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Dr. Bob is Robert Hsiung, MD,
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Posted by paisleygirl on January 18, 2012, at 20:52:06
In reply to Re: update » paisleygirl, posted by Dinah on January 18, 2012, at 19:03:53
> Well, I don't see any evidence pointing to evil. Not in what you've said.
>
hmmm..> Do you see where your anger with her might have caused you to behave in ways that, according to what she told you, would end in her terminating your therapy? I think it's normal enough, when someone gives an ultimatum, not to want to comply. But when you don't, the result is that you won't have that person in your life.
>
i think it all spun out of control. i really didn't think she would leave me.> Maybe you could think about it this way. She gave you an ultimatum. You deliberately cancelled future appointments with the DBT therapist without first discussing it with your pdoc. You then sent her an unprecedented communication that might be expected to confirm her fears that she's out of her depth, without the additional help of a DBT team. In effect, you arranged for her to leave you. You rejected a pdoc who gave you an ultimatum, and by doing so appeared to put conditions on her caring. You took actions to effectively leave your pdoc.
>
i really felt like i couldn't afford therapy with the dbt therapist. what am i supposed to do? go into major debt for therapy- which i feel like i should be strong enough and not even need?... the other option is to die.. that is more and more become a valid option... i talked with a crisis counselor tonight and basically promised her that i wouldn't do anything tonight, at least not until a follow-up phone call from them tomorrow... so i'm holding steady right now... but i see no solution to my problem. i'm still without a pdoc/therapist.. i'm still all alone.and what makes me upset is i told this pdoc stuff i hadn't told anyone before... i never trusted anyone.. i had seen her for 4 years. and i feel like she got to know me, found out about me, and then was like okay- i don't like her/i'm not dealing with her/she's crazy/ she's horrible/ she's bad. it's really sad when you reveal yourself to someone then get rejected.
> So... What do you do now? ER sounds like a good option to me. You don't currently have a treatment team and you might find one there. You would be making a decision to help yourself find providers you prefer to the ones you had.
>i've been to the er before in the past and the whole experience just seems really embarassing... like checking in - you say your complaint is 'depression', people may give you a funny look, and then they like put a one-to-one near you, so that you don't leave... and then you have to wait and wait and wait for hours... and get blood draws and stuff... and then i feel like they are judging me... and how do you trust the person who is chosen to talk to you when you dont know anything about them.. i feel like they would be making fun of me... i also think they think psych patients are annoying and wish they would go home so that it's less work for them... just my opinions..
> I once heard Marsha Linehan say that her patients were often thought manipulative by others. When the reality is that we all want to have our needs met, and behave in ways that we hope will achieve that end. Her patients just weren't very good at it.
>
> What are your goals at this point? What do you want in the way of a treatment team? What would you like from Babble? What are the best ways to get it?
>
my current goal is getting through a minute at a time... i have a bottle of percocet that i thought about taking, but i have decided i won't do that tonight... i think i'm going to try and take a hot bath... try not to cry... as far as what i want from Babble- i dont know support? i dont want to be seen as the crazy person. i think everyone is saying that i did stuff wrong, which may be true, but doesn't help me to feel better. actually can make me feel worse.. so i made a mistake sending the picture. at the time- even though its probably hard for you all to believe- i didnt' really realize that she would get so upset. i think i'm a bit desensitized to blood and stuff b/c actually i'm a physician in residency... this is another reason i dont want to go to the er.. i hear things when i work in the er, and i know that people get judged. i dont want to be judged. and sort of like being judged by my own people.. its hard. so hard. physicians never really want to ask for help... especially not young ones in training- it's sort of a sign of weakness.> Your pdoc is telling you that there's no way you can feel bad enough for her to take you back as a client. What doors would you like to see open? Can we help you problem solve to achieve your goals? Or at least some of them?
>i really wish i had an appt with someone this week. i dont want to be left for days and days and days by myself. but not sure how that's going to happen. i sort of feel like this is an emergency, but like i said, i dont want to go the er.
> We'd all like to be loved unconditionally. But in reality that may not be a realistic goal.
>
very sad.
> I really do urge you to contact the ER. It seems a sensible course of action for you at this point.hmm... i'm trying really hard not to go there.
Posted by sleepygirl2 on January 18, 2012, at 21:16:46
In reply to Re: update » Dinah, posted by paisleygirl on January 18, 2012, at 20:52:06
I'm glad you spoke with a crisis counselor.
