Dr. Robert Portley is a psychiatrist practicing in Phoenix, AZ. Dr. Portley is a medical doctor specializing in the care of mental health patients. As a psychiatrist, Dr. Portley diagnoses and treats mental illnesses. Dr. Portley may treat patients through a variety of methods including medications, psychotherapy or talk... more
Whether it is your first visit or you’ve been working with mental health professionals for decades, meeting a new clinician can be a daunting task. There are some very straightforward things you can do in advance to ensure that the visit is productive and mutually tolerable as a step to building a therapeutic alliance that will help you reach your goals.
Know your history. No, not the dates of the Spanish-American War, but your own symptom and treatment history. This sounds obvious, and if you’re reading this kind of article, may not apply to you, but you’d be amazed at how many people know remarkably little about themselves. They may have taken a white pill, “a long time ago” that “had side effects”. If this is all you know, that’s fine, but just know, we’re trying to start from scratch and reinvent the wheel. If you have the opportunity to call previous doctors and ask for details, please do. If you’ve been through extensive treatment, please make a list with dates, doses, and experiences. It is much easier to have it all written down than try to remember when you are in the middle of a new experience with a new person in a new place. This will let us focus on what we can work on with you, rather than trying to piece together your history bit by bit.
Be honest. I have to tell you a closely guarded secret within the mental health community…we are not psychic. I will give you a moment to process and accept the shock and disbelief that come with that news. Ready? Maybe not, but let’s try anyways. I don’t think any reasonable clinician expects that you will share all of the details of the most painful parts of your life on the first meeting, but if you deny that those things are part of your experience, it will be hard for you to benefit from working with a therapist or psychiatrist. Instead, I’d encourage you to say something to the effect of, “yes, but I’m not ready to talk about it in more than that” if something applies that you don’t want to discuss in exhaustive detail.
If someone pushes you after you say something like that in a way that makes you feel uncomfortable, they’re probably not the clinician for you. There are certain details we need to know as a matter of safety, but beyond that, you always have the right and opportunity to share as much or as little as you are comfortable with. We are there to help you, not make life more stressful. But we can’t help with what we don’t know about, the more honest you are, even if painful to discuss, the more we may be able to help you.
Decide what is most important today. One of my most influential mentors would always ask everyone she spoke to “how can I be helpful?”. In my experience, people either know exactly how to answer this question, or it shakes them to the core where they begin to question the laws of physics because they were unprepared for the question. Please have an idea of what you are looking for from meeting with us. We are experts in depression, but if a specific symptom like energy or sleep is particularly getting in the way of your regularly scheduled programming, please tell us.
The more precisely you are able to communicate what “better” will look like for you, the better we will be able to do to explore getting there with you. Don’t worry too much if you absolutely can’t do this yet. We will help you. But if you know what motivated you to ask for help, and what you would like to be better, it is a lot easier to focus on if you can share that with us.
Remember, almost no one meets us by accident, and we are here to try to help you. If you know your own medical and personal history, be honest to the extent that you are comfortable, and know what you would like to work on with us. This will help you by ensuring that you get the most out of your first visit with a psychiatrist.