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communistmeme · 4 months

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#dbt #personalposting #bpd #dbt patients ARE YOU OUT THERE #i will be so emotionally unwell and then i open my dbt book for the answers #and literally the answer is im hungry or tired or missed my T shot #pain

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ohara-n-brown · 5 months

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As a late diagnosed autist I will say one of the most damaging but transformative experiences I've ever had was being misdiagnosed with BPD.

Everyday my heart goes out to people with BPD.

The amount of stigma and silencing they face is astonishing and sickening.

I took DBT for years. Therapists use to turn me away because of my diagnosis.

I would be having full blown autistic meltdowns, crying for help literally - but because I was labeled as BPD ANY time I cried I was treated as manipulative and unstable.

As if the only reason I could be crying was if I was out to trick someone.

95% of the books out there with Borderline in the title are named shit like 'How to get away from a person with Borderline', 'How to stop walking on eggshells (with a person who has BPD)'

I was never allowed to feel true pain or panic or need.

That was 'attention seeking behavior', not me asking for help when a disability was literally inhibiting my ability to process emotions.

There were dozens of times where I had a full meltdown and was either threatened with institutionalization or told I was doing it for attention.

My failing relationships weren't due to a communication issue, or the inability to read social cues. No, because I was labeled borderline, my unstable relationships were my fault. Me beggong nuerotypicals to just be honest and blunt with what they meant was me pestering them for validation.

Borderline patients can't win.

And the funny thing is - I asked my therapist about autism. I told her I thought I was on the spectrum.

BPD is WILDLY misdiagnosed with those with autism and I had many clear signs.

Instead - she told me 'If you were autistic we wouldn't be able to have this conversation'. She made me go through a list of autistic traits made clearly for children, citing how I didn't fit each one.

And then she told me that me identifying with the autism community was the BPD making me search for identity to be accepted - and that I wasn't autistic, just desperate to fit in somewhere.

I didn't get diagnosed for another ten years. For ten years I avoided the autism community - feeling as if I were just a broken person who wanted to steal from people who 'really needed it'.

Because of my providers - I began to doubt my identity MORE, not less.

Ten years of thinking I was borderline and being emotionally neglected and demonized by a system meant to help me.

To this day, I still don't trust neurotypicals. Not fully.

I know I'm not borderline now - but my heart aches for them. Not for the usual stuff. But for the stigma. And the asshole doctors. And the dismissiveness and threatening and the idea of institutionalization hanging over their head.

I love Borderline people. I always will. I'm not Borderline but if you are I love you and I'm sorry.

You're not a bad person. You're not a therapists worst nightmare, you are a human with valid feelings and fears.

Borderline people I'm sorry.

#autism #bpd #borderline personality disorder #actually autistic #neurodivergent #neurodivergency #neurodiversity #cluster b

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drdemonprince · 8 months

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Hi,

I think I might have BPD and I'd like to talk to a therapist about it because I've found therapy helpful in the past, however I'm also worried that if it goes on my record it could be used against me in the future. Do you have any advice? Thank you!

Don't do it!!! Do not say those words to a therapist no matter what you do!! I cannot stress this enough. Therapists are taught in school to dread and hate working with BPD patients, and many many manyyyy of them openly revile them and see them in the most negative unhelpful light. I'm sorry to have to be so discouraging but BPD is by far the number one most stigmatized disorders when it comes to the views of therapists. Seek out a DBT therapist, and someone who says they are experienced working with BPDers but tread very lightly. Don't tell them you think you might be BPD unless they have earned your trust. And reallly grill them about their attitudes on the subject beforehand. This is seriously dangerous territory. I don't want you to be institutionalized or treated like a problem client or worse. Please read Marsha Linehan's memoir, the DBT workbook series, and the book Psychiatric Hegemony (or at least the chapter on BPD) if you can. Those first two books will give you practical tools, the last is so you know what to look out for.

And also consider that BPD isnt really a "thing", all it is is a particular attachment pattern that gets unfairly demonized because of sexism and psychiatric stigma. Most of the people that get labeled BPD are Autistics or abuse survivors or both, and all of them are people with attachment trauma, and drilling into those things may be more useful and safer to you. There is no such thing as having a disordered personality.

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gothhabiba · 1 year

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hi i just saw some of ur posts on anti-psychiatry and then kept reading more on ur blog about what it is. for the most part i agree with what you've said about how capitalism uses psychiatry to designate people who are bad/abnormal and how it aligns itself w/ misogyny, racism, and so on. with that said i think i have some similar concerns/questions as another asker about what this means for those who do/would suffer even in a non-capitalist society, even if we didn't ascribe a specific label to X symptoms. if we are opposed to psychiatry, what are the options for people today who are suffering and want help? are you opposed to psychopharmaceuticals and therapy? i dont mean to ask this in a confrontational/accusatory way, i'm just new to this and genuinely curious

There are a few different parts to your question & so there are a few different angles to approach it from—

are you opposed to psychopharmaceuticals and therapy?

If this means "are anti-psych writers and activists opposed to individuals seeking treatment that they personally find helpful," then, no—a couple posts in my psychiatry tag do clarify this.

If it means "are there anti-psych critiques of psychopharmaceuticals and therapy," then, yes. Keep in mind that I'm not a neurobiologist or otherwise an expert on medications marketed as treatments for mental illnesses, but:

The evidence for the effectiveness of SSRIs in particular is sort of non-existent—even many psychiatrists who promote the biomedical model of mental illness doubt their efficacy, and refer to the "chemical imbalance" theory that enforces their usage as "an outmoded way of thinking" or "a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists." But promoting SSRIs (and corresponding "serotonin deficiency" theory of depression, despite the fact that no solid evidence links depression to low serotonin) is very profitable for pharmaceutical companies. Despite the fact that direct-to-consumer advertisements are nominally regulated in the U.S., the FDA doesn't challenge these claims.