I'm hopeful for you, that you'll find a way to get treatment you need.
Right now, you don't see a solution, but that's just right now, and while you're feeling awful.
I hope tomorrow feels a little better.
Posted by paisleygirl on January 18, 2012, at 22:05:04
In reply to Re: update » paisleygirl, posted by sleepygirl2 on January 18, 2012, at 21:16:46
thank you
> I'm glad you spoke with a crisis counselor.
> I'm hopeful for you, that you'll find a way to get treatment you need.
> Right now, you don't see a solution, but that's just right now, and while you're feeling awful.
> I hope tomorrow feels a little better.
>
Posted by Dinah on January 18, 2012, at 22:44:41
In reply to Re: update » Dinah, posted by paisleygirl on January 18, 2012, at 20:52:06
I'm sorry if I seemed to be judging you. My intent was to help you feel less out of control. To me, it's scary to think that I'm at the mercy of others. It's more helpful for me to recognize what power I do have.
I've done things not all that different from what you've done. The primary reason for stopping those things was that I was trying to convey certain things to my therapist, and he was coming to completely different conclusions about what I was saying. After butting my head over it time and time again, I started trying different ways of communicating with him.
Take care, and don't let fear of what others might say stop you from getting help if you need it.
Posted by Dinah on January 19, 2012, at 10:12:59
In reply to Re: update » paisleygirl, posted by Dinah on January 18, 2012, at 22:44:41
I wanted to add that although my behavior generally hurt my relationship with my therapist, I was extremely fortunate to have a therapist who didn't give me ultimatums about terminations. He did once ask me what my response would be if he were to give me an ultimatum. But he then said he wouldn't do it.
I think I'd have interpreted an ultimatum as abandonment. Because even if I had complied, I'd always know that I couldn't trust him to be there. I'd have wondered when he would put another condition on his presence. I'd have felt like he used something that I considered almost sacred to manipulate me. I know I'd have felt those things because I did feel them just at his question. The question alone upset the therapeutic relationship for a while.
I was extremely fortunate. I had a therapist who was able to tolerate his feelings of helplessness and his anxiety. I'm sorry you weren't that fortunate. The fact that she wasn't is a statement about her and her limitations, not a statement about you and whether you are bad. Any limitations on her services should have been disclosed up front, and I hope she does that in the future.
I'm more surprised that the DBT therapist won't take you back. As I understand it, any DBT therapist worth his salt would see that your actions fall well within the range of expected for a potential client. They would treat this as a therapy-interfering behavior and be equipped to deal with it.
That being said, I also had an experience where I saw a pdoc once and quit and wasn't allowed to return. I still feel ashamed of that, even though I understand that the Wellbutrin I was on contributed to my behavior, and he wasn't a good enough pdoc to notice that. My next pdoc noticed it on the first session and added a mood stabilizer.
This is an opportunity to find better help than you've been offered thus far.
Posted by paisleygirl on January 19, 2012, at 14:28:03
In reply to Re: update, posted by Dinah on January 19, 2012, at 10:12:59
i guess i didn't realize that dbt therapist doesn't want me back, but you're right- he didn't say oh, you can make an appt with me... he was more like- okay go away.
i came to work like an hour ago- of course everyone was pissed that i'm slacking and skipping work.
i have a major headache. i feel miserable.
i really wouldn't mind going to the er after all actually now, if i knew i would get to go home. i dont want to be admitted to a hospital. i don't want to leave my dog. and i dont want to get in more trouble with work.
i feel like i need to be able to speak with someone daily right now. for at least support... and realistically, that's not going to happen. so i'm kinda screwed.
my head hurts.
i want to shout to the world that I AM HURTING AND I'M IN PAIN.
i'm tired of trying to be strong, or that i can handle things, i cannot.
noone has ever taken care of me. i can't do things by myself. i feel like throwing my hands up in the ear and screaming I GIVE UP.
i am still pissed by my psdoc/therapist's words: "i know you're not okay, but what i was doing for you wasn't helping"
if i'm not okay, which you realize, and i realize, why the hell are you leaving me. why am i left all by myself.
i kinda feel dared to just kill myself. i want to show the world that everyone is awful. also, i am very sad and i dont want to live like this. there are so so so so many reasons why i should die. i feel like i haven't accomplished enough, that i'm not smart enough, that i'm not pretty, that i'm too fat, that i'm mean, that i'm gross, that i'm evil. plus, i'm poor, in major debt, all alone. just too many responsibilities on my shoulders. can someone please take these responsibilities away. please.
