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Monster on the Hill
Member Since Sep 2020
Location: by the river
Posts: 5,484
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May 02, 2024 at 08:36 PM
When I am IP, I do try to get things out of it, but I simply don't. Their goal is to get you to a place where you won't kill yourself the day you get discharged which they are generally successful at. Do I have enough coping skills to distract myself enough to survive? Sure. Do I want to use those coping skills? No. Just passing through life with (a guitar, book, walks, deep breathing, music, yoga, etc.) is going pass time and distract me from SH/sui, but I've never WANTED or felt like I deserve to live. IP will do the same. I get through however long I'm there, but I don't think I've ever been okay for more than two days after being discharged.
I don't want to run to the hospital every time I feel unsafe anymore. I'm a risk to myself more often than not, and I'd rather not live there.
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When patients with borderline personality disorder are admitted, they enter an environment that reinforces the very behaviors that therapy is trying to extinguish. Procedures developed for treatment of acute suicidality among patients with mood disorders are rarely appropriate for chronic suicidality. Most clinicians recognize the scenario in which a patient with borderline personality disorder escalates suicidal or self-mutilating behaviors in the hospital. Two mechanisms account for this phenomenon. First, for patients with poor social supports, a week on a ward, or even a night in an emergency department, provides a reinforcing level of social contact. Second, the environment of a psychiatric ward acts as a reinforcer, since patients who cut themselves or who carry out parasuicidal actions receive more, not less, nursing care.
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If, as so often happens, the patient becomes suicidal again shortly after discharge, little has been accomplished. A patient who eventually recovered from borderline personality disorder illustrated this problem with the following admonition: "Do not hospitalize a person with borderline personality disorder for any more than 48 hours. My self-destructive episodes—one leading right into another—came out only after my first and subsequent hospital admissions, after I learned the system was usually obligated to respond"
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(From Chronic Suicidality Among Patients...)
I want to live. Actually live, not just be breathing while time passes.
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