Trouble communicating with doctor


Trouble communicating with doctor


your avatar   Joan (40 year-old woman) from CA

I am a Mental Health Consumer with Unipolar disorder. I work, take Meds and live independently with my young daughters. I have Med-i-cal and am stuck with this lousy County Service Doctor who sees me for 15 minutes every 4 to 8 weeks to adjust my meds. I have a hard time telling him how bad things are sometimes, particularly if I've had actively suicidal thoughts or feelings. My family thought illness was a sign of weakness and I have a hard time opening up to him in 15 minutes. He thinks I'm doing just fine, but I'm slipping away.

How can I make this Doctor treat me seriously? He hardly knows me and he thinks I'm doing just great. Someone suggested going in with bad personal hygiene or crying to make him see. I hate false theatrics. What is the best way to open up to a doctor in this situation considering these facts: 1. The time is very limited (truth be known that 15 minutes includes their coming to get you, walking with you back to their office and out again) 2. They think I'm okay because they are use to dealing with very dysfunctional population and my personal hygiene is the last step in my regressions (come see my house they'd change their minds!) 3. I have a problem communicating openly.


    Bob Rich, Ph.D.

Dear Joan,

How frustrating for you to be treated like a customer passing through the supermarket checkout instead as a person! Obviously this fellow is not competent at helping with any problem, he is just a pill pusher.

Here are a few things you could try:

  • I don't know what 'Med-i-cal' is, but assume it's some kind of health insurance. Very well, they are the people who pay this doctor. He is therefore accountable to them. He is costing them money, because he is doing you absolutely no good, yet they are paying for your visits and presumably the cost of the drugs he is prescribing. If you have major depression, at the most 8 sessions with a competent cognitive therapist should allow you to get in control of it, and if in the future it strikes you again, you can use the same techniques by yourself, or have one or two revision sessions. So, if I were you, I would tell the doctor (face to face, or if that is too threatening, through a polite but firm letter) that you are dissatisfied with his treatment of your depression, and unless he does something to ensure you get competent counseling, you will make a formal complaint to 'Med-i-cal'. I would assume that if he referred you to a suitable therapist, the insurance will cover some or all of the costs.

  • Suppose that the insurance does not pay for counseling, even with a referral from the doctor (that would surprise me a great deal). I don't know your financial circumstances, but just imagine it was your car that had broken down. Would you be willing to pay a few hundred dollars to get it fixed? What if your television blew up. Would you buy a new one? Perhaps you might be able to save up, and pay for a counselor out of your own pocket.

  • Another option is to read self-help books. Aaron Beck has written quite a few. They are readable, and describe a very effective family of techniques. Look him up in the local Library. If you find one of his books to be relevant to you, buy it as an investment in your future well-being.

  • A final alternative is counseling by email. Costs are typically cheaper than face to face (because the therapist can answer emails from home, at any odd time), and yet it can be just as effective. For only $5, you can buy my e-book Personally Speaking: Single session email therapy with Dr Bob Rich and see for yourself.

    Look me up at

    All the best,

    Bob Rich

This question was answered by Dr. Bob Rich. Dr. Rich has 30+ years of experience as a psychotherapist. Dr. Rich is also a writer and a "mudsmith". Bob is now retired from psychological practice, but still works with people as a counselor.For more information visit:


Make it a point to learn a new skill. You never know when it will come in handy.
"Don't cry because it's over, smile because it happened."
Dr. Seuss
Guilt is a waste of energy. Acknowledge your mistakes, make amends, make peace with yourself, and move on.