Other psychotropic drugs, such as "antipsychotics" or "antianxiety" medication, shouldn't really be called e.g. "antipsychotics" as if they specifically targeted the biological source of psychosis. No biological cause of any specific psychiatric diagnosis has been found (p. 851, section 5.1). In fact, rather than "act[ing] against neurochemical substrates of disorders or symptoms," these medications "produc[e] altered, drug induced states"—but despite the fact that they "produce global alterations in brain functioning," they are marketed as if they had "specific efficacy in reducing psychotic symptoms." Reactions to these medications that don't have to do with psychosis or anxiety (blunted affect, akathisia) are dismissed as "side effects," as though they don't arise from the same global alteration in brain function that produces the "desirable" antianxiety/antipsychotic effect. This doesn't mean "psychiatric medication turns you into a zombie so you shouldn't take it"—it means that these medications should be marketed honestly, as things that alter brain function as a whole, rather than marketed as if they target specific symptoms in a way that they cannot do, in accordance with a biomedical model of mental illness the accuracy of which has never been substantiated.

Psychiatrised people also point out that meds are used as a tool for furthering and maintaining psychiatrists' control: meds that patients are hesitant about or do not want are pushed on them, while patients who desire medication are "drug-seeking" or trying to take on the role of clinician or something and will routinely be denied care. Psychiatrised people who refuse medications are "noncompliant" and prone to psychiatric incarceration, re-incarceration, or continued/lengthened incarceration.

As for therapy: there are critiques of certain therapies (e.g. CBT, DBT) as unhelpful, status-quo-enforcing, forcing compliance, retraumatising &c. There are also critiques of therapy as representing a capitalist outsourcing of emotional closeness and emotional work away from community systems that people largely don't have in place; therapy as existing within a psychiatric system that constrains how therapists, however well-intentioned, are able to behave (e.g. mandatory reporting laws); psychotherapy forced on psychiatrised people as a matter of state control; therapists as being in a dangerous amount of power over psychiatrised people and being hailed as neutral despite the fact that their emotions and politics can and do get in the way of them being helpful. The wealth divide in terms of access to therapy is also commonly talked about; insurance (in the U.S.) or the NHS (in England) may only pay for pre-formulated group workbook types of therapy such as DBT, while more long-form, free-form, relationship-focused talk therapy may only be accessible to those who can pay 100-something an hour for it.

None of these critiques make it unethical or something for someone to get treatment that they find helpful. It's also worth noting that some of these critiques may be coming from "anti-psych" people who criticise the sources of psychiatric power, and some of them may come from people who think of themselves as advocating for reform of some of the most egregious effects of psychiatric power.

if we are opposed to psychiatry, what are the options for people today who are suffering and want help?

This looks like a few different things at a few different levels. At its most narrow and individual, it involves opting out of and resisting calls for psychiatrisation and involuntary institutionalisation of individuals—not calling the cops on people who are acting strange in public, breaking mandatory reporting laws and guidelines where we think them likely to cause harm. It involves sharing information—information about antipsychiatry critiques of psychiatric institutions, advice about how to manage therapists' and psychiatrists' egos, advice about which psychiatrists to avoid—so that people do not blame themselves if they find their encounters with psychiatry unhelpful or traumatising.

At the most broad, it's the same question as the question of how to build dual power and resist the power of capitalism writ large—building communal structures that present meaningful alternatives to psychiatry as an institution. I think there's much to be learned here from prison abolitionists and from popular movements that seek to protect people from deportation. You might also look into R. D. Laing's Kingsley Hall experiment.

what does this mean for those who would suffer even in a non-capitalist society, even if we didn't ascribe a specific label to X symptoms?

It means that people need access to honest, reliable information about what psychotropic medications do, and the right to chuse whether or not to take these medications without the threat of a psychiatrist pulling a lever that immediately restricts or removes their autonomy. It means that people need to be connected to each other in communities with planned, free resources that ensure that everyone, including severely disabled people whom no one particularly likes as individuals, has access to basic resources. It means that people need to be free to make their own choices regarding their minds and their health, even if other people may view those decisions as disastrous. There is simply no defensible way to revoke people's basic autonomy on the basis of "mental illness" (here I'm not talking about e.g. prison abolitionist rehabilitative justice types of things, which must restrict autonomy to be effective).

Also, I've mostly left the idea of who this would actually be untouched, since my central argument ("psychiatry as it currently exists is part of the biomedical arm of capitalism and the state, and the epistemologies it produces and employs and the power it exerts are thus in the service of capitalism and the state") doesn't really rest on delineating who would and wouldn't suffer from whatever mental differences they have regardless of what society they're in. But it's worth mentioning that the category of "people who are going to suffer (to whatever degree) no matter what" may be narrower than some would think—psychosis, for instance, is sometimes experienced very differently by people in societies that don't stigmatise it. I see people objecting to (their interpretations of) antipsych arguments with things along the lines of "well maybe depression and anxiety are caused by capitalism, but I'm schizophrenic so this doesn't apply to me"—as though hallucinations are perforce more physically "real," more "biological," more "extra-cultural" in nature than something like depression. But the point is that positing a specific neurobiological etiology for any psychiatric diagnosis is unsubstantiated, and that capitalist society affects how every "mental illness" is read and experienced (though no one is arguing that e.g. hallucinations wouldn't always exist in some form).

#psychiatry #long post /#mental illness #antipsych #antipsychiatry #Anonymous #questions #psychotropic drugs #ssris

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loving-n0t-heyting · 2 years

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When ppl argue about the reasonableness of DBT as therapy they commonly seem to overlook what always has seemed to me the obviously sensible way to approach it: as a set of tools

The components of dbt worth anything (relationship negotiation stuff, emotion regulation techniques, some of the meditation) can actually work pretty impressively, but they frequently do so blindly. The stress management skills really can de-seethe you, but they do so without discriminating between seethings worth and not worth taming. You have to figure that out yourself, there are no simple therapeutic algorithms onto which you can offload the work of phronesis

And it is important to understand that the official DBT literature is antithetical to this approach. When they acknowledge it at all, it is handwaved as sort of a triviality, like the little asides about checking if yr emotional response is “reasonable” before applying regulation techniques to it. And rather than encouraging the patient to think of the therapy as a modular assortment of amoral psychological tech, the manuals etc present them as cohesive parts of an overarching-if-vague philosophy of life (which incidentally is cult shit). They can afford to pass the buck of moral discernment, bc the implicit assumption throughout most of them is that the patient is trying to be a docile Npc but inhibited by the emotional and interpersonal barriers DBT aims to reduce and so can simply passively absorb their canons of practical rationality from their social circle without comment

But ofc you should not be a docile Npc, as a human being you have a duty to seek out the true and the good against repressive forces to the contrary, including ones pervading the psychiatric system. But this doesn’t mean none of that systems products can be fruitfully scrapped for parts

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threadsun · 1 year

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Anonymous Asks: "Don't have to answer this:

How would the Sunny Day Jack characters (not the manager) and Bo do with an MC that feels useless and stupid. Always messing up, feeling unmotivated to do things, and falling behind work?"

