3 weeks ago, I went to my very first psychiatrist appointment. It was a pretty big milestone for me as I haven’t been in contact with any mental health professional since I was 15, and I was really looking forward to finally getting the help I need. The whole experience was dissatisfactory overall, from filling out forms in the waiting room, to waiting for the doctor to actually come in for hours, I had switched from anxious but hopeful to frustrated and wishing I could just get it over with. Eventually, she (the psychiatrist) called me in and we talked for no more than 5 minutes. She asked me many questions but by the end she was completely dismissive about everything I confided in her about and ushered me out the door saying “I am a psychiatrist, I deal with people who have REAL problems, which you do not have, just bad coping skills.” Ah, yes, “bad coping skills”. I left with only one question in my mind: If I don’t have any problems, what do you think those bad coping skills come from? To say I was upset upon my arrival at home would be a massive understatement. It took everything within me to not express my rage. I wanted to scream, I wanted to cut, I wanted to burn my entire house down even if it meant death to my whole family just so I could die in it – but that’s not me. I hate bringing others into my personal problems. And so, I crashed into an extreme depressive episode in which I spent the evening crying for 7 hours, didn’t get out of bed for days, didn’t eat for more than a week (I’m only recently starting to eat at least one meal a day) and spent every waking moment feeling like I need to jump off a bridge because even the thought of my own existence makes me feel incurably sick to the stomach and pained in the head. Currently, I’m doing significantly better, and aim to contact a new therapist within the next week or so, but that initial experience is something I doubt I’ll ever forget, but honestly, I just wonder what’s the purpose of it all, as my desire for escape from existence runs its course, even when I’m not in any way depressed at all. (from the USA)

A:  I am terribly sorry this mental health professional treated you in a way that was dismissive. It sounds like the psychiatrist was only interested in prescribing medicine — not actually engaging you in therapy — and managed to insult you in the process. It also sounds like it took a tremendous amount of courage for you to bring yourself into the appointment, and I deeply admire your persistence and willingness to contact a new therapist. I highly recommend someone other than a psychiatrist so the emphasis will be on therapy, rather whether or not you are a candidate for medicine. This isn’t saying a consultation with a psychiatrist might be helpful downstream — there are plenty of magnificent, compassionate ones — but for now let’s put the emphasis on explaining your needs to someone who knows how to listen and isn’t necessarily looking to prescribe.

You asked about the purpose. The reason therapy can be very helpful in the hands of a skilled therapist is that often the safety and relationship in the therapy has a great deal to do with correcting the issue. You said it just right: “If I don’t have any problems, what do you think those bad coping skills come from?” The answer to that is often rooted in prior relationships, often in the family of origin. The relationship with the therapist combined with techniques, interventions, and the process of therapy often change the dynamics beneath the symptoms.

I hope you find someone who can honor you needs better, and help make the changes in your life you are looking for. The Find Help tab at the top of the page can help you find someone in your area.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral