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Help! My psychiatrist and I are not seeing eye-to-eye

Q: Dear Dr. Guterson, Here's my question. I have a psychiatrist I like and respect a lot. I am comfortable with her level of expertise and her treatment plan for me. We've been together for 8 years. This time, however, I do not agree with her. I don't know how to tell her that I feel like she's not listening to me. I don't want her to think I don't trust her or I'm being disrespectful. How should I approach?

A: Thank you for your thoughtful question. The relationship between a psychiatrist and patient is certainly deep and intense. But it always needs boundaries. Because boundaries keep it safe and sacred.

You obviously think highly of your psychiatrist. You respect her greatly. First, I would advise that you look at past experience. Has there ever been a time before this where you felt she wasn’t listening to you? Or where you may have disagreed with her treatment advice? How did that turn out? Was her guidance in the end helpful - or not?

By definition, we humans are locked inside ourselves and often cannot see clearly. That’s why mentors, caring friends, and mental health professionals can be so helpful. You have been with her for eight years - so start with reviewing your past work together.

Next, any good and noble psychiatrist should not feel disrespected when a patient registers a different opinion or even a criticism. On the contrary, we psychiatrists should welcome such words. It gives us insight into our patients as well as ourselves. It opens wonderful doors of communication and vulnerability. Based on your description of her, my strong guess is that the conversation you desire will only enhance your already mutually trusting relationship. And thereby increase respect.

So talk with her. Start by addressing it as YOUR discomfort, what you’re going through internally. And on another note: your question reflects what we all go through in our life’s journey. A desire for connection. And that’s an essential part of who we are

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