Okay before I answer this I need to know if people adding Barry The Manager to headcanon posts is a common enough thing to warrant a disclaimer like that 😂 is there a thriving Barry The Manager community?? Are people out here Barryposting on main??

Anyway, as for the request, I hope this works for you!

Content: negativity/depression/lack of motivation, therapy, medication, nonsexual bdsm as a coping mechanism, general rejection of capitalist ideas of worth

Jack:

He's Mr. Motivation! This is exactly the sort of thing he was made to help with!

He'll become your #1 cheerleader! He'll get you out of bed every day, make you eat three square meals and drink enough water, give you your 5 a day, everything to keep you healthy!

Too much work and no motivation to do it? He'll help you break it down into smaller pieces and do bits at a time until you're all caught up

He won't stand for any sort of negative talk! No "I can't do it" "I'm useless" "I suck," he'll make you replace every negative thought with a positive one!

Seriously, he's basically your personal CBT/DBT coach! He'll get you out of your slump with no judgement or guilt, just love and support

And if there's anything you need to get done that he can help with, he's absolutely jumping at the chance, of course!

Ian:

He gets it. I mean he really gets it. He's felt that way for a lot of his life, and you were the one to help him through it. So, of course he's going to return the favour!

He won't let you forget how amazing you are and all the things you have managed to do

He takes on anything you need him to, helping you get things done or even just spending time with you while you get things done to help keep you motivated

If you think therapy or some sort of medication would help you, either with your executive function or the negative feelings, he'll happily pay for it himself

He's pretty good at balancing up and deciding what things do and don't need to get done, and what corners you can cut while doing things

Generally, he'll help you come up with quick fixes and coping mechanisms until you can get more help

Shaun:

He's on top of everything all the time. It's almost scary how someone can seem like they've not got their shit together at all while still getting everything done

But that means he knows how to help you cram things at the last minute when you've procrastinated them

He's a master at half-assing things so they're just good enough while not taking all of your time and energy. He'll help you come up with all sorts of cheats!

When you get too overwhelmed and shut down, he'll remove you from the situation and help you calm down before letting you even think about all the things you need to do

He's another person who will help you break things into easier to digest pieces, so you can take things at your own pace and get things done

He's so patient and reassuring, reminding you that productivity isn't what defines your worth

Nick:

Some people will use bdsm and d/s dynamics to keep themselves organised and as a coping mechanism for executive function

Nick is very familiar with that sort of thing, so if it would interest you then he's happy to make you check in with him and show proof of the things you do

He'll help you devise a system of rewards for when you do what you're meant to, and also for when you're gentle and kind with yourself

If that's not your cup of tea, then he'll just help you set up systems that make your work easier for you. He makes sure you know that there's no shame in needing accommodations

Seriously, he's big on using accommodations, whether you have a diagnosed disability or not. If something makes your life easier, he'll encourage you to use it!

He really does go out of his way to help you find systems that work for you so you don't have to struggle

Joseph:

He will NOT accept any sort of negative talk about yourself. No calling yourself stupid or useless

That doesn't mean you can't vent. In fact, he encourages it! But he'll make you change your language to things like "I feel useless" rather than "I am useless"

He gives you space to let your feelings out and he'll listen to your venting. He'll talk it through with you, reminding you to talk to yourself the way you'd talk to him

Seriously, he'll make you say everything you want to say to yourself to him instead, to make you realise how mean you're being to yourself and how unnecessary it is

Once you've understood that, he'll suggest that you give him advice as if he's the one struggling with these things, and then get you to take your own advice instead

He's incredibly understanding and level-headed about it. He'll make you love and support yourself eventually!

Jean:

Look, there's nothing he can't get done with his money and influence, so you never have to worry about getting enough things done when he's around

He'll take everything off your plate, leave you with nothing to worry about while he makes sure everything gets done

But once your plate is cleared, he'll start focusing on your feelings and lack of motivation. He's not going to just fix things for you, he's going to help heal you too

If it's therapy you want, he'll happily pay for it. If you need money or need him to buy you things that'll help you be productive, he'll do that too

He's not got many of his own suggestions about how to fix it since he's always been almost too motivated and struggles to turn off work-mode, but he'll try his best

He'll look to you for guidance, asking what you want to try rather than suggesting things

Bo:

He has no idea why you might think that you're useless just because you don't get work done or mess things up

Seriously, he doesn't. Of course you're useful! You make him happy, you try your best, you impact the world around you. Of course you're useful, you're alive!

His whole outlook on life is so different from a human's. Productivity isn't a measure of worth, and he's one of the lucky ones who realises that

He makes you set aside anything that isn't 100% necessary to do, and instead makes you connect with the world around you and realise you matter just because you exist

Once you feel recharged and ready to conquer the important things, he helps you with them. But he's always there to remind you to just ignore the stuff that doesn't matter

Seriously, he'll change your entire world view if you let him. He'll remind you of what it means to be alive

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ineffectualdemon · 1 year

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You know for a long time I was really confused when people would complain about CBT and say it doesn't work on people with autism or for CPTSD or EUPD because I had been through CBT and it worked pretty well! I made a lot of progress!