Posted by Dinah on January 19, 2012, at 15:21:25
In reply to Re: update » Dinah, posted by paisleygirl on January 19, 2012, at 14:28:03
Oh, I'm sorry. I misunderstood. If the DBT therapist is still available, I think you should call and make an appointment.
Posted by sleepygirl2 on January 19, 2012, at 17:56:51
In reply to Re: update » Dinah, posted by paisleygirl on January 19, 2012, at 14:28:03
I agree with Dinah. It didn't sound like you were banned from dbt, but that you just were not engaged in treatment with them. You could tell them you changed your mind.
Posted by emmanuel98 on January 19, 2012, at 18:56:27
In reply to Re: update » paisleygirl, posted by sleepygirl2 on January 19, 2012, at 17:56:51
I'm a little unclear on the DBT guy. You didn't keep a follow-up appointment and he sent you an email saying call 911 if you need help. But he didn't close the door on your reconnecting, right? Can you call him again and make an appointment? Of course, if you don't keep the appointment, he may drop you. This is something therapists take very seriously with good reason.
As far as ultimatums. Maybe if you start the DBT you can call your p-doc and ask if you might meet with her and discuss this. But my p-doc/therapist has twice given ultimatums and I took them very seriously. They really put a fire under me, because I cared so much about our relationship. When I first started, he insisted I attend an outpatient program and, after two days, I said I couldn't go. He said, in that case, he couldn't work with me. He was serious, so I went to the program and actually got a lot out of it. Later he told me that if I didn't get off opiates, he would not continue to see me. I started calling every suboxone clinic/provider in the area, found a good one and he tapered me off, which was a good outcome.
Therapists don't issue ultimatums to intimidate you or because they hate you. They have simply reached a point where they realize -- I can't help this person or deal with this person if they don't get additional resources. It is too much for me. They have their limits. Therapy is emotionally draining and they need to set boundaries for their own peace of mind. Once I asked my p-doc what our relationship was like for him and he said, it's intense. It's intense on both ends. He said it's not a job where you just go home and forget about everything, although you have to learn to do that to some degree.
Anyway, if I were you, paisleygirl, I would reconnect with the DBT guy and make a committment to it. (DBT therapists are very big on committments and contracts). If you are suicidal, go to the ER. You don't have to go to the hospital where you work. I know ER's suck and you wait and wait and wait. Another option is to connect with this DBT guy and ask him to help you get admitted. Some stand-alone psych hospitals do direct intakes if a therapist calls and arranges it without you having to go through an ER.
Posted by paisleygirl on January 19, 2012, at 22:51:42
In reply to Re: update, posted by emmanuel98 on January 19, 2012, at 18:56:27
i called dbt guy and emailed him asking basically if he would still consider seeing me... no response.. previously he would reply promptly... its been like all day. i dont think that's an option.
i just called pdoc/therapist and left an angry message- blaming her for leaving me b/c i wouldn't see dbt person, then saying dbt person won't see me, and that you left me without a psychiatrist and therapist and no referrals and after 4 YEARS and that i was angry and that ultimatums are unfair and i think i said i'm a suicidal person. but i didnt' mean immediately suicidal, just suicidal ideation. after hanging up the phone, i thought about calling back and clarifying that, but then i thought its already way too messed up so oh well. and i am actually not sure she is going to even listen to my message. she said she wouldn't read my emails. that she would just delete. i have a feeling if she hears my voice on her voicemail she'll just click delete too.
so the moral of the story is- i am all alone. and i have no official treatment people. i guess i have burned all my bridges. way to go me.
i kind of want to shout her name to the world and say she is a very bad therapist... how could i have trusted her at any time point. i dont know.. i dont get it.
Posted by paisleygirl on January 19, 2012, at 23:50:16
In reply to Re: update, posted by paisleygirl on January 19, 2012, at 22:51:42
oh i just got an angry email back from old pdoc/therapist telling me not to call her anymore.
lovely.
f*ck everyone. i give up.
Posted by Dinah on January 20, 2012, at 8:48:30
In reply to Re: update, posted by paisleygirl on January 19, 2012, at 23:50:16
It's probably just as well at this point to give up on old pdoc.
