Private psychiatric assessment results in script for anti-psychotic medication.

[thetruth]

Hi,

I would like some feedback please before I decide how best to address my situation regarding what I consider to be an appallingly ineffective private psychiatric assessment back in June.

The main points to recount are that I went to the assessment less than adequately prepared to substantiate my claim that my symptoms and history pointed to Cptsd. The psychiatrist was very quick to poo poo my claim and he stated that Cptsd was not really likely as it is considered to be a condition that stems from abusive and traumatic childhoods. So he ruled out Cptsd because he said it could only be a product of a traumatic childhood. He did this twice during the assessment.

He filled the hour up with asking questions about me and my family and my life which were not pertinent to the issue I was bringing to him.

I might add that my condition was worsened by an indifferent NHS doctor who refused to say my stress was work related and in doing so he helped facilitate a deeply unfair dismissal from my job. When we touched on this subject, rather than explore it thoroughly, the psychiatrist, who is himself an NHS doctor began to to ask me if I believed in conspiracy theories and did I believe that the world was a fair place or did I believe that everything was connected to each other.

This man performed the assessment in a non exploratory way and an avoiding way- avoiding what mattered.

He concluded by saying that I had been troubled for long enough by these distressing thoughts of injustice and asked me would it not be better if I could get rid of them so that my quality of life would improve? All lovely and simple and easy! He didnt care for my talk of Cptsd. So he said that he was going to suggest to my doctor that I go on a course of anti-psychotic medication, something that I knew I would not even consider doing as his assessment had been such an offensive farce.

I paid £250 out of my own pocket for this assessment because I has asked for it and I hadnt the nerve to refuse to pay, nor had I the steadiness of mind to know I was being robbed. I went home and I never heard from either him or my GP.

I feel I should write to him and tell him I want a free assessment as his first one was a joke and he botched it from the outset by saying Cptsd wasnt possible because I wasnt bringing him an account of a traumatic childhood.

What do other site users think about this? Oh, my symptoms continue to make my life not a life anyone should have to live. Only on here have I any interaction with other humans who can relate to this taboo existence I am 'indulging'.

Thank you.

[Rainagain]

Did you actually get anything like an assessment? Any written report?

I'm not sure why antipsychotic s are prescribed, was he thinking schizophrenia or something?

Sounds confusing, was he saying that drugs can take away the distressing thoughts?

I'm sorry you had this poor experience.

[thetruth]

Hi Rainagain,

No he didn't suggest I was schizophrenic. He delved into my past and identified some history of depression, well, he already knew it was there from reading my notes. Coming out of prolonged depressions in the past, going well back in time to 1999 and 2006, I have had 2 experiences of hypomania. These were see-saw type reactions to having endured prolonged depression. In 2008 I suggested to a psychiatrist that I might be bipolar? She said no, you are most certainly not bipolar and your hypomania is a common enough result of coming out of long term depression. I couldnt agree more with her. It is the truth. I am not bipolar and I know I am not.

However, jump to 2018 and a private psychiatric assessment asked for by myself because I am living the life wrecking symptoms of Complex PTSD, and I find a private psychiatrist who is also an NHS psychiatrist telling me that I am on the bipolar spectrum and that is the reason that I cant process and leave behind these troubling thoughts about a former employer after 5 years out of the job. He did this without scratching the surface of the nature of what I am experiencing and what has been done to me and as I said above, when we got near the betrayal by my own trusted NHS GP who wouldnt say my stress was caused at work, he began to quiz me on whether I believed in conspiracy theories.

His conclusion was that I was wrong that I was experiencing CPTSD, I was to some degree bipolar, this was the reason that I couldnt cope with the injustices I had been met with and that antipsychotic medication would help me forget my troubles and give me a better quality of life. Im sorry but this is an absolute disgace. It is nonsense.

In a nutshell, the injury to me in 2013 by my life long trusted NHS GP was massive. It compounded the injury of 4.5 years of health removing harassment like a knife through my heart. This is what is so inconvenient about my case.

My employer seized on the fact that I had current and historic issues with depression in a disgusting strategy to deflect attention from the extent of his mistreatment of me. My own trusted GP played along and facilitated his lie because he knew him and the the last thing on earth he was going to do was enter any kind of conflict with him. Now that I am permanently damaged and I cannot find my sense of self or self worth as a result of their actions, I have a private psychiatrist who will not even explore my grievances thoroughly and honestly because an NHS GP played a massive role in the damage caused to my mind.

