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Author Topic: Any experience with in-patient intensive therapy? Any success?  (Read 392 times)
DS2020
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What is your sexual orientation: Straight
Who in your life has "personality" issues: Romantic partner
Relationship status: Married
Posts: 57


« on: September 16, 2020, 10:03:01 AM »

My thread titled Very Sudden Crisis Part 1 and 2 lays out what has been happening. The first meeting with the attorney to work out the divorce and the interpersonal problems she is now having with her boyfriend is precipitating the breakdown that I had expected. She texted me telling me she was struggling and then called me saying that she needs to go inpatient somewhere for treatment. She is saying how she has made a mess of her life. Once a week counseling is not adequate for the amount of help she needs. I have started calling some places to see what is available.

My question for the group is whether anyone has had any success with these? They certainly include a lot of DBT and group therapies. I know every facility is different and the willingness of the pwBPD to take it seriously is obviously of vital importance, but in general, assuming a willingness, and a good facility, is there any likelihood of success or significant improvement?

Just hoping someone has some insight.

Thanks
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Naughty Nibbler
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Gender: Female
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« Reply #1 on: September 19, 2020, 03:22:06 PM »

DS2020:
I don't have personal experience to share, but I'll share some comments to perhaps prompt some thought on your part.  Perhaps, it might help to make a litte list or spreadsheet on the pros & cons for you.

If insurance is available to pay for in-patient, then it's a good opportunity. If you would personally have to contribute a substantial sum of money, then you would need to go into it with no expectation of success. Is she wanting to take advantage of some insurance use, before the marriage is dissolved?

She has a boyfriend.  You might want to examine your impulse to try and "fix" her.  Is there some hope that you could resume a relationship with her & cancel the divorce?


I think it's rather rare for anyone to go to an intensive in-patient situation and come out "cured" or remarkedly better, especially the first time.  As you mentioned, a person has to be motivated. Inpatient care can be helpful to get a diagnosis, a 2nd opinion and to perhaps pinpoint some meds that could be of long-term benefit. With a motivated person, it could be a good launch in a good direction, but a direction that needs to  be fostered.

Even with motivated individuals, it will never be a "one & done" situation.  Learning DBT, healthy management of emotions, ways to interact with emotional intelligence - takes constant practice and refreshing.

In-patient therapy could give a very motivated person a base to grow from.  I think that if someone goes through an intensive course in DBD, on an inpatient basis, they need on-going outpatient coaching, with real-life situations, to cement the strategy/logic.

For a motivated person, there are DBT books, and online worksheets to use. If an outpatient DBD class isn't available, where she lives, I believe there are some online courses.  Although, it's best to have a therapist who is experienced with BPD and DBT therapy, I would guess that most therapists would be able to help coach someone through some of the exercises and discuss.  The elements of BPD seem to relate to basic strategies that any psychologist would be exposed to during their training. (Certain elements are combined & packaged as DBT)

One thing to evaluate objectively is why hasn't her current therapy helped?:
1. Is the therapist suited for her and BPD issues?
2. Are therapy goals established?
3. Has she learned any DBT skills?
4. Has she learned to develop any coping skills to manage her emotions? i/e A personal list of things to do help manage her feelings when she is feeling angry, anxious, sad, etc.

There is no magic fix.  There needs to be motivation to keep working the issues. If meds. might help, then she should be evaluated for that.  If she is motivated now, then there could be multiple opportunities to consider.

Do a reality check with yourself?  Is this an attempt at a recycle? Is it in your best interest to get into "fixer" mode. Might you be setting yourself up for another round, only to end up with more legal fees down the road?

Anyway, just throwing out some things to consider.  If insurance and/or money for inpatient is an issue, then you need to look at alternatives. If you provide substantial cash, then it's a gift without any expectations.   
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