SWF Seeks CAP (Competent Adult Psychiatrist)


Single White Female seeks Competent Adult Psychiatrist. (Those not covered by my insurance or who have leather couches smelling of mothballs and insanity need not apply).

Seeking out a new psychiatrist is never easy. The psychiatrist-patient relationship is the most sacred and intimate one I know of outside of the bedroom. (And don’t get me wrong, it should stay that way. If it’s not…then you have real problems).  It has recently become time for me to seek new representation, for lack of a better way of saying it, and I set about my arduous journey methodically.

I started in the most logical place- my insurance company. After all, if the provider isn’t covered, I cannot afford the care and it becomes a moot point, right? So, off I go to the website of the insurance carrier that the state of Arizona has chosen to represent its employees in sickness (you may do your own research if you need names) and sought names and addresses of qualified clinicians. The website seemed pretty straightforward and produced an impressive 22 names.

I’ll spare you the three weeks of calls and call backs and cut to the chase. Out of 22 names, only seven were actually currently practicing psychiatry and accepting new patients. The rest were a hodgepodge of out-of-practice shrinks or family physicians that do not actually see mentally uneasy patients.

Out of the remaining seven, I actually got an appointment in the near enough future to make it feasible and booked a morning meeting. Dr. Freeman (names have been changed to protect the totally inept) welcomed me with a cool handshake and a “Nice to meet you Mrs. Cleveland.” We entered his very bare and antiseptic office and he sat on his left leg like a child before putting on his serious doctor face.

The next hour and a half- yes, ninety minutes- was like pulling teeth. He asked me to “please construct my illness from diagnosis to present, including all medications taken and reaction to them.” Um…well…seriously?

I was diagnosed at nineteen years old (if you do the math that’s fourteen very long years ago) in a manic state, followed by a lot of medication tweaking. That alone isn’t truly conducive to remembering medications with unrecognizable names and their dosages, much less how I reacted to each of them. That was swiftly followed by losing my only brother to suicide, which resulted in being drugged up even more, then a series of ECT treatments, which (please forgive me if I’m wrong-you are the professional here, right?) result in memory loss as well.

He mentioned over and over again to “Mrs. Cleveland” (although we clearly covered in my history that I am not married, not ever have been) that he is unable to help me if he does not know everything about my past treatments. I dutifully offered to get him my full records from previous doctors, but that suggestion was met with clear disdain, and it was very carefully explained to me that other doctors simply do not take the kind of detailed, careful (ahem- anal) notes that he does, and he “rarely finds them helpful in any way.”

Well, then. How did I ever find myself so lucky as to have landed my bipolar ass in the only competent psychiatrist’s office with no carefully detailed personally taken records on me? Dr. Freeman couldn’t believe it either.

After a long silence and some heavy sighing (on his part- not mine), he got right to the point. “Well, Mrs. Cleveland, I am not sure how you came to be sitting in my office today, since my specialty is child psychiatry.”

Whoa! Back the tuck up here! A CHILD psychiatrist? Of the many thoughts that flooded my brain, three stood out to me. First of all, why the hell did my insurance company send me to a clinician who does not treat adults? Second, why the hell did he wait until after that agonizing ninety minutes to reveal his “specialty” to me, when I clearly walked in the door as a 5’6” woman with no parental escort? Third, and most importantly to me, if this man was so clearly unpleasant and unbearable to a grown woman in charge of her own care, how in God’s name did he relate to children?

In the end I took away some good from the craziness. Yes, I was unbelievably frustrated to have taken time out of my life to indulge this man in his sadistic patient history techniques. However, he did make a very good point. It is very important for me to go back in any notes I may have from my experiences (most likely in the form of personal diaries and journals) and gather all the details of my reactions to medications tried in the past I can. He was probably right in that doctors have different styles and practices that may not translate well to another. The best way for me to take control of my care is to be my own advocate. Thank you, Dr. Freeman. Point taken.

Secondly, I did walk out with a referral to another doctor who actually specializes in adult psychiatry that happened to be covered by my insurance. According to Dr. Freeman, they have similar styles and expect a lot of background information from their patients, but somehow I feel more prepared to enter into my next appointment armed with as much personal documentation as I can dig up. I am quite serious when I say that I took away the importance of being my own advocate.

Looking back on the experience, I do feel as though I should have been sent to “time out” in the corner with a dunce cap while being told “bad patient!” Dr. Freeman may specialize in children’s issues, but it is clearly because he has no earthly clue how to relate to an adult. I can only hope that he is an entirely different professional when someone underage walks in the door.