Finding a Good Psychiatrist: A Key to Progressing in Recovery
by Sarah Hancock
For
12 years I have had two psychiatrists, one for my frequent inpatient
experiences and one whom I saw as an outpatient. Both doctors were
well trained, but dynamically different in the way they provided
services.
My
inpatient doctor (whom I’ll refer to as Doctor In) had a
cramped and busy schedule, which he always brought up as an excuse
when trying to get me out the door of his office instead of answering
my questions about medications and treatment durations.
The
more I ended up in the hospital, the more I felt like a burden to
him, a thorn in his side — one that he couldn’t figure
out how to remove. My returning visits seemed to frustrate him.
My
outpatient doctor (who I’ll refer to as Doctor Out) is
different. He also has a hectic schedule. The HMO schedules his
patients every 15 minutes. He works to make those 15 minutes count.
He doesn’t make me feel like he has a timer ticking in his
brain until he can shove me out the door.
For
years I saw him about every three weeks. As I became more stable,
time between visits stretched six to eight months. However, never did
I feel like my questions and comments were taking him off schedule.
He worked with me, listening to my concerns, asking me about symptoms
and genuinely listening to my answers.
In
2008, after working with him to figure out what would help me, we’d
checked all prescribed possibilities off the list. He looked at me
with tears in his eyes and told me that he didn’t think the
medication that would help me had been invented yet. He paused for a
breath and then let me know that he’d walk with me until it was
and that we would discover the solution together.
Doctor
In didn’t take the time to figure out what was really
happening, strictly viewing me through a complex medical deficit
perspective, separating me and my symptoms from my life’s
context.
His
frustrations with me were often apparent. It was as though he viewed
my reoccurring visits as a failure on his part. Consequently the
services he provided became less and less personal as the 12 years
progressed.
In
contrast, Doctor Out looked at my illness from more of a
strength-based recovery model. He acknowledged my intrinsic
characteristics and values, encouraging me to explore them. He is
willing to listen to my observations and challenges me to develop
them further.
Doctor
In believed one obvious reason for my reoccurring hospitalizations
was my undying desire for attention. He told my parents I was simply
attention seeking. Doctor Out commended me for being proactive in
seeking services when I needed them.
When
I shared my dreams of going to graduate school with my Doctor In,
he’d tell me they were unachievably grandiose and that dwelling
on them set me up for failure. He even told my parents to lower their
expectations for me and not to encourage me to do things that might
stress me out. Although I admit this approach was good when I
experienced acute symptoms, it wasn’t good for me between
episodes.
During
graduate school in 2011, after nearly a year and a half without a
hospital stay — a huge achievement for the girl who’d
gone in and out about every 5-8 weeks — I had another episode
and chose to check myself in to regulate my medication.
When
I explained that my long absence was due to increasing stability and
my graduate program, Doctor In scoffed, thinking I was simply caught
up in a delusion. He didn’t believe me until I showed him my
business card, proving my graduate assistantship.
When
I applied for graduate school, Doctor Out encouraged me to get tested
for possible accommodations. When I was accepted to my program he
told me he always knew I had it in me. When I graduated, Doctor Out
congratulated me exuberantly, assuring me that he always knew I could
do it.
I
felt as though Doctor In was my taskmaster. He viewed himself as the
person-who-must-be-obeyed. In May 2009, he even restrained me in a
gurney, forcing me to sign a “consent” form for
electroconvulsive therapy. After the session, I refused to return for
further treatment, quitting against medical advice.
Conversely,
I felt Doctor Out was my partner. He and I worked tirelessly together
for 12 years to find a medical balance, mitigating my symptoms. I
relied on his knowledge and prescribing creativity. He relied on my
feedback and honesty.
Together,
after eight years of roller coaster-like symptoms, we found a mix
that worked. Through the entire experience, he invited me to grow and
stretch myself. When I felt a medication wasn’t working, he
listened to my reasoning and took me off it.
Is
it any wonder that I trust Doctor Out more than Doctor In?
Last
year Doctor In retired. When I heard about it, I rejoiced, knowing
that should I ever need inpatient services, I won’t have to do
it with Doctor In. Shortly after I discovered Doctor In’s
retirement, I told Doctor Out that I dreaded Doctor Out’s
retirement. He laughed, reassuring me that he had a good 10-15 more
years of practice. I breathed a sigh of relief.
This
past week I learned Doctor Out was assigned by my HMO to focus solely
on children and adolescents with mental illness. When I got the news
from my nurse, I broke down sobbing in disbelief. I had visions of
being assigned to another psychiatrist like Doctor In.
Gratefully
my nurse knows me well and works closely enough with the
psychiatrists’ personalities to pair me up with one that might
be a good fit. Although I feel nervous about going to a new
psychiatrist, I’m going to have to trust her on this first try.
Finding
a good psychiatrist (or any other service provider) is like finding a
good pair of jeans. I just might have to try a dozen before I find
the right one. You can bet that if this new doctor falls on the
spectrum closer to Doctor In than Doctor Out, I will continue to
search for one willing to work with me as a partner and not patronize
me as an intolerable means to a paycheck.
I
encourage everyone who has had a bad experience with a psychiatrist
or other service provider to do the same. It can be a hard and
frustrating process, but the peace of mind is well worth the effort —
pun intended.
Sarah Price Hancock, a graduate of San Diego State University's rehabilitation
counseling Masters of Science program with a certificate psychiatric
rehabilitation.
Having embarked on her own journey with a mental health diagnosis, she is
passionate about psychiatric recovery. She enjoys working as a lector
for universities, training upcoming mental health professionals.
Sarah also enjoys sharing insights with peers working to strengthen
their "recovery toolbox." With proper support, Sarah
knows psychiatric recovery isn’t just possible — it’s
probable.
Born and raised in San Diego, California, Sarah served a Spanish-speaking
and ASL mission for the LDS Church in the Texas Dallas Mission. She
was graduated from Ricks College and BYU. Sarah currently resides in
San Diego and inherited four amazing children when she married the
man of her dreams in 2011. She loves writing, public speaking,
ceramics, jewelry-making and kite-flying — not necessarily in
that order.