Monday, September 11, 2017

Therapeutic Relationship Killers: What to Do if Your Psychiatrist is Having a Bad Day

Your psychiatrist or psychotherapist is having a bad day and you catch them on their bad day. What do you do?

Some truths:
  •  You have bad days, I have bad days. Every human on earth has off days. That includes your psychiatrist and psychotherapist.
  • Only Dr. Sydney Freedman has perfect clinical days all the time. The biggest killer is unrealistic expectations but the good news is that it's possible to work through these expectations with your psychiatrist. 
  • Most psychiatrists and psychotherapists are not going to admit to you they aren’t at their best. This is important. 
  • You are definitely going to notice that they are behaving out-of-the-ordinary for your relationship
  • You are very likely going to negative mind read their behavior. It’s hard not to

Signs your psychiatrist/psychotherapist is having a bad day:
  • They aren’t listening in their normal attentive style
  • Their responses feel hurtful or not carefully considered, also not the norm for them
  • They are distracted and usually, they pay attention
  • You feel like they are rushing you. They are uncharacteristically not letting you think through what they are saying and not letting you respond

So, what should you do?
  • Give them the benefit of the doubt. If they have a consistent track record and they are off one session, let them be human.
  • Don’t own their off day. It’s not about you. Maybe they just handled 3 emergency calls or maybe their dog died. You don’t know.
  • If you have a really comfortable relationship you can ask something like, “You seem distracted to me.” See where the conversation goes.
  • If you are not in a really comfortable relationship, find a way to communicate your feelings to him in less threatening ways.

1.Try a letter or e-mail. I illustrate this in a number of examples in my upcoming book Finding My Voice: A 20 Year Patient-Psychiatrist Journey
2.Leave a voicemail message on his office answering machine
3.Address it at your next session when he’s back to his old self.
4.Always be respectful, and you’ll get a more meaningful response.
     It’s really hard in these circumstances but don’t jump to negative mind reading. It only hurts YOU and damages your relationship with him.

In My Perfect Therapeutic World
      Psychiatrists and psychotherapists would give their patients up front permission to ask if they feel something is amiss in a session.

    Patients would take them up on that invitation and ask.

1.My standard line with Dr. Rosen in my book Finding My Voice is: “You seem a trifle cranky today.” That usually precipitates a longer, more helpful discussion.
2.Find a statement that feels safe to you that you can try on him the next time you encounter a Bad Day Syndrome.
     Patients would be understanding of their psychiatrist’s humanness and not let his bad day become their bad day.

Next relationship killer to tackle: what do you do if your psychiatrist or psychotherapist makes a mistake with your care. I’ll use two examples from my own experience to illustrate.

Copyright: Photo credit 1

Copyright: Photo credit 2

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