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Question

Hello,

I have a question about boundary issues with my psychiatrist.

I am a graduate student and see a psychiatrist in our university's mental health clinic. I had been seeing my psychiatrist regularly (once a month) for about a year, then he disappeared. I was told he went on sabbatical and was transferred to another doctor.

He is now back and have begun seeing him again. I asked him what happened last summer (probably not cool on my part). He told me that he had been in rehab. We then proceeded to talk about experiences using drugs (he specifically said he had been "popping pills") and drinking.

Don't get me wrong- I like talking to him about these things. But I am wondering if this is weird behavior? Or is he just self-disclosing to relate to me?

PS part of the problem may be because I'm developing a crush on him because of these conversations- cliche but true.   I'm not sure what I am supposed to do about the whole situation.

Thanks in advance for your advice.

Submitted: 68 days and 12 hours ago.
Category: Mental Health
Value: $15
Status: AWAITING CUSTOMER ACTION
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Optional Information

Gender: Female
Age: 34

Posted by Ralph LMHC 68 days and 11 hours ago.

Answer

Hello,
I was answering this question and as I ended, it disappeared into the ether world. What you are talking about are called boundary issues and in my years of running clinics and conducting supervision has been one of the most vexing issues. If he had briefly told you that he had been practicing while impaired and required rehabitation that would probably be ok. But since it made you feel strange, the line was crossed. What appearded to occur was ongpoing detailed description of his behavior which i believe clearly crosses the line as it does not provide you with a benefit, but ratner gives him/her the arena to discuss his own problems. You are not there to socialize This is your therapy not his/hers. You should tell him that this has made you uncomfortable and you wish an immediate transfer. Although not your responsibility, the department should be advised to protect more fragile patients.
The crush you allude to is not real,but a byproduct of therapy called transference. It should had been brought up and discussed. This individual is in my opinion clearly violating professional ethics and should at the present time not be treating patients.

Sincerely,
XXXXX XXXX
Please click green "ACCEPT" button on this page if you are satisfied with my answer so that I get credit for my work. Your feedback and bonuses are always welcomed.

68 days and 10 hours ago.

Reply


Hi Ralph, thank you for your answer.


I don't think I was clear that I also have substance abuse problems, and I thought maybe he was trying to relate to me and thus being therapeutic? That way he wouldn’t have been violating ethics?

About transferring to another doctor- I really like the rapport I have with him and would rather stay with him. He really seems to understand where I'm coming from: I've had problems with abuse in childhood, and we've bonded over that; he's talked to me briefly about his experiences with abuse growing up. He’s also pretty funny and irreverent and that is refreshing to me. I’ve never been able to tell a doctor as much as I’ve been able to tell him- usually I’m too scared. And his meds choices have worked the best for me so far.

Plus, the only other doctor available for me to see at the clinic I’ve already worked with and didn’t feel as comfortable with. And I can’t afford to see someone in private practice, so I'm sort of stuck.

So I guess I'm wondering if I should try to stick it out with him and work through the transference stuff? I’m worried that it might be a bad idea because he might reciprocate?

(BTW, I’m knew to this website- I’m definitely happy with your answer and will accept, but I wasn’t sure if I do that before or after I reply.)

Thanks again,

(edited for privacy)



Edited by TropicalMoe on 9/15/2009 at 8:26 AM

Accepted Answer

I thought you had a substance abuse problem but the level of self diclosure was over the top, no amount of your problem is helped by sharing the deatils of his substance abuse problem. I think you are rationalizing for inappropriate behavior ehavior on his part. Ask him if nhe brought it up in his supervision. Maybe he wanted foregiveness, who knows, but the degree was excessive. It is your choice, but in my opinion an older or more experienced person would not do what you described. As to likinhg him, he should be working on that as well as a poor object choice. See your concern is on it's effect upon him. Not where it should be on-what is best for you. I am sorry if i sound harsh, but in my opinion this is a serious breach of your trust. I think there most be other people available as I have worked in wellness programs and if they (admin were aware they would most likely terminate the treatment with him.) The choice is clearly yours and you should do what is best for YOU.
Sincerely,
XXXXX XXXX
Please click green "ACCEPT" button on this page if you are satisfied with my answer so that I get credit for my work. Your feedback and bonuses are always welcomed.

PS: Again clearly your call, but expressions like bonding with him are of concern to me. Comfort is important but not the only or most significant issue.

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Expert: Ralph LMHC
Pos. Feedback: 99.4 %
Accepts: 
Answered: 9/15/2009

Therapist

20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs

68 days and 9 hours ago.

Reply

Thank you Ralph,

I know that you are right and that I need to stop treatment with him, I just needed to hear it from someone else. I guess I was hoping it wasn't a breach of trust and ethics so that I could continue seeing him- usually it's the highlight of my week.

As a female engineering graduate student, I feel pretty isolated in my classes. In most of my classes I'm the only woman and the boys seem to be too intimidated to talk to me. So it's fun to flirt/talk with an attractive man my age who seems to be flirting with me too. Stupid and self defeating, but fun.

I know it's just transference, but sometimes it's hard to line up the intellectual knowledge with my emotions.

Anyway, thanks again and I'll quit seeing him. (And I think I might confront him about what's going on, as now that you've pointed out the breach of trust I'm starting to become angry about the whole thing.)

Posted by Ralph LMHC 68 days and 9 hours ago.

Info Request

Allow me to compliment you on a brave move, but do it because you believe it, not because I said it. But again I am quite confident in what I have said.
Sincerely,
XXXXX XXXX

68 days and 8 hours ago.

Reply

Thanks for the compliment.

And I'll be doing it because I believe it- I just needed my suspicions confirmed by a neutral third party so I knew I wasn't going crazy or misinterpreting what was going on.

Too bad you don't work at my school!

Thanks again and have a good night.

68 days and 7 hours ago.

Reply

Hey again, sorry to bother you. I know I'm taking up probably more than my share of time, but I just thought of something-

He and I have hugged a couple of times at the end of sessions lately- just a regular hug of like 3 or 4 seconds. Is that inappropriate too?

Sorry about the tiny bonus, but I'm a poor student Smile.

Posted by Ralph LMHC 67 days and 20 hours ago.

Answer

Hello,
A friendly hug may be appropriate. I avoid physical contact so it cannot be misunderstood. I do shake hands. Don't worry about the bonus issue. Positive comments are appreciated.

Sincerely,
XXXXX XXXX

67 days and 19 hours ago.

Reply

OK, I won't worry about the bonus issue.

I left you positive feedback last night- I wish I could leave you another one!

Thanks, you helped me out a lot in getting my thinking straight about this situation.

Posted by Ralph LMHC 61 days and 16 hours ago.

Info Request

<p>Your consideration is most appreciated! This is being sent under need info so there is no possibility that you p[ay twice. Sorry it took so long to get back to you. It was due to a computer glitch.</p><p>Sincerely,</p><p>Ralph LMHC</p>

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