I completely understand where you're coming from. Two Fridays ago, after I'd had an especially rough week, (during which I'd called my T at midnight the night before and texted my marriage counselor at 3 a.m. a few nights before that) my p-doc suggested that I go to intensive outpatient therapy, which she called a day program. It would have been 4 hours a day for a month. I was immediately hit with abandonment fears and said, "No! I don't want to leave the people here (my T and marriage counselor)!" She said, "You wouldn't be leaving them. You'd go to the program for a month, then you could come back here." But to me, that was still leaving them. Leaving people I trusted to talk with bunch of strangers (would have been individual therapy plus group stuff). And I said it felt like they were just trying to pawn me off on other people. I was shaking and sobbing and begging her to just give me some more time to think about it/get in a better place. She said we should decide within a week, and that she, T, MC, and I would have a conference call to discuss what to do. Which just sounded like a panel of people judging me, which is another one of my triggers.

A couple hours later, I talked to my T and asked if I try a self-care and safety plan, where I'd do things like exercise daily, reduce alcohol use, choose alternatives to self-harm, check in with her regularly, etc. Thankfully, she agreed to that and got my p-doc on board with it (MC agreed too). It sounds like you might need something a little more though based on how badly you're feeling--what would the social worker involve?

Back to the abandonment fears part. Tuesday, we saw my MC, who I hadn't seen or talked to since I saw my p-doc. He asked how I was doing, and I immediately started sobbing and saying how freaked out I'd been by the stuff on Friday. I was mentioning the fear of abandonment and being judged and loss of control. And he was like, "Plus fear of rejection," which he knows is one of my things because of some stuff with my transference for him. He (speaking for himself, T, and p-doc) said that it wasn't that they were angry at me or frustrated with me or annoyed at me--it was that they cared about me and thought I might need a greater level of care than what they could give me. Hearing that (and the caring coming through in his voice as he said it) made me feel better that they weren't just sick of me and trying to dump me off on other people.

I was saying how now I was afraid to reach out because it might be like a third strike, and he noted how I made it sound like punishment. I said it kind of felt like it. He compared it to watching his kid have a illness (something physical) and at first you think they aren't so bad, but you have to keep watching them, and if they have other symptoms, keep getting worse, etc., then you have to take them to the doctor to get checked out. That the kid won't like it, but they need more care than he could give them. So this was like that. It made sense to me, and I realized that I think of mental health differently from physical health. Like, if I went to my doctor for a cough, and she said she thought it was pneumonia so I should get admitted to the hospital for treatment, I wouldn't think she was dumping me off on the hospital.

But therapy is much more personal and also much more of a judgment call how a client is doing. Your T can't give you a blood test to determine whether you'll get through this without more help or not. So she's trying to use her best judgment and err on the side of caution. She clearly cares about you very much. It sounds like you're in a very bad place, so please consider what she's recommending. If you can keep seeing her while doing whatever she suggests, then you could continue getting her support, which sounds like it's been helpful to you so far. I hope the new med helps you, too.

Please hang in there and take care of yourself.