Turns out it was never ever CBT I received

There were CBT elements for sure but the therapy I got was always way more involved and involved a lot of stuff not covered by CBT and was definitely not as simplistic

It wasn't until I heard a lot of people talking about their CBT therapies and I looked into it that I found out that my NHS therapists, who were told to only use CBT on patients at the tier I was on at the time, called it CBT and included CBT elements and paperwork but it was actually DBT and sometimes other trauma specific therapy options

So I was told it was "CBT" because they weren't supposed to do any other kind of therapy

Which it's fucked up that they had to do that but also good on them for manipulating the system for their patients benefit

#mental health

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growing-home · 2 months

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i spent nearly two decades of my life severely depressed and suicidal and for so long i believed wholeheartedly that it was my fault. i believed that the reason no medication or therapy had ever worked for my depression was because i wasn’t ACTUALLY depressed— i believed i was just lazy, bad, manipulative, and just using depression as an excuse for the inherent badness i thought was inside me. this was a story that was told to me and reinforced over and over again by treatment providers.

this past summer, i tried my 30th+ psychiatric medication, not expecting to see any results. the day i realized it was working was the day i realized that i was…planning my future???suddenly i no longer wanted to stay in bed all day and never go outside. i no longer wanted to isolate. i wanted to see people, talk to people! i started spending more time with friends and facetiming people and talking on the phone, things that i rarely did in the past. when i had been depressed, the only movies/tv shows i could focus on were super intense, fast paced, and scary or disturbing because that was the only way to hold my attention. after starting this medication, i started enjoying SITCOMS! i no longer felt like i was fighting to just get through every single day of my life.

there was such a clear and measurable difference in the quality of my life that i started to question why i believed that my depression had been my fault. it became very clear to me that a large part of my depression had been biological. i had not been lazy or bad. i had been sick. my brain was sick the same way other organs get sick sometimes. this brought up a lot of grief for me— grief for all the lost time that i’d spent trying to find something that worked, grief for how much pain i had been in for so long. but it also brought up sheer FURY at all of the therapists and psychiatrists who had treated me like i just wasn’t trying hard enough to get better.

i had been labeled treatment resistant, of course, and the only recommendations i had received after being given that label were TMS, Ketamine, and ECT. once i had tried all three with no success, i believed i was just a lost cause. i thought i was out of options. i was made to feel that way by so many treatment professionals. i was told that nothing was working because of my complex trauma and that once i healed from that then i would stop being depressed (as if it’s that easy to just fully recover from CPTSD!) i was told that i just needed to do more DBT, i just needed to live and breathe DBT skills and then i would get better, even though i’d done intensive DBT programs for years with no improvement to my depression. (yes, it helped me to change my behavior and quit self harm, but behavior change isn’t necessarily indicative of a change in mood. i could do all the right things all the time and still be in excruciating mental pain.)

i was told that i just wasn’t trying hard enough, or that i must have a personality disorder, or that i just needed to exercise more, or eat less, or eat MORE, or eat differently, or get a job, or get a dog, or do yoga, or acupuncture, or biofeedback, or find purpose in my life— psychiatrist after psychiatrist looked for something to blame everywhere but in the mirror. instead of admitting that they weren’t equipped to help me, they made me believe that it was MY fault i wasn’t getting better. and i believed them. for SO long, i believed them.

and now after finding a medication that works for me, i see everything so much more clearly. psychiatrists need to put their enormous egos aside and actually treat patients with treatment resistant depression instead of blaming us for suffering from a (partially at least) biological illness. if you’re a doctor and you know that a patients illness is outside of the scope of your abilities, either do more research and get more training to help them or refer them to someone who specializes in what they need. don’t keep them around letting them pay you thousands of dollars while you make them try the same thing over and over and over again and expect to get a different result. people act like things like ECT are a last resort option, and in doing so make people believe that if it doesn’t help then you’re out of options. but nobody ever tried me on tricyclics. nobody tried me on MAOIs. nobody told me about how some dopamine agonists like Pramipexole have had some success in treating treatment resident depression. instead i was made to feel like asking to not be suicidal daily was asking for too much. if you’re a clinician who thinks that’s asking for too much, you’re in the wrong profession. we can do better than that. we NEED to do better than that.

in my experience, out of every profession, doctors have some of the biggest egos i’ve ever seen. i say this as someone who is both mentally ill as well as physically disabled. many doctors HATE it when you do your own research. they HATE it when you have suggestions, or when you ask for what you need. it’s almost as if they feel threatened by it, like they need to believe that they are superior to their patients because of how much time and money and energy they put into going to med school— they need to believe they hate their hard work was worth it so they have a tendency to dismiss any ideas their patients might have. i don’t care how many years you’ve been in school. you do not get to tell your sick patients that it’s their fault they’re sick to justify your laziness and refusal to learn new things. put away your god complex and actually listen to your patients.

and the strangest part to me is that the longer you have been suicidal for, the less seriously they take it. the same way that the more chronically ill you are the less people believe you. it’s bizarre— when people see pain that is beyond what they can fathom, instead of feeling empathy, they tell you you must be faking it or that you must be looking for attention. i’ll never understand this. it’s as if they think that suicidality doesn’t need to be taken seriously unless the patient has successfully completed suicide. and i think it’s very clear how that logic is flawed. i was treated like i just wanted attention whenever i asked for help with my chronic suicidality and it made me terrified to ask for help with ANYTHING. i still constantly am afraid that if i’m too honest with clinicians then they’ll think i just want attention. attention isn’t a bad thing to want, all human beings need some degree of attention, but regardless that doesn’t negate the severity of a person’s suicidality. i wasn’t attention seeking by asking for help. i was STRONG. i was really fucking strong, far stronger than i should’ve had to be. i fought for my life every single day and i am lucky to still be here but it’s not luck that got me here. it’s ME that got me here.

i don’t want to make it sound like i speak for everyone who has suffered from TRD, because i don’t think that would be fair. i can’t tell you if there’s a med out there that’ll work for you. all i can tell you is that most psychiatrists prematurely tell chronically suicidal patients that there is nothing they can do to help them or that they’re out of medication options. if you’re a psychiatrist or doctor and you feel yourself getting defensive while reading this, i invite you to get curious about where that activation is coming from.

and if you are someone with treatment resident depression or chronic suicidality reading this, i am telling you now: your illness is not your fault. i don’t know if it’s going to get better or not, but i can promise you— it is not your fault and it never has been.

