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Physician, Heal Thyself

October 4, 2012

Last week, Joanna wrote about a wonderful experience she had in an urgent care facility. Wonderful because she was treated as a normal human being rather than just treated as “fat” — not wonderful that she had to go to an UCF.

I also had an experience last week, but mine was definitely not what could be considered “wonderful.”

I have stated before that I am a survivor of extreme abuse. How I was literally starved by my parents growing up (only one small part of my abuse).  I also have PCOS (polycystic ovarian syndrome/disorder) with insulin resistance (IR). My goal these days, where my body is concerned, is to be healthy (by evidence of true measurements of health), rather than to be thin.

Because of some issues that have cropped up between me and my former therapist, I am in the process of finding a new therapist. Friday, I had a “second interview” with a potential therapist. The “first interview” had been a few questions I asked him on the phone before I scheduled the appointment.

If there was such a thing as “bad therapist bingo,” this therapist would have scored a blackout.

I won’t go into all the things he did wrong, most of them aren’t germane to the idea of Size/Fat Acceptance or Health at Every Size®. What he tried to push about my weight was bad enough.

On one of the forms he had me fill out, he had a space for my height and weight. I was displeased to see that because we are talking about a counselor here. In all my years of going to counselors, I’ve never had to state my height and weight.

I put a question mark in the weight section. I really don’t know what my weight is. I don’t own a scale and have refused to be weighed the last few times I’ve gone to a medical doctor. I figure once a year is good enough, and my clothes are the exact same size they’ve been for the past five years, so there’s been no dramatic weight gain or loss.

When we went over that part of the form in session, he became outright antagonistic with me. It turns out, he was using that section as a shortcut to diagnosis.

How many times has that happened with medical doctors? “Your problem with x is that you’re fat. Lose weight, you’ll be fine!” Where x, of course, stands for anything that is wrong with you that the doctor doesn’t want to deal with.

I have never had a counselor try to use it as a diagnostic tool, however.

Yes, increased weight CAN be a sign of depression. So can loss of appetite. So can a lot of other things. And since I went into the office stating, “I’m depressed, and have x, y, z diagnosis,” he should have taken it as given.

Instead, he was trying to convince me that 1) my not knowing, 2) my not caring, and 3) my not trying to reach a “normal” weight was all signs of depression and lack of self-care.

I was already irritated at things he’d said (just because I was born into a family with a preponderance of alcoholism and drug abuse, that means I was “born addicted,” among other things), but I became angry at this.

First, he’d not heard about the starvation I’d endured as a child.  Second, he’d not asked if, or how long, I’d ever dieted in my life, let alone the results. Third, he didn’t even ask what PCOS was or what its symptoms are (IR and weight gain, as well as other things). He just looked at me, all size 22-26 of me (depending on clothing manufacturers), saw that I really don’t know exactly how much I weigh, and decided I am depressed and do not engage in self-care because of that.

He did not ask any questions of my daily diet or exercise regime. He didn’t know that I’m a purple belt in karate or how, even though our dojo self-destructed and we’re still searching for a replacement, I keep practicing what I know daily. He doesn’t know about the bike and my struggles to ride it due to my fear of cat calls. He doesn’t know about the daily walks I take with Piffany, my Yorkshire Terrier, or how many times a week I go hiking in Garden of the Gods.

My weight does not define my health, whether it’s physical or mental. My weight does not define whether I’m engaging in self-care, or whether I’m depressed or not. Not just my weight.

I explained, rather heatedly (since I was feeling attacked) that I am a Size Acceptance activist and that my weight had no bearing on anything. He tried to give me grief about my physical health, and I told him in no uncertain terms that I wasn’t going to see him for my physical health, that I was there for my mental health. I told him that my physical health was fine, according to the real indicators of health (e.g., blood pressure, resting heart rate, cholesterol). When he continued to try to press me about being “as overweight as [you] are,” I explained a very little bit about the starvation as a child, the PCOS and IR. And then I told him that my weight was definitely not open for discussion.

He dropped it then. But I had the feeling that this would not be the last I heard of that.

The kicker on this? He wasn’t within “normal” weight himself. As he was attacking me, I really wanted to turn the tables on him and ask him why he was so depressed, and why he wasn’t engaging in self-care. But I’m not that way, and he’d done quite a few other things in that session that shocked me into not really being able to speak coherently. Staircase wit, I had it in spades on Friday.

Needless to say, I will not be going back to see him.

I’m actually kind of proud of myself. I stood up to an authority figure and made him back down (at least for that day). I engaged in appropriate assertiveness and did not let him pigeonhole me without answering back.

The thing is, I shouldn’t have had to.