When trying to embarrass me into denying that I thought there had been discussion between my employer and my GP before my redundancy, this psychiatrist asked me did I ever have thoughts like my employer and GP had discussed me in secret? I said I know they discussed me because in my desperation for a solution to the stress that I was enduring I gave my employer and GP permission to discuss me. They discussed me over the phone  as many times as my employer wanted to. The psychiatrist hadn't been made aware of this fact because my old GP has only made one tiny reference (which could very easily be overlooked) to this in his medical notes and my new GP has very scant knowledge of everything that went on.

There was a short silence and then he completely changed the subject. So he wasn't interested in exploring the nitty gritty details pertinent to why my mind and my life is in the state of disrepair it is in.

It was by this permitted communication that I reckon my employer secured reassurance that my GP would not stand in the way of my removal from my job. I believe this because 1. I had made my GP fully aware of my difficulty with this employer several times over the previous 3 years and his refusal to acknowledge that my stress was caused at work was inconceivable, and 2. The extent of the lying by my employer within the redundancy process was so brazen that they must have had some prior reassurance that I would be fighting them single-handed.

My damage is too inconvenient, and paradoxically that is why its so damaging. No one wants to hear it. So it cant be validated. It is all mine to endure and the longer it lasts, the easier it is to just classify me as a basket case who mysteriously holds on to some historic grievance about a low grade job he once had.

[thetruth]

Did you actually get anything like an assessment? Any written report?

I'm not sure why antipsychotic s are prescribed, was he thinking schizophrenia or something?

Sounds confusing, was he saying that drugs can take away the distressing thoughts?

I'm sorry you had this poor experience.

I have seen nothing yet.

Oh yes, he was saying I have been troubled for long enough by these difficult thoughts about the past and antipsychotic medication would help me to live a better quality of life with less difficulty from these thoughts from my past. That was his conclusion, and he did not need to see me again. Hand shake, nice to meet you , All the Best. £250 please.

[thetruth]

As far as I can see, GPs and psychiatrists have massive professional license to hear what they want to hear and to disregard what they would rather not hear. It comes down to what is less inconveniencing for them in a legal sense. The actual truth is of little importance when a patients health is on the line and there are legal implications. They have an awful lot of leeway to abuse their positions to adapt the facts to their liking. The pressure is then on the patient to fight back and they might not be in a position to, and they know it.

[Rainagain]

The big difference in the opinions of the two experts is just impossible to digest.

What are you supposed to do now? Get another 6 opinions and try to average them out?

That can't be a thing.

A lot of these diagnoses all have the same treatment, i.e. talking therapy and the same narrow range of meds, maybe a diagnosis doesn't change much.

Mine didn't make any real difference.

I was diagnosed with major depressive disorder as I'd had more than two episodes of depression in life so far.

Sounds like you have too.

But the treatment for that is the same as other things I have also been diagnosed with (anxiety, depression, reactive depression, disthymia, PTSD, cptsd)

So, maybe that's how it is, ask two experts and get more than two opinions?

Everything I have been diagnosed with seem to be related, all in the same area on the DSM iv I'd guess.

And on different days I probably am in a different condition so I might fit different categories depending on how I am doing.

There were symptoms 'left over' too, stuff that belonged with yet more diagnoses but weren't exactly right to win any more diagnostic prizes, or whatever.

And some stuff was apparently more brain tumour or narcolepsy type indicators rather than mental health, I'm still waiting for assessment of those.

If I kept getting assessed I'm sure I'd get some extra illnesses added to my list.

But your bipolar/not bipolar is a proper puzzle.

Maybe think about meds and therapy? A bit like antibiotics work on most bacterial infections so you don't need to know exactly which one is involved?

I'd avoid venlafaxine though, nasty stuff I found.

I thought the complex in complex PTSD meant the trauma was complex, it seems to mean the symptoms are complex as well.

Or maybe people are complex, so they can show their damage in lots of ways.

[Libby183]

I am so sorry that you are suffering so much. Your ruminations over your abuse at work and at the hands of the medical profession are utterly valid and understandable. I want you to know that I validate you 100%.

In exactly the same way, I suspect, I have ruminated excessively over my parents abuse. I cannot and will not forgive them. However, what has helped me very much is letting go of the belief that anyone else can help me.

At my husband's suggestion, we looked into seeing a private psychiatrist, as I have never seen anyone other than GPs. I didn't bother because I would have needed a referral from my GP. I couldn't see, therefore, that an assessment would be unbiased.

