Should I see the school psychiatrist?

• My professor is requiring that I see the school psychiatrist. What should I do? Sorry, this is terribly long, but I feel that the back story is necessary to understanding why I was referred to the school psychiatrist in the first place. I am in school for a health career that involves interaction with patients. We has an assignment to interview patients in groups in a hospital, and our teacher asked for a volunteer to do a solo interview that she would personally observe. Nobody was volunteering, and I thought it would be good practice, so I volunteered to interview the patient solo. I was significantly more nervous about being observed than I thought I would be, and could feel my hands shaking. The patient had an incredibly complex history, and I wanted to do a good job, so I took copious notes to try to keep track of the details of their many issues. I realized that in an effort to understand the patients multiple issues, I had deviated from the usual interview structure, and skipped a few important questions. I looked back at my professor to see if she had any feedback. I was nervous and could tell that the interview was not going well. My professor was frowning. I wasn't sure how to interpret that, but I figured the worst thing would be to miss an important piece of information, so I asked the patient more questions, I asked the questions that I had skipped, and attempted to gather as much information as possible. It was the worst interview I had ever done, but I felt that I got all the necessary information. After the interview, my professor took me aside and said "That was terrible. How have you even made it this far?" She explained that I went too long, was disorganized, and that she didn't understand how I had been allowed to pass my courses related to patient care. I tried to apologize, and explain that I was extremely nervous, and that this wasn't typical for me. I agreed that I was disorganized, said that was something I was practicing to try to improve, and asked if she had any specific suggestions. She just kept shaking her head and saying "That was really really bad. I thought you could do this, but clearly you can't." I was particularly hurt because she had taught a course on building empathy. I had been in a discussion group with this professor, and we has confessed our deepest fears and anxieties. This professor had a reputation for being cold, but I gradually came to trust her. I thought she had gotten a bad rap - she seemed like a shy but caring person, a good listener, and very human. That's why I was so shocked that her feedback was so negative. I told her I was going to practice interviewing with a special eye for organization, and asked her again for specific suggestions on how I can improve. She said that I took too many notes, and went too long. "You weren't present at all! You weren't even listening to the patient! You didn't have any empathy at all. How did you have us all fooled?" That hurt a lot. As much as I tried to fight it, my eyes started watering. She said that I would need to be monitored closely by the faculty, and I nodded and said "I just want to improve. I'll do whatever you think will improve my performance." That week I met with a classmate, and worked on organization and timing. I practiced with a family member. I tried to improve my performance. I think I am an empathetic person, but I practiced expressing empathy verbally. It came time for another evaluation, and I was shitting bricks. I didn't know who would be observing me (this time behind a two way mirror), but I knew they would be watching me closely. I interviewed the standardized patient. I did almost everything in the correct order. I payed careful attention to time. I took minimal notes. I listened to the patient and made extra sure to thank them for sharing their information, and to mirror back what they were saying so that the could correct me if I had something wrong. When they mentioned that they were in pain, I reassured them that we would do everything possible to find out what was causing it, and work to help make them comfortable. I was incredibly nervous, but I thought the interview went pretty well. When my evaluator came out, she asked me how I thought I did. I said I thought I did okay, but mentioned the things I did out of order, and mentioned a few small steps I had skipped. She said that she had been asked to watch me by the other professor, but that she was surprised at how well I did, that my performance didn't fit the description given to her by the first professor at all. I thanked her, but I was really embarrassed. She asked why I thought I had done so poorly the first time, and I said that I had been very nervous. She asked if the hospital setting had made me nervous, and even though I didn't think that was the main problem, I said yes. I didn't want to say that I get anxious about being scruitinized, because there will be many more instances in my academic career when I will be observed and critiqued. She asked why hospitals made me nervous, and I said I was worried about saying something insensitive to a patient who is coping with a lot of pain or a life threatening illness. I told her that I had a family member who had been hospitalized, and had complained about the way they had been treated by staff. I told her that I didn't want to cause patients any more stress than necessary. She said that I was very different from she had expected from the other patient's email. I was so incredibly embarrassed at this point that I started tearing up again. She seemed concerned and said that if I cry that easily, I was in for a rough couple of years as I advanced in my training. She suggested that I seek therapy to work through my issues. I nodded, but didn't tell her that I am already seeing a therapist regularly. I recently got an email from the first professor saying that to pass the class, I will need to meet with the school psychiatrist to "assess my attitudes and emotional well being." So here's the rub. I have seen the school psychiatrist, and I really don't want to see her again for a number of reasons, including that I don't trust that the sessions are confidential. During sessions, she would leave my prescriptions in the common copy machine that she shares with the first professor as well as a dozen other administrators. One time she left my prescriptions there for for over 30 min, even though I asked if she could move them someone more private. She has also accused me of lying. During a session last year, I asked for my usual prescription of 150mg of an antidepressant. She said that according to her notes said I was taking 300 mg. I said that I had only ever taken 150 mg, and that she had prescribed me 150 mg in the past, but she said I was trying to exert control and wrote me a script for 300 mg. I thought I might have been mistaken about the, but when I got home I saw that my previous prescription was indeed for 150mg. I knew it would be very hard to get another appointment with her, so I took the 300 mg and was loopy for a month until I saw her again. When I saw her, I tried to explain I was having terrible side effects, and that 300 mg was too much. She said I was perseverating and paranoid. I told her I felt terrible, and asked her to look at her notes to see that she had prescribed me 150 mg in the past. She looked at her notes, and saw that I had indeed been taking 150 mg. She asked me: "Why did you tell me you were taking 300 mg?" I said "I didn't." She rolled her eyes, and I decided not to argue with her. So I have to schedule an appointment to talk to her about my emotional well-being and I really don't want to. Since the middle of last year I have been seeing a different psychiatrist who is not affiliated with my school, and he has been treating me for Generalized Anxiety Disorder. I haven't yet told him about this situation because I have been away on break, but I will see him again next week. I don't know what to do. It seems like I should suck it up and see the school psychiatrist, but at this point I feel like anything I say can, and will be used against me. What do you suggest I do? If you want to contact me, my temporary email is [email protected]

• Answer:

  Express your concerns to the dean of students. Seriously, that is their job.