Try calling the DBT therapist and telling him why you didn't come back the first time, and how your situation has changed. Tell hm if you're willing to contract to commit to therapy.
Posted by paisleygirl on January 20, 2012, at 9:51:45
In reply to Re: update » paisleygirl, posted by Dinah on January 20, 2012, at 8:48:30
i dont want to give up on old pdoc. i'm crying.. noone loves me. i see no solution right now.
> It's probably just as well at this point to give up on old pdoc.
>
> Try calling the DBT therapist and telling him why you didn't come back the first time, and how your situation has changed. Tell hm if you're willing to contract to commit to therapy.
>
>
Posted by paisleygirl on January 20, 2012, at 9:53:33
In reply to Re: update » Dinah, posted by paisleygirl on January 20, 2012, at 9:51:45
i know i sound like a whiny baby.
i guess i'll stop posting.
im so retarded and f*ck*d up.
> i dont want to give up on old pdoc. i'm crying.. noone loves me. i see no solution right now.
>
>
>
>
> > It's probably just as well at this point to give up on old pdoc.
> >
> > Try calling the DBT therapist and telling him why you didn't come back the first time, and how your situation has changed. Tell hm if you're willing to contract to commit to therapy.
> >
> >
>
>
Posted by emmanuel98 on January 20, 2012, at 18:41:44
In reply to Re: update, posted by paisleygirl on January 20, 2012, at 9:53:33
No. Keep posting. The worst thing to do when you're having a hard time is to walk away from help and tell yourself -- I'm whining, nobody cares. Believe me, I've been there. Keep posting and we will keep responding and helping as best we know how.
Posted by Dinah on January 20, 2012, at 19:41:17
In reply to Re: update, posted by paisleygirl on January 20, 2012, at 9:53:33
You wouldn't judge others so harshly would you?
I've told you I've had a similar experience with a pdoc. Would you call me those things?
I'm sorry you are losing a trusted pdoc. Losing my therapist is one of my biggest fears. It's a big loss.
Posted by paisleygirl on January 21, 2012, at 11:20:10
In reply to Re: update, posted by emmanuel98 on January 20, 2012, at 18:41:44
i dont know. i appreciate you guys' support, but i feel all alone in real life.
i've concluded when people get to know me, they then hate me, and then they leave me.
> No. Keep posting. The worst thing to do when you're having a hard time is to walk away from help and tell yourself -- I'm whining, nobody cares. Believe me, I've been there. Keep posting and we will keep responding and helping as best we know how.
Posted by paisleygirl on January 21, 2012, at 11:29:05
In reply to Re: update » paisleygirl, posted by Dinah on January 20, 2012, at 19:41:17
i dont think i would judge others as harshly, but its different when its yourself.
i think too old pdoc, i'm chronically suicidal, chronically self-destructive, chronically looking for ways to make my situation worse, and that i dont know how to get better.
i just keep going down this tunnel and hitting new er and newer lows.
i've never felt as alone in the world as i do have.
i realize over the past months to years, i have isolated myself from all of my old close friends.
i'm like a stranger now. and i think i've turned into a ghost of a person.i've done bad stuff. and i know better.
i've cut, i've looked for old men online to hurt me and abuse me- and then met up with several regularly. really self-destructive stuff. ive taken too much tylenol from time to time, but not enough to cause ultimate fulminant liver damage.and i guess to my old pdoc i ignored her recommendation regarding dbt treatment, but really i dont think i did that on purpose. i think the true reason is i feel like i cannot afford it. well actually not "i feel like", i really cannot afford it at this time. i'm behind in all my bills as it is.
i have no family i can turn to for support, my friends are gone and if i try to get back in their lives with this stuff, they are going to just think i'm psycho and scary and not the same person i was. if i say anything to my boss or people at work to try and get help, it will just look bad, and i will get into more trouble at work.
so i really think i've calmed down and have thought things through. i just dont know what to do. i dont see a solution.
even if i saw a new pdoc tomorrow, which i dont think is possible, i have a very hard time trusting people and i'm not going to just blab out "oh by the way, i have thoughts of killing myself like several times a day". it takes time to build up trust to let someone know that in person for me.
i could prescribe myself some prozac and re-start that, but that will take a couple weeks to have an effect.
i dont know. i am hurt by old pdoc. i feel alone. she's just another person to add to the list of people who have abandoned me. i agree i was difficult. i dont think i meant to be. i dont know.
so confused so confused.
sorry that i just rattled off what i was thinking.> You wouldn't judge others so harshly would you?
