Wanna Find A Shrink

[Pudgimelon]

I am trying to find a reasonably priced English-speaking psychiatrist in Bangkok, any suggestions???????

<{POST_SNAPBACK}>

Actually, this is a very good question. It seems to me that mental health care in Thailand is either entirely non-existent or takes some form that we Westerners don't recognize (spas? "time-outs" at the temple? maybe? dunno).

If you need a psychiatrist with the ability to legally prescribe meds, you might want to try Bumrungrad Hospital.  If you need/want talk therapy bmw's post is probably a good place to start.

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Actually, there is a psychiatrist at Bumrungrad, but I wouldn't recommend her.

My wife and I decided to go to Bumrungrad for health care during her pregnancy. I kinda insisted on it because I really dislike the methods of many Thai hospitals and doctors.

It seems to me that in Thailand there is a tendency to medicate first, ask questions later. The doctors seem to be more interested in getting as many patients through their doors in one day than they are in actual health care.

They don't bother to test you to find out what you really have, they just take a guess, give you meds based on that guess and then if you're still having problems a few weeks later, they make a new guess and prescribe new meds.

Additionally, OBGyns in Thailand have a real tendency to cut a woman up during delivery of a baby. Maybe they think it makes the delivery easy, but to me it seems that slicing should only be done when NECESSARY, not just because it's convenient.

So we went to Bumrungrad and found a very good doctor there who had the right kind of philosophy about child birth. Unfortunately, my wife was suffering from a lot of mood swings during her pregnancy. This is normal for some women, but my wife was really suffering from some extreme swings. She'd get herself really worked up sometimes and we were at a loss as to how to settle her down.

So we decided to try out the psychiatrist at Bumrungrad to see if she had any recommendations. Her office is stuffed way off in a corner (next to the dentist) and I got the distinct impression that the "Psychiatry Department" at Bumrungrad was an after-thought.

Anyway, she talked to my wife for HALF-AN-HOUR and then whipped out a prescription for PROZAC. I mean, geesh, the whole reason we went to Bumrungrad was to avoid pill-happy doctors, but even at that supposedly "good" hospital, there are still some doctors who follow the medicate-first-ask-questions-later philosophy.

I said, "Hang on a minute, you've barely talked to her, how come your prescribing a serious medication like Prozac so quickly?"

The doctor looked at me like she was shocked that I'd actually question the distribution of drugs, but then she replied, "Oh, don't worry. Prozac is no big deal. It's a relatively mild drug."

To which I replied, "Hmmm... but do you know my wife is pregnant? Wouldn't Prozac have an effect on the fetus?"

To which she again replied, "Oh don't worry. The risks are slight, and we really need to medicate your wife before we can start any treatment." (This is while my wife is sitting there, calm and rational).

I said, "Well, I'd like a second opinion on that, so we'll wait on that prescription for now."

Later on, my wife and I looked up Prozac and pregnancy on the internet, and while there is some evidence (from corporate sponsored studies) that Prozac has no impact on the fetus, there are also some recent university studies that indicate that women taking Prozac have a high incidence of fetal death!

Hmm... I don't know about you guys, but "fetal death" sounds like a more that "slight" risk".

Needless to say, we did NOT go back to that psychiatrist, nor did we get a prescription for Prozac.

So I guess that's the state of mental health care in Thailand. Even at one of the best hospitals in the country, you still find pill-happy doctors who probably get a kick-back from the hospital or drug companies for every prescription they fill.

It would be really nice if we could find a decent, qualified counsellor who could help my wife manage her mood swings, but I really don't think such services exist in Thailand.

I'm also sure that there are many mixed couples out there who could use some help sorting through problems caused by cultural differences. So frankly, I'm quite surprised there isn't a booming counselling business in this country, you'd think there'd be a big demand for that kind of thing.

But there isn't.

[Phil Conners]

Additionally, OBGyns in Thailand have a real tendency to cut a woman up during delivery of a baby. Maybe they think it makes the delivery easy, but to me it seems that slicing should only be done when NECESSARY, not just because it's convenient.

