Psychologist vs. Psychiatrist

My BPD seems to be especially florid these past few days. I keep thinking about my psychiatrist and whether she likes me or not, among other random thoughts. They don’t let me study. I can barely concentrate with all the noise in my brain.

So in my previous post I mentioned I went to my med school’s psychologist initially to seek help for my depression. That was last year, when it all started. Fast forward and I’m no longer seeing this person as my therapist (thankfully).

The reason I stopped seeing this specific psychologist was a very BPD thing of me. After finishing my first year of med school I went to a research internship in another city. Because I was leaving and my depression was still very palpable and present, the psychologist told me to periodically email her with updates about how I was doing (weekly, like our therapy sessions) and to return home immediately if things got worse. I was hesitant at first to write her emails and keep in touch, because I tend to get ridiculously attached to people (spot the BPD trait!). However, I told her I’d do it, and I did, at first. I sent her one email, which she answered. I sent her a second email….no answer. I’m still waiting for an answer, actually.

That was it. The end. Finite. No more contact with the psychologist. My irrational brain was telling me she didn’t care about me and that’s why I didn’t email her again, ever. I felt let down. Crushed, to be precise. How could this person, who had helped me so much during this time, do this to me? How could she forget about me and just walk away? Just like that? She had abandoned me (spot the BPD trait #2). Even after returning home when the internship ended, I didn’t contact her or schedule a session with her again. I still see her occasionally walking around the school, we bump into each other and I feel forced to say hi.

Now, just a month or two before I left for the internship I started seeing a psychiatrist, who eventually diagnosed me as having MDD and BPD. I was having weekly sessions with her and the psychologist by that time. She also asked me to email her and keep in contact during the summer. So I did. I emailed her. And she responded each and every email I sent her during the internship. My emotional brain got attached, and the relationship with this doctor grew.

Finally, I decided that what was better for me was to stay with the psychiatrist only, as both my doctor and therapist. I’m a little biased as I’m interested in doing my residency in Psychiatry, so take this with a grain of salt. The reality is that I prefer that the person who manages my meds be also the person who gives me therapy. This doctor knows me like no other person, and she demonstrates she cares about me and gives good therapy. The psychologist made me feel judged at times, she answered her phone during therapy, and worst of all, she made me feel abandoned when I most needed her (spot the BPD trait #3: I know I’m demonizing her a bit, black and white thinking).

So that’s why I ended up only seeing a psychiatrist and dropping the psychologist. Abandonment is the worst crime you can commit against someone with BPD. The problem is, now I’m absolutely and ridiculously attached to my psychiatrist. I have her on a pedestal, she can do no wrong. However, I’m constantly on edge waiting for the moment when she’ll let me down. I know it’s going to happen, it’s just a matter of time (BPD trait #4).

Still, I wish it weren’t like this. I really hate how obsessed and attached I become to certain people. It’s sickening, it drives me insane, it distracts me from my own life (what life?). It’s a problem I’ve been meaning to tell the doctor but am too embarrassed to even remotely bring it up during therapy. But I need help. I can’t keep demonizing and idealizing people. It’s no use, it does me no good.

What do you think?

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