![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by tygereyes on April 26, 2006, at 20:56:46
I waited only two days after stopping EMSAM (at the lowest dose, 6 mg) to starting Parnate at 20 mgs. I had a hypertensive crisis. It was not resolved with nifedipine. I almost died. Again. I am twenty-three years old. I am a med student and I am an anorectic and I am a recovering heroin (among other drugs) addict and I am a self-injurer and I am hopeless. Truly and completely hopeless. Even the prospect of becoming a psychiatrist (my intended specialty) isn't enough to make me maintain my weight.
I think I might wait a week and give EMSAM a real chance. I am tired of living like this. Please see my post on the Eating board and respond if you can. I am thinking of trying something called Schema Therapy, which has supposedly been effective for Borderline Personality Disorder (my primary dx) and chronic anorexia nervosa.
I feel like I am screaming and no one can hear me.
I have been so hurt by people on this board and some of the responses here have resulted in fresh scars on my skin and yet I keep coming back here and you know why? Because I have no one else. No one. Isn't that sad? I fired my treatment team a month ago because Dialectical Behavior Therapy was NOT working for me and because they had me on a weight contract that was NOT working for me and I can't tell anyone at school about these issues and I am just lost.
Four hospitalizations for anorexia nervosa THIS YEAR ALONE. I am sick of the hospital so do not suggest I go into the hospital. Besides, I'm back in a normal weight range which makes me want to die [not literally, don't worry] and I would NEVER allow myself to be hospitalized unless I was AT LEAST at an emaciated BMI. And I am not suicidal. And I don't believe in hospitals unless it's a crisis situation, which this is not. It is a chronically hopeless situation but not a crisis.
I know there is no pill or patch to make this go away, to make ANY of it go away. The BPD, the anorexia, the self-injury, the drug addiction (plus I have body dysmorphic disorder) ... I know I need therapy for all of that. But which therapy? I've failed so many therapies. And which meds will make it possible for me to even be in therapy at all?
I guess I'll go back to EMSAM. It's worth a try. And I'll look into this Schema Therapy, too.
I want to - NEED to - believe that I can overcome this.
But how many twenty-three year olds do you know who have been labeled chronic multiple times by multiple doctors?
Does anyone ever recover from borderline personality disorder and/or anorexia nervosa? If so, how?
Pretty soon I will be able to write prescriptions. And yet I can't write my own prescription for happiness.
Posted by Phillipa on April 26, 2006, at 21:24:36
In reply to Labeled chronic losing hope. (Long), posted by tygereyes on April 26, 2006, at 20:56:46
Tigereyes I have tears in my eyes for you. You have been through so much in a short while. To be honest I know not much about AN nor ENSAM and no one at this point knows much of ENSAM. My own pdoc will pescribe it for me but didn't even know of the wash out period. I am thinking of you and wishing you the best as you will make a wonderful pdoc. As they say walk in the shoes first. Just trying to be supportive to you. Love Phillipa
Posted by SLS on April 26, 2006, at 22:16:13
In reply to Labeled chronic losing hope. (Long), posted by tygereyes on April 26, 2006, at 20:56:46
I am dismayed that you feel injured as the result of your interactions here. I usually find people here to be kind and supportive. I don't doubt that you have encountered people who are less than supportive. However, it might be part of your BPD that is amplifying a sense of rejection.
Parnate isn't a bad choice if you can adhere to the diet restrictions. Another drug to consider is either Tegretol or Trileptal. It helps to reduce impulsivity and mood lability. You can combine it with Parnate. I have seen Zyprexa work wonders for BPD. However, it will produce weight gain. If this is an issue, it might be worth considering Abilify instead. Plenty of people will find my suggesting Zyprexa or Abilify as being unjustified when treating a disorder other than schizophrenia. However, BPD is difficult to treat, and one must weigh the potential benefits versus the risks of developing EPS side effects. For myself, I have decided that the risk of EPS with Abilify is low enough that I can justify using it to treat bipolar disorder.
I'm sorry that DBT didn't work out for you. I hope you fair better with the Schema Therapy.