How long have you been in Thailand? You should know by now that if there is an option between doing something convenient and costly (for you) then that is the way it will be done, regardless of consequences.

The doctor looked at me like she was shocked that I'd actually question the distribution of drugs, but then she replied, "Oh, don't worry. Prozac is no big deal. It's a relatively mild drug."

She was probably shocked that you put here devine judgement in doubt. Doctors in the western world are beginning to understand they're not God and discuss treatment with their patients. Not so in Thailand.

[Sheryl]

I am trying to find a reasonably priced English-speaking psychiatrist in Bangkok, any suggestions???????

It would be really nice if we could find a decent, qualified counsellor who could help my wife manage her mood swings, but I really don't think such services exist in Thailand.

I'm also sure that there are many mixed couples out there who could use some help sorting through problems caused by cultural differences. So frankly, I'm quite surprised there isn't a booming counselling business in this country, you'd think there'd be a big demand for that kind of thing.

But there isn't.

Hi, I'm a registered nurse. Mood swings in pregnancy are the rule rather than the exception and do not need treatment unless they are posing a threat to the woman's health (for example, not eating/sleeping due to depression or anxiety; and of course any suicidal thoughts) or threatening the welfare of the family unit to an extent not resolvable by counselling alone (for example, fits of rage, or neglect of other children). If what's happening with your wife doesn't fall into any of those categories, the best thing to do is reassure her and yourself that these mood swings are completely normal, due to hormones, and will resolve after delivery. In the meantime try to take them in stride, perhaps joke about them.

If however despite such reassurance it seems to be posing a risk to her welfare then some intervention is needed. One very simple and safe thing you can try on your own is use of natural progesterone. Itis available as a micronized capsule brand name utrogestan, I have found it at large pharmacy on Sukhumvit around soi 2, and also available in a topical gel at Villa Market pharmacy (name = progestogel). Both preparations are completely natural progesterone, the female hormone which is naturally present in the body in very large amounts in pregnancy. It is most likely to help if the problem is anger or agitiation. The capsules work faster but last less long than the gel. Suggest you buy just a few capsules and have her try it, she will very quickly know if it helps or not. If it does help then flunctuating levels of progesterone are very likely a factor and she can safely use it in eitrher gel or capsule form as necessary. Progesterone is not in any way harmful to a fetus, on contrary it is necessary to maintain a successful pregnancy and in any event the amounts contained in the capsules and gels are miniscule compared to the normal levels in a pregnant woman.

Natural progesterone also helps pre-menstrual mood changes, in fact that's its main use.

If this also doesn't work and the problem is serious (threatening her health/just can't be lived with) then you have no recourse but to keep trying to get competent professional help. If none of the counsellors mentioned on this site do it, try another ob-gyn. An ob-gyn would be pfreferrable to a psychiatrist and more likely to understand the problem in context (pregnancy) and be sensitive to dangers of mediciation to the fetus (one would hope!) Good luck

[Pudgimelon]

Hi, I'm a registered nurse. Mood swings in pregnancy are the rule rather than the exception and do not need treatment unless they are posing a threat to  the woman's health (for example, not eating/sleeping  due to depression or anxiety; and of course any suicidal thoughts) or threatening the welfare of the family unit to an extent not resolvable by counselling alone (for example, fits of rage, or neglect of other children). If what's happening with your wife doesn't fall into any of those categories, the best thing to do is reassure her and yourself that these mood swings are completely normal, due to hormones, and will resolve after delivery. In the meantime try to take them in stride, perhaps joke about them.

...

Natural progesterone also helps pre-menstrual mood changes, in fact that's its main use.

If this also doesn't work and the problem is serious (threatening her health/just can't be lived with) then you have no recourse but to keep trying to get competent professional help.  If none of the counsellors mentioned on this site do it, try another ob-gyn. An ob-gyn would be pfreferrable to a psychiatrist and more likely to understand the problem in context (pregnancy) and be sensitive to dangers of mediciation to the fetus (one would hope!) Good luck

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Thanks Sheryl, that was a truly helpful and informative post. I will pass that information on to my wife and we'll try out progesterone (after we consult with her doctor) and see if it helps.

