My Psychotherapist thinks I'm "CLINICALLY FINE" ?????????

R

rugbymurf

PEB Forum Regular Member
I'm concerned. I had my MEB VA appointments about a month ago now. My MEB is primarily for PTSD. I've been treated for PTSD for almost 4 years since my first deployment, but it worsened after my second, after which my psychiatrist decided I needed an MEB. I am on medications, and have been diagnosed with PTSD by 2 psychiatrists, several clinical psychologists and Clinical Social Workers. I'm pretty classic symptom wise.

I got a new Psychologist 3 months ago who thinks I'm fine psychologically. Thinks maybe something physical is affecting my mood. He dismisses nightmares as being unimportant. He dismisses the fact that I can't think of almost anything other than "what if's" from Afghanistan as fine. Constant replaying of events in my head, and a mix of revulsion and wanting to go back and "finish business" there - fine, as just wanting to be somewhere else. My mood issues, the fact that if I try to get lower than the max dose of Effexor I start coming apart at the seams, all not an issue he thinks. Or thinks maybe it's something from my childhood..... negative father perhaps. Which never bothered me for the first 34 years of my life (whose family wasn't a bit messed up?), so why suddenly am a a basket case after Afghanistan, and worse after Iraq? Coincidence? Or did I just suddenly decide that my Dad wasn't a great guy and fall apart about it? I doubt it.

Yesterday, he forgot that I had been working for 2 years on Ward 57 in Walter Reed as a nurse with severely wounded soldiers. And that I had been a case manager in the WTU in Walter Reed and had one of my soldiers throw himself under a train.... a young one I was really close to. He had FORGOTTEN all that. He seems to forget symptoms I tell him about from one week to the next. He is really NOT GETTING IT! I really like the guy, and we can have interesting discussions, but he still doesn't seem to realize no matter what I say, that my post deployment self is definitely a damaged and somewhat volatile and often dangerous version of who I was. It's like, if I don't jump across the room and break things, or cry (I'm not a crier), I must be fine?????

I know that he has a neurological disorder. Which may be affecting his thinking/memory. He doesn't really take notes. He added the diagnosis of "adjustment disorder" to my medical record, which my psychiatrist saw and said "that's wrong, who put that in there". And I'm now really worried about what he may have been writing in my notes that the MEB may end up seeing. I like the guy, and don't want to do something to damage his career, but I'm concerned. Plus, I haven't been able to get copies of my behavioral health records at all (so the VA doesn't have them either). Not even my old ones, never mind these. What do I do? I'm going to request to end my therapy with him, but I hope that doesn't appear like I'm not cooperating with my plan of care. This isn't working. I'm a bit scared here. Do I just wait for the NARSUM, and then raise it if his notes appear to have influenced it disproportionately?

Murph
 
If it were me I'd get out of that situation, ASAP. I also suffer from PTSD. You, your psychiatrist, and psychologist should be working as a team to try to heal you. If you don't feel comfortable with your Dr, you need to see about awitching to another one. Psych docs are very personal and you need to be able to trust him. Plus, it sounds like your psychatrist has some doubts about the adjustment disorder diagnosis.

Another note--I'm sure others will pipe in here but I'm concerned about the adjustment disorder diagnosis. Especially if you have been diagnosed/treated for PTSD for such a long time. "Adjustment Disorder" is less "serious" than PTSD. I'd just worry how that would effect a potential PEB rating.

Nate
 
i had the same issue when i 1'st started treatment. i was so pissed w/the doc, i stopped going to to the naval hospt. and enrolled w/the VA and the VA's vet's center. it was the best thing i ever did. there should be zero stress/frustration when dealing w/mental health issues. all i ever wanted to do is get better and i'm sure it's the same for you. if you need help w/the VA stuff, let me know. i would highly suggest starting w/a local VA Vet's Center, plus they can help you navigate the VA side of the house, when it comes to the application to receive care @ the VA. for me it went smooth. i left the naval clinic called the vet's center, got an appt that week. they helped me w/my VA application and stayed ontop of it so it went through in a matter of weeks and i was enrlled @ the VA. like i said before, if you need help w/ANYTHING let me know. you should be concerned about your treatment and not petty BS. good luck and keep me posted!!!
 
Thanks both of you guys,

I talked to my Psychiatrist and expressed my concern. Turns out that she knows about his neuro condition too. When I pointed out the things that didn't add up, she agreed that it sounded pretty off, and not like him. I had also dealt with him in the past as a colleague (which was a bit weird anyway), and he did seem to be kind of slipping compared to then. So anyway, I am "terminating" with him next week. She said that basically, it doesn't matter what he thinks, that she is my physician, and that everyone else for the last 4 years has had it in their notes (3 psychiatrists and a few other BH professionals) that I had PTSD anyway. I think she is going to remove the Adjustment Disorder. I don't know what's in his notes, but I did get a hold of the woman in the OIF/OEF special actions section of Medical Records in Walter Reed who told me that my BH request was never done. She is doing it right now and said that "This time I'm pretty certain noone is going to try to stop me from doing it"???? Hmmm.... not sure what that's about. But either way, I will be picking the packet up next Friday and copying it before giving it to the VA rep and my PEBLO.

In the meantime, I am going to group, which is helpful. And I'm starting with a different therapist, a resident. I'm still active duty and in the WTU, so I am kind of in their system right now. I'm in the middle of my MEB and until I'm found fit or unfit, I have to do it their way. In fairness, the first psychiatrist I had was a resident, who did my therapy as well as meds, and she was great. I made a lot of progress under her, and quite frankly, I think I'd be dead or in jail, if it were not for her. So I'm willing to give this one a go. They are going to try the more conventional Cognitive Behavioral Therapy approach on me this time, which I really didn't do before, partially because I was really averse to any kind of exposure therapy. I was a big fan of the avoidance strategy, which, of course we all know, might get you by, but it doesn't get you better.

I'll be keeping my fingers crossed for what is or isn't in those records!

Murph
 
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