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kiki-strike · 4 months

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hi would you mind tellin me what ed ward was like? i might have to go there at some point and im scared also sorry if im phrasing it wrong and also also if you're more comfy dming or not answering at all thats fine

Hi yes I can!! And you can dm me if you want or send another ask if you have more questions :)

So there’s two kinds of 24-hour ED care, inpatient and residential. Inpatient is usually inside of a hospital, sometimes integrated with the psych ward (hence “ed ward”). This is where people that aren’t medically stable go (think serious heart conditions, people who flat-out refuse to eat, people who need to be in a locked ward to be safe). I haven’t been to inpatient ed, so I can’t say much on that subject. I do know that you typically stay in inpatient much shorter than residential.

I was in residential for four months. Usually ED treatment takes longer than treatment for depression and such and it’s not uncommon for people to go into residential more than once, but it’s pretty rare for residential to last more than six months. It’s expected that you’ll do a step-down plan which means after you leave res you’ll do a PHP and an IOP (PHP is when you live at home but go to programming during the day, usually 40-60hrs a week with all meals there, and IOP is usually half a day 2-3 times a week).

My res was three houses in a neighborhood (not in a row) and we would all go to the biggest house during the day. There was usually 2-3 group therapy sessions and 2-3 classes (DBT skills, nutrition, etc) per day, every day (inc weekends). We spent the rest of our time doing leisure stuff and eating.

Meals took up a HUGE portion of the day because we got half an hour for each meal, and then there was another half hour for supplements, plus 15 minutes for snacks and 15 minutes for snack supplements, so that amounts to… 4.5 hours every day. The way meals worked was each person got their own plate, to their own needs (some people got tiny amounts bc refeeding, some people got huge amounts bc restoration, etc). You got to choose 3 blacklisted foods that they would never give you, other than that if you didn’t like the food you had to suck it up. I chose spicy food, eggplant, and I think peanut butter? Because being vegetarian didn’t count (though I told them I was vegan instead because I was scared of milk😔). If you didn’t finish your food you got supplemented - 1/2 a sup for eating 3/4 but not finishing, one sup for 1/2-3/4, and two supps for eating less than half. Our supps were Kate Farms unless you had other dietary restrictions; I got switched to ensure clear halfway through because I went on a Kate Farms boycott to get it haha, WORTH IT ensure clear I love you. You had to sit at supps table for the whole half hour or until you finished it (it was a socially-acceptable choice to just sit there for half an hour). If you didn’t drink your sup you lost privileges for the next day, but unless you’d been there for a few months you didn’t actually *have* any, so… privileges were going on our daily 10 minute walk, the weekly strip mall field trip, and if you were VERY LUCKY going to the bathroom with the door closed. During meals there were a lot of blacklisted topics because yknow. Bad Time Let’s Be Nice. If you weren’t eating staff would gently encourage you but wouldn’t be mean about it, and the other patients would too. It’s pretty hard to fake eating there, but not impossible, and definitely impossible to do it without other patients seeing (because we all watched each other eat So Closely and we know all our tricks…) and other patients ratting you out is a definite possibility. You weren’t allowed to leave the table during meals but sometimes it happens. If you didn’t eat for two days they sent you to inpatient (they couldn’t actually force you to eat in res, but in IP they can tube you).

In our free time we all got really close. Everybody had a roommate and we slept in real bedrooms with our own bathrooms (which we could only use at night, they were locked during the day). A lot of us crocheted, there was lots of reading and coloring. We were allowed an hour of screen time, including TV, a day but that was taken away if you were Really Bad (think screaming fit not like “didn’t eat fear food”). If you were still in high school you were expected to do that (online) during free time (which was also a ticket to unlimited computer time during free time lolol, same with AA). The people you go to res to become like a weird version of your family, you’re together for months with ONLY each other doing something very emotionally taxing, so like within the first few days boom you now have 15 new best friends. It’s also very insular in that there are trends? Within your res? I started a rock painting trend, and also pestered staff enough that they finally let us garden (this was just me gardening and everyone else reading in the yard). Everybody listened to top 50 pop even if they hated it, because at res you like it (I’m very attached to billboard pop 2021 still), we all watched every Keanu Reeves movie because it’s funny to say that you have (none of us even liked him that much).

At res everything is funny because everything’s so bad? It’s this sort of delirious sheen that takes over everything, like looking at the world through a soap bubble. That said I was also on the maximum dose of seroquil. Everyone’s super supportive, not like the movies. If they didn’t actually want to recover they didn’t say anything about it.

Staff there consisted of three types: the babysitters (I don’t know their real titles), mostly college girls who babysat us and ran the houses, the therapists/psychiatrists who ran groups and did individual therapy, and the nurses. There was a nurse on staff until 11 every night, because we all had hot girl stomach issues and sometimes hot girl heart problems. They took blood once a week and there was a doctor that saw you once a month or if you complained about something long enough. The babysitters were all really nice though some were less pushover-y than others (let you stay on computer longer etc). They said they did room sweeps once a week but I had contraband they never found. They also said we weren’t allowed to touch each other for more than five seconds at a time (I am the reason that rule exists haha) but like… you have a roommate for a reason!! (I’m not even talking about sex I just mean snuggling ;-;)

In terms of visitors you mostly only got your parents or if you were married your spouse, maaaybe somebody’s friends came once? But not common. You’re not allowed alone time with your visitors (like prison!) and anything they give you has to be searched by staff (same as stuff you order online or buy on the strip mall field trips). A lot of rules are very very strict because people with eating disorders are masters at worming their way out of things which sucks but makes sense.

