Ask a Psychiatrist for Advice in Austin, Texas

Dear Dr. Kim,

I have been meeting with my therapist for several months, and I just started feeling that I was ready to open up.  However, the last time we met by video, I saw a reflection of her screen in the diploma behind her desk, and she was playing a video game during our session.  I didn’t feel comfortable continuing.  Do therapists do this normally?  Is this what I should expect?

-Crushed in Crestview, Austin, Texas

Dear Crushed,

No.  You don’t have to expect such a low level of care for your psychotherapy needs.  And really, you should feel entitled to getting a mental health professional who is listening to you.  I think it’s obvious that, if someone is playing a video game, they would be distracted and unable to devote attention to your mental health conditions. This part is absolutely crucial—paying attention to your treatment and having a psychologist that really cares about you.  How rare is that in our day-to-day lives?  It is a central value of mental health professionals.

It’s Difficult To Seek The Advice Of A Mental Health Professional

Let me review, Crushed in Crestview: I’m going to make up a few details, for the sake of setting the context.  You got started with an Austin-based therapist, which takes self-awareness and courage, and you were feeling anxious about getting the talk therapy you wanted.  Good for you!  You suffered through several types of treatments, trying to figure out what to say and how your therapist would respond to the various types of symptoms. 

Again, this has to be pointed out:  how hard therapy is, and how hard you’re working to get a correct diagnosis.  And then, one day, you feel a higher level of connection and want to move forward with your daily life.  That’s how gaining new skills in therapy works.  Am I getting it right?

And then you’re ready to make the leap, and your trust is broken by your discovery of the video game your therapist is playing.  Crushed in Austin, I have to tell you I’m not exactly sure you’ve had an opportunity for any therapists to research and listen to you in the first place. 

Hopefully, your therapist was only playing video games once or twice.  You should be able to feel that—how well your therapist listens to the themes and your behavior as you’re talking, mirrors back your feelings.  Honestly, it’s hard for me to believe you were getting a good shake of things at the start.  But the basic, most fundamental rule of a therapist is paying attention.  I’m sorry your therapist broke that trust.

Psychotherapy and the Role of Seeing Mental Health Professionals In Person

It pains me to say I’m hearing on more and more occasions of a breakdown in some of these fundamental expectations of psychiatrists in our profession.  I am happy that we all are getting greater access to resources and therapies, and there are many benefits to tele-psychiatry here in Texas as well as the rest of America.  I do worry that, without any physical location for in-person visits to build a relationship, we are losing touch with the guidance and fundamental needs of therapy.  For example, I started a new evaluation with a young woman on a treadmill!  She was being very efficient.  But not very effective at slowing down and listening to her emotions and behaviors.  I guess she could have hired movers to bring her treadmill to my office, but I don’t know if that would’ve worked so well.

Keep Seeking The Mental Health Services You Want!

Crushed, keep looking for the mental health services you want! Maybe consider finding a hybrid provider who can also see patients in person or consult the American Psychiatric Association website.  It’s easy to remember these fundamentals when you’re seeing people face-to-face in an office.  I know finding the right treatment is challenging and involves many factors.  But you can do it. You can find psychiatrists and therapists out there with different skills and treatments.

Lastly, my different types of clinical experience over the last 20 years has only strengthened my belief that we all can be helped with our disorders, to some degree or immensely, through psychotherapy. 

Thank you for asking for a Psychiatrist’s Advice in Austin Texas

Dr. Bernard Kim
Pondworks Psychiatry & Psychotherapy
Austin, Texas