SO got instutionalised; feels like he's in jail...

[lemon flower]

My friend is staying in a psychiatric hospital since july.

First he was in a rehab facility where he stayed 3,5 months and where he was relatively happy; he had his own room, TV, internet, he got medication in order to balance his moods and his cravings, he made some friends with whom he played pokergames in the evening, and in the weekends he was allowed to come to visit me and his family.

I had the impression he was quite content, felt safe, and doing much better than when he had to "survive" in the outside world, almost like joining some summer camp, ( occasional figts and drama with the companions or the staff included   )

After three months he was, not surprisingly, diagnosed with BPD and got transferred to another unit in the hospital that is specialised in treatment of comorbid BPD and toxicomania.

I think this is a good thing because he now hopefully will receive the appropriate treatment and therapy that he needs. He is 31 years old and I have the impression it is "now or never" regarding a positive impact of the therapy (DBT).

Unfortunately he is very unhappy there. He is the only guy amidst 8 women and he has been deprived of all the privileges he had in the previous unit: no more TV or internet in his room, not allowed to keep his mobile phone on him, no free weekends, and very limited visits allowed (visit under surveillance in a visitors room). IT FEELS LIKE JAIL!

I am a bit puzzled by all this. My friend came to the hospital voluntarily (he didn't see any other option anymore and lived a very problematic drug-orientated life) but he ain't some criminal, and he now feels hugely betrayed, not only by the clinic and the therapists, but also (ofcourse) by me and his mum, he says we wanted to dump him there, we don't love him, we want to get rid of him, etc.

I am trying to motivate him because if he decides to leave he will probably end up on the street, and will be addicted again in no time, but I fear he will not accept this for a long time.

Did any of your SO's have had similar experiences ? how did they react on this kind of draconic regime? was it useful ?

(it seems the privileges can slowly be re-obtained by time and the total durance of the "traject" is estimated 6 months )

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[MaybeSo]

Hi lemon flower.

I can understand your concerns.

A couple of things come to mind.

First of all, the feedback you are hearing is typical of this disorder.  Right?  So, pw BPD tend to go into victim mode really quickly when they are uncomfortable and they blame and complain A LOT.   This is likely what you are hearing from him.  And, you are hearing it only from him, you really don't know what the docs etc. are doing or why they do what they do in that program.

It appears he is in a treatment hospital that targets dual diagnoses like BPD and addiction.  Keep in mind, your friend isn't the only person there.  Everyone there is in the same boat.  For a reason.  

He is struggling with addiction.  He may not stay.  If he doesn't stay or doesn't make it through the program, that would be because of his addiction and his illness, and not b/c of the accommodations or lack thereof. We don't know the reason behind the program rules or exactly how it's set up or organized but many programs have certain rules etc. that set the "frame" for recovery, meaning, dealing with everyday inconveniences and learning healthy coping skills, in other words, the inconveniences often are part of the therapy frame and the recovery process.  

(You and I for example, feel inconvenienced and put-out every single day of our lives, while we continue to follow tons of implicit and explicit rules that are annoying... .we just cope with it in a functioning manner every day, often with little thought and we don't personalize them.   Which means we get to live independent, richer lives because of our ability to cope despite life's irritations.  If he is successful with recovery, he has the chance to live a richer more independent life, too.  )

The part of the hospital he was in earlier was probably much more comfy, and this was probably where he stabilized and was observed.  But if he ever does get better, he would need to deal with life as it is, so that he can get healthy and be an independent person with functioning coping skills.  A comfy cozy hospital stay isn't real life.   Unless he plans to be institutionalized or completely dependent on others for the rest of his life, by necessity he is going to have to learn to cope with discomfort and inconvenience as part of his recovery.

If you are really worried, I would suggest doing some research on the program and see if they have stats regarding the population they treat, any success rates or success stories, along with understanding what their treatment plan/ philosophy is for recovery at this institution.  :)o they do a traditional DBT group / individual therapy, for example?  What is there overall treatment philosophy?

Finally, I guess if he were super rich he could go to the Betty Ford Clinic or some such institution. I know some of these private pay programs are extremely luxurious in it's setting,  but the person still has to suffer the discomfort of recovery.  There's not getting around it, no matter how nice the place is.

Anyway, I hope you don't worry too much; recovery is a very long, difficult road, so you need to pace yourself.  At least he is there getting treatment.  That is so much farther than most people ever get.  You can take comfort in that at least.

Best to you!

[lemon flower]

If you are really worried, I would suggest doing some research on the program and see if they have stats regarding the population they treat, any success rates or success stories, along with understanding what their treatment plan/ philosophy is for recovery at this institution.  :)o they do a traditional DBT group / individual therapy, for example?  What is there overall treatment philosophy?

I am mostly worried that the total lack of any freedom will chase him away before he could benefit from any results of the therapy... .but up till now, he's still standing, which means that maybe he's slowly getting used to the system or maybe it ain't as bad as he's putting it... .I noticed that the nurses and social assistants are fully involved with their patients so I hope he will start to develop some kind of mutual trust to his personal assitant, as that is one of the goals of the program.

he will be offered DBT, but not earlier than 4 weeks after the intake, so it's really building up slowly. Meantime I have the impression that they are testing his motivation and his (un)ability to stick to the rules and to learn to respect restrictions, the hard way... .

[ziniztar]

Being treated for BPD internally, means trying to get to core issues.

Having a phone, internet, TV, whatever always around, will allow for distraction. The drugs probably played a big part in this as well, and without solving core issues, this type of addiction will transfer to something else, e.g. a game, alcohol, sex or even Netflix addiction .

In schema therapy it's what they call the 'unattached self soother', that always uses distraction to avoid feeling something.

I guess, if he gets through the agony of being confronted with his feelings, he'll be allowed to use this stuff more and more if he's able to do it in a healthy way. It's a step that is required...

[lemon flower]

Being treated for BPD internally, means trying to get to core issues.

Having a phone, internet, TV, whatever always around, will allow for distraction. The drugs probably played a big part in this as well, and without solving core issues, this type of addiction will transfer to something else, e.g. a game, alcohol, sex or even Netflix addiction .

In schema therapy it's what they call the 'unattached self soother', that always uses distraction to avoid feeling something.

I guess, if he gets through the agony of being confronted with his feelings, he'll be allowed to use this stuff more and more if he's able to do it in a healthy way. It's a step that is required...

oh yes, he's a very experienced self-soother, using all the variety you mentioned

but he's also stubborn and persistant, allready he managed to negotiate with the staff and that resulted in a small victory: he got the permission to install his computer in a side room and he now is allowed to use his computer every day for one hour in the evening.

another positive thing is that two other guys arrived this week, he won't be the only testosteron-magnet in the unit anymore  

[ziniztar]

That sounds good! I hope his journey is full of new insights  .

How about yours?