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The Challenges of Finding the Right Psychiatrist

Between my diagnoses of major depressive disorder with psychotic features, the anorexia, and the borderline personality disorder, I've worked with a lot of psychiatrists. Not to mention the multiple admissions to inpatient psychiatric hospitals and outpatient programs.

Some psychiatrists I recall quite well because their actions were egregious and ended up causing me harm. Only 2 possessed that rare combination of empathy and competence that is essential for promoting life-altering change and growth.

My first psychiatrist

In 1985, I was referred to the first psychiatrist I saw by Naomi* (my therapist). I'd been seeing her for 2 years for psychotherapy and my depression was worsening. Naomi recommended medication.

I will call this psychiatrist "Freud" because he was elderly and his white hair and beard reminded me of the famous Austrian psychiatrist. He told me he was prescribing an antidepressant. I found out much later what he had actually prescribed was a stimulant.

When I took the stimulant, it didn't affect my depression at all, but it erased my appetite. My weight dropped dangerously low, and I was diagnosed with anorexia. I don't know if Freud ever realized what he did. I was hospitalized on an eating disorder unit soon after, not by Naomi, but by my mother.

More psychiatrists and a BPD diagnosis

Ironically, I encountered one of the best psychiatrists I've ever met and one of the psychiatrists who caused me grievous emotional harm at the same time. In 1989, I made my second suicide attempt. My second hospitalization for the anorexia caused me to lose a job I'd climbed rung by rung to achieve for 8 years. When I lost a position at a prestigious company, I was bereft, and the depression took hold swiftly. I lost hope and overdosed.

On the psych unit, a team of psychiatrists diagnosed me with borderline personality disorder (BPD), in addition to the major depressive episode in which I was already ensconced. I was transferred to a private psychiatric hospital north of New York City that had a unit dedicated to treating patients with BPD.

Treatment in the BPD unit

It was there I encountered Dr. Stevens (who insisted we call him Corey) and Dr. Byrne. Corey was the chief of the BPD unit and ran the dialectical behavior therapy (DBT) program there. Dr. Byrne was assigned as my psychiatrist and therapist, and I saw him 3 times per week for the 10 months I stayed on the unit.

Corey was warm and open, and he made himself accessible to all the patients. That he let us call him by his first name was radical. He had a quality that inspired both the patients and the staff, many of whom volunteered to work with us, stigma be damned.

Looking for answers

By the time I was discharged from the unit, I was convinced I'd been sexually abused by my father. Dr. Bryne implanted false memories of sexual abuse during our sessions and at one point during my stay, I started to experience vivid flashbacks. I don't believe he did this with malicious intent. I think he believed I was truly sexually abused. I was vulnerable and was looking for a tidy answer as to why my life had turned out the way it did.

In 2005, depressed and hopeless, I quit therapy with the social worker I'd been seeing for 12 years and stopped all my medication. I quickly became suicidal. A therapist who was facilitating a women's group in which I was participating referred me to a psychiatrist for a medication consultation.

The doctor who gave me a life worth living

I saw Dr. Lev for the medication consultation, and we ended up working together for the next 11 years. It wasn't until I met Dr. Lev and she explained the nature of my illness, that I realized how sick I was.

She specialized in a treatment known as transference-focused psychotherapy (TFP) for BPD. TFP is a psychodynamic treatment that examines the transference, or the relationship between the therapist and the client.

Tools that stuck with me

Dr. Lev was whip-smart, and she confronted me when I needed to be challenged, but she could be warm and caring when I needed a tender ear.

My work with Dr. Lev saved my life and gave me a life worth living. Her favorite phrase was "What comes to mind?" When I'm struggling or trying to figure something out for myself, I hear her say that phrase in her Hungarian accent and it helps me to sort out whatever I'm stewing over.

We terminated treatment at the end of 2016, but she continues to manage my medication. Her door remains open for when I need a check-in session, even years later.

Finding the right psychiatrist

Finding a psychiatrist who practices psychotherapy is rare. Finding one who espouses competence and empathy in equal parts is even rarer. Despite the psychiatrists I encountered who may have harmed me, I consider myself fortunate to have worked with one who was by my side every step of the way.

*All names have been changed.

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