There were some unsavory things that happened to me there that I’d like not to talk about here, just know that when you go, it’s very possible for staff to lie to your parents/caretakers to the point that they don’t believe you. It is very hard to leave once you check yourself in, and if you do leave before they let you, that’s called AMA and your insurance won’t pay for the part of your stay you did already (which for me was $2k a day. For four months). Once you go there you’ve basically handed over your rights indefinitely to the program in exchange for learning how to eat good and not die. Which is better than dying but not amazing either, but that’s the way it is.

Some other unintended side effects:

1. If you were scared of blood draws before you went in you won’t be when you come out.

2. You’ll be able to pee anywhere no more pee shyness. Along those lines we had to describe our shit every morning to the nurse in earshot of everybody? So you won’t be embarrassed about that any more.

3. You might forget to close the bathroom door the first few months you’re home.

4. You’ll become very attached to some foods in res and then when you get out can never eat those foods again. For me that’s biscoff cookie butter.

5. You’ll be WAY less on your phone. You’ll know how to sit and wait instead of going on your phone immediately for entertainment.

All in all I’d say you get more freedom than the locked ward and less freedom than rehab, but stay longer than both of them combined. Fellow patients are awesome, staff is a mostly positive mixed bag, and activities are dismal (eating).

I wish you so much luck in recovery. You can do this! Every meal is a new beginning. I believe in you!

A funny for you for making it this far:

#ALSO I didn’t want to put this in the main body bc it’s a lil dreary but if you relapse that is SO OKAY that doesn’t mean you should lose y #your support network or are a bad person or not trying hard enough. everyone relapses. that’s okay. the important part is that you keep goi #going and don’t give up!#BEST OF LUCK!!! you’ll be in my prayers!!!#Ed tw #psych ward tw

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trans-axolotl · 1 year

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for anon asking about NPD/ASPD resources

For context, anon sent in an ask searching for nonstigmatizing resources for support with PD diagnoses and other stigmatized diagnoses.

And this is such a good ask--it is so fucking frustrating and dehumanizing to try to search for support when half the stuff that pops up is using really cruel language or just directed towards family and friends. The community definitely deserves better, both when it comes to the way psych professionals perpetuate stigma and in regards to the prejudice and sanism that shows up in other communities in our lives. Unfortunately, I don't have a ton of resources on hand, although I do know one good support group. The rest of the resources I know of are kind of mediocre or not PD specific, so if other people could add on I would really, really appreciate it!

Neuromancers runs a discord and a Cluster B peer support group that I've heard really good things about. I haven't been myself, so I can't 100 % vouch, but they're a group with abolitionist and mad pride values.

This might not be exactly what you're looking for, but it's an article exploring cultural bias in PD diagnosis that links to a lot of sources that talk about how psychiatry contributes to stigma around personality disorders. I clicked through some of the studies that it links to and it does use a lot of medicalized language, but I thought I would link the article anyway in case it's ever helpful to have academic sources to show to other people.

Also not exactly what you're looking for, but another article debunking some of the common talking points about NPD in pop psychology (Content warning that it is discussing some very ableist myths in the context of challenging them)

Last sort of general resources for peer support that I have some trust that they are PD friendly are the Wildflower Alliance and Hearing Voices Network Groups. Wildflower alliance groups offer a lot of different general peer support and I have one friend with NPD who has spoken positively of those spaces. Hearing Voices Network groups can vary a lot depending on location, so defintely plan to email ahead, but I've been to a few groups that welcome people who generally identify as psych survivors/mad/ex patients who want to share community spaces around those values. Also want to share is the neurodivergent friendly workbook of DBT skills (the link is to buy it directly from the creator but if anyone who is interested can't afford it rn, dm me and I'll send you a pdf.) Again, I know this is really not super relevant to what you asked for but is one of the less stigmatizing, less medicalizing workbooks I can find for accessing info about coping skills and this is one of my general favorite support resources.

Overall I'm really sorry that I don't have better resources to offer you, and I think that really should be a sign to the mad pride/psych abolition/peer support community that we need to do a lot better job in making sure that our spaces are explicitly welcome to people with stigmatized PD diagnoses. The work shouldn't have to be on you to try to navigate these spaces and figure out whether or not you're welcome, and any spaces that offer peer support, are aligned with mad pride and psych abolition, really should be doing the work to make sure lateral violence and sanism aren't being perpetuated.

followers, esp followers with lived experience, please add on!

#antipsych #psych abolition #mad studies #mad pride #cluster b #npd #aspd #spent a bit of time looking through my clinical databases as well but could not easily find any articles #that weren't fucking awful #also to clarify: i have lived experience being diagnosed with a cluster b personality disorder #but don't currently identify with that diagnosis or really interact in a lot of pd specific spaces or know #tons about what community preferences and community consensus on things r #so this is def something where i would love input from people with relevant lived experience!

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wheelie-sick · 8 months

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so a couple weeks ago I told my therapist about my self harm. I initially phrased it as something in the past (it wasn't) to test the waters and he promised that he would never send me to a psych ward over it. I trusted him so the next week I told him that actually it wasn't in the past. he suddenly started asking invasive questions that I did not want to answer and that were not necessary for him to know like how I was self harming, how often, and when. I didn't want to answer these questions but I didn't feel like I had a choice so I did. it felt violating. we discussed starting DBT. he brought up the psych ward knowing it makes me panic.

the next week he immediately started with his self harm questions again and I shared. I had hope that maybe this would help. I confessed I was having a crisis, he brought up a psych ward again while knowing it makes me panic.

this week he started asking about self harm and I said I don't want to talk about it this week. that I was doing well but didn't want this session to be about self harm. he got angry, he told me I was resisting therapy and that therapy isn't supposed to be comfortable. he tried to pressure me into talking about self harm. I refused and brought up a different topic (conflict with my roommates that was resolved) he asked me how I felt about it. I said I didn't know. he asked me if I felt comfortable or uncomfortable and I said I didn't know. he told me I was resisting therapy again. I said that sometimes I just don't know what my fucking emotions are and he said "well you usually do" and I responded that well this time I don't. he continued to call if avoidance of therapy.