I wish I could say that her mood swings (both before and during her pregnancy) were of the normal type, but unfortunately my wife is in the minority of women who have a real tough time every month and with pregnancy.

It's probably a hormonal imbalance and that can be tough on a woman, especially if she's intelligent and organized like my wife. She really feels bad about the loss of control and it really impacts her self-esteem. I'd like to help, but like I said, the options for competent mental health care in Thailand are extremely limited and of piss-poor quality.

A hormonal imbalance is one possibility, but there are many others, and without proper testing how can a doctor know what's going on? Yet here in Thailand, they just prescribe the drugs they THINK might work, and then wait and see what happens.

I'm sure there must be some sort of test to determine if a hormone-treatment is necessary, but my question is why do we have to go in and specifically REQUEST that the doctor actually DO a test?? Shouldn't the doctor be the one suggesting a course of action?

I pray to God that I never get seriously ill in this country. I can just imagine going into the doctor with stomach pains and having him take a wild guess as to my condition and send me home with some anti-gas pills. And then when it gets worse a few weeks later, going back in and having him tell me, "Oh sorry, you didn't have an ulcer, you've got cancer. Gee, wish we'd have caught it sooner because now there's nothing we can do. Nice knowing you, buddy."

Edited March 29, 2005 by Pudgimelon

[Pudgimelon]

Natural progesterone also helps...

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Sheryl, got a question for you. I've been reading up on Progesterone and it appears that Progestogens (synthetic Progesterone) are the main ingredient in birth control pills.

It appears that progestogens (unlike estrogen) increase the presence of MAO enyzemes which degrade seritonin levels in the brain (causing depression).

On our doctor's advice, my wife is taking birth control pills for the next few months to prevent pregnancy and allow her uteral lining time to recover from her miscarriage.

Could this be causing her problems? If she is sensitive to the progestogens in the birth control pills, could this actually be worsening her mood?

Progesterone, on the other hand, appears to elevate mood, though I'm still a little unclear on how/why natural Progesterone pills elevate mood and synthetic Progestogen pills lower mood. It's a bit confusing to me.

From the website I read, they said that Progestogens taken at the same time as Estrogen don't seem to lower mood because the two cancel each other out. So my question is would this be the same for Progesterone? Would Progesterone cancel out the negative impact of Progestogen found in the birth control pills?

[bina]

i'm sorry but in the recent posts your wife was pregnant and then miscarried... or did i miss the timing;

i have three woman friends who all use prozac or newer derivitives or similar for help with their very awful post menstrual syndrome: one is a doctor, one a high level manager and one a secretary... they all lose it when pms; also some problems after pregnancy (post partum depression that needed medical and psychological intervention for the first few months after birth ); one other woman friend uses alternative (chinese) medicines that probably have the same chemicals in them etc etc....my friends all report that they found it to be very helpful (one was my manager she used to burst out crying and really lose it even in basic meetings, etc. like roller coaster); i'm not a great proponent for meds for everything but when needed, is best to use it especially if its for short term

an other thing, c-sections are very popular in third and second world countries because the doctors tell the women that 'you dont want to suffer do you?' and then they do a c-section; in some european and american (i think) the 'natural' birth thing is bigger, home birth, no meds, no c-section unless danger to mother or child.... statistics in israel show large percent of women opt for c-section even if not neccessary.... so its not 'careless doctor' but rather a general (male) doctor philosophy of convenience etc....and dont forget, our average family has five kids so we discuss pregnancy, problems , births and child rearing as a national obsession...

if your wife miscarriaged, then there are hormonal mood swings but also the psychological aspect even to someone who is usually philisophical about things etc, the miscarriage can be devastating (my sister really mourned her unborn child when she miscarried even though she knew it wasnt anything she did etc etc etc (was a non viable fetus actually)... if your wife is very organized etc then this is just made worse because she is sort of losing control over things that she cant really control which is rather frightening actually....

why dont you check some site like la leche league -- thy're very 'holistic breast feeding etc but they do have good info and forums and such; as an american in israel i used them as help for breast feeding when working etc etc when i found the ob/gyns werent really helpful w/annoying women who ask questions and whom dared to view the ob/gyn as just someone who studied more and is nto really god....

good luck...

