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this was posted on another site that I am a member: "there are also some people with borderline BPD who need the 'validation' of being in hospital so they say/do things to try to get themselves admitted. if you present saying you feel suicidal, then it is likely to be perceived as you saying you're suicidal in order to get another hospital admission."

I don't know if I have BPD, but this need describes me exactly. I have done this once before, got myself admitted, then I was put on a hold. I fought like hell to get off the hold saying I wasn't suicidal (I wasn't) but I did want to harm myself, but I think it was only to the extent that I wanted to stay in the hospital longer and be cared for.

I know that it is hurtful and wrong to purposefully try to hurt myself just so that I can be admitted. I have seen the hurt and angry faces of my friends and family. I don't want to hurt them, yet I have not found another way to fulfill this urge that I have been dealing with for a long time.

please, if anyone has dealt with this and has any suggestions I'd really appreciate them.
thanks
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I'd say you need a secure attachment to a therapist. That way you know your needs will be met, even if you have to wait.

Failing that, I'd do a child/adult dialogue.

hmm... what is a child/adult dialogue?

I do have a therapist that I've been seeing about once a week since about jan/feb?
I do trust him, but it's almost impossible for me to show and express emotion. We have talked about this and I understand that when I am able to express and feel emotion, talking will feel as satisfying as self harm.

It's this in between time while I'm learning the tools and trying to change that I'm really struggling. I know in my heart that change can happen... I'm just afraid that I won't be patient enough to wait for it. I know that each time I use a negative skill it robs me of the change to move forward with using my positive coping skills. I guess my problem is that right now the positive things just really aren't doing it for me...

Thanks again
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You've only been in therapy for a couple of months, you might need to build up that trust a bit more. I was the same when I got there. Give it time.

We all have a child and an adult (hopefully) inside of us. Sometimes they have conflicting feelings. Sometimes I write letters to the child part of myself for comfort or reassurance. I wrote a little book with pictures when I had to have a 6 month break from my therapist. Something along the lines of:

"t is going to be leaving you for a while. You might feel scared or upset, but I will help you get through this. You will be okay. When the break is over, you will see t again".

You could also try EFT using the template "Even though I have this need for attention from hospital staff I deeply and completely accept and love myself". I'd follow that with a round using the word "validation" in place of acceptance, taking note of any other feelings which arise while doing so. And then tap on them, too.

You can find the EFT sequence on You Tube. (Just type in EFT). My personal favorite is the EFT/NLP picture switching..this is invaluable!

Going to hospital is obviously filling a need.......but can you describe more accurately what that need is?

Need to be taken care of?
Need to feel loved?
Need for others to take care of things so that you can have less stress?
Need to show people how badly you hurt on the inside by hurting yourself?
Need to be understood?

The key is to find a way to meet that need on your own. Only by really and truly identifying the need (what you want to be validated) will you find a way to meet it.

hmmm

I guess the need is to feel safe and cared for, because in my everyday life I do not feel safe or cared for. I know that I do not care for myself as in take care of but I also do not care for myself as in .. prefer...

I guess I need to reassure myself that I am safe, because I know that I am "safe" as in nothing is going to happen to me (that I haven't done to myself)
and I know that I need to learn to love and take care of myself, but I guess that just takes time. It is being patient and sitting with uncomfortable feelings that I am not good at. (don't like)

Thanks

You're not alone with this. I haven't acted on them, but I certainly have those urges.

I like Harmonium's questions. I think for me, a lot of it comes down to the fact I feel I should have been hospitalised when I was at my most unwell (severely depressed, suicidal and quasi psychotic), but no one realised how bad things were. I tried to seek professional help, but found it hard to express what was going on, and it took years for me to be taken seriously, despite not being able to work and losing just about everything that mattered to me. It was an incredibly painful time.

Then all that has echoes to my childhood when I was being abused and developing MH problems and no one noticed or (apparently) cared.

Being hospitalised somehow seems like the ultimate validation - I don't know why!

But I now have a really good pdoc now who I trust and I think I'd like to tell her how bad things were eight years ago. I realise it may not be relevant now, and I'll say that to her. I just feel I'd like to have the facts recorded in my medical notes, and maybe that will help.

Im glad things seem to be looking up for you. But I'm sorry that you didn't feel like you were getting the help you needed when you were worse off.

I can really relate to that. I feel like I am trying really hard to be honest with my doctors, yet I don't want to be dramatic or feel like I'm making myself worse off than I am.. yet I feel like my symptoms and how I feel are being underwritten or not taken seriously.

Last week at my psychiatry appt I told my psychiatrist that what I've been struggling most with is my suicidal feelings, that they are still mostly passive, but very present. She says "but you've struggled with those for a long time right?" and I said yes. so then she moved on. I felt like she was saying because I've struggled with them for a long time that she didn't need to address them?!?

I feel like no one is taking me seriously and that asking for information and telling her I am considering ECT, inpatient treatment and suicide is about all I have to say. I feel like saying something more might be acting like a drama queen or something.

I guess I am just feeling very alone and scared right now. sorry to keep bumping this up to the top. Thanks for everyone's help.
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It sounds to me like you're seeking external validation and affection when it really needs to come from within yourself. I'm sure you already know this but I think it's important to clarify what the hospitalizations & such are trying to fulfill for your present self.