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18 Comments leave one →
  1. vesta44 permalink
    October 4, 2012 10:36 am

    Yay for you standing up for yourself and making him back down, and shame on him for not addressing your concerns about your mental health at all. Yes, physical health/appearance can sometimes give an indication of mental health, but when a patient tells a therapist that her physical health is just fine and her appearance (meaning weight) is of no importance, said therapist should take her word for it and not continue to belabor those points. Hopefully you can find someone who will take you at your word and give you the help you want without the concern trolling you don’t need.

  2. Duckie Graham permalink
    October 4, 2012 12:42 pm

    http://www.haescommunity.org/search_registry_results.php

    maybe this will help folks – the HAES page keeps a searchable registry that includes psychologists, social workers, counselors, and life coaches among many others.

    As a mental health provider myself, I’m sorry to hear about your experience with this fool and am embarrassed to admit that some of my professional peers can be like that.

  3. October 4, 2012 12:43 pm

    We often forget that even though we go to therapists because they are supposed to be educated, wise, and sympathetic, they do not have authority over us. Ultimately, we HIRE and can FIRE them without apology, especially when it’s blatantly obvious they’ll be no help. They are supposed to be our sherpas to self-actualization. They work FOR us and they’re supposed to work WITH us. They are not our parents, bosses, and certainly not supposed to be our bullies.

    Be sure to get on YELP and leave a review detailing your experience and save others from this man’s special brand of “help”.

  4. October 4, 2012 12:52 pm

    Sheesh – you would think at least he’d let you get past the “getting to know you” part before just jumping right to a baseless diagnosis… This is yet another reason I just try to manage my crazy on my own… I think if I had to go deal with someone like that I would end up wrecked. Good for you for not taking it!!

  5. Deadgrrrl permalink
    October 4, 2012 12:59 pm

    Fascinating that he thinks nothing of worsening your mental health through bullying and bad medicine (medicine beyond his scope!)… What is it? Job security? Since 95% of wt loss attempts fail, those people will always “be depressed,” and YAY lifetime patient!

    What a crock of crap.

    YOU ROCK for speaking up like this. But good luck on your search.

  6. LittleBigGirl permalink
    October 4, 2012 1:02 pm

    Un-fucking-believable. I am limiting myself to typing a response, when what I really want to do is hunt this guy down and break my laptop over his head. The one place you need to feel safe, the one place you should absolutely NOT be judged, is therapy! When you said that he used weight to diagnose I went back and reread thinking “Oh she must mean she was looking for a *physical* therapist, because no *mental* therapist with 2 brain cells to rub together would *possibly*…” but no, you were talking about a mental health professional – and I use the term “professional” loosely. Judging someone’s mental state by THE WAY THEIR BODY IS?!? Unacceptable. Mental health therapy is for invisible injury. Psychologists don’t set broken bones any more than ER techs spend time walking people through CBT exercises. Mental health and physical health are definitely connected, but they’re not interchangeable! I can actually *feel* myself growing another layer of cynicism right now, just to prevent a brain aneurysm…

    I am grateful for my therapist – she is the one who sent me a link to Ragen/Dances With Fat, and turned me onto SA/HAES in the first place! Keep looking bronwen, they *are* out there! *HUG*

  7. bronwenofhindscroft permalink
    October 4, 2012 2:46 pm

    As usual, one size does not fit all.

    What is “a small amount of weight loss”? How much is needed to “likely” start up your menstrual cycle and ovulation? What if you’ve had a “small” amount, or even a “large amount” and it’s done jack crap to help?

    And here is the problem with “one size fits all” diagnosis or “answers from the web”. They. Don’t. Fit.

    I am almost 46, and been infertile since I was 14. Yes, after the first 6 months of being so regular you could set a calendar by me, I went to once a year. Then once every two years. Eventually once every 3 years. I was told by doctor after doctor after doctor that “all I had to do was lose weight” and I’d have my menses back and be able to have babies. It wasn’t until 1998 that I was officially diagnosed with PCOS, and I was told to lose weight and it would go away.

    I was told, by doctor after doctor after doctor, that I must not have wanted to be pregnant bad enough, because I “refused” to lose weight. This was when I was engaging in bulimic and anorexic behaviors. (More anorexic, but every so often I would binge.) Note: I did not say I was bulimic or anorexic. Just that I was willingly engaging in those behaviors to try to lose weight.

    I’ve been on every diet I could be on, both medical and fad. I’ve been on the metformin which DID make me lose weight, 70 pounds of it, for two years. When my body finally adjusted to it, and the weight started coming back on, the doctor blamed me for becoming so fat again.

    So, no. Sorry. As far as I have lived in my body, this is crap. Weight loss does nothing for me, in controlling the symptoms, in starting up my cycle or allowing me to ovulate. It takes a superhuman effort to drop even 2 pounds (without drug intervention), and when I have drug intervention, my body grows used to it.