>
> I've told you I've had a similar experience with a pdoc. Would you call me those things?
>
> I'm sorry you are losing a trusted pdoc. Losing my therapist is one of my biggest fears. It's a big loss.
Posted by Dinah on January 21, 2012, at 11:42:35
In reply to Re: update » Dinah, posted by paisleygirl on January 21, 2012, at 11:29:05
DBT sounds perfect for you. The feelings you are struggling with are feelings that DBT was meant to deal with. The founder of DBT based her treatment approach on her own familiarity with those feelings and it's obvious.
Can you afford DBT now that you no longer have to pay a psychiatrist?
Have you tried other medications than SSRI's? I actually started self injuring on Luvox, and self injured far less off Luvox. A mood stabilizer definitely helped while I was on Luvox. But the medication that helped me most was low dose Risperdal taken when I was feeling the onset of a meltdown. A good psychiatrist helped me immensely and had the detachment that self medication doesn't provide.
Medications were most helpful in that they gave me a base to tolerate therapy.
Is your job in any jeopardy? My therapist always considered any actions that jeopardized my employment as jeopardizing therapy, since they affected my ability to pay.
Is the DBT treatment covered by insurance, in or out of network? Do they have sliding scale rates? What problem solving can you do involving the affordability of the program?
Posted by Dinah on January 21, 2012, at 11:46:04
In reply to Re: update, posted by Dinah on January 21, 2012, at 11:42:35
In the meantime, can you borrow a copy of "Skills Training for Treating Manual Borderline Personality Disorder" or "Cognitive Behavior Treatment of Borderline Personality Disorder"?
The latter actually helped me more than the former. I had so many "ah-hah" moments reading it.
Posted by paisleygirl on January 21, 2012, at 14:29:24
In reply to Re: update, posted by Dinah on January 21, 2012, at 11:46:04
i dont want to have borderline personality disorder
> In the meantime, can you borrow a copy of "Skills Training for Treating Manual Borderline Personality Disorder" or "Cognitive Behavior Treatment of Borderline Personality Disorder"?
>
> The latter actually helped me more than the former. I had so many "ah-hah" moments reading it.
Posted by Dinah on January 21, 2012, at 15:09:16
In reply to Re: update » Dinah, posted by paisleygirl on January 21, 2012, at 14:29:24
I don't meet the diagnostic criteria and have never been diagnosed with it. But I still found myself in her books. Don't get hung up on the label. Despite the book names, her treatments weren't designed for borderline clients. They were designed for clients with suicidal and self injuring tendencies. She talks about labile emotions.
Posted by emmanuel98 on January 21, 2012, at 18:22:55
In reply to Re: update » Dinah, posted by paisleygirl on January 21, 2012, at 14:29:24
> i dont want to have borderline personality disorder
Why? What's so terrible about that? The things you write -- fear of abandonment, self-harming, undermining relationships with p-doc and DBT therapist, feeling isolated, hated, unable to get help -- these are common borderline traits. I have (or used to have) a lot of borderline traits. DBT and therapy have helped.DBT works for a lot of conditions but it is especially helpful for people given to despair, suicidality, emotional dysregulation, self-harm behaviors. Like Dinah said, maybe if you aren't seeing a p-doc, you can afford DBT.
As far as meds go, like Dinah, I take risperidone on a prn basis. Very infrequently since it makes me gain weight. I take it with ativan to knock me out when I get suicidal and agitated. 12-14 hours of sleep really makes me feel much better.
Do you have insurance? If you're a resident, you
must have insurance. You could get a scrip for risperidone from a primary care doctor.There are options. You're not out of options and you're not alone.
Like Dinah said, if you can't work directly with someone on DBT, you could buy the skills training manual. Amazon has it. It's not the same as working with a therapist or in a group, but it can be very helpful.
Posted by Dinah on January 25, 2012, at 7:19:35
In reply to Re: update » Dinah, posted by paisleygirl on January 21, 2012, at 14:29:24
Have you been able to get in touch with the DBT therapist?
Posted by paisleygirl on January 25, 2012, at 14:40:23
In reply to How are you doing? » paisleygirl, posted by Dinah on January 25, 2012, at 7:19:35
nope he ignored me and didn't write or call back.
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