I would say that you have some rough road ahead of you. However, I think you can make it. You are resolved and constructive. I know you have reached a point of frustration and despair, but this crisis will pass and you will continue your journey. I know this because of the strength of character you have demonstrated. I wish I could do more to help.
All I can say is that Parnate + Trileptal + Abilify is a weight-neutral treatment regime that might optimize your chances of success. There probably isn't a precedent for combining these drugs, but it should be safe. I hope others will chime in and comment on this.
- Scott
Posted by Racer on April 27, 2006, at 1:36:12
In reply to Labeled chronic losing hope. (Long), posted by tygereyes on April 26, 2006, at 20:56:46
I think you're right, about there not being a happy pill that will make all this go away. But there is hope -- even beyond the usual "where there's life, there's hope" routine.
My dxs are Major Depressive Disorder, Anxiety Disorder Not Otherwise Specified, and Anorexia Nervosa. An I'm a couple of decades older than you are, so I guess you could say it's chronic...
There's good news and bad news about my story, the good news being that I've had long periods of time with only a few symptoms of the anorexia. I'm being honest here -- some of the symptoms have just never really gone away. I've always had trouble with recognizing hunger and satiety, for instance. But in many ways, during those times, I just ate what I wanted, when I wanted. I didn't go through my anxiety attacks about whether or not I could eat something, no automatic calculations of fat/protein/carbohydrate/calories, no consideration of how many calories I burned in any activities -- and I didn't step on the scale if I could help it, and made doctors' offices weigh me backwards so that I wouldn't be triggered. And it didn't bother me.
The bad news being that I have relapsed a number of times.
I figure the fact that I could eat what I thought sounded good, without thinking about it beyond whether something else sounded better, tells me that it is possible.
I admit a strong bias -- I think psychodynamic therapy is probably the most effective model for anorexia. I also think that it might be helpful for your BPD, too, in that it can help you identify how you learned certain behaviors, and maybe that will help you in overcoming them. That's my opinion, and I have nothing to back it up. (Although the ED expert in the area where I live is psychodynamic, so maybe I'm not alone in thinking it...)
I don't know enough about what drugs would be most helpful, although I can tell you that SSRIs have been shown to help prevent relapse in weight restored anorexics, Topomax helps reduce binging/purging behavior for many people (you didn't mention whether you restrict or b/p, but I'm guessing that's an issue for you, too?), Walter Kaye published a study last fall that showed abnormal OVERactivity in the serotonin system of weight-recovered anrorexics (which might indicate that non-serotinergic ADs would be a better choice), Zyprexa has been shown effective in reducing the obsessive compulsive symptoms and the anxiety regarding weight gain, and I'm pretty sure there are some I'm missing.
I hope that's helpful. I didn't answer you on Eating earlier, both because I was short of time, and because I really wasn't sure how to respond. I didn't really feel as though I had anything useful to offer.
Posted by Crazy Horse on April 27, 2006, at 8:25:31
In reply to Labeled chronic losing hope. (Long), posted by tygereyes on April 26, 2006, at 20:56:46
> I guess I'll go back to EMSAM. It's worth a try. And I'll look into this Schema Therapy, too.
>
> I want to - NEED to - believe that I can overcome this.
Going back to EMSAM, and trying Schema Therapy are i think excellent choices you are making. And you can and will overcome this with persistence, and a lot of hard work. You seem like a very intelligent and determined young women...use those strengths to fight your illnesses. I wish you only the best and will remember you in my prayers.Monte
Posted by tygereyes on April 27, 2006, at 21:05:22
In reply to Re: Labeled chronic losing hope. (Long) » tygereyes, posted by SLS on April 26, 2006, at 22:16:13
I had to stop Parnate because of cystic acne (which still hasn't gone away), severe insomnia, and addiction (I kept upping the dose to get high & started using it as an appetite suppressant & even began snorting it). I have realized that I cannot take Parnate without abusing it.
Trileptal ... been there, done that. Had memory and cognition problems at even low doses (300 mgs, which is what it was reduced to, from 1050 when I realized I couldn't study anymore and couldn't remember events that had happened last week).
