“But how does it actually help? How does it work? What’s going on in my brain right now?” This series of rapid fire questions came from an intake with a woman whom I’d just slapped a PTSD label onto. Label? Slapped? Really? I know. It has been a long journey to get where I am. And I recognize that labels don’t usually help people as much as they do with insurance reimbursement. But I’ve learned a lot. “Well your brain experienced a lot of trauma and now it’s extra sensitive. Zoloft can be super helpful. It works on serotonin.”
“Yeah, ok. But what’s wrong with my brain? How does the serotonin help fix it?”
And then the floundering half answers poured out of my mouth in an attempt to answer her questions and help her feel like Zoloft was a good option. So much about that is wrong. I’m going to blame it on baby brain, burnout, and lack of experience, because this scenario happened about 9 years ago. But I’m so glad it did! That single patient encounter told me that all those fancy journals I was reading and all the residents I was teaching did little to help the person in front of me. The person with clear, solid questions that I served up with green jello answers. Shaky, at best. Not because I didn’t know. I just didn’t know in a way that would be helpful to her. Her real question? “Can you help me?” To which my gobbledy-gook answer did not go over well. She didn’t return for her follow up.
This ever happen to you, Reader? You feel like you kind of, probably, mostly know the answer but then you pull back and hedge because you’re either not sure enough or feel like you don’t want to slide out of your lane. That feeling? That comes from you probably never getting the whole story to begin with! And I’m not talking about the gritty painful details of this woman’s trauma, I’m talking about your professors that glossed over neuroscience or mentioned medication as something that’s someone else’s responsibility to address.
You never even had the chance to decide how that stuff would sit with your clients. How to spin your own ways of explaining how things go “wrong” in the brain and what medications might be able to do to help. How can you answer questions that no one ever gave you the opportunity to feel out, discuss, and get comfortable with talking through? You’re left confused about what you can or can’t talk about and your clients are left waiting to see a prescriber in 3 months for 15 minutes so they can get “all their medication questions answered” because you don’t want to practice outside your scope. Which is something you should feel good about! ☺️ Except what I’m talking about here isn’t actually outside your scope; you’re exactly the RIGHT person to talk about this with clients! When you put off the uncomfortable med and brain conversations, clients can’t get better as fast and may not feel like you trust them with the information that you must have about this. How could you not know? You’re the best therapist they’ve ever known and this is the best they’ve ever done in treatment. They just still feel like there’s so far to go and why is it always so hard? Will this client eventually drop out of treatment? Will they get the help they need or just give up trying and rely on Reddit and fall down Google's rabbit hole?
But if you had resources tailored to you, your background, your training, your clients, you might be able to keep all of those demoralized, "un-help-able" clients. At least for a little while because they'll respond so well in treatment that they’ll finish up with amazing gains. Being able to explain details about the amygdala or DMN in a client who suffered trauma as a child can be so validating! But what good is it JUST telling them what’s wrong? You can also explain all the different ways therapy is awesome AND what medications might be able to do on top of that, what options may be a good fit. Your clients will get more out of treatment even if they never start meds! Having options and being informed helps people take meaningful action which can lead to profound gains and benefits. And they feel like you get them and they finally understand what’s going on. How amazing does that sound? Find out more from my first ASWB-approved CEU course by clicking below! I mean you’re practically there. You already know a ton about what trauma can mess up, and the ways therapy can help. Imagine the confidence you’ll feel when you can dig into some of the neuroscience when a curious client asks. Or being able to talk through types of helpful medications with the timid client who only went to a psychiatrist once and hated everything about that experience. Feel that profound joy that comes from helping someone in exactly the way they need it. Pull medications and brain science of trauma into your comfort zone. You can feel confident talking about these topics with your clients and you’ll be known as the therapist who really knows, because you really get it. Remember! If you reply before 7/1/24 when this course goes "live" it's FREE!! 1 CEU ASWB approved! Happy Almost July! Cheers to healthy brains, Dr. B Jessica Beachkofsky, MD Your friendly online psychiatrist! p.s. FREE CEU on trauma! All about brain science and meds + a little psychedelics too! Reply by 7/1 and I'll send you course access for $0!! p.p.s. This was a lot. Have an awesome week! You're fabulous and don't forget it! p.p.p.s. That number and word you thought of? Take __number__ % off of 0$ for this __positive adjective__ course when you reply to me now!! |
Brain Bites is all about broadening your reach with easy-to-digest psych knowledge! Join me for quick, interesting medication and brain science tidbits! Elevate your therapy practice with insight and data from your friendly online psychiatrist!
It's well into summer here in sunny (and thunderstormy) Florida! And that means time for me to take a pause for a couple of months. Not just to chill (wouldn't that be nice!) but to study for my Menopause Certification! (See? It's telling me to take a pause right in the name!) Hardcore studying for something feels weird. I read journals and take courses all the time but I usually do that for "fun" or just to add to my bank of information about mental health. This is new. this is what I feel...
Jarod was 56 years old and super anxious. He'd been a nervous kid, a stressed out teen, and was nearly incapacitated by his anxiety as he moved through adulthood. He'd worked with multiple different psychiatrists, and I was consulted because he just wasn't getting any better. How much longer can I go on like this? he wondered. Before we'd met, Jarod paid $400 out of pocket for pharmacogenetic testing. THIS will have the answers! Except... It didn't. Jarod was devastated when his results came...
Introducing: SertraGlow™ Feel more like you again, with support that starts from within. Crafted from a proprietary blend of serotonin support agents, SertraGlow™ is designed to help you: ✨ Enhance emotional balance ✨ Increase your resilience to daily stressors ✨ Support overall mood wellness ✨ Reconnect with what makes life joyful With daily use, SertraGlow™ may promote: Calm clarity in chaotic moments Renewed motivation to tackle your goals A brighter outlook that feels more like home 💊...