Boundary Issues/To Change T's?

Nope. That's your straw man version of my argument. My point is that the T should not be abusive or unprofessional or impatient or stupid, even if things are difficult. It's her job to be the opposite of those things. It's her job to at least not make things worse. If she does make things worse, that needs to be acknowledged, not glossed over.

It's stressful for the therapist? Poor thing. The OP carved up her skin and is in acute distress.

There is no reason to schedule clients close together, other than it serves the therapist's need to maximize revenue, or it satisfies some logistical or administrative need. Just because this model -- parading people through, one after another, in tightly regulated time chunks, as if on a conveyor belt -- is common does not make it healthy. If one accepts this model, then it's necessary to rationalize all the obvious problems it causes. I don't accept it. Can too easily become dehumanizing and damaging. Agree that OP might need to consider other options. But first priority should be seeing clearly what is happening NOW.

OP, hope you are ok.

It might be most supportive to keep the discussion focused on this poster rather than debating general therapy pros/cons, etc.

OP, I hope you have found additional support since this clinic seems unable to provide the level of services for your needs.

Hey everyone, the OP returns.

I can't thank you enough for all of the replies. The last few days have been an absolute roller coaster of emotions and I finally reached out for help from my school and their recommendation wasn't what I wanted to hear, but they agreed that they would work with me throughout the process.

That being said...tomorrow I am (well supposed to be...I already got delayed a day due to my physical health concerns) starting at a voluntary inpatient hospital. Hopefully for only about a week of intense treatment. I am scared out of my mind, though. I've never been in inpatient and I've heard horror stories.

But, that being said, I started to realize how severe my emotional dysregulatiob has been and what a burden it's been putting in everyone else, including T. I feel like I've completely lost control of my life and I don't know how it happened and I'm just in a fog. I definitely need some more intensive treatment for the time being. I just wish it wasn't so scary and full of unknowns. ��

MRT-

Where is the psychiatrist in all of this? Is s/he coordinating with the therapist? Coming off MAOIs without tapering can be dangerous and can cause serious effects like aggression and paranoia. Were you switched to something else?

eta: we cross post, so i just read yours. You sound so different. Did your meds change-and what was changed? Sorry you have to go to IP. I wondered if you talked to the clinic psychiatrist.

It sounds like she is well intentioned, but not competent and unseasoned. All that inconsistency leads to dysregulation, while it seems like you need someone stable, calm, and containinig. Have you thought about trying a male therapist? I wouldn't go to some kind of day treatment crisis services without finding another therapist first. You may be much better off with a different one, an experience done. Perhaps try a male. If there is a psychiatrist at the clinic, maybe talk to him/her first.

But you can't just not leave like that! But I liked that you were developing strategies on your own to get yourself to leave. Sorry they didn't work out when she wasn't interested in using them along with you. Could you both plan a strategy at the beginning? That could be something you could do together-you could create some kind if ritual together, 5 minutes prior, where you connect then disconnect in a formal and grounding but lighthearted way. It could be creative and grounding. Like you could bring a nice stuffed animal or beanie baby to her office and then at the end of session watch her cuddle it and tuck it into a desk drawer. It would be an essence of You (a transitional object) staying with her!

Let us know how it goes.

__________________________

Want to respond to this too:

What would be even more unprofessional, much more unprofessional, would be to let an incapacitated client leave instead of taking a few minutes to ensure she is ok and grounded. Letting an incapacitated client leave and wander into the street is the same as letting a dimentia patient wander out of a hospital. (And being upset or angry is not incapacitated). I'd report a therapist if they knowlingly let a client leave while incapacitated (eg dissociated).

Best of luck to you. I'm glad you are getting more intensive treatment while you are feeling so unsafe. Probably the most reassuring aspect of being inpatient was that I knew I was physically safe from harming myself; I knew I could not keep myself safe on my own without help.

I always left the hospital in much better shape than when I went in. It's scary, particularly the first time when you don't know what to expect, but it wasn't nearly as awful as I imagined it would be (honestly, not awful at all except that I was just so unwell at the time and felt awful).

Hopefully, you'll leave in a few or so in a better place mentally and emotionally than you are at present. Check back in when you return.

No kind of tapering. No attempt to soothe me at all in this process. I was told to turn in my remaining doses, that the withdrawals wouldn't be that bad, and that I "couldn't be trusted with medication." I was told this by the clinical director (this is not a school counseling center btw, it's a community one) who is a psychiatrist. He wasn't my psychiatrist, but since I was taken off my meds entirely there was no need to see my psychiatrist anymore. I had only seen her 3 times in total so far so we had legit no relationship and I didn't trust her at all anyway because of some previous issues.