I will not take Topamax (Stupi-max) for the same reason. I need my cognitive facilities intact for med school. Besides, after the weights I've gotten to in the past and the way Parnate's anorexic properties precipitated a relapse into anorexia in October when I began taking it, no doctor will prescribe Topamax to me.
I've never tried Abilify but heard it can cause insomnia - I have severe insomnia and can't handle anymore of it, especially after Parnate used to leave me awake for 72 hours straight, in spite of taking Ambien AND Ambien CR AND Seroquel!
I know I will never be helped by medication in the same way that people who have Bipolar Disorder or Major Depressive Disorder do. I might not even start EMSAM again - I don't really feel particularly worse since I stopped the Parnate, after the awful withdrawal was over - but we'll see how long that lasts.
I am going to have to work so hard in therapy if I ever want to have a chance at life. I know that and I'm ready for it.
Thank you all for your responses.
Posted by Crazy Horse on April 28, 2006, at 8:40:21
In reply to Re: Labeled chronic losing hope. (Long), posted by tygereyes on April 27, 2006, at 21:05:22
> I had to stop Parnate because of cystic acne (which still hasn't gone away), severe insomnia, and addiction (I kept upping the dose to get high & started using it as an appetite suppressant & even began snorting it). I have realized that I cannot take Parnate without abusing it.
>
> Trileptal ... been there, done that. Had memory and cognition problems at even low doses (300 mgs, which is what it was reduced to, from 1050 when I realized I couldn't study anymore and couldn't remember events that had happened last week).
>
> I will not take Topamax (Stupi-max) for the same reason. I need my cognitive facilities intact for med school. Besides, after the weights I've gotten to in the past and the way Parnate's anorexic properties precipitated a relapse into anorexia in October when I began taking it, no doctor will prescribe Topamax to me.
>
> I've never tried Abilify but heard it can cause insomnia - I have severe insomnia and can't handle anymore of it, especially after Parnate used to leave me awake for 72 hours straight, in spite of taking Ambien AND Ambien CR AND Seroquel!
>
> I know I will never be helped by medication in the same way that people who have Bipolar Disorder or Major Depressive Disorder do. I might not even start EMSAM again - I don't really feel particularly worse since I stopped the Parnate, after the awful withdrawal was over - but we'll see how long that lasts.
>
> I am going to have to work so hard in therapy if I ever want to have a chance at life. I know that and I'm ready for it.
>
> Thank you all for your responses.I think you are ready for it too. You sound like a very determined young lady. Here's to you getting well! :)
Monte
Posted by Dr. Bob on April 28, 2006, at 11:31:11
In reply to Labeled chronic losing hope. (Long), posted by tygereyes on April 26, 2006, at 20:56:46
> I have been so hurt by people on this board and some of the responses here have resulted in fresh scars on my skin
I'm sorry it hasn't gone better for you here, but the idea here is not to post anything that could lead others to feel accused, so could you please rephrase the above?
But please don't take this personally, this doesn't mean I don't like you or think you're a bad person.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by ravenstorm on April 29, 2006, at 9:59:14
In reply to Re: please rephrase that » tygereyes, posted by Dr. Bob on April 28, 2006, at 11:31:11
I just wanted to say how proud I am of you for reallizing that you can not take parnate anymore. It is a big step and big departure from earlier posts by you. I was very concerned by your posts of wanting to get back on parnate to get high and control your weight. So, congratulations for not wanting to abuse yourself in that manner anymore.
My advise to you, you probably don't want to hear, but you've asked so here goes.
I think a PRIVATE, small in patient facility that will deal with all of you and your problems cohesively is what you need. Stop school and go save your life. You are more than your diagnosises. You need to go somewhere that treats not only the dx's but the core issues that have caused the borderline, the eating disorder the addiction. You need somewhere safe and you need TIME. This won't go away in a week or two. It is the hardest thing you will ever do in your life. I hope you don't think I'm attacking you. I feel for you and want you to get well.