[lampard10]

There are heaps of amateur psychiatrists right here on TV; how may we help you?

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Just over 15,000 actually

[Sheryl]

Natural progesterone also helps...

Sheryl, got a question for you. I've been reading up on Progesterone and it appears that Progestogens (synthetic Progesterone) are the main ingredient in birth control pills.

It appears that progestogens (unlike estrogen) increase the presence of MAO enyzemes which degrade seritonin levels in the brain (causing depression).

On our doctor's advice, my wife is taking birth control pills for the next few months to prevent pregnancy and allow her uteral lining time to recover from her miscarriage.

Could this be causing her problems? If she is sensitive to the progestogens in the birth control pills, could this actually be worsening her mood?

Progesterone, on the other hand, appears to elevate mood, though I'm still a little unclear on how/why natural Progesterone pills elevate mood and synthetic Progestogen pills lower mood. It's a bit confusing to me.

From the website I read, they said that Progestogens taken at the same time as Estrogen don't seem to lower mood because the two cancel each other out. So my question is would this be the same for Progesterone? Would Progesterone cancel out the negative impact of Progestogen found in the birth control pills?

Natural progesterone and synthetic progestins (which is what birth control pills and hormone replacement therapy for menopause contain) are ENTIRELY DIFFERENT compounds. The only reason the synthetic progestins ever came into being is that you cannot patent a natural substance & the pharmaceutical companies wanted to turn a profit...so they developed the synthetic progestins, which have similiar action with respect to lining of the uterus but in amost all other respects differ, often in opposite directions.

Synthetic progestins make depression of any sort much worse. They also greatly aggrevate pre-menstrual syndrome (nowadays recognized as a medical disease and called premenstrual dysphoria) and post-partun depression (including post-miscarriage depression) . Synthetic progestins are not safe to use during pregnancy, whereas natural progesterone is not only safe but widely used to help women who have difficulty conceiving and to help avoid miscarriage. Both problems often occur due to inadequate progesterone levels.

In his book, "Premenstrual Syndrome & You", Neils H. Lauersen, M.D., from Mount Sinai Medical Center in New York, states that natural progesterone may be helpful to maintain pregnancy. The cream in not only safe for use during pregnancy but is recommended. The cream is also useful for post-partum depression, which many women experience after childbirth.

If your wife has a history of mood swings, especially anger or depression, in the 2 weeks before her period, had more than usual mood swings during pregnancyand has just suffered a miscarriage then it is VERY likely she has either inadequate levels of progesterone or an estrogen:progesterone imbalance.

It is very difficult to test progesterone levels as they flunctuate so widely from moment to moment that blood levels aren't useful. In a non-pregnant, non-post-partum woman there are salivia tests that can be used and ordered on line (I doubt very much any docs in Thailand have them, except possibly in fertility specialists). However it would be hard to interpret if your wife has just recently miscarried.

Aside from progesterone, the SSRI class of antidepressants (Prozac, Zoloft, Paxil etc) are also very effective but they should not be used while pregnant. If your wife has miscarried then there is no reason not to start them especially if she's very depressed. Personally I recommend Zoloft over Prozac because it is much quicker acting, one sees the difference within a week or even a few days, whereas Prozac takes weeks.

Assuming I have the story straight (that she has miscarried) I strongly recommend the following:

1. Go OFF the birth control pills and use a non-hormonal form of contraception (IUD or condoms). While it is possible to prevent pregnancy using natral progesterone rather than synthetic progestins, the necessary research to establish dosage etc has not been done due to fact that it's not patentable

.

2. Go on an anti-depressent (but only while using effective birth control) such as Zoloft.

3.Try progesterone. Do not go for the various online creams for sale because they vary in actual composition. The 2 forms I recommended are made by a reputable pharmacological company in Belgium and available in Thailand albeit in only a few places. In a non-pregnant woman it shopuld be used only during the last half of the menstrual cycle. (She will probably menstruate at least a little as soon as she stops the birth control pills.)

