Scared

I know it's ridiculous and they're just trying to keep me safe, but I'm having serious trust issues with her and the pdoc now. It makes it hard to be honest and I even have a horrible knot in my stomach right now. I know it's stupid, but it's hard to get over it being a punishment and not wanting to be "caught" being unwell.

I know I need to force myself anyway, but it's hard not to feel a little betrayed/hurt/alone right now. Even though logically I know they need to put my safety first.

It's not ridiculous--I totally get it. I had similar fears when my p-doc/T/MC were talking about having me do an intensive outpatient program, where I wouldn't be able to see any of them for like 6 weeks. Talk about those fears with them. I did, and it helped me understand more and feel safer and more secure with them. That it was because they cared, not that they were frustrated or annoyed with me. That it wasn't "punishment," just them thinking maybe I needed a higher level of care than they could give right then. But if I hadn't talked about it with them, then I still would have had those fears, I'm sure. I'm still pretty jumpy around my p-doc, who I've known much less time than the other two.

As others have said, they're doing the opposite of abandoning you like your ex-T did--they're trying to help but are only able to do so much themselves. They want to see you get better and not be in so much pain.

Please be honest with them. You need to be and stay safe.

I feel like if it were 6 weeks I could do it. But this would be 2 years with no guarantee I could come back anyway. If it were just a matter of that, I think I could convince myself, but I hate the idea of being a full time psych patient for that long. It's an identity thing, and I feel like it would be damaging/hurtful to me, and make it hard for me to go back and finish grad school. I finished an intensive program like this about 8 yrs ago at another hospital, and finishing it/having to re-enter the real world afterward was way more damaging than never having done it. It took forever to think of myself as a "normal person" or to shed that "sick" identity, and I swore never again. We will talk about it tomorrow though.

Is there any sort of in-between option? Like you just go for a month or something, then if needed, you could switch to the 2-year program? Because 2 years does sound like a really long time.

The least amount of time is 6 months (they make you sign a contract), and then it would still be up to them whether I am "well enough" to be an outpatient again. I don't think I'll be "well enough" to just quit after 6 months either, and because I'm in Canada, this is all under public health in a hospital, so it's not like being with a private therapist in the US. They all work under that medical model, even outpatient, with people at this hospital being considered really ill. The therapy is all meshed in with your pdoc and meds and all that, in the same department.

This also is really ridiculous I realize, but I am also terrified of being labelled BPD again. My current T who is an expert on BPD (lots of publications, etc. She also works with one of the world experts on it. If you google pretty much anything on BPD, decades of his books and articles pop up, he's testified in a bunch of high profile trials, etc) also worked in that program for10 years says I am not, and it was a misdiagnosis because of the SH (I also clearly have abandonment issues), but also that this is the closest thing they have for treatment for people with severe self-harm issues. I was so grateful to get away from the stigma of BPD, and terrified of how people will treat me if I'm in this program which is mainly people with BPD. I have had people say the worst things to me because of my scars or when I was younger in the ER for stitches. I'm so afraid of that. I think maybe I need to talk about that too.

I'm worried the program is going to influence how the staff interpret you even though they know you do not have BPD. How is it supposed to help you?

If you do attend the program on thing that could help are boundaries such as no socializing with other clients, not discussing your illness and focusing solely on your recovery.

I don't think it is ridiculous. In the 1990s I went through it and experienced all kinds of stigma from clinicians. Almost all of them ignored me or accused me of manipulating them. Suddenly I was a monster. BPD was such an invalidating and very unhelpful diagnosis.

The biggest problem with all 'personality disorders' is that they don't exist. Not in the way real diseases do. Cancer, for instance, is where an observable change in the cells causes uninterrupted replication.

BPD is just a list of behaviors from which you pick a handful and toss a label at someone. BPD can't be seen in the brain. There's no blood test for it. It's not real. It's only use is for those who provide treatment to be able to discuss people who display a set of behaviors at various times.

Nobody 'has' BPD. They are described that way. Does that make sense?

So you don't have to accept the BPD diagnosis. You don't have to label yourself that way. You don't have to announce it, or identify with it.

And you don't have to accept ****** treatment from people either. It sounds like you have a really great therapist and I really hope you get the help you need to keep yourself safe. No made up acronym should stand in the way of you getting healthier.

Pink, I read everything and please, you deserve help to help yourself.

You really do deserve to not be in such pain. Please believe that your clinicians care about you.