Posted by Crazy Horse on April 29, 2006, at 10:50:36
In reply to Re: tyger, posted by ravenstorm on April 29, 2006, at 9:59:14
> I just wanted to say how proud I am of you for reallizing that you can not take parnate anymore. It is a big step and big departure from earlier posts by you. I was very concerned by your posts of wanting to get back on parnate to get high and control your weight. So, congratulations for not wanting to abuse yourself in that manner anymore.
>
> My advise to you, you probably don't want to hear, but you've asked so here goes.
>
> I think a PRIVATE, small in patient facility that will deal with all of you and your problems cohesively is what you need. Stop school and go save your life. You are more than your diagnosises. You need to go somewhere that treats not only the dx's but the core issues that have caused the borderline, the eating disorder the addiction. You need somewhere safe and you need TIME. This won't go away in a week or two. It is the hardest thing you will ever do in your life. I hope you don't think I'm attacking you. I feel for you and want you to get well.Excellent advice Ravenstorm! I agree, saving your life is the most important thing Tygereyes. You are young and can finish school at a later date.
Monte
Posted by Racer on April 30, 2006, at 10:46:04
In reply to Re: tyger » ravenstorm, posted by Crazy Horse on April 29, 2006, at 10:50:36
I think Raven's advice is very good. A small private facility would be great, and I do know of a few recommended by my T for me, and there are a few scholarship-type programs that may help pay for the treatment. Insurance often pays for part of it, but it *is* expensive, no question.
My T highly recommends Mirasol, and Sierra Tucson. I looked them both up, and Sierra Tucson kinda didn't do it for me... It's based on the addiction model, because it started as a substance abuse center, and it has a ton of regulations -- what you can wear, what you can read, etc. For me, in the summer, in Tucson? I'm sorry, I will MELT if I have to wear knee length shorts. I have my "I'm over 40, these are as short as I will go" shorts that I live in through the summer, and see no reason to buy others just to stay within the rules. They also restrict what you can read -- and it's not just "no fashion magazines, you don't need to be triggered..." stuff. They *only* allow recovery related reading matter.
Of course, they're also highly recommended, they have a comprehensive program, and I know my T has actually been there for a retreat they gave for people who refer clients there. She sounded as though that was her preference for me, (maybe because of the equine assisted therapy), so I have to say keep an open mind about it. And the addiction model might work better with the borderline component added to your issues.
Mirasol looked really good to me, and if not for a few real life issues going on at the time, I probably would have tried to get coverage and get there. (Whether or not that would have worked, though, is another matter... I would have been afraid of battles over food, because I'm a picky eater, and get into panic-y things where I just *can't* eat something that I don't want to eat. Hard to explain, but the second someone says, 'You *have* to eat this,' all bets are off.) Their prices were lower than some of the other facilities, their philosophy fit better with what I thought I needed, etc.
And truly, Tyger, Raven's given you some really good advice. You can take a leave of absence for health problems like this, surely? And don't worry about what the long term effects of that leave might do to your career -- because dying has a bad effect on careers, too, and being too sick to care properly for your patients would be a Very Bad Thing, especially because when you're starving, you really don't know how messed up your thinking is.
Hope that helps. Something Fishy should have info on scholarships, if you need to find on. Good luck.
Posted by ravenstorm on April 30, 2006, at 16:42:38
In reply to Raven's advice was good, following up on it, posted by Racer on April 30, 2006, at 10:46:04
Racer, thanks so much for adding that practical information to my previous advice. I didn't know where to suggest and I don't have the energy right now to do that kind of research. I so appreciate you chiming in with actual suggestions!
Tygereyes--where are you? We are all concerned for you and care about what happens to you.
Posted by tygereyes on April 30, 2006, at 21:07:51
In reply to Re: tyger, posted by ravenstorm on April 29, 2006, at 9:59:14
I have done inpatient facilities. I have been inpatient for anorexia multiple times, self-injury, and drugs. And a suicide attempt.
From working in psychiatry, I have seen that inpatient programs do not help. Period. They help for crisis stabilization (and clearly, when I weighed under 60 pounds or when I was habitually sticking syringes in my veins, I needed that kind of stabilization) but ANYTHING that takes you away from your real life is very dangerous, because you enter a state where the only way you can be in recovery is to be in that "safe" environment.