I jumped to a different topic again and tried to go over some of the stuff I had written in my DBT packet and he said I was avoiding therapy but jumping topics too many times. I finally got him to stop calling it resistance and he insisted I find a different word to describe my "behavior"

he started to interrogate me about "what happened" because I was such an easy patient a year ago and had much better mental health. he got accusatory, like I was hiding something, when I said that I didn't know it just happened. I'm just depressed. he said he has a therapeutic obligation to make sure I'm safe and tried to force me to "compromise" on talking about self harm. I said that we could check in at the beginning of the session and if I was doing well we could talk about something else and if I was doing poorly we could talk about self harm. I wasn't happy with this compromise and it felt like it was stripping me of my autonomy. he wasn't happy with this compromise either, he made the accusation that I'd just lie. instead he forced me to fill out a spreadsheet based on day with all of my emotions, when I self harmed, when I smoked, etc. it's a violating spreadsheet and I'm not doing it.

through the entire thing he was confrontational and accusatory.

I'm dropping him as a therapist. after 5 fucking years of trusting him he pulls this bullshit I'm so fucking upset

#antipsychiatry #anti psych #anti-psych #tw self harm

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theratpy · 5 months

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question! what kind of rat is Dr. Zo? like genus? also what sort of therapist is he? like specialized fields or experience if applicable.

What kind of rat is Dr. Zo?

All rats you will meet in the Universe are Fancy rats (Rattus norvegicus domestica)! Any other rat species do not exist now, though many used to. The closest prior species was simply the Brown Rat (Rattus norvegicus), who's brains were not quite of the same complexity as Fancy, and died out inevitably due to evolution.

Dr. Zo and Therapy (excerpt from Dr. Zo character sheet paragraphs available to Patrons):

Dr. Zo found a love for therapy crop up repeatedly throughout his life, and decided to actively pursue it after his first two years of college. He has training in CBT and more narrowly DBT, both and especially the latter will come in handy for treating his newest patient, Ratticus.

Hope this helps! <3 -beetlerat

#beetlerat #theratpy #i love you guys #rats #dr zo

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ecoamerica · 1 month

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angiethewitch · 7 months

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If it’s not too invasive, can I ask what onset was like and what meds and therapies you tried in your recovery? Or any good therapy resources? My best friend was recently diagnosed with schizophrenia and she’s got a lot of anxiety surrounding her situation. She also tends to respond weirdly to meds and so far a lot of things just haven’t worked. She’s a very strong, determined person and I do believe that she’ll be okay and be able to get back to regular life at some point. I just don’t want her to feel hopeless about the current situation.

its hard to describe onset because I actually had childhood onset schizophrenia, which is pretty rare. my psychologist had a hypothesis that whatever big red genetic button in my brain that caused the schizophrenia was triggered by trauma in childhood, as stressors have been observed to cause someone predisposed to schizophrenia to have a psychotic break. so it's not easy to describe because I've grown up with it, it's pretty much all I know, I never even knew I was different until I was older. I mean, all kids have imaginary friends, all kids lie, all kids make up wild stories, so I wasn't to know any different and neither was my family. I was actually discussing this with my older sister and we were like oh okay that behaviour in childhood was a fucking symptom.

the therapy process was first rehab, to get sober and clean, to rule out any alcohol or drug induced psychosis. then I was referred to the community mental health team (CMHT) to find out what exactly was Wrong With Me and after a few months they gave me a diagnosis. then it was on to medication and on a waiting list.

now because the nhs, especially the welsh mental health sector, is chronically underfunded, it took 3 years until i finally got therapy. in the meantime I self referred to a local trauma service, who take on patients for free and i had 2 years of trauma therapy. eventually I got a care coordinator who referred me to the acute psychosis intervention team and I was with them for 3 years. I was discharged this summer.

I cant really tell you much about anything I did in the years prior to psychosis therapy. they kept upping and upping my meds, which also acted as a sedative, and studies have shown they can cause neural degeneration, so those few years are a black hole. I barely remember any of it.

however, CBT didn't work. what really helped me was ACT (acceptance and commitment therapy), DBT and my therapist also thought stoicism would work for me. we did values focused therapy which I found very helpful. in rehab I also had resilience training which was very helpful. from everything I've read about shadow work, its a lot like ACT, but I do not recommend it for your friend (or anyone really but especially if youre inclined to psychosis) without medical supervision.

I wish your friend the best of luck and I get the hopelessness - realising I'll have this illness for life and facing societal stigma was almost too much to bear, on top of the constant cycle of relapse and recover, rinse and repeat. but my therapy taught me that yes i have this illness, but I can live with it. it doesn't need removing, just caring for. its a part of me that deserves compassion and acceptance like every other part of me. tell your friend that, she deserves to know she's not a monster and she still deserves respect and compassion, even from herself.

I wish her the best of luck

#anonymous

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findingmypeace · 3 months

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Have you considered a harm reduction approach rather than pushing for full recovery? I know it’s a bit controversial & I think you can have full recovery if you want it, but that seems intolerable for you at this stage of tx. Which isn’t a criticism & we know ambivalence is normal, but my belief is it doesn’t have to be an all or nothing choice. You discussed thinking about how your body can’t tolerate going back to bx, but truly you don’t have to go back to purging most food, no water & abusing diuretics if you aren’t eating the full meal plan & totally b/p abstinent. Maybe you just commit to not using diuretics, not purging on workdays or whatever doable minimum you can manage that allows you to work & feel functional. Whenever you can, you do more & continue to try to decrease bx over time. I’m a DBT therapist & have found that many people who struggle with abstinence from addictive behaviors really benefit from a dialectical abstinence approach. Are you familiar with that section of the book in DBT? I hope you can tell this is meant constructively & with compassion, I just think that sometimes tx centers can be rigid about what “success” is & they don’t bother to ask clients what they want out of their own life & what their limits are in recovery. I wish you well in any path

Edit: This is also an older question. I was able to halfway respond but then I got interrupted and couldn’t finish. So here it is now.

