Profiles in Tremendousness

Profiles in Tremendousness is a segment on the Daily Show with Trevor Noah that pokes fun at the competency (and lack thereof) of various characters in the Trump White House.  I’m going to borrow that idea to take a look at the less than stellar characters I’ve come across in my mental health journey.

My first hospitalization was a sh*tstorm of incompetence all around as far as I was concerned, and years later I found out a little tidbit that gave at least some objective confirmation of that.  One of my discharge diagnoses was borderline personality traits.  There’s nothing wrong with that diagnosis if it’s accurate, but unfortunately sometimes it says more about a practitioner’s stigmatized views than anything else, and is applied as a euphemism for “difficult patient”.  Any competent psychiatrist would know that a diagnosis of personality traits/disorder can’t be made cross-sectionally (i.e. just looking at a specific point in time), particularly when someone is acutely ill; it needs to be made based on patterns that are relatively consistent throughout the person’s life.  The hospital psychiatrist seemed to  have skipped this lecture in med school, and instead decided to ignore taking any sort of social history or gathering any collateral information and instead just slap a label on because I fought the treatment team tooth and nail while I was in hospital.  Not only does this leave me with a diagnosis that doesn’t accurately reflect my experience, but it minimizes the significance of the challenges that people with BPD often face every single day.

I used to go to a medical clinic associated with the local university’s medical school, and I would get seen by whatever medical resident happened to be on for that day.  The discharge summary and who knows what else from my first hospitalization were in my chart at the clinic, and I think a lot of the residents were scared because I was the crazy girl who had tried to kill herself and they didn’t know how to deal with that.  When I went in for pap tests, they would always insist on doing a PHQ-9 (a depression screening test).  One day I went in asking for a lab requisition to get routine blood sugar and cholesterol  checks.  I was stuck there for an hour because, even though my illness was in full remission at the time and I had a psychiatrist who I was seeing regularly, the resident had a very hard time believing I wasn’t going to jump in front of a bus the moment I left the clinic.

The first time I tried therapy was okay but not particularly productive.  I decided to try again when I became depressed a few years later, and made an appointment through my Employee Assistance Program.  I wasn’t thrilled with the therapist’s interviewing style, but the real treat came as we were wrapping up the session.  Her advice was that I would feel better if I started dating.  Seriously?  That was the end of that.  And to top it off, when I emailed her to say that I wouldn’t be seeing her again and explained the reason, she thought it was peculiar that I would have chosen to fixate on that particular statement.  Um, perhaps because it represents incompetence?

That theme came up again more than once.  I clearly remember a nurse in hospital who observed that I must be depressed because I was single, and that must have been why I attempted suicide.  Between her and the nurse who was convinced that I must have attempted suicide because I was angry about something, it was a sad state of affairs.  But the stellar lack of competence didn’t end there.

The hospital psychiatrist who initially treated me on the inpatient unit knew I didn’t like him (I guess the screaming and swearing was a pretty strong hint), so he decided to transfer my care to a different doctor.  This character was very much of the psychoanalytic/psychodynamic therapy persuasion, and as far as I could tell he was even more of a nutbar than I was.  My first meeting with him was all very Freudian, with a focus on sex and early childhood.  How old was I when I lost my virginity?  Did I like sex?  Did I remember how I felt when my brother was born when I was 3 years old?  He told me that the ONLY way for me to get better was to get psychoanalytic therapy, and I should only be on meds for a couple of months and then come off them.  Wowza.  But I wanted to get discharged, so I said the things he wanted to hear.  Later, my community psychiatrist commented that he wasn’t sure who that discharge summary was written about, but it definitely didn’t sound like me.