No way.
I'm going to do this in the real world. I have managed to survive for twenty-three years and things have been much, MUCH worse in the past. I am not one of those people who can devote my entire life to recovery, to getting better. Even six weeks in the hospital (my longest hospitalization to date, for anorexia) caused me to go out of my mind. I would have checked out if it hadn't been an involuntary admission.
Thank you for your concern. But I am not doing inpatient. Aside from the fact that there are NO effective inpatient programs for borderline personality disorder [what underlies the addictive behaviors], I have seen the lack of efficacy of these programs with my own eyes.
> I just wanted to say how proud I am of you for reallizing that you can not take parnate anymore. It is a big step and big departure from earlier posts by you. I was very concerned by your posts of wanting to get back on parnate to get high and control your weight. So, congratulations for not wanting to abuse yourself in that manner anymore.
>
> My advise to you, you probably don't want to hear, but you've asked so here goes.
>
> I think a PRIVATE, small in patient facility that will deal with all of you and your problems cohesively is what you need. Stop school and go save your life. You are more than your diagnosises. You need to go somewhere that treats not only the dx's but the core issues that have caused the borderline, the eating disorder the addiction. You need somewhere safe and you need TIME. This won't go away in a week or two. It is the hardest thing you will ever do in your life. I hope you don't think I'm attacking you. I feel for you and want you to get well.
Posted by tygereyes on April 30, 2006, at 21:13:01
In reply to Re: Raven's advice was good, following up on it, posted by ravenstorm on April 30, 2006, at 16:42:38
I'm sorry, I spent the weekend away with my mom and haven't had Internet access until now.
I am tired of compartmentalized treatment. Tired of treating anorexia only to relapse on drugs. Tired of getting clean only to relapse into anorexia. Tired of stopping both to take razors to my skin.
These are all the surface issues. And the more so-called "treatment" I receive for my ED and my addiction and my self-injury, the worse this cycle becomes.
I have looked into Schema Therapy. It takes into account EVERYTHING - from the behaviors to the underlying psychopathology to the childhood trauma - and it "fits" in a way that DBT never did. I have hope, having read the practitioner's guide. And their center is in NYC, where I currently live.
I have said that I will see the inside of a coffin before I ever see another treatment facility again, and I meant it. I will do this outpatient or I won't do it at all. Call it borderline thinking if you will, but I am not going inpatient. Not now, not again, not ever.
> Racer, thanks so much for adding that practical information to my previous advice. I didn't know where to suggest and I don't have the energy right now to do that kind of research. I so appreciate you chiming in with actual suggestions!
>
> Tygereyes--where are you? We are all concerned for you and care about what happens to you.
Posted by Racer on May 1, 2006, at 10:35:57
In reply to Re: tyger, posted by tygereyes on April 30, 2006, at 21:07:51
>
> From working in psychiatry, I have seen that inpatient programs do not help. Period.
>
> Thank you for your concern. But I am not doing inpatient. Aside from the fact that there are NO effective inpatient programs for borderline personality disorder [what underlies the addictive behaviors], I have seen the lack of efficacy of these programs with my own eyes.
>So, if you already know what you're going to do, and you've decided that you're not going to do anything other that this one thing, why are you asking for advice here? Or maybe what I want to say is, "We're offering advice in good faith, could you maybe take it with a little more grace and a little less stridency in your refusal?" It does sound like Borderline thinking, on your part, to ask for advice and then say it's wrong quite so bluntly.
For the record -- neither Ravenstorm nor I said word one about inpatient treatment. We were talking about residential treatment facilities, which are very different things. You're absolutely right, they do take you out of real life and put you into a place that doesn't have a lot of those stresses that trigger people. But they have a wide range of treatements available within their programs, and they can help a lot.
You'll excuse me for saying this, too -- you say that you've seen and learned so very much in your 23 years, so you know best what sorts of treatments work or don't work? I've been anorexic for 28 years now, am in treatment for it now, have learned apparently much less than you have, and am here to tell you that you will have a much harder time with any sort of treatment if you reject what other people offer quite so broadly.