Original response: thought a lot about this over the years. I’m truly not sure what approach would work for me ie: ‘cold turkey’ vs ‘harm reduction’

Response on 2/10/2024: I started with a new therapist this week and we are going to do a harm reduction approach. I put my recovery on a spectrum of 0% (total relapse) and 100% (total recovery). I said that right now I would rank my recovery at 45%. We are aiming for 80% right now. I started meeting with my outpatient dietitian 2 weeks ago. I don’t have a meal plan but we are going to make a new one and I’m really going to make an effort to follow it.

I agree with you in that sometimes 100% recovery is too large of goal. I am so sick of having an eating disorder and at the same time full recovery seems in possible.

And DBT. I am VERY familiar with DBT. I’ve done so many DBT groups as a patient but I’ve also used it for various clients over the years. To be honest, I’ve always thought it was great for my clients but I hated it for myself. But with this last time in treatment I’ve started to see how it can be useful for me, especially in those moments of complete despair. I realized I can tweak some of the skills so it’s a better fit for myself. For example one of the skills (I think it’s in ACCEPTS) is comparison. That is not good for me so I’m going to take that out. Now it’s just a matter of implementing the skills into my life.

Anyway, thank you for this ask. It was thought provoking and I appreciate that.

#personal #ed recovery

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detentiontrack · 1 year

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I want to apologize for my strange and erratic behavior the last few months, and especially the last month. As y'all know, I was diagnosed with bipolar type 2 last year, and that is what I was being treated for. However due to me not communicating with my doctors properly, it turns out I was misdiagnosed, and I'm actually bipolar type 1, which comes with more severe symptoms, and since I wasn't being properly treated, I ended up going into a major manic psychotic episode around early February. I have been stuck in psychosis and delusion for the last few months and I don't even remember posting half the stuff I did, but I know it was bizarre and I wasn't as positive or nice as I usually try to me. I am on medication now and will be starting DBT therapy soon, and my head is finally much clearer, and I just want to say I'm sorry for everything. Thank you all for sticking w me and being so patient <3

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spiderace · 2 months

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Because of my diagnosis of autism in September 2023, I was in a full eight-session course of Dialectical Behavior Therapy group this winter. I've been thinking about it a lot, so I have some comments to share. Feel free to skip this if it's not interesting, but I know a fair amount of fellow autistic or BPD people are on Tumblr and might end up considering emotion regulation therapy.

Some stuff from DBT was distress management, which was useful. For me it was worth it for that alone. So from the start, I do recommend it if you are offered it. But:

Some of DBT was the therapist failing to explain basic masking to a group of autistics and people with BPD. This was because whoever developed the course she was rushing through did not examine the reason WHY these people haven't learned masking skills already. It was usually because those that hadn't, had never had explained to them the difference between expected social diplomacy and lying.

See, I'm going to explain this now, from the POV of a Level 1 late-diagnosed autist with pretty decent masking skills. So this is going to seem super obvious to those of you that are neurotypical.

Many people with autism feel inherently that concealing your feelings or opinions is the same as lying, and that you are doing someone specific harm by not telling them when you know they're wrong. We can't read tone or expression well a lot of the time, so it's not clear to us when someone is saying something just to be polite, or otherwise saying other than what they mean. And we hate not knowing what people mean. So we tend to just SAY what we mean. The natural result is that the autistic person sounds like a rude asshole to everyone except other autists. It's not unusual for people with BPD to have a similar problem, as I learned from my fellow patients!

Neurotypical people generally agree that lying is wrong in a broad sense, but they also preserve an internal distinction between lying that is wrong and stating a non-fact for social reasons that are obvious to the listener. No one tells the autistic person about this, because you're supposed to just know it.

An example of this that we discussed in class is that a coworker in a lunch discussion says the world is flat. Now, you, the autist, know that's not true. But the important fact is that everyone around you does, too. So when you gently deflect the person by politely saying, "Wow, Dave, that's interesting. I've never heard that before," everyone around you is NOT assuming you believe Dave. They assume that you are being polite. You're not actually lying or deceiving anyone, because everyone actually knows what you mean ("I'm not comfortable with this, let's change the subject"). It's possible even Dave will get the message and not bring it up again, depending on how good Dave is at reading the room himself.

This is a much better use of your time and social presentation than point-blank telling Dave he is nutter butters and starting an argument that ruins everyone's lunch break. Because at that point it's not Dave everyone blames, it's YOU. Everyone knows Dave is wacky about the flat earth, why can't you just skim over it as fast as possible so we can all get him off the topic?

The important skill to learn here is when not to engage on something. If you don't agree from day 1 that sometimes there's a Dave and we don't have to point out they're wrong, you simply can't function or mask for longer than it takes for someone in a conversation to say something you don't agree with. This is a very common autistic problem.

Because the fact is that there will definitely be times where you are sure someone is wrong, even Dave and the flat earth level wrong, but it's NOT obvious to everyone. If you can also learn not to try to correct everyone when that happens, you can be a lot less annoying to other people socially. (And I do mean socially here; obviously if you work at a nuclear plant or something and see someone doing something unsafe, you have to speak up, and I'm saying that because I know a lot of us are also very literal.) But you definitely don't have to tell Madison, your boss who can fire you, that there is no evidence essential oils have other than a placebo effect on any health condition. You can say that's very interesting, Madison, and hey did you watch the game? For "the game" you can swap out something else you know Madison likes. It doesn't really matter what it is, it matters that you got her off the thing you disagree with onto something you don't care about, and then you shut up and let her talk about it, so she still has a positive feeling about the conversation.

This is the most basic thing on earth, and if any neurotypicals are reading this you probably can't fathom how anyone doesn't know this. This makes a lot more sense if you are coming at it from the point of view of never, your entire life, knowing what people mean by a certain tone, or what the thing they're doing with their face exactly means. It's very possible to learn these things (not easy, but possible), but you have to first realize there's something there TO learn, and that learning it is not BAD or EVIL, and that's a hurdle my DBT course failed to clear immediately for most of my classmates.

#autism #dbt #dialectical behavioral therapy #bpd #borderline personality disorder #masking #late diagnosed autistic

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ecoamerica · 1 month

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