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BPD and becoming too reliant on IOP?


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Okay, long story short: I'm currently in an IOP program, they were planning to release me on 11/29, even though I've been having suicidal ideations. My therapist said that the program shouldn't become a crutch for me. They pushed back my graduation until 12/6 after I said that I didn't feel completely safe. I didn't even know I had a set graduation date until a couple days ago. I have outpatient therapy and medication management set up but I don't know how I'll get to the therapy because my car is broken. I got to thinking about how I've heard that people with BPD can become too comfortable in hospitals and whatnot and that they prefer it to the outside world. Which can be true for me. And it might be happening in my IOP right now.

 

But if I just filled out a suicide risk form on the same day I'm informed of my graduation date, doesn't that seem kind of weird? Doesn't quite mesh in my mind that I'm ready to leave. I said that when I've been feeling bad lately, I've thought to myself that at least I can make it through a day or two to get to IOP. But then I'll have a therapist I might not be able to get to perhaps once a week? What if I do something stupid? I'm frightened of myself lately. I explained this. Other than this, I've found this program much better than others I've been in.

 

My therapist says I've made a lot of improvement and I've been using my coping skills more. But I still feel like shit.

I became hysterical in group over this and I never cry in front of people. I'm about to cry now about it. I think this program might actually be a crutch, and they might be right. I don't want to leave it. So perhaps typical BPD getting too attached? 

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I think that people with BPD on the whole have a harder than average time with endings, separations, and with change.  It doesn't necessarily mean that you have become TOO reliant, but it means that you might have to accept the fact that whenever you do leave, it won't feel good and you will probably feel quite anxious and struggle with it.

 

For me, the most important thing is having time to get used to the idea.  It's crummy that they didn't give you a lot of notice.

 

Do you have clear goals for IOP that you are trying to meet before you leave?  I am just thinking it might be less confusing if there was a clear indicator of when things should be "over".  You might never feel "ready" to leave, because IOP isn't designed to cure you - just bridge you to the next step.

 

Have you met your new therapist?  That might help.

Edited by tryp
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Thanks, that does make sense. I have a treatment plan which does mention using coping skills, which I am doing a little more. I haven't met my new therapist yet, and I don't know if I can get to my appointment because it's far and my car is broken and I have no money to fix it. I'm trying to see if anyone can bring me and public transit sucks here and won't get me there either because no buses go that way. I do have problems with change, for sure.

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I did speak to them about it, and they're telling me it's very important to get to my outpatient appointment and seem very worried that I might not, even tried to look for any public transportation that might get me there. I've asked my mom and fiance about getting a ride, but so far they've been non committal about it. Last night my fiance was concerned about me I think, my affect was very blank and I said that maybe that's what I look like at work and that's why everyone is asking what's wrong.

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The first time I went IP, my consultant told me that one of his biggest considerations was not to let IP be a way to escape the world. IP is great to serve a purpose, and let's face it, no one goes because it's their first choice option, I am sure if you could get some relief from the BPD and live in the world, you'd be doing that. When ordinary life feels so impossible and loved ones get frustrated, IP becomes a safe place. And it is supposed to be, by giving you space from everything else and caring for your physical and mental health, it can get you through a crisis. There should be no guilt about experiencing that as a good thing or feeling insecure about the prospect of returning to life. So many CB members and people with mental health issues that I have worked with feel exactly the same, irrespective of diagnosis.

 

In a way, people with BPD get a lot of stigma about their experiences, as if there is an element of deliberateness or that because they have emotional difficulties, they can snap out of it. So if you felt more vulnerable about talking about how this feels like a loss to you or your fears about coping post IP stay, that would be understandable.

 

It's okay to look at this time as a transition. In a relay race, the baton gets passed, and there is a pass over moment. It may be that passing the baton of your care to a tdoc takes a while, are there are crisis telephone lines you can ring or a skills coaching place at the centre/hospital? Can your pdoc give you some extra appt time? As for how you are day to day, well in my experiences, I differ from day to day both in how I feel inside and how others perceive me. I may not have the skills to show how IP has helped me and my mood problems or emotional issues are not solved 100% for being IP. So if you wake up and feel shitty or your SO thinks you seem low, notice it but don't feel like you have to try harder. My advice, if you can, is be gentle with yourself, don't plan too much activity or social time but don't leave your schedule blank for lots of alone time at home being introspective. If you have a journal or want to post here, do that.

 

It took time to get to this place of having BPD and it will take time to recover, you are entitled to that time no matter how long it takes or what anyone else thinks.

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Thank you, I don't feel especially connected to my therapist there, so more time with her wouldn't be especially helpful, I think it's the groups I'll miss the most. And don't have any friends that I'd like to see (or a car with which to see them) so I will be spending time alone if I'm not at work. I know there's support groups outside of where I'm doing my IOP, but logistically speaking, without a car in suburbia, I can't do much. I do like to journal, so I'll have to try to remember to do that more.

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