Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Thursday, January 01, 2009
Ringing In A New Year!
It's over. It's over. Can I tell you how glad I am it's over? Did anyone have a good year? Michael Phelps seems to have managed okay. And somehow I think Barack Obama enjoyed 2008 more than he will enjoy 2009.
The rest of it: it can be done with.
We saw the worst stock market decline in 77 years with the S&P 500 down about 40 percent. Banks failed, housing prices failed; who's next in line for a bailout? Lehman Brothers liquidated, Merrill Lynch sold out, the list goes on.
We're still fighting a war in Iraq, and Afghanistan. Terror in Mumbai, continued unrest in India and Pakistan, the war between Georgia and Russia, nuclear power in Iran, and Hamas and Israel continue to fire on Israel with no signs of peace.
An earthquake in China, floods in the midwest, I lost count of the hurricanes-- Ike and Gustav, to name a couple. Wildfires in California.
We've learned that a single man can steal tens of billions of dollars over the course of decades without being detected. And a governor can try to sell a senate seat. Trust-- what's that?
I've ignored whole continents here--
Time to move on.... Here's to hope for a better 2009. I'm ready.
Posted by Dinah on Thursday, January 01, 2009
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We DID have the most amusing Presidential race in my memory. There was great fodder for comedy sketches which was put to good use. The most amazing, inspirational, intelligent man won the Presidential race. Since Obama's popularity took hold, suddenly it became OK to be intelligent in America... and OK to be black.
In my backyard, a fabulous new Academy of Sciences opened in San Francisco. I saw wonderful opera at the SF Opera this summer and through December plus a terrific SF Ballet Nutcracker. There were inspiring art exhibits all year at the DeYoung Museum.
In my personal life I restarted school after a 30-year gap and discovered my brain is intact and I am able to compete successfully with 22-year olds.
I lost a shocking amount of money in a proportion similar to the general decline of the stock market and I did NOT have a cent invested with Madoff in his Ponzi scheme.
There's really a lot to look back on that was positive for me.
I have a question on my mind that I've been wanting to ask and have never taken the time to. Maybe you could shed a little of your infinite psychiatric wisdom on this situation in a blog post...? ;-)
Earlier this year, I was fortunate to be connected with the psychiatrist I now have, who has helped me handle some seemingly impossible things. But, there's one issue about this pdoc that I can't get past thinking about almost constantly...
Most of the time when we see boundaries addressed, it is in the context of appropriate/inappropriate physical contact. But what I can't find many references to online is about boundary issues connected to routine everyday things, as I explain further below.
Up front, I was provided with any/all contact phone numbers for the pdoc. (office, home, cell) My past pdocs have never given up such.
At one time, I couldn't afford to fill a prescription, there were no more samples, and it was a holiday weekend, so pdoc gave me $20 to get it filled rather than go without. It was a little awkward, but its all we could do at the moment, so I shrugged it off.
Most recently during a session, after expressing worry about something that was going to happen with my financial situation, pdoc offered me the amount needed to fix the situation, from the office's general accounting. Two nights later, here I sit with a check that I so desperately need to use, but at the same time feel that I shouldn't.
I know that pdoc has done similar things for other patients before, so is it truly a boundary violation if it is simply a gesture of assistance, and something pdoc does regularly?
Perhaps the blog authors will answer your question, but in the meantime, won't you consider talking to your pdoc about this? I would directly ask my pdoc that question if I felt as you do.
I know that I had a discussion with my pdoc about my worry about an upcoming change in my financial situation as possibly affecting my ability to afford to see him and he told me that if/when that would occur I should ask him and he would adjust my rate downwards. I have continued to be able to afford the rate and have not asked.
You might consider the money to be a loan and proceed to start paying him back a little at a time as you can afford it or when your circumstances change you might repay him in full in a lump sum.
I am a school teacher in a very poor area and I occasionally give my students money for lunch or money for a bus if they ask. One of my girls (14 years old) came to me in tears because she did not have enough money to buy a ticket to the winter ball ($18) and I gave her the money. I was a faculty chaperone at the dance and was SO proud to see the trouble she had taken with her hair and makeup for the event and how happy she was that night.
I had already decided to bring this issue up with pdoc next time. But in the meantime, I was just bouncing the situation off others in the know. Even if for no more than to have a balanced perspective on the whole professional boundaries issue.
Another part of this came to mind soon after posting:
-1 hour appointments have never been that, often times much longer, by pdoc's prodding, not mine
Hmmm. My pdoc has 50 minute appointments and he never goes over by more than a minute. I don't know how he manages it! If the session is pretty intense, towards the end of the session he announces that we have 5 minutes left to tie up loose ends. Also if I introduce a new topic towards the end he cautions me about the time left so I can give him a condensed version of the story or we start, then pick it up at the next session. He has other patients and a personal life. Even when I know I have been his only patient in a particular time slot, the session ends promptly and very clearly. It's not ambiguous at all. He says something like "We are going to have end now. Our time is up."
Regarding the home number and cell numbers, all my pdoc's patients have his home number and his answering machine directs patients to call him at home. When I have called him at home or on one of his work days between his patients he keeps calls to under 5 minutes. He's very good at getting right to the heart of the matter in very short order so I'd guess some of my calls even when I have been in tremendous distress may have been handled in 2-3 minutes. On my side I respect his personal time and only call when extremely distressed. When things were going really badly for me he actually urged me to NOT wait until I was at a breaking point to call. We had discussions about that. He'd rather be contacted sooner and nip things in the bud. I was trying to avoid interfering in his life. He was worried about me between visits and actually felt relief when I'd check in (when I was in crisis). That's why I think it depends on what's going on with you. My pdoc isn't looking to hear from me between sessions when I am stable.
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