Therapist won’t work with me anymore unless I take drugs

[TinaTeaspoon54321]

I am 5 months pregnant so this feels particularly unfair. I know people can and do take SSRIs in pregnancy and that it’s a risk/benefit analysis. Yet I personally would prefer not to and feel confident that I can get by without. Surely that should be my decision and being able to receive support from the person I’ve already established a rapport with shouldn’t depend on this?

BiscuitLover

I would love to see the primary research you are referring to, being as you are so confident in your assertions.

There is absolutely no more information needed on how you feel or an explanation on your history

its your choice should you want to take medication or not

if your therapist feels they can not work with you unless you do they need to take this to supervision and explore why

@Newnamenewname109870
Of course the therapist can end their sessions with a client but it's hugely unprofessional, not to say unethical, to do so in the way that is being described here. In any case, with SSRIs it can take anything between four weeks and two months or more to determine the correct therapeutic dose. What's the OP meant to do for support in the meantime?

It sounds like she thinks she can’t progress with your therapy anymore. I don’t think it’s unreasonable for her to suggest SSRIs if she feels that would help your therapy to progress, but equally it’s not unreasonable for you to say no. Therapy is a relationship and it sounds like yours isn’t necessarily working out for whatever reason.

İs your therapist medically trained? İf not they should not be giving any advice at all about medication.

İs there a perinatal mental health service where you are,OP? İf so they would be better placed to advise on medication during pregnancy.

I’d also add that a psychotherapist cannot prescribe medication and I’m not sure they should be telling you that’s what you need, OP. It seems like a serious overstep of boundaries. If they are concerned they can’t work with you because the support you need is outside their remit at this time, they should refer you to a psychiatrist or back to your GP.

@CountZacular strictly speaking, a medical psychotherapist could prescribe medication ( ie a psychiatrist who is also a psychotherapist). But they usually don't.

Nah, she can’t prescribe herself. She wants to refer me.

have you seen your gp-maybe ask to see someone through nhs

Yes, this seems very unethical . If OP was more vulnerable /easily led she may have taken the drugs due to this pressure. From what I understand Op is seeing therapist due to panic attacks? If a therapist can’t work through panic attacks for at least a few months while someone is pregnant without insisting they are medicated they seem a bit useless.

OP you can probably get therapy for free because NHS primary care services usually prioritise pregnant women so you don't get stuck on a long waiting list. Worth considering. Most therapists wouldn't / shouldn't be pushing meds. (Unless your life at risk like I said earlier)

Completely agree with you SailingAround. Medication should not be first line in pregnancy due to the known small risk of birth defects. I support their use when the mothers life is at risk as the benefits would outweigh the risks at that point, but for a therapist to attempt to emotionally blackmail a pregnant woman into taking them for panic attacks... highly highly unethical.

I would look for a new therapist. This isn’t the right one for you.

Personally, I found SSRIs, at the right time in life, to be enormously beneficial. I took them for about 18 months and then weaned off and have felt no need to go back on them since.

But ultimately it’s about your needs and what’s comfortable for you, and any reputable therapist should be respecting that. They can decide they don’t think they should work with you. And you can decide not to work with them.

This is another valid point, I was seen very quickly for CBT as part of pain management for severe pelvic girdle pain.

Change therapists, she sounds loopy.

Agree with PPs that this sounds highly unethical. I’m 30 weeks into a high risk pregnancy and at risk of PND. I decided to start sertraline prior to IVF and it was the best decision I’ve ever made for my mental health. Always been of the opinion that I wanted to talk everything through but 50mcg just seems to take the edge off my anxiety and I’ve coped well. That said, I’ve just started some perinatal counselling for six weeks in the lead up to birth and it helps to know someone is there. Can your midwife refer you to a perinatal mental health team if there is one?

That doesn't sound right op, and the fact that she's using her position to persuade you into it sounds highly unethical. I would look for someone else anyway.

I'd guess this therapist feels out of their depth with providing therapy in your situation. I thought initially you'd come off medication during your pregnancy, comment re not taking in pregnancy and this was a long term therapist who might well in those circumstances have a good idea that you'd need to go back on medication. That scenario or self harm/suicidal/imminent breakdown aside there is no reason a counselor or psychologist should be pressuring you on this. Suggesting you discuss if medication is appropriate with your GP would be one thing, this is way beyond what is acceptable. Find someone else.

I'm sorry you've been let down by your therapist. It's so important to not abandon clients, yet I have heard many stories of therapists behaving unethically and leaving clients feeling worse.
I wonder how long she's been practicing and what her qualifications are?
The main accreditations to look for are

BACP and UKCP.

Let's get things in perspective. We have very little information about OPs condition, state of mind or history other than what she's shared. We also do not have a transcript of the conversation. It's quite probable that the therapist feels OPs anxiety is so acute that it's unlikely any talking therapies will work. I would imagine she's suggested OP speak with a prescriber (GP? Psychiatrist? MHN?) to discuss medication or has noted that she was prescribed medication before but declined to take it and her condition worsened.
If you don't trust this therapist find another. If they were was not to be trusted they'd probably just say OK, let's see what we can do and take your money.....a lot of it.

If you went to a hairdresser and said I want my brown hair blonde, but I don't wanna bleach it, they could well reply given the colour and condition of your hair in my professional opinion that's not going to work. Now it could be you have a risk averse hairdresser who is nervous it might go orange, an incompetent hairdresser or a professional hairdresser who doesn't want to take your money and you be disappointed with the results. Either way they're within their rights to say no.

No-one is coercing or bullying. No one has broken any professional code or done anything morally wrong.
OP needs to agree to disagree and part company and make it clear from the get go to anyone else that she will not take any medication.

Oh Jesus.

This is gaslighting at its finest.

Patients can and do have these experiences. I'm inclined to take the OP at face value, because she's a woman of child bearing age. You really should read Jessica Taylor's book "Sexy but Psycho" before coming out with this nonsense. Coercion, blackmail and dismissiveness happens to women in mental health treatment at an alarming rate. It's an epidemic. Don't come on here trying to convince the OP that she's wrong about her personal experiences and perceptions!

And I say this as an ACP in mental health!!!!

I am a therapist and I'm also someone who struggled with mental health in my own pregnancies. I didn't take antidepressants during pregnancy so I totally understand that you'd prefer not to take them too.
I'd never dream of telling a client what they should or shouldn't do, that isn't my job or my prerogative.
Sorry to hear you're having this experience with your therapist.

Dig your heels in. You don't have to take any pills if you don't want to. I have never come across a psychotherapist who advocates meds so yours is unusual. Remember you are in charge of this scenario and responsible for your own health. You can also find another therapist. Power to you. I hope things improve.

@RMNofTikTok
Im sure patients do have 'these experiences'. I'm sure therapists do too. Nowhere have I tried to convince OP she's wrong about anything, I've just given a few suggestions as to why a therapist might think 'No, this isn't going to work and I don't want to be part of it' It's possible that the therapist would actually continue working with her (but feel medication would have benefited a lot), but bearing in mind OP doesn't trust them I think my advice to find another therapist is reasonable.
OPs thoughts and feelings on the matter are perfectly valid, as is the therapists, as are mine.

The therapists opinions are valid but the role of therapist is not giving out medical advice and you do not give ultimatums

its not unusual to feel frustrated when working with a client this is explored in supervision