3. Consult an ob-gyn who specializes in infertility and miscarriage to discuss the possibility that low progesterone may have been a factor in both your wife's mood swings and the miscarriage, and discuss use of progesterone (NATURAL form!) to assist in conceiving and maintraining a pregnancy in future. (If you wish, do this before step 2). It may take a while to find a Thai ob-gyn with experience in use of natural progesterone as they've been pretty much brainwashed by the drug companies to equate progestins with progesterone. If all else fails you could do it yourself as it is NOT in any way harmful in pregnancy:

"In his book, "Premenstrual Syndrome & You", Neils H. Lauersen, M.D., from Mount Sinai Medical Center in New York, states that natural progesterone may be helpful to maintain pregnancy. The cream in not only safe for use during pregnancy but is recommended. From conception to delivery, apply primarliy to abdomen, breast, low back, and upper thighs (where it will tend to prevent the skin from stretching). For the first six months of pregnancy, use an average of 1/2 to 3/4 teaspoon 2 to 3 times a day. Discontinue at delivery and resume again at a level of twice per day starting one month after delivery. The cream is also useful for post-partum depression, which many women experience after childbirth. "

However, when trying to conceive, use the progesterone only after ovulation, i.e. the 10-14 days before menstruation would normally occur or 2-3 days after she notices the cervical musous changes/body temp changes that signal ovulation (if she is able to detect these). Otherwise if used conti nuously if may inhibit ovulation.

Whatever you do, do not underestimate the danger if your wife seems depressed. Suicide is a very real possibility. Many suicides occur as a result of reluctance or delay in starting anti-depressent therapy. Although the list of side effects for these drugs may look scary, as long as she's otherwise in good physical health and not pregnant, they're pretty sfae and most side effects are mild and pass after a wek or so of treatment. If she does go on anti-depressants, wait until she has been depression-free for at least 6 months then slowly go off them (taper off) and make sure she's still OK befoire trying to conceive. You do not want to conceive while on the drugs and do not want to suddenly stop, have her get pregnant and then have a repeat of last time's problems or worse.

The following sites give more info on natural progesterone:

www.yourlifecource.com/womens-health.htm

www.natural-progesterone-advisory-network.com

Good luck! I empathize as I myself suffered severely from pre-mesntrual dysphoria. Combination of progesterone and Zoloft have been a miracle for me, and I've extensively researched the subject.

[Pudgimelon]

Again, Sheryl, thanks for the informative and helpful posts. I'll show these to my wife and then at our next appointment with her doctor, we'll go over the various possibilities for treatment.

The miscarriage was devestating to both of us, but particularly my wife. She was five months into the pregnancy and both of us were really looking forward to having a child.

We went over every possibility with her doctor, and he reassured her that it was merely an unfortunate accident and there was nothing we could have done differently. The umbilical cord was just too thin and got twisted up by the natural swimming actions of the fetus.

We're still greiving pretty hard though, and it'll be a long time before either of us recovers. I got to see the fetus after they induced a delivery to remove it. He would have been a son and he was big and strong and healthy and perfect in every way. I could even tell that he had my wife's nose.

Anyone who says a miscarriage is "no big deal" (and I used to be one of them), has no idea what they are talking about. It's just as crushing a blow as the death of any child would be to any parents. In fact, in some ways it's worse, because I never got to meet him or hold him or teach him anything. There was so much potential there and it's all been lost.

That's a hard thing to take.

[Sheryl]

Again, Sheryl, thanks for the informative and helpful posts.  I'll show these to my wife and then at our next appointment with her doctor, we'll go over the various possibilities for treatment.

The miscarriage was devestating to both of us, but particularly my wife.  She was five months into the pregnancy and both of us were really looking forward to having a child.

We went over every possibility with her doctor, and he reassured her that it was merely an unfortunate accident and there was nothing we could have done differently.  The umbilical cord was just too thin and got twisted up by the natural swimming actions of the fetus.

We're still greiving pretty hard though, and it'll be a long time before either of us recovers.  I got to see the fetus after they induced a delivery to remove it.  He would have been a son and he was big and strong and healthy and perfect in every way.  I could even tell that he had my wife's nose.

