thing is a terrible, terrible bug to have in one's code. It circumscribes your life unnecessarily. I know because I have been there myself.
posted by Sidhedevil at 5:11 PM on July 9, 2012 [22 favorites]
The "it's too late to fix it, I've already fucked it up" thing is a terrible, terrible bug to have in one's code. It circumscribes your life unnecessarily. I know because I have been there myself.
posted by Sidhedevil at 5:11 PM on July 9, 2012 [22 favorites]
It sounds like this itself is part of the therapy.
I think you should go back to wrap things up properly and make a plan for whatever's next for you, particularly in terms of your med regimen.
One time, after an angry session, I forgot to pay my therapist. She didn't remind me, either. She felt this was significant. When she brought this up, thought, yeah, I was done paying for this particular experience with this therapist. She told me she thought this was my resistance to therapy--something I never felt I was experiencing--we just were not a good fit. I did continue to go for a while, though, to visit this question and kind of wrap up. My sense is that most therapists will want to discuss the end of therapy.
posted by Riverine at 5:18 PM on July 9, 2012
I think you should go back to wrap things up properly and make a plan for whatever's next for you, particularly in terms of your med regimen.
One time, after an angry session, I forgot to pay my therapist. She didn't remind me, either. She felt this was significant. When she brought this up, thought, yeah, I was done paying for this particular experience with this therapist. She told me she thought this was my resistance to therapy--something I never felt I was experiencing--we just were not a good fit. I did continue to go for a while, though, to visit this question and kind of wrap up. My sense is that most therapists will want to discuss the end of therapy.
posted by Riverine at 5:18 PM on July 9, 2012
This is really common. I have done it at least twice before myself. Just call up and ask for another appointment.
posted by ubiquity at 5:25 PM on July 9, 2012 [3 favorites]
posted by ubiquity at 5:25 PM on July 9, 2012 [3 favorites]
It is a better surprise that you said it than if your shrink said it. It does not sound, from your description that it is too late to re-book your next appointment if you want to. Part of this sounds like you are dealing with resistance as well craftily (in a good way) preempting getting shafted when your shrink shrinks his practice.
If you want to continue with someone else, get a reference, but considering leaving is a major symbolic step, it would best to have a final session to wrap up, that is not a surprise to you or your shrink.
posted by snaparapans at 5:32 PM on July 9, 2012
If you want to continue with someone else, get a reference, but considering leaving is a major symbolic step, it would best to have a final session to wrap up, that is not a surprise to you or your shrink.
posted by snaparapans at 5:32 PM on July 9, 2012
I don't know if it's professional to call the secretary and book another appointment after what I have done.
You are not a professional in this situation. You are a client and a patient. So no need to imagine them judging your behaviour on such a standard -- they shouldn't be judging it at all, but even if they are, this won't faze them.
posted by jacquilynne at 5:34 PM on July 9, 2012 [8 favorites]
You are not a professional in this situation. You are a client and a patient. So no need to imagine them judging your behaviour on such a standard -- they shouldn't be judging it at all, but even if they are, this won't faze them.
posted by jacquilynne at 5:34 PM on July 9, 2012 [8 favorites]
I would recommend you give yourself the gift of ending your relationship with this therapist properly. It sounds like a great many things were going on in the appointment you describe: is this when you found out your therapist was shrinking his practice and leaving? That's a lot to learn an can be destabilizing. Forgive yourself and make an appointment. End your relationship with this therapist in a way that feels respectful to you.
posted by Milau at 5:53 PM on July 9, 2012
posted by Milau at 5:53 PM on July 9, 2012
This article seems like a sort of model for how to end therapy.
posted by escabeche at 6:08 PM on July 9, 2012
posted by escabeche at 6:08 PM on July 9, 2012
They left the door open for you to return and you have a right to change your mind.
posted by heyjude at 6:23 PM on July 9, 2012
posted by heyjude at 6:23 PM on July 9, 2012
Just call and book the appointment. It'll be totally OK.
Also call the psychologist and book another appointment with them. It is not too late - unless they die or they specifically tell you (out loud or through the mail or otherwise very definitively and directly) that they can no longer see you. You might need to pay a skipped appointment fee, but it won't be a huge amount and they might forgive it if it was the first time.
One of the best parts about dealing with therapists and psychiatrists is that it is totally not a secret to them that you have emotional/mental problems. They have seen all of this (and more) before. Lots and lots and lots of times. They have had a lot of patients "drop out" without really meaning to, and 9 times out of 10 (maybe more often than that) they are hoping the clients will change their minds. The only reason you haven't had affirmative contact from them is because they're busy (and they probably don't want to freak you out.)