    If I sound defensive about this issue, it’s because I am. I’ve read crap like that posted for many years (and this isn’t the latest research, btw). I’ve had to deal with being blamed for my own inability to “get pregnant” because I’m obviously choosing to be obese. My first husband left me for another woman (using the phrase, “at least she’s a proven breeder”) after almost 10 years of marriage, because having children became extremely important to him. Yeah, it was just as important to me, maybe even more so because I can remember being 5 years old and wanting “to be a mommy”. That goal never went away.

    So, people who write stuff like what you took from whatever website you visited can just kiss my fat ass about how “losing weight helps.” It doesn’t. Not in every case. Definitely not in MY case.

    • Werner permalink
      October 4, 2012 3:02 pm

      Studien haben gezeigt, dass so wenig wie 10% Gewichtsreduktion wirksam sein kann bei der Wiederherstellung der normalen Eisprung und Menstruation. Dies kann dazu beitragen, das Niveau der Androgene im Körper und kann sogar dazu beitragen, Ihre Symptome und machen die Behandlung von Unfruchtbarkeit effektiver. Regelmäßige Bewegung ist auch gezeigt worden, um die Symptome von Depressionen zu reduzieren und die Qualität des Schlafes sowie.

      • bronwenofhindscroft permalink
        October 4, 2012 3:15 pm

        From Google Translate:
        Studies have shown that as little as 10% weight reduction may be effective in restoring the normal ovulation and menstruation. This can help reduce the level of androgens in the body and can even help improve your symptoms and make infertility treatment more effective. Regular exercise has also been shown to reduce symptoms of depression, and sleep quality.

        And what part of, “I lost 70 pound on metformin and it did nothing for restoring normal ovulation and menstruation” did you not understand?

        Or are you just calling me a liar?

        I’m calling asshole on this one as well, because whomever this person is is questioning the validity of my statements, both in the answer to “Sharon” and in posts elsewhere.

      • October 4, 2012 3:16 pm

        Filterung unausstehlich MEINUNGE durch eine Übersetzung-Generator überzeugt jedermann nicht, dass Sie nicht Fat Bastard. Schleicht ‘s euch, Werner-von-Dipshit und ein verdammt Hobby zu erhalten.

        (Translation: Filtering your obnoxious opinions through a translation generator does not convince anyone that you aren’t Fat Bastard. Fuck off, Werner von Dipshit and get a fucking hobby.”

        Peace,
        Shannon

    • October 4, 2012 3:02 pm

      Ignore Sharon, Bronwen, it’s Fat Bastard.

      Peace,
      Shannon

      • bronwenofhindscroft permalink
        October 4, 2012 3:12 pm

        Ah. I was being relatively nice, giving “Sharon” the benefit of the doubt. Now I wish I’d just have called it for what it is: A dick move.

        Live and learn, I guess.

        • October 4, 2012 3:16 pm

          Well, I guess I am the Fat Bastard expert, sadly. 🙂

          Peace,
          Shannon

      • The Real Cie permalink
        October 7, 2012 5:28 am

        Oh–now he’s cross dressing. How unbelievably clever of him.

    • bronwenofhindscroft permalink
      October 4, 2012 3:16 pm

      Calling “asshole” on Mercel as well.

  8. Ann Mouse permalink
    October 6, 2012 3:47 pm

    I’m so sorry you had to go through that. I recently had a Tale of Two Doctors experience myself. I was tired all the time, having trouble focusing, nauseous, dizzy, couldn’t seem to keep food around long enough for it to be digested, and I’d been gaining weight to the point none of my clothes fit anymore.

    Doctor A, who I’d been seeing for 3 years was really unhappy about my weight gain. He wanted to know about my exercise habits and I told him I couldn’t do as much as I’d like because I was always tired and exercise was exhausting. By exhausting, I mean I’d be feeling ready to pass out after doing my grocery shopping at Sam’s Club and needing a nap after I put everything away. Blood work revealed my cholesterol levels shot up when they’d previously held steady. Aha! My weight gain caused the increased cholesterol and I’m depressed because of it. Eh, not so much.

    I’d only seen Doctor B a few times. He also noted an my weight gain, but as a symptom. His primary concern was how much trouble I was having in my day to day living and so worked out an evidence-based diagnostic plan. Depression never entered the picture. It turned out I had hypothyroidism and many of my symptoms went away with treatment, including the high cholesterol, although the weight I gained remains. A good doctor is worth my weight in gold. I don’t know where I’d be if I’d stuck with Dr. A’s diagnosis and treatment plan but I don’t think it would have been on a path to health.

  9. October 7, 2012 5:27 am

    This schmoe is an asshat of the first order and has no business being a therapist. Unfortunately, as my old pappy always said, the woods is full of ’em.

  10. October 9, 2012 11:15 am

    Well, I guess we now know an indicator that your psychiatrist is a dickweed: asking a prospective patient’s weight is unnecessary, unless we’re deciding the dosage of certain medications.

    Peace,
    Shannon

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