Anyone who says a miscarriage is "no big deal" (and I used to be one of them), has no idea what they are talking about.  It's just as crushing a blow as the death of any child would be to any parents.  In fact, in some ways it's worse, because I never got to meet him or hold him or teach him anything.  There was so much potential there and it's all been lost.

That's a hard thing to take.

You have my deepest sympathy. Your and your wife's grief is entirely normal and justified. There is nothing in the world more painful than the loss of a child.

Although grief is a completely normal and necessary emotion, it sometimes requires intervention (therapy and/or antidepressent medication). The dangers are prolonged or really severe depression (especially in the woman, where hormonal factors are also in play on top of the emotional loss) and also damage to the marital relationship, which sometimes happens if the couple handle their grief in very different ways or have trouble expressing their feelings with each other.

Only you can judge if any of these apply or if the grief process is proceeding in a healthy (not to be confused with good feeling!) way. If you and your wife are drawing towards each other in your grief and able to express and understand each other's feelings and ways of handling the loss, and if depression is not so severe as to prevent normal functioning or produce suicidal thoughts, and also gradually lessens, then all is as well as can be expected under these tragic circumstances.

[Pudgimelon]

...or have trouble expressing their feelings with each other....

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Hmphf. That's almost the definition of communication in many mixed couple relationship. Expression of emotion is a very culture-specific function, and during times of extreme stress it is often difficult to be "understanding" of emotional displays that don't pair up with our own expectations or needs.

My wife and I are fortunate in that we don't have a lot of other unnecessary baggage in our relationship. We've got a very strong commitment to each other and a true love for one another, so that's seeing us through. We both know that this "terrible time" will be followed by good times, so we just need to weather the storm, but we are definitely feeling fatigued from dealing with so much stress, sorrow, and anger (at the unfairness of being robbed of our son by an unkind fate).

My mom's cancer and our new business haven't exactly lightened the load on me. So I'm bearing just about all a man can bear without completely breaking down. I've probably aged about 5 years in the past month.

My wife and I have had our tough days recently, and its been especially hard on us because our marriage is still new and we're supposed to be still in the "honeymoon" phase, not dealing with anguish and grief. We sort things out eventually, but at a time like this, the normal communication-errors that occur in a mixed couple can become magnified by stress and grief.

That's one of the reasons I wish there was a better mental health infrastructure in Thailand. There are times when my wife and I misunderstand each other and we have to unknot a lot of tangled emotions before we clarify what we were actually TRYING to say to each other, rather than what was PERCIEVED to have been said. It would be really nice to have a mediator that we could turn to, who could help us sort out the misunderstanding in a more healthy manner.

If anyone out there has a good mind for business and some experience in social work (or can hire people who have it), I'd recommend they open up a clinic specializing in mental health care and counselling services for mixed couples. It'd probably be a first-of-its-kind thing in Thailand, but I have a hunch that there's a real unspoken need for these kinds of services here.

Unfortunately, there is probably a big stigma to overcome here. In America, mental health care still has a "you're crazy" stigma attached to it, but here in Thailand, I think it's probably much worse. I really wish people could see mental health care for what it really is: an organ-specific medical discipline no different from optometry or cardio-care or dentistry or podiatry.

The brain is a part of the human body just the same as the back or liver or hands or reproductive organs. If we'd been in a terrible care accident and injured our backs, there'd be plenty of treatment options available and no stigma at all attached to seeking help for back pain. Alas, the same is not true for our mental health. We've both received a terrible blow and we are both, in some way, injured by our son's death. If we were Stateside, we could seek treatment options to help us recover from our loss, but here, we pretty much have to muddle through on our own, self-diagnosising and self-treating, often with less than optimal results.

So, again, anyone with a good business mind should consider trying out a counselling clinic. It might be a bit difficult to get Thai couples to try it out (though I'm sure many need it), but there are enough mixed couples in Thailand to support a healthy business, I think.

[John K]

So why Thailand, John? It can't be the money, although your fee of 2,000 baht an hour is certainly quite high by Thai standards.

