Therapist considering discharging me

I recently had a very disturbing experience and it’s taken me a while to post it, I still find it hard to believe that it happened to me. I have spoken many times here about anxiety disorders and PTSD and it’s been somewhat helpful to talk about it with people who understand how it feels and affects your life. I was going through a very rough time for some time probably due to finding the right medication for me, I don’t adapt easily and often have horrible side effects that just make things worse. I asked my doctor to refer me to a psychiatrist and he did, basically it was an outpatient clinic and they would contact you once a doctor was available. I got called very quickly, even the secretary said I was lucky because it takes up to a month usually to get in. I went to my appointment for a consultation and the doctor questioned me thoroughly, I found myself opening up quite fast about my past traumas…about 30 minutes later he said to me I know a family that shares your surname and he said my brother’s name and his wife. He also said that they are socially connected, I thought I was going to throw up and just sat frozen staring at him. The abuser in my past was my brother, I realized why he brought me in so fast and I’m certain that it wasn’t because he cared about me. Honestly I am still shaking just telling this story.

To further my story I had to battle with my thoughts, I began to get anxious and also angry, the feelings were so overwhelming. I knew that I had to come to terms with it but I was afraid he would tell my family and I bigger problem would arise.. reasoned with myself that I didn’t do anything wrong, I trusted the doctor to be a professional but I’m not his patient, I even thought about contacting his office but I’m too fragile mentally to go into this situation besides he’s a doctor and I’m a troubled patient. I decided not to see him again and I retreated from the whole thing. In conclusion he’s the one who behaved unethically and betrayed my trust, he should have told me from the start so I could walk away from this, he never contacted me again and I’m not surprised.

@junkartist I also live in a very small community. Your description of the discharge conversation you've had with your therapist is and should be a part of every therapy practice. The information you have posted here is broad enough that I doubt your therapist or anyone in your community will connect your posts with your therapist. I have heard about similar conversations in my community and honestly unless the person tells me who the therapist is I would not know.

Discussing a plan to discharge a patient when they are doing significantly better than when they first came in is a reasonable conversation. You have let your therapist know that you do not feel ready to be discharged and so your therapist plans to discuss this with her supervisor. If you were my family member I'd suggest that you talk to your therapist about seeing her on a less frequent basis such as every other week or once a month. In that way you can put to practice what you've learned in your sessions and report back to your therapist on how you are feeling about yourself and these less often visits. This is a very good way for you to figure out, for yourself, what you would like to do.

What do you think about my suggestions? When do you next see your therapist?

@frouke There are many different reasons or possibilities about what happened and given what you have shared I understand why you feel betrayed. Perhaps you did get that appointment quickly because the psychiatrist recognized your surname and got you in quickly. However, until you opened up to the psychiatrist he may not have known any details about your traumatic experiences and how these connected to your brother.

In my view, telling you that he recognized your surname and that he is socially connected to your brother should bring up the following points for discussion. He decides he cannot see you again because of this social connection--this is the clinically sound and ethical move to make. He tells you this so that you will understand why and then refers you to another psychiatrist. When he makes the referral he lets the other psychiatrist know why he cannot see you without providing any details. I assure you this can be done and I have seen it happen in my community.

You have a lot of trauma in your past and I imagine that talking with this psychiatrist triggered all of that to come up. Do you have a therapist you can talk with about all of this?

I definitely agree with what you said, I did leave out some finer details in my story, it was just too lengthy. I am very sensitive and will most assuredly react badly to this event, my expectations were high and hopeful, he concluded the meeting with recommending that I take a certain medication and added that if I don’t he will not see me again…my referral clearly states that I am phobic to meds which doesn’t make it any easier. I felt his words were harsh and unkind, at the same time he was leading me out of the office. I’ve tried to be objective and also spoke to several trusted people who know me well enough, in all cases they strongly advised that I should not return to this person. No matter how I look at it, his reason for bringing me in was primarily more based on curiosity, my surname is unique in this country and he said what were the chances that you’re not related. He really should not have picked up my case and even if he did so to be sure then it would have been more decent and ultimately ethical on his part to give me the choice of what I wanted to do, thank for your input, I do appreciate it.

Being considered for discharge can feel like rejection, but indicates that you are recovering. The therapists goal is to help you become independant of them. There are cases where oversight keeps a patient safe from the therapist. The relationships in therapy are genuine. A therapist can become engaged in a way that hinders timely withdrawal.
Counter transference describes a pattern where the therapist developes a dependancy on the patient.
Someone in the organization your therapist is involved with is exercising diligence.
You say things have changed and maybe you should be encouraged venture into non-professional relationships. Then again, it might be too soon. You may need to continue with this therapy.
You are probably the best person to figure this part out. Do you look forward to therapy as a pleasant experience. Are you still solving problems that you feel like you don't have the skills to resolve.
I really like your protectiveness of your therapist, evident in later posts.
It sounds as though you have a great therapist who has truely helped you. Congratulations on your progress!

By the mere fact that you are expressing profound anxiety about being discharged from therapeutic care, I would question whether you are actually ready for discharge. By no means do I mean to be critical of your anxiety, I'm simply making a point that you are not yet prepared. Assessment forms and information gleaned from them, in my opinion, are not the end point. Don't look at the numbers, look at the patient! I am also thinking that if any discharge occurs you need to be given a 30 day notification by regulation.....I may be wrong, but somewhere along my career I believe that to be true.