Overthinking Therapy: Navigating Anxiety and Patient-Doctor Dynamics

Due to mental fatigue?

I am troubled by the fact that when I visit the doctor, I feel like I am only discussing very minor issues, and I worry that the doctor will laugh at me.
So when the doctor laughs, I say, "Please don't laugh," fearing that I won't make any progress if I keep bringing up these trivial matters.
Although some people say that if something bothers you, it is a problem that needs to be addressed, others argue that the bother itself is not the issue, but failing to address it is.
I just want the doctor, who has seen so many different patients, to not think that I am just someone who is overly concerned about trivial matters or that I am not content with my life.
Sometimes I feel like I am endlessly asking myself when I can improve and when I can stop seeking help for these minor issues, which feels almost like a joke.
Even though I talk for 5 to 10 minutes and still feel inspired, I sincerely thank the doctor, but I realize that this is another point of over-concern.
I genuinely appreciate the doctor, yet I worry that he might not perceive my gratitude (it's quite funny; I can't control others' feelings, but I feel disappointed by them).
I fear that the doctor might not see my sincerity, or...
when will I be able to let go of my preconceived notions? When can I stop imagining these scenarios?
Additionally, my doctor is male, and I wonder if I should switch to a female doctor because I find myself projecting and transferring feelings.
If I have to seek the doctor's approval even during a consultation, that would be exhausting.
I also wonder if my feelings stem from not being married yet and having an excessive admiration for authority figures, which makes me feel fond of the doctor.
Rationally, when I remove the doctor's professional identity, I realize I don't know this person, and he doesn't resemble a prince charming.
I recognize that my attraction is superficial and based on external factors.
I understand that the doctor is there to provide advice and support, yet I still worry that he might be laughing at me.
I know I am just a patient, but I excessively hope for the doctor's empathy and understanding, wishing to be someone the doctor likes and values.
I am fully aware that the doctor has his own life, but I still wish to feel valued and cared for.
When I leave the consultation room and see the doctor quickly shift focus to the next patient's records, I feel disappointed, as if I were just being "pretended to be treated." I know that empathy in the moment is enough, and I shouldn't have excessive expectations, yet I find myself doing just that.
I think my disappointment stems from noticing how quickly the doctor transitions to the next patient’s information or how he might be writing a hospital admission form or filling out related paperwork while I am speaking (I understand this is a good use of time).
I realize that all of this is likely due to my excessive concern.
I want to escape this situation, but I also want the treatment to continue being effective.
What should I do to make an effort? Thank you, but I feel too embarrassed to directly tell the doctor about these concerns; it feels too shameful, and I would want to hide away because I find it all quite ridiculous.

chia, 30~39 year old female. Ask Date: 2011/12/12

Dr. Lin Junyuan reply Psychiatry

Hello, I understand from your letter that you are experiencing distress due to the tug-of-war between your rational belief that it is a minor issue and your inability to stop thinking about these problems.
Your situation shows signs of excessive anxiety and obsessive traits.
While being detail-oriented is a strength, overthinking details and being overly sensitive can often affect your efficiency, leading to decreased self-confidence and even impacting your interpersonal relationships.
This aspect indeed requires professional assistance, and no physician will take your concerns lightly! If you have been collaborating with your physician, I recommend not changing your primary doctor casually.
Additionally, please rest assured that as long as you continue treatment and appropriately adjust your medication, you will see improvement! Wishing you all the best!

Reply Date: 2011/12/12

More Info

Navigating anxiety, especially in the context of therapy and patient-doctor dynamics, can be a complex and often overwhelming experience. Your concerns about discussing seemingly minor issues with your doctor, fearing judgment or ridicule, are quite common among patients. It’s important to remember that every patient’s experience is valid, and what may seem trivial to one person can be a significant source of distress for another.
Firstly, it’s essential to understand that doctors are trained to listen to a wide range of concerns, from the most severe to the seemingly minor. They are there to help you, and their laughter or reactions are not meant to belittle your feelings. Instead, they often reflect a human response to the shared experience of discussing health and wellness. If you feel that your doctor’s laughter is inappropriate or dismissive, it may be worth addressing this directly with them or considering a different healthcare provider who aligns better with your comfort level.

Your anxiety about how your doctor perceives you can be a reflection of broader issues related to self-esteem and self-worth. It’s not uncommon for patients to feel as though they need to impress their healthcare providers or to worry excessively about how they are perceived. This can lead to a cycle of overthinking, where you become preoccupied with your doctor’s potential judgments rather than focusing on your own healing process.
One effective strategy to combat this overthinking is to practice mindfulness and self-compassion. Mindfulness can help you stay present in the moment, reducing the tendency to ruminate on past interactions or future worries. Techniques such as deep breathing, meditation, or simply taking a moment to acknowledge your feelings without judgment can be beneficial. Self-compassion involves treating yourself with kindness and understanding, recognizing that everyone has flaws and that it’s okay to seek help for your struggles.

Regarding your feelings of transference towards your male doctor, it’s important to recognize that this is a common phenomenon in therapeutic relationships. Patients may develop feelings for their therapists or doctors due to the intimate nature of the relationship and the vulnerability involved in discussing personal issues. If you feel that these feelings are interfering with your treatment, it might be worth exploring this with your doctor or considering a switch to a female provider if that would make you feel more comfortable.

You mentioned the fear of being perceived as trivial or overly concerned with minor issues. It’s crucial to remember that your feelings are legitimate, and addressing them is part of the therapeutic process. If you find it difficult to express these concerns directly, consider writing them down and sharing them with your doctor. This can help you articulate your feelings without the pressure of a face-to-face conversation.

Lastly, it’s essential to focus on your progress and the therapeutic relationship itself. Therapy is a collaborative process, and your doctor is there to support you. If you feel that your concerns are not being addressed adequately, don’t hesitate to advocate for yourself. You deserve to have your feelings acknowledged and validated.

In summary, navigating anxiety in a therapeutic context involves recognizing the validity of your concerns, practicing mindfulness and self-compassion, and fostering open communication with your healthcare provider. Remember, the goal of therapy is to support your healing journey, and it’s okay to express your fears and anxieties along the way. Your well-being is the priority, and finding a comfortable and supportive therapeutic environment is key to achieving that.

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