Posted by Dr. Bob on May 1, 2006, at 18:04:08
In reply to Re: please rephrase that » tygereyes, posted by Dr. Bob on April 28, 2006, at 11:31:11
> > I have been so hurt by people on this board and some of the responses here have resulted in fresh scars on my skin
>
> I'm sorry it hasn't gone better for you here, but the idea here is not to post anything that could lead others to feel accused, so could you please rephrase the above?
>
> But please don't take this personally, this doesn't mean I don't like you or think you're a bad person.
>
> If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
>
> http://www.dr-bob.org/babble/faq.html#civil
> http://www.dr-bob.org/babble/faq.html#enforce
>
> Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
>
> Thanks,
>
> Bob
Posted by Dr. Bob on May 1, 2006, at 18:04:55
In reply to Re: tyger, posted by Racer on May 1, 2006, at 10:35:57
> "We're offering advice in good faith, could you maybe take it with a little more grace and a little less stridency in your refusal?"
Sorry, but again, the idea here is not to post anything that could lead others to feel accused or put down, so could you please rephrase the above?
Thanks,
Bob
Posted by tygereyes on May 1, 2006, at 18:41:35
In reply to Re: in case you didn't see this before » tygereyes, posted by Dr. Bob on May 1, 2006, at 18:04:08
I apologize; I didn't know you wanted me to literally rephrase it; I simply thought you were warning me about the phrasing of future posts.
Here it is, rephrased:
One of my big triggers is feeling attacked or put down. At times like this, I tend to act self-destructively, as I did when I read a thread in which I felt someone was attacking me.
I take responsibility for my decision to self-injure after reading this board and can blame no one but myself for that decision.
> > > I have been so hurt by people on this board and some of the responses here have resulted in fresh scars on my skin
> >
> > I'm sorry it hasn't gone better for you here, but the idea here is not to post anything that could lead others to feel accused, so could you please rephrase the above?
> >
> > But please don't take this personally, this doesn't mean I don't like you or think you're a bad person.
> >
> > If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
> >
> > http://www.dr-bob.org/babble/faq.html#civil
> > http://www.dr-bob.org/babble/faq.html#enforce
> >
> > Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
> >
> > Thanks,
> >
> > Bob
Posted by tygereyes on May 1, 2006, at 18:48:45
In reply to Re: tyger, posted by Racer on May 1, 2006, at 10:35:57
You're right; I was asking for suggestions. However, I was asking for suggestions that are realistic to me: medication management and outpatient treatment.
I have been on both sides - a psychiatric patient and med student. I've been involved in research though (obviously, for privacy purposes) I can't disclose the nature of that research.
Additionally, I have done a tremendous amount of independent research. I have learned that CBT - the standard treatment for AN - is horribly ineffective for this condition. That DBT as a treatment for BPD, if you examine the research studies, has not yet been proven to be effective [despite what Marsha Linehan would have you believe from her conclusions/discussions - however, scrutinize the methodology and actual numbers and do a head-to-head comparison with other BPD treatment studies and you will find that DBT is actually rather ineffective]. Psychodynamic psychotherapy has a similar lack of efficacy for both populations. Residental programs work - until the individual returns to the real world and realizes they've just wasted a significant period of time in their lives.
When I speak of knowing what does and does not work, I speak not only as a patient who has failed multiple treatments but also as someone who has done extensive research, both personally and professionally.
> >
> > From working in psychiatry, I have seen that inpatient programs do not help. Period.
> >
> > Thank you for your concern. But I am not doing inpatient. Aside from the fact that there are NO effective inpatient programs for borderline personality disorder [what underlies the addictive behaviors], I have seen the lack of efficacy of these programs with my own eyes.
> >
>
> So, if you already know what you're going to do, and you've decided that you're not going to do anything other that this one thing, why are you asking for advice here? Or maybe what I want to say is, "We're offering advice in good faith, could you maybe take it with a little more grace and a little less stridency in your refusal?" It does sound like Borderline thinking, on your part, to ask for advice and then say it's wrong quite so bluntly.