A couple of years ago, things started falling apart.  A very close friend died unexpectedly. I was bullied at work and ended up quitting because of it.  I was worried about getting sick, but I held it together.  And then I found out that my ex-manager was doing his best to destroy my career (in very much a reality-based sense, not a cognitive distortion sense), and the sh*t really hit the fan.  When I went in to see my psychiatrist, I was so slowed down that I moved from the waiting room to his office at a snail’s pace, and had a hard time even stringing a sentence together.  He knew about all the other stuff I’d made it through, but the best he could come up with was that I needed therapy to learn better coping skills so I wouldn’t get depressed when things like this happened.  I’m not sure why he thought that was the appropriate response and the appropriate time, but that was the last time I ever saw him.  Once trust is broken, I’m done.  So I decided to go see my new GP, who didn’t know me from a hole in the ground.  And what did she have to say after I told her the reason I’d decided to stop seeing my psychiatrist?  “Don’t you think you do need better coping  skills?”  Are we passing around stupid pills?

Don’t get me wrong, there are some great mental health professionals out there; I know because I’ve worked with some of them.  Unfortunately there are also some real duds, and in the next edition of Profiles in Tremendousness I’ll cover some of the specimens that I’ve worked with.  It would be nice if this wasn’t an issue we faced when trying to access mental health care, but sadly it’s far too often the reality.

What have been some of your worst experiences?

22 thoughts on “Profiles in Tremendousness

  1. Barb says:

    Omg, the incompetence! I’m sorry you went through all that. The psychiatrist I began seeing in 1994 slapped the BPD label on me as well, probably because it was starting to become a “vogue” diagnosis at the time. She also said I had major depressive disorder, and it wasn’t until I was hospitalized that I got the correct diagnosis by my new psychiatrist. But while I was seeing the first one, I complained about something once, and instead of exploring the issue, she said, and these were her exact words, “Call your Congressman”!!! Wha–???

    Liked by 2 people

  2. Donnalee says:

    I think all the mention of ‘get a date’ is just strange. I can see if you had said to the people that you genuinely wanted to date or get married or something, but for it to be a focus of theirs when it wasn’t a focus of yours just sounds unhelpful and off. And advice to get better coping skills is also WTF unhelpful. It’s like a friend of mine who had an interview to get funding for her special needs kid, and the woman actually said to her, “Or you could get a job like everyone else”. !!!!?????!!! Some professionals are just not helpful, or maybe they are burned out or overwhelmed and just seem to give bad advice.

    Liked by 1 person

  3. Kerry says:

    For the most part I find EAP a waste of time and employer resources. Even the counselor I saw with EAP had nothing good to say about it (and that’s why she left). It’s short-term for sure and good only if you want a free book. At least that’s my experience with them.

    I’m sorry you had so many bad experiences.

    Liked by 1 person

  4. Luftmentsch says:

    Oh, don’t get me started! I’ve had some terrible experiences on the NHS in the UK. I’ve seen different mental healthcare providers privately, through a mental health charity and on the NHS. The private therapist never missed a session without contacting me well in advance. At the charity, I once arrived to be told that the occupational therapist was away and someone should have phoned me to cancel the appointment. On the NHS, this happened to me so often, I actually lost count of the times. Must have been a good half dozen, at least.

    Then there was the therapist I was seeing (again on the NHS) who suddenly vanished without explanation. I never got to the bottom of what happened (I’m just a mere mortal, why would the NHS explain anything to me?), but I have my suspicions, which I won’t air on a public blog.

    Liked by 1 person

  5. Meg says:

    Wow, your experiences are so depressing. First off, I definitely don’t think you have borderline. And I know how pejorative it can be for someone to accuse you of having a personality disorder (with me, I’m always accused of being narcissistic). And you’re right–if you ARE borderline (or whatever), then you should embrace it as your unique challenge, but if you aren’t, it just hurts and is offensive to be called it.

    I’ve had bad therapists too, and the only thing I want to warn you about is that with the EAP, there can be confidentiality issues. I hope that doens’t happen to you!!