Did you go through Indo-Siam for your work permit?

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Well I don’t think 2000 per hour is high for a therapy that is very short as compared to others. What I mean is if you had a mental health issue and went to a psychologist you would need to go 4 to 6 times longer for the same results. That could add up to a much higher total if they charged anything over 500 per hour. As for the work permit, Sun Belt Asia. As for why.. I have been wanting to come here for a long time as a tourist, and when I arrived I just decided to stay. It would seem I am getting to be somewhat of a celebrity too.

John Krukowski, C.H.

[John K]

So why Thailand, John? It can't be the money, although your fee of 2,000 baht an hour is certainly quite high by Thai standards.

Did you go through Indo-Siam for your work permit?

<{POST_SNAPBACK}>

Well I don’t think 2000 per hour is high for a therapy that is very short as compared to others. What I mean is if you had a mental health issue and went to a psychologist you would need to go 4 to 6 times longer for the same results. That could add up to a much higher total if they charged anything over 500 per hour. As for the work permit, Sun Belt Asia. As for why.. I have been wanting to come here for a long time as a tourist, and when I arrived I just decided to stay. It would seem I am getting to be somewhat of a celebrity too.

John Krukowski, C.H.

[sriracha john]

Anyone who says a miscarriage is "no big deal" (and I used to be one of them), has no idea what they are talking about.  It's just as crushing a blow as the death of any child would be to any parents.  In fact, in some ways it's worse, because I never got to meet him or hold him or teach him anything.  There was so much potential there and it's all been lost.

That's a hard thing to take.

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You and your wife have my empathy, Pudgimelon....as does this very unfortunate women and her horrific experience... in a topical story from today's paper. It sometimes helps to know you are not alone, Pudgimelon.

Published on March 31, 2005

A pregnant woman complained to a Bangkok radio station yesterday that a doctor at Chulalongkorn Hospital had left a dead foetus inside her womb.

Speaking to the FM 91 traffic radio station, Wimol Wutthipradit, 41, asked that Dr Somchai Suwajanakorn explain why she had been left with the dead foetus in her womb instead of being given surgery to remove it.

She said her baby had been due on March 22 and, on that day, the doctor had informed her that she should undergo a caesarean section the following day.

However, she had not felt ready for surgery, and asked him to postpone it.

She said that on that day, the doctor had detected the foetus’ heartbeat was not normal. Nevertheless, he let her go home after making an appointment for surgery on March 29.

She said tests on Tuesday revealed that the foetus was dead.

Another doctor then made an appointment for her to return on April 5, and told her to go home.

“I grieve this loss and continue to suffer,” Wimol said. “I am unable to eat and sleep out of fear that the dead baby inside me might affect my body. I’m forced to look at my big tummy with a dead child inside.”

Somchai later explained on the radio programme that normal procedure in these circumstances was to wait for the body to expel the dead foetus naturally. This process usually occurs within a few days, but can take up to four weeks, the doctor said.

A caesarean section, on the other hand, would be painful and would cost a lot of money.

Somchai said that if the foetus was not stillborn within four weeks, the mother’s body could be affected.

Doctors will see Wimol at the appointed time next Tuesday and, if the foetus has not been expelled, surgery will be performed immediately.

[John K]

So why Thailand, John? It can't be the money, although your fee of 2,000 baht an hour is certainly quite high by Thai standards.

Did you go through Indo-Siam for your work permit?

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Well I don’t think 2000 per hour is high for a therapy that is very short as compared to others. What I mean is if you had a mental health issue and went to a psychologist you would need to go 4 to 6 times longer for the same results. That could add up to a much higher total if they charged anything over 500 per hour. As for the work permit, Sun Belt Asia. As for why.. I have been wanting to come here for a long time as a tourist, and when I arrived I just decided to stay. It would seem I am getting to be somewhat of a celebrity too.

John Krukowski, C.H.

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More like notoriety as for what I can see. The adage "you get what you pay for" comes into play here. There are many reasons a psychiatrist gets a bigger paycheck. One is called e-d-u-c-a-t-i-o-n and qualification is another. It is why shamans and elixirs are less expensive than psychiatrists also.