>
> For the record -- neither Ravenstorm nor I said word one about inpatient treatment. We were talking about residential treatment facilities, which are very different things. You're absolutely right, they do take you out of real life and put you into a place that doesn't have a lot of those stresses that trigger people. But they have a wide range of treatements available within their programs, and they can help a lot.
>
> You'll excuse me for saying this, too -- you say that you've seen and learned so very much in your 23 years, so you know best what sorts of treatments work or don't work? I've been anorexic for 28 years now, am in treatment for it now, have learned apparently much less than you have, and am here to tell you that you will have a much harder time with any sort of treatment if you reject what other people offer quite so broadly.
Posted by Dr. Bob on May 1, 2006, at 19:47:44
In reply to Re: in case you didn't see this before, posted by tygereyes on May 1, 2006, at 18:41:35
> I apologize; I didn't know you wanted me to literally rephrase it; I simply thought you were warning me about the phrasing of future posts.
>
> Here it is, rephrased:
>
> One of my big triggers is feeling attacked or put down. At times like this, I tend to act self-destructively, as I did when I read a thread in which I felt someone was attacking me.
>
> I take responsibility for my decision to self-injure after reading this board and can blame no one but myself for that decision.Thanks. It may seem minor, but IMO, even better than the above would be:
> One of my big triggers is feeling attacked or put down. At times like this, I tend to act self-destructively, as I did when I read a thread in which I felt attacked.
I hope that makes sense,
Bob
Posted by Racer on May 2, 2006, at 1:48:30
In reply to Re: please rephrase that » Racer, posted by Dr. Bob on May 1, 2006, at 18:04:55
> > "We're offering advice in good faith, could you maybe take it with a little more grace and a little less stridency in your refusal?"
>
> Sorry, but again, the idea here is not to post anything that could lead others to feel accused or put down, so could you please rephrase the above?
>
> Thanks,
>
> BobNo, I'm the one who's sorry. Some days I let my own frustrations -- often about nothing to do with this place -- come out inappropriately. (And the fertility drugs don't help. Next week I think the crying over nothing starts again... {sigh} )
Anyway, let me try that again:
"I offered advice i thought was good, and I offered it in good faith. When I read your response, I felt rejected and frankly, rather insulted. That might have been my perception, and I'm sorry that we weren't able to help one another this time."
I hope that's better. It's late, and I am tired, so it may -- well, I was about to say it might not reflect any sort of articulateness, but that can probably be said about most of my posts...
Posted by Racer on May 2, 2006, at 1:51:16
In reply to Re: tyger, posted by tygereyes on May 1, 2006, at 18:48:45
>
> When I speak of knowing what does and does not work, I speak not only as a patient who has failed multiple treatments but also as someone who has done extensive research, both personally and professionally.
>I only know what's helped me, and been suggested to me for treatment by people who have helped me tremendously. And, after all, I'm only a patient.
Posted by tygereyes on May 2, 2006, at 10:05:33
In reply to Yeah, you got me beat » tygereyes, posted by Racer on May 2, 2006, at 1:51:16
I did not mean to imply that I am privvy to some kind of higher level of knowledge than you are - the papers are all there. Some are accessible without having to belong to an academic institution through google scholar or BMJ. Anyone can do the research if they take the time to do so.
Also, please remember that what worked for you will not work for everyone. I am fairly opposed to residential treatment in general and definitely opposed to it for myself. I need the distraction of work/school; I cannot put my life on hold. I have tried to do this before and decompensated beyond what I'd ever thought possible.
> >
> > When I speak of knowing what does and does not work, I speak not only as a patient who has failed multiple treatments but also as someone who has done extensive research, both personally and professionally.
> >
>
> I only know what's helped me, and been suggested to me for treatment by people who have helped me tremendously. And, after all, I'm only a patient.
Posted by Dr. Bob on May 2, 2006, at 20:01:59
In reply to Mea culpa... trying it again... » Dr. Bob, posted by Racer on May 2, 2006, at 1:48:30
This is the end of the thread.
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