As far as sounding different...yeah...I feel different. I feel in a state of complete and utter helplessness. I feel like I've been beaten down by the system so that I will just obey and submit to the treatment everyone thinks is best for me. Such an extended period of dysregulation is taking a serious toll on me.

I don't know who I can trust anymore and who I can't. Even with this inpatient program, I was supposed to be admitted today and then that didn't happen and I spent all days sending emails and making phone calls for something I barely even want because I feel like I have no other choice. It was an incredibly stressful day and I have barely been able to eat or drink or sleep in the last few days. I'm deteriorating quickly so I hope they stay true to their promise to admit me tomorrow. On the bright side, the school has been super supportive through all of this.

I don't know what's gonna happen with my outpatient therapy after this, but I agree that something definitely went awry with the T I've been seeing. I worry it's her lack of experience, too.

I wish I could reply to more but my brain is honestly so fried i can't comprehend much anymore.

It would be good to get some rest and take it easy.

Could it have been the MAOI that caused the mood swings or if you need admitted at this point?

I hope you feel better soon. I know what you mean about feeling brain fried.

From what I can see MRT was already struggling with dysregulation and they took all of the beds as some kind of misplaced safety strategy - it's incredibly negligent to take away current medication without a plan to taper and deal with withdrawal. They could have agreed that someone would keep your meds for you safely and give you what you need. The community clinic really doesn't sound equipped for your level of need both in terms of structure and experience, do you have any other options once you finish the in patient treatment?

I've possibly missed where the OP said she was dissociated? Highly distressed and a danger to herself yes and no, it's not ok to let someone leave in that kind of state and nowhere have I said the clinic were ok in what they did. I do think it's a practical limitation of most clinics that work with an appointment system where they need to see as many people as possible. Which means it's not a good service for people who need a higher level of support and who may struggle with dysregulation.

Yes, i suspected that, which is why i asked.
The place sounds reckless, not good for someone already having dysregulation

No, i dont think you missed something. i was a making a general comment about the notion its ok to kick clients out the door after the exact end of the session no matter what the circumstance. No other healthcare workers send someone out the door unsafe just because the allotted clinic appointment time has passed and someone else is waiting, and its not ok for therapists to do it either!

And as someone who had spoken to a numbet of ER docs about this, its also not appropriate to be sending people to ERs for non emergencies.

Yeah she has definitely let me leave while dissociated before. And extremely dysreguated. The thing is, she didn't use to and things used to be a lot different with out treatment, and then something suddenly changed. I think that's because her supervisors got involved in my case, and they don't know me or the full story yet they think they can make decisions about my care without seeing me and seeing the problem. ��
Hopefully I won't be dysregulated after inpatient though and I'll be able to go back there. I'm unfortunately really attached and can't bear the thought of seeing a different therapist right now.

I went IP during a time where I was very dysregulated. Like Lola said, it was such a huge relief to be some place where I was safe. The dr, nurses and staff were very kind to me. After discharge, I continued to see T1, to,whom I was/am very attached and started seeing another t who had experience treating trauma, and experience with my diagnosis. I actually did the testing to get a formal diagnosis while I was IP. While I don't think a diagnosis is necessary for recovery, it helped point me toward some stuff I could read to better understand what was going on with me.

I hope your IP experience is ok. Probably not great because you feel so bad, but I hope you can relax due to not having to fight those impulses and regroup. If you go in voluntarily, you can leave. It's a hassle, but you can do it.

Is it possible the MH system is fueling the dysregulation rather than lessening it? Seems iatrogenesis is endemic to psychiatry especially but also therapy.

i did things like the OP did with my therapist in the beginning. it was all just a test for me to see how much he could take of my crazy. and boy did i go at it. he patiently went through it with me, even though he was mad as hell, annoyed... people even tried to kick me out of that program and he would say no. to be honest i never understood it?

i met my T in a unconventional residential treatment facility though, so we had a pretty 'different' relationship than most people who meet their Ts in private practices, etc

I hope this comment does not dissuade anyone from seeking emergency medical treatment in the event that they feel unsafe due to their mental health.

EDs are absolutely equipped to handle mental health emergencies and if you cannot drive yourself or if you are SH'ing in such a state of mental dysregulation, do not feel shamed or guilty about taking up the "precious" time of ED doctors. [I work trauma in a hospital].

That aside, it is all about boundaries. The therapist should know when to recommend a client for further treatment and when not to.. Recognizing a patient in a spiral / mental breakdown vs. recognizing someone occasionally needing some extra time for grounding.