But hey, I wouldn't want to deny someone the chance to make a living, so if you can find people that believe in your hocus-pocus, more power to you. Enjoy your stay in Thailand.

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I love this debate but too often I must repeat myself. First many people think Hypnotherapy is the same as Psychology or what a psychiatrist does. That is only true for one small part of Hypnotherapy and that is you are dealing with mental health issues. But Hypnotherapy is so much more than just that one small area. For example there is no psychology used in the vast majority of Hypnotherapy. Plus Psychology deals with the conscious mind and not the subconscious. That is why going to a psychologist can take 4 or more time longer to get the same results. The reason for that the conscious mind is very structured and all possibilities must be addressed by the psychologist. That is why it takes so much longer. The subconscious is much simpler than that, it’s very impulsive and responds to concepts. Once the concept is accepted the conscious mind sets out to make it work. Yes I agree if a person wants to spend a whole lot longer in therapy they can go to a psychologist, or if they want to be medicated and live in their own new little world they can go to a psychiatrist. The choice is theirs to make. I can tell you that there no psychology used in smoking cessation, eating disorders, pain management, stress and anxiety management, sexual dysfunction including erectile dysfunction and premature ejaculation. For a woman arousal problems or painful sex. There is no psychology use with dealing with IBS (irritable bowel syndrom) or Fibromyalgia. There is no psychology used with dealing with fears or if you prefer the word phobia’s. The list goes on and on. You must think of Hypnotherapy as a long road that passes through many towns or states. Each town is a different application that can be used in another profession. 40% of the people who I saw in the USA were directly referred by there PCP, surgeon, specialist ,psychologist, psychiatrist, and even some substance abuse consolers. From time to time they encounter people that need the extra effectiveness of Hypnotherapy to augment their therapy. 2 of 3 Doctors in the USA refer their patients for Hypnotherapy if they feel it is needed. Insurance companies are even starting to pay for Hypnotherapy because they see how effective it is. They are only looking at their bottom line, and Hypnotherapy has proven over and over to be very cost effective because the duration is so much shorter. Also know I have no problem turning people away who I am not qualified to work with. Some people do need to see a psychologist because of the complexity of their issues. Many times their psychologist will seek my help as well working as a team to help that person. There is no magic in Hypnosis, it happens to people everyday in natural life. Unfortunately people only see the stage hypnotist and think it is all like that. Trust me when I say that many people don’t understand. You are just responding to a SUGGESTION that we are all some sort of fakes. So I will leave you with this though,. In the USA about 42% of psychologists and psychiatrists are also certified Hypnotherapists like myself. Why would those highly E-D-U-C-A-T-E-D people get certified in Hypnotherapy if it was what you think it is? And another thought, The Thai government is very interested in hypnotherapy too. I could send you to my website but I may get spamed, but I think you could find it if you tried.

John Krukowski, C.H.

[sriracha john]

Been to the website...

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Sriracha John, C. S. (Certified Skeptic)

[John K]

Been to the website...

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Sriracha John, C. S.    (Certified Skeptic)

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Well I can understand you are a skeptic, and all the more power to you. However just don’t go around planting negative suggestions for people who are on the fence. You don’t need to me hypnotized to get suggestions. As for my weight, well first off the photo is about 2 years old. And that is down about 70 pounds from my high, now I am down about 100 pounds from my high. (50 k) so moving on to the next question or comment I don’t use snake oil, and that comment is more harmful to how people view you and not how they view me. I have helped well over 1000 people with a variety of things. Someone posted a link from another thread on hypnosis written by a PhD. It says all the same that is on my website, just worded slightly different. Search Hypnosis here and you will find it. If you want you can read In the Big Chilli or Thailand Opportunities this month, both are on the stand. I have contribute to both publications at their request. I don’t plan to change your mind, however you must understand how you appear to professionals and others that know better, and I am not referring to myself. My advise to you is to do a lot more research from places that you trust like webmd or from respected universities. Then we can chat on a more constructive level.

John Krukowski, C.H.