Every December, I return to my family home in the USA from Costa Rica. This voyage signifies the beginning of the holidays for me, and also indicates that it’s time to see my therapist, whom I only visit once a year. During previous visits, I’ve made sure to schedule a double appointment to allow us plenty of time to review the year, current symptoms, and medications. Based on these experiences, I’d like to offer a short list of ways to maximize your time with a therapist that you may see infrequently or annually, like me.
- Keep a Journal of Your Year – I’ve been writing a short journal of each year since 2006, highlighting events that caused me stress, produced BPD reactions, or altered my behavior patterns. To be clear, the journal is not a day-by-day discussion of my life. Instead, I keep it just under 10 typed pages, covering about 12 different topics that I really want to review with my psychiatrist. I write it early in December before I travel, so that I can put together a document that has a central theme, is cohesive, and thorough. Then, I mail it in advance of my appointment, so my doctor can read it and comment. I realize this might seem like a big production, especially if you can keep an appointment agenda in your head and then discuss it extemporaneously. For me, however, I prefer to write, so that I can communicate effectively and succinctly.
- Keep Your Therapist Focused – Don’t forget that psychiatrists/psychologists are people, too. They have their good days and bad days, even if they have years of experience and countless satisfied patients. During my once-yearly double appointment with my doctor, I make sure to keep the conversation on topic and flowing. Inevitably, we might stray off on a tangent for a few minutes, but eventually one of us steers the discussion back on course. Some therapists are more chatty than others. If you have a very talkative therapist, politely remind them that you have a short amount of time to review a lot of important information. If they’re worth their salt, they will understand your concern. Don’t forget, you’re paying THEM for help, not the other way around.
- Make of List of Prescriptions to Renew BEFORE the Appointment – This might sound anal retentive, but I find writing down notes regarding my medications before the actual appointment to be great reminders. Many times, I get caught up in the discussion with my therapist, and will forget to mention that I need to renew my Effexor or Welbutrin. When this happens, it only causes stress later on when I have to either call my therapist and arrange to pickup the prescription, or coordinate a plan with my local pharmacy. Keep things simple: write down a list of eveything you take and put it in your back pocket. When you’re leaving your appointment, be sure to take it out and make sure all your medical needs are met and that your prescriptions are current.
- Ask If you Can Communicate Using Other Methods Besides In Person Appointments – If you only visit your home country once a year like I do, sometimes it’s good to know that you can reach your therapist through alternative means. Most therapists are happy to schedule phone conversations, if they are planned well in advance. If you decide to go this route, make sure you are the one calling the therapist and picking up the charges. This is a nice gesture and will avoid costing your therapist exorbitant amounts of money for a long distance call. If you’re short on cash, setup a Skype account, which allows you to call anywhere in the world for minimal fees. Note also that you will be subject to your doctor’s normal billing practices, which means you might get a copay notice from your insurance company.
Some other therapists might offer email communication, which can be an effective way to patch up any small emergencies in your life without putting an undue time burden on the doctor or yourself. Speaking personally, my doctor does not do email because of limitations imposed by her malpractice insurance. If you’re in the same boat, try to setup a call which is the next best thing to visiting in person and is permissible under nearly every insurance policy. Again, if you exchange a series of emails with your psychiatrist, it’s likely he or she will charge you for their time. Make sure you pay them and your health insurance provider in a timely manner.
I hope this list is helpful for those that don’t see their doctors that much, but still have to deal with their BPD every day. Organization is the key to success. Write down notes about symptoms you are experiencing before visiting your doctor. Also, don’t forget to write down any prescriptions that need to be renewed. Most importantly, whether you see your therapist in person, chat on the phone, or exchange emails, make sure that you use the time efficiently. Don’t waste time with off-topic discussions that don’t address helping YOU feel better.