It helps a lot if you write down the stuff that you're anxious about and either give it to them or read it to them when you have your next appointment. It also helps, if you're too nervous to call and set up an appointment, to send them a letter (through the mail.) Address it to their name (with their title if they are a doctor) and mail it to the address you see them at.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 6:23 PM on July 9, 2012 [1 favorite]
Also call the psychologist and book another appointment with them. It is not too late - unless they die or they specifically tell you (out loud or through the mail or otherwise very definitively and directly) that they can no longer see you. You might need to pay a skipped appointment fee, but it won't be a huge amount and they might forgive it if it was the first time.
One of the best parts about dealing with therapists and psychiatrists is that it is totally not a secret to them that you have emotional/mental problems. They have seen all of this (and more) before. Lots and lots and lots of times. They have had a lot of patients "drop out" without really meaning to, and 9 times out of 10 (maybe more often than that) they are hoping the clients will change their minds. The only reason you haven't had affirmative contact from them is because they're busy (and they probably don't want to freak you out.)
It helps a lot if you write down the stuff that you're anxious about and either give it to them or read it to them when you have your next appointment. It also helps, if you're too nervous to call and set up an appointment, to send them a letter (through the mail.) Address it to their name (with their title if they are a doctor) and mail it to the address you see them at.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 6:23 PM on July 9, 2012 [1 favorite]
At my first appointment with my last psychiatrist, he asked me whether the antidepressants I'd been on before had worked. I said I didn't know. He said in that case they hadn't worked. He prescribed Zoloft. Right out of the ballpark, it was ridiculous how well it worked. Not only was I happy and productive, I was CRAVING VEGETABLES and BIZARRELY PUNCTUAL. Go figure.
Make another appointment (nthing that no one on the other end will be surprised or even judgmental in any way) and go try Zoloft. I've no idea whether it'll work for you the way it did for me, but it is so very worth trying. And that's what psychiatrists are for -- not to think highly of you and your professionalism, but to find you meds that work.
posted by feral_goldfish at 7:02 PM on July 9, 2012
Make another appointment (nthing that no one on the other end will be surprised or even judgmental in any way) and go try Zoloft. I've no idea whether it'll work for you the way it did for me, but it is so very worth trying. And that's what psychiatrists are for -- not to think highly of you and your professionalism, but to find you meds that work.
posted by feral_goldfish at 7:02 PM on July 9, 2012
A lot of great advice there. Go for it and book appointments with both.
In my experience seeing a psychologist, it took me a while to learn this very useful concept: That while you do have a close relationship with them, it's not like any other close relationship you have. While they on some level care about your fate, they are ultimately just a contracted professional, whom you are hiring to provide some useful tools to improve your life. Which means that:
A) You don't have to worry about whether they like you. There's no need to impress them. They're going to keep seeing you not because you're a good person, but because you're paying them to. So there's no pressure at all to behave "professionally" or even socially acceptably. Be as nuts as you want and give them your money. :)
B) Ultimately they don't really care whether you put in the effort to get better. Yes they're human and would like you to succeed, but they're not personally invested in your success as much as say your friends and family. That sounds harsh, but actually it's liberating. They're not going to reprimand you for missing appointments or failing to do your homework, because ultimately YOU are in charge here, not them. They're just a tool that you're choosing to use to feel better.
posted by pablocake at 7:21 PM on July 9, 2012
In my experience seeing a psychologist, it took me a while to learn this very useful concept: That while you do have a close relationship with them, it's not like any other close relationship you have. While they on some level care about your fate, they are ultimately just a contracted professional, whom you are hiring to provide some useful tools to improve your life. Which means that:
A) You don't have to worry about whether they like you. There's no need to impress them. They're going to keep seeing you not because you're a good person, but because you're paying them to. So there's no pressure at all to behave "professionally" or even socially acceptably. Be as nuts as you want and give them your money. :)
B) Ultimately they don't really care whether you put in the effort to get better. Yes they're human and would like you to succeed, but they're not personally invested in your success as much as say your friends and family. That sounds harsh, but actually it's liberating. They're not going to reprimand you for missing appointments or failing to do your homework, because ultimately YOU are in charge here, not them. They're just a tool that you're choosing to use to feel better.
posted by pablocake at 7:21 PM on July 9, 2012
This is no big deal. If you want to make another appointment, call tomorrow and make another. Really. You're probably, like, the 10th person today to say you didn't want to come back. (And if you want to go back to the psychologist, give him or her a call too. They totally get that people sometimes need a break. It's cool. Really.)
posted by Aquifer at 7:53 PM on July 9, 2012
posted by Aquifer at 7:53 PM on July 9, 2012
Response by poster: Thanks, everyone! I just got off the phone with the secretary and decided to book an appointment with both the psychiatrist and psychologist. I'm going to explain what happened when I see the psychiatrist this coming week and then I'll be seeing the psychologist later on this month.
posted by livinglearning at 8:44 AM on July 10, 2012
posted by livinglearning at 8:44 AM on July 10, 2012
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posted by quince at 5:09 PM on July 9, 2012 [5 favorites]