We looked at on line psychiatrists, but when I asked if any were trauma informed, we were told that any would do. I felt that this said it all. They are all just part of the same system.

So I made an informed decision that no doctor or psychiatrist could or would help me. I told my parents, over the phone, that I hated them. Something I had never done before. Their response confirmed to me that, for me, they are indeed abusive. I have left behind my guilt about them.

The abuse of children by parents, abuse of patients by doctors and the health service as a whole, abuse of employees by bosses is rife. It's like I have accepted this at last, and have accepted why I am who I am. It has been very freeing and at long last I am living on my own terms. I wouldn't say I am deliriously happy but I am better than I have ever been.

CPTSD is the best fit for me, and I suspect, for you. I know now that I don't need a diagnosis as such, because, after all, these things are just the opinions of people I don't really trust and who I don't believe have my best interests at heart. Just as my parents didn't.

I don't know if this is of any help, but I wanted to tell you my most recent story, in the hope that something might just click for you, like it did with me.

I would like to add that my last experience with medication also played a part in my progress. It was a horrible experience but it led me, indirectly, to where I am now. If you are interested, I would be happy to share.

I feel for you so much, and want to show my support for you.

[Rainagain]

That's a beautiful post Libby.

[thetruth]

Morning, Libby and Rainagain and thank you both for your posts. This just a short acknowledgement as I am going to justify my existence today with a bit more oil painting practice. This is a good thing.

Libby you are hitting many nails on the head. Im not for a moment trying to suggest my trauma equates with yours but it appears the damage caused is of a similar nature. We are both managing the psychological consequences of stress and betrayal. Despite the differences in the nature of our hardships we can well relate on the psychological effects being dealt with now. Cptsd most closely resembles what I am living by a million miles. I had the light bulb moments when I discovered it and when I read Pete Walker.

You are right about the therapeutic properties of accepting that no help is available or forthcoming from those who traditionally should be providing it. I was only able to overcome an absolutely horrendous 2.5 month flashback (worst one yet) in the spring after the galling experience of sitting across the table from a private psychiatrist and watching him avoid the damaging truth of my situation. I listened to the most disgusting, flimsy, embarrassing misrepresentation of reality coming out of his mouth and all generated by his need to avoid exploration of the historic criminal practice of another NHS GP. His assessment was in part based on my doctors notes. My doctors notes are designed to mislead. I have them. They are an utter disgrace.

After this I realised that it would be easier to win the lottery than have these people hear the truth and accept what it has done to me. So I was somehow, quite remarkably, then able to end that particular flashback and throw myself into some work projects. This worked for a while then the season changed into Autumn and the thoughts got the upper hand again.

Thanks so much for both of your posts. It is all fantastic stuff!!

Later. I will get back to you later Rainagain.

[thetruth]

Hi Rainagain,

There is no puzzle re bipolar/not bipolar. I am not bipolar. I am a person who has experienced fully explainable hypomanias which only happened because of the duration of the depressions which I had just negotiated. I would never have experienced hypomania without the preceeding prolonged depression. Neither were my depressions mysterious or unexplainable. Emotional and physical abuse by parents during childhood and adolescence made sure I thought I was a useless piece of crap for long enough to produce clinical depression.

There is no debate to be had on this. The suggestion that I am to some degree bipolar by this psychiatrist serves to illustrate one point and one point only. The fact that my GP chose not to explore the abuse I had experienced in the workplace, and the fact that he refused to say my stress was caused in the workplace is too inconvenient for the psychiatrist to accept. He cannot be seen to support my claim that I was further injured by the decision making of an NHS GP. By this stage I am not remotely surprised by his appalling course of action.

The  true nature of the stress I was caused in work was denied by the bully, then it was denied by the GP and now 5 years later, it is simply too much for the psychiatrist to do anything other than deny its validity too. The psychiatrist needs me to go away and be quiet, the same as my GP needed me to do that and the abusive employer before that. He will say anything to have me just go away and desist from this inconvenient story of abuse and betrayal by one of his colleagues.

There is no mystery here whatsoever. I will say it again, the damage that was caused to my mind is too inconvenient for these people in a legal sense. That, alas is of little help to me. They can all imagine it away as long as I shut up. They are not the ones managing the symptoms day and daily. I dont have the luxury of pretending I am just a silly, deluded nuisance.

