"No obstacles are insurmountable when God commands and we obey"
- - Heber J. Grant
June 6, 2014
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.


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About Sarah Hancock

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 isnít just possible ó itís 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 ó not necessarily in that order.

NAMI San Diego's Fall Keynote Address: Living in Recovery with Schizoaffective Disorder

Having recently moved into a new ward, she currently serves as a visiting teacher.

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