    And the whole innate problem with therapy is that unless it’s counseling to solve a particular problem (like if you just married into a blended family and became a stepmom), then it’s too open-ended for therapists to succeed at without shoving their foot into their mouth. Date more?! That does seems offensive!! On the other hand, no one has ever told me to date more, because they look at me and immediately know I have no innate femininity, and no man would ever like me. 😦 Maybe, if nothing else, these morons perceive you as being gorgeous and feminine. 🙂

    And they thought you attempted suicide because you were angry? Facepalm. Anger can be tied into it, but usually (and I speak from similar experience), attempting suicide is terrifying and desperate. The sense of darkness around you and the hopelessness are pervasive and horrific. Or, yeah, maybe you were just angry (I said sarcastically).

    I’ve been bullied at work too. 😦 And your psychiatrist told you to develop better coping skills?! How about this: it’s HUMAN to get upset and be in a fog when things go horribly awry. It’s NORMAL. What a doink. Everyone (who isn’t a robot) is going to have days when life slows down and you’re in the throes of despair. The smartest thing the psychiatrist could’ve said was, “I’m sorry you’re having so many problems. I hope things get better. It’s brave of you to keep it together so well.”

    Oh well.

    Liked by 2 people

  6. Ashe says:

    You were depressed because you were single Ash? HA! That’s one I haven’t heard. Gee I’m must be as depressed as all hell, I’ve been single for about 6-7 years now! Gee, some people!

    I was never shoved in a psych ward, thankfully. I am sure had someone noticed the scars on my arms back then it would have been a different story. However, I have had my fair share of idiot psychs over the years. You know – them thar *text book* psychs that have never had a serious problem with anything in their lives. You know the kind Ashley! ~laughs~

    The one when I was first in plonked in jail sat me down one day. Told me that she “was sorry Ashe, after seriously considering your case, I think you were sexually abused by your father.” I was dumbfounded, as you would be. I mean, the father was an ass sure, but he NEVER touched me sexually. Which I told her. She claimed the memories were “repressed”! ~laughs~ (Back then, I wrote a lot of stories about men beating up, raping, or murdering women because I was a masochist. At the time though, I never put two and two together.)
    Now, the problem with this text book psych was that she was the ONLY psych in the whole jail for up to 200 odd women. I am sure a good percentage of those woman had been sexually abused. Of that I have no doubts. You are not in jail if your life has been perfect (well, not normally!) I am sure a good number of those women NEVER were abused sexually, but thought they had been because of this f**ken idiot. I hate to think how many families that woman wrecked telling nearly every inmate they were sexually abused by a family member or close family friend. -ugh- I hope she was sacked.

    I had another psych about 10 years ago. Said he’d have me “back to normal” in no time. Told me how one of his other patients had as many problems as I did, that they had come out the other side.
    I saw him twice. Nice enough guy, but we didn’t *gel*.
    I think to really succeed with a psych, or any kind of counselor/social worker, you need to be able to trust them. Think of them like a good friend. I mean you are telling these people some of your deepest, darkest secrets.

    Honestly, after that experience in jail I trust psychs as far as I can throw them. Psychology is not an exact science. Anti-psychotic and anti-depressant meds are just trial and error, often doing more harm than good. I was on anti depressants for a good year or two, cheered me up but it didn’t address the real issues that needed fixing. That said, I have had friends where anti-depressants have worked. Had friends that had a psych they’ve seen for years. Unfortunately, it doesn’t work for everyone.

    Actually, when I came out of jail I started a course to become a drug and alcohol counselor. I dropped out. I tend to take on other people’s problems as well as my own. If I’d completed the course I’d be a burnt out mess now. More than I already am.
    I am normally the psych for my friends. I am who people come to when they have problems. Even just that takes it’s toll on me. So, so draining, depending on the problem. Hell, I’ve even had random people come up to me at the train station, tell me their *story* or problems and then I’ll never see them again. I wonder sometimes if I have a neon sign on my head that says “Idiot here, talk to me”. ~laughs~

    Okies, I’ve nattered on enough Ashley. I have another quick look around then come back another time when I not half asleep!

    (Ohhh give your lil’ guinea’s a cuddle for me! I had guinea pigs as a kid. They can be lovely little pets.)

    ~smiles, waves and wanders off to look for more caffeine~

    Liked by 1 person

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