There is nothing impossible to digest about the disparity of the 2 diagnoses. One of them was made at the correct time when it was well informed and fully impartial. The other one is a desperate attempt to avoid the truth of the present day by using historical information. I sat and watched this man orchestrate an assessment in which his main priority was to refuse the validity of the words coming out of my mouth. That says it all.


Having said all of that, I am currently enjoying a bit of respite from the deeply complex pain that has visited me again recently. Long may it last. I am really enjoying some music at the moment. That is a pretty remarkable breakthrough!

[thetruth]

"At my husband's suggestion, we looked into seeing a private psychiatrist, as I have never seen anyone other than GPs. I didn't bother because I would have needed a referral from my GP. I couldn't see, therefore, that an assessment would be unbiased."

Hi Libby,

Thanks again for your post, as Rainagain says, it is really thoughtful and insightful.

I wonder what you mean about the difficulty of receiving unbiased healthcare because your GP would have had to make the referral for a private psychiatric assessment, when your GP wasn't directly involved in your traumatising?

This strikes a deep chord with me because I do not know to what degree the psychiatrist that I attended and paid money to was informed (or misinformed) about me by my GP's practice before I spoke to him. The nature of the  assessment would suggest to me that he was somewhat prepared for me and that he was not an impartial listener.

In my naivety, I thought I could get an unbiased ear to hear my case if I paid a private psychiatrist. I rang one up. I was very surprised to hear a referral had to be made by my GP's practice for this to happen. I wanted them to have nothing to do with it as they have been a source of trauma and they have ridiculed my struggle ever since. One of the receptionists has laughed down the phone at me when I was in a state of distress. So I well understand your sentiment about the difficulty of getting non-biased private care.

Thanks again for your fantastic post.

[Libby183]

Hi,

Thanks so much for your reply and your interest.

I felt that the issue with my gp practice was that, after twenty years of mental health issues, they do not take me seriously. I have asked to be referred to a psychiatrist, but all have refused this. They tell me that they are perfectly capable of treating me. If I attend with something physical, which is rare, I am told it is related to my MH problems, and if I attend with MH issues, they tell me that there is little wrong with me. I actually rarely go to the doctors. I find them utterly patronising. I feel sure they have me pegged as borderline PD, and shut me down instantly. I have never been difficult - they never listen. I think they would either refuse a referral of tell the private psychiatrist what my issue is. As they are all linked to the NHS, I believe, like you, that they stick together. I have never even managed to mention my childhood /CPTSD. I think, as well, that my experience of childbirth, having premature, special needs twins, and the awful treatment we all received, is another layer of my trauma. Again, they don't want to acknowledge any of this.

I have a psychology degree, I trained and worked as a nurse, my daughter is a neuroscience PhD student and I have read widely, but they are determined to maintain that I have no idea what I am talking about. I suppose they view this as my conspiracy theory, but I simply don't trust any of them.

Sorry to have waffled on. I just wanted to expand on why I too have a very poor opinion of the medical profession, in general. I can notice and appreciate when people are positive, despite finding it very hard to trust. I have rarely seen anything worthy of trust in these people.

All the best to you.  I was really interested in your mention of painting, which sounds great. Creativity is so good. I paint, but only walls and furniture, and I make clothes!

Take care.

Libby.

[thetruth]

Libby,

We are having exactly the same experience with our NHS health centres. As I said, I have been laughed at down the phone by one particularly frosty woman who answers the phone. It is because they have categorised me (with the help of my life long GP) as a lunatic and a nuisance, that my desire for support against health crushing workplace harassment was denied. I was spoken to by my GP as if I was not a person he had to take seriously and when I could not shake the effects of the trauma even years later, he got angry with me and asked me if I was going to move on or what? And this after he had point blank refused to be informed of the nature of the harassment that I endured for 4.5 years.

He assisted my employer in an unfair dismissal of me. This is not exaggeration in any way. After I was made redundant because he refused to say my stress was work related, he told me "its my job to get you well!" This particular chestnut was said by him to cut short and deflect my very first attempt to explain to him the wrongness of his refusal to say the stress I was suffering from was caused at work by unfair treatment, a decision which paved the way for a disgustingly unfair dismissal that he knew was going to happen.  He decided the stress of my harassment was just mental illness and unrelated to my job, and that meant he could just speak to me as if I was his ill patient that needed meds and my redundancy was in no way related to him. The fact is, my redundancy was fully facilitated by him. He was fully complicit in my unfair dismissal. I had given my employer permission to talk to him on the phone and between them, my removal from my job was decided upon.

