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NGonzalez
NGonzalez, Psychotherapist
Category: Mental Health
Satisfied Customers: 56
Experience:  15 yrs of clinical experience, relationship issues, marriage & family therapy, eating disorders
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i am extremely paranoid with little evidence,i am a highly

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i am extremely paranoid with little evidence,i am a highly analytical person and have a great deal of self awareness and insight into my behaviours.Yet whilst trying to change my behavioural patterns i find myself questioning things more deeply.I have low self-esteem and a 'be the best' complex. i also believe i have some form of passive dependency disorder or personality disorder because i have erratic moodswings, am paranoid, unable to rationalise internally although externally i give a very open, reasonable, rational demeanour yet cannot do it for myself.i also have obsessive tendencies.am seeing a counsellor but i feel like i cant openly disclose to her because i fear she will judge or be disappointed in me.I find myself looking for male attention yet have a boyfriend of 3 years,am a bit of an attention seeker and i always have some%2
Submitted: 5 years ago.
Category: Mental Health
Expert:  NGonzalez replied 5 years ago.

DearCustomer

 

Thank you for your questions. Given how well you described yourself it is apparent that you have done some diligent work toward self-exploration. I can certainly appreciate the anxiety and fear that emerges for a patient when she thinks about disclosing what feels like embarrassing information. Its a normal reaction given our tendency to seek full acceptance. However, I would encourage you to work through this block and to find a way to talk to your counselor about your concerns. When people start to reveal intimate details they have intentionally excluded in therapy it paves the way for more exploration and potential resolution of their problems. The other benefits is that you will probably learn that despite your fear of being judged or rejected, your counselor will still value you as a person and the therapeutic relationship becomes even more intimate and safe.

 

One way to approach this difficult situation is to talk about your fears before you reveal or disclose any information you are not ready to talk about. This will result in a productive dialog that may make it safer for you to reveal more in the future and relieve some of your symptoms. Talk to her about your fear of judgment and any other associated fear. I think she will appreciate the opportunity to discuss these concerns with you.

 

With regard to the medication, you may want to reconsider taking medication if the obsessive and paranoid features are interfering with your daily functioning. As you may already know, the key to effective medication is consistent and regular use as prescribed by your doctor and finding the correct medicine and dosage. I also encourage you to talk to your counselor about medication.

 

I hope my reply was helpful. You can do this, especially given you trust and feel safe with her. Good luck.

 

Best regards,

NGonzalez

Customer: replied 5 years ago.
Thanks for your feedback and although i appreciate that further disclosure to my counsellor would be beneficial in terms of expanding on the more dormant issues i feel i have, i still feel that even the issues that i have discussed with her, such as the paranoia, tendancy to over react and become obsessive in my behaviours she has offered few strategies or solutions.

my counsellor and doctor do not share information , for some reason the 'system' prohibits this, so in terms of medication i would need to discuss with my doctor who is reluctant to prescribe due to my age.

I suppose my real question is if i were experiencing a MH type disorder,such as a personality disorder or passive dependancy, what strategies or medications could i explore or ask about in more detail to my clinicians to make my life more manageable? and do any of my 'sympotoms' sound typical of any disorders that you are familiar with that i could perhaps explore in more depth to try to gain an insight into my behaviours adn thought patterns. I have also tried CBT but i have too much awaraeness for this to be effective.

Expert:  NGonzalez replied 5 years ago.

Thanks for your reply. I'm not sure why they cannot talk to each other, this is vital for continuity of care. If you signed a consent giving them authorization to exchange information would that make a difference? Its something to consider.

 

If your doctor has concernes about prescribing you medication that means you are left with making a choice. If you think it would really make a difference and want to try medication again you can talk to him about how important it is to you and why. If he still refuses and you want to take medication you may need to ask for a second opinion. GPs are conservative about prescribing psychotropic medications. You should probably see a psychiatrist or ask him for a referral.

 

Similarly, if it feels like therapy is not helping you are faced with the same problem. Do you stay and talk to her about how you feel or seek someone else. If you really feel that you have a personality disorder its probably worthwhile to seek an expect in personality disorders. From what you described, its possible that you have some features but its also possible that its something else. Its impossible to know without a comprehensive evaluation.

 

There are a variety of strategies you could use (CBT being one) but given what you described about yourself and preference, some form of long-term insight oriented and/ or relational therapy may be a good fit. Dialetical behavior therapy has demonstrated good outcomes with personality disorders and is another choice.

 

Of course the first step is getting the diagnosis. You should have an evaluation first before you start considering treatment because you want to be sure the treatment is appropriate.

NGonzalez, Psychotherapist
Category: Mental Health
Satisfied Customers: 56
Experience: 15 yrs of clinical experience, relationship issues, marriage & family therapy, eating disorders
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