That woman who laughed down the phone to me when I asked are there any other doctors available (my own one was off), I have noticed that when she answers the phone to me now, as soon as I identify myself, she asks me to hold on a second and the phone goes dead. She is deciding what to do. She is deciding what to tell me. Funnily enough, my doctor always seems to be off and rather than pass on a message, she tells me to ring back on friday when my doctor is back in. This way I might not bother.

Like you I am not being taken seriously, my old GP steadfastly refused to reconsider his position on my harassment. He withheld support when I needed it so he had to stick to his guns and that meant denying the validity of my grievance, denying that 4.5 years of harassment happened. On one occasion when I was trying, in vain, to reason with him, he said- "well I have no axe to grind with them". That was his position on my being driven to the brink of my sanity by the most abusive boss you could imagine.

Painting might just get me out of this mental prison. It certainly wont do any harm. Ive already identified thoughts of authenticity about myself since I started a bit of painting. I havent had such thoughts in years. I might just have discovered some form of emotional salvation/healing.

Maybe with our similar life stories it is no coincidence that we are both creative? I feel better already for having taken up the paint brush again!

Sorry for going over my situation in so much detail again, I cant seem to help it. I think I need to go over and over it because of the scale of the deceit that was carried out to misrepresent facts in order to have me cast aside.

[Libby183]

Don't apologise for going over your story again. It's what we all do. The trauma is so deep that it can't just be switched off.

I think that the way we have been treated by the so-called helping professions is atrocious. It is an abuse of power, as you discussed in your employment thread. It seems so convenient for them to say that a person probably has a personality disorder, so they don't deserve any treatment.  They are unwilling, it seems, to accept that these problems are the result of trauma, because if they did accept this, then they would have to help, and that would be too difficult. Really, the only thing I ever asked for was validation of my suffering. It would have been so simple and so cheap. But no. The system denies the abuse, says  I am too sensitive and then wants to medicate me to get rid of me. I don't expect to recover, I just wanted to be listened to and understood. Nothing more complicated than that.

I am very grateful for the EMDR therapy which I had earlier this year. It really helped rid me of the awful physical pain I had suffered for years. But the insistence of the therapist that I should forgive my parents,  which I tried but failed at, meant that I lost trust in her. I suspect that is recorded as my sabotage of therapy, not her failure to help me move on. I asked how to forgive and was told to write a letter and burn it. I wanted it to work, but it didn't.

Being too sensitive shouldn't be such a handicap, should it?  When my children were young, and I was still in contact with my parents, my mother often encouraged and invited me to emotionally abuse them. I started to fall into her trap and she loved it. But I couldn't bear to see the pain in my daughter's eyes. Too sensitive, I suppose. If I had gone ahead and placed all blame and guilt onto my children, I may well have felt better and it would have improved my relationship with my mother. But for some reason, I didn't. And I really believe that society does not approve of my choice. I suppose this is my pet conspiracy theory, but it feels very real to me.

In each of our cases, it seems we have suffered for causing trouble within the system.  You, in the workplace, me, within the family. How dare we!

I don't know if this makes sense to you, but it's good to share stories and ideas.

[thetruth]

Like you Libby, all I asked my doctor to do was to validate the stress I had been put through for years. I told him that I was being lined up for a very unfair dismissal if he didnt. His reply was, "I cant put that (on your sick line) just because you say it. Im sorry".

He refused to say the reason I needed a week off was due to work related stress. 2 weeks later I was unfairly dismissed.

Im afraid I cannot help but think that your therapist didnt have sufficient comprehension of trauma if she couldnt consider the possibility that forgiveness might not be possible. She may have personally had to employ forgiveness for certain things in her own life but that doesnt mean she can impose a no exception rule on mandatory forgiveness on you or anyone else. I have not forgiven, not genuinely. I have said the words and attempted to do it for my own sanity but it hasnt been authentic.

I have not forgiven and no one can tell me to. It cant be forced, whether anyone likes it or not.

Youve made me remember an occasion when I was confiding in someone I know, re my difficulties 5 years after redundancy. After I had given a description of the injustice I experienced, and explained the psychological injury as best I could, he suggested that rather than continuing to hate my old boss, I should maybe try forgiveness. I think he really began to get a sense of the whole thing when I told him that my old boss has had more forgiveness from me than from any other person alive and that it hadnt made me one iota less angry or less injured.