When you mentioned the suicidal feelings and the psychiatrist moved on, what kind of response or reaction were you hoping for? You don't need to answer here - it's more of an introspection-type of question, really. And you can be honest with yourself - you're the only one who would judge you. Were you hoping she would rush over & put her arms around you, stroke your hair and tell you everything would be alright? Were you hoping she would focus on the issues & engage you in lengthy-conversation about what you're thinking and feeling? Were you hoping she would offer to write a paper about your feelings and issues for a psychiatric journal? Some of these are - of course - a bit far-fetched but it's okay to have had those types of expectations. Just being able to acknowledge that you had those sorts of expectations might help you move forward if you're able to recognize that you want something specific and/or see the expectations as unrealistic so you can work toward re-engineering your expectations into something more realistic so that you won't always feel so empty inside.

Hmm.

That is a very good point that you bring up. What I want is internal validation. I just don't seem to be able to fulfill it.

I think that what I honestly wanted was a bit more of a reaction. Maybe some drama and more concern? I know that I do thrive a bit on drama and people worrying over me and have done things in the past that have manipulated people's actions so that they act in worry/concerned ways because of my actions.

But honestly, from her, I think that what I really wanted was her to address the fact that I feel like I don't want to live. Maybe I wanted some acknowledgment about how hard it has been for me to keep my thoughts passive and not form a plan.
I really wanted her to address the fact that she is a psychiatrist... who prescribes meds and apparently I've been pretty consistent in telling her that I feel suicidal and she has not changed my meds.

I have never really felt like meds have worked for me. I have been on over 5 different types (that I can remember) and none have had much effect. What I really want from her is an honest answer of what to expect. If meds are not going to work and I am going to have to live with these feelings until (if) psychotherapy begins to take affect, then I would like that to be acknowledged... at least I won't keep holding out hoping that maybe she knows of a med I haven't tried that will help me out.

I guess I was so frustrated because I feel like she is leading me on by continuing to see me and but just lowering my medication without suggesting a different one to try. If she feels that we have really tried everything I think it is her job to tell me such, not just keep seeing me every 2 weeks and wasting my time and money.

Sorry. This turned out long and a bit angrier than I had thought it would.

Meds don't stop suicidal thoughts. No med that I know of anyway. In fact, many exacerbate those kinds of thoughts. So that route is just not available. Meds can help with the depression (or other contributors) that usually causes the suicidal feelings though. I would be very direct with her in stating that whatever meds you are taking now are not working and that you are still depressed (or whatever is causing the suicidal thoughts for you). That's what she can tweek. Also.....when you tell her something like you feel suicidal and she doesn't react the way you would like, why not talk about those feelings? Clear, honest, direct (even brutal sometimes) communication is the only way I know of to really get my own needs met the way I need or want them to be met. How can she know that you need her to tell you your options (or lack thereof) if you don't vocalize that need?
Another thought about why she might not be focusing on this aspect......some people get worse in terms of suicidal thoughts when they discuss it in detail with a therapist. If you are not actively forming a plan, then her job is to help you focus your life (emotionally) in such a way that you don't want that anymore. Is she doing that?

Okay.....so you want internal validation, but it sounds like you are seeking it externally (wanting from your T, hospitalization, etc.). All the actions you are describing to gain validation are ones that require someone else to validate you. For me at least, I tried and tried to internally validate myself through manipulation or other external ways only to find that it never, ever worked. My expectations of others are usually not on par with my own wants or expectations, or so I've found. In fact, much of the time I've found my expectations were way off. Maybe looking at your own would put things in a more doable perspective?

What are you doing in your everyday life to fulfill your internal validation needs? Are you simply expecting it to 'click' one day? Do you take care of yourself physically? Do you follow the 4 agreements? What does validation mean to you? Can you break it down in smaller chunks (like, validation in work or validation in my values or whatever)? If you can break it down or seperate the thought "I don't feel validated" into "I feel validated in x area, but not in y area" then it can be less overwhelming and easier to achieve. Make sense?

For me, I couldn't find that internal validation until my actions lined up with what I thought were 'good' things-- what I call my Authentic Self or who I really am. I found myself wishing and hoping to like myself and find myself 'worthy'-- but all (or most) of my actions were ones I was ashamed about or just regretted. I had to make my actions line up with what I thought of as 'valid'. I had to do things that I find 'esteemable' in order to find self-esteem (internal validation). In my experience, internal validation takes time and practice. It won't happen overnight, but all the little baby steps you can take in that direction WILL add up. And.....when your actions are valid in your own mind......well, it's funny how when I act in accordance with my authentic self, other people validate me or praise me or whatever. It's a really good feeling, that external AND internal validation, but I believe it has to begin with internal validation. Other people will notice, I promise, though at least for me that wasn't so important anymore.

I think you've found the key. But, maybe you are going about it a little backwards? What I mean is.....in order for me to feel loved, safe and cared for externally, I had to love myself, secure myself and care for myself first. Then and only then did I receive that external validation. You could start really small and slow......like making sure you get enough sleep, eat healthily, give yourself a facial, exercise, etc. Those little things add up. And I've found that when I don't take good care of myself physically my mental self goes haywire-- every time. I guess the way I see it is I can't be mentally healthy if I don't give my body what it needs to fulfill that need (nutrition, stress relief, exercise, etc.).

Oh, and I think it's really good when threads evolve like this one has. I find out more about myself in such cases and I hope you are too.

Thanks. I was just going to apologize for going off topic. This thread has helped me to understand a lot of things and I greatly appreciate everyone helping me to analyze and process my thoughts.

I am glad that someone else is able to get something good from this thread. It makes me feel less like I am wasting people's time and the space of the forum.


Hmm... I'm not sure I understand what this means. That what I'm expecting from people is unrealistic? Or like I ask for one thing from a person, but that is not what it is that I really want?

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(a lot of this turned into a rant, and less solution oriented, so I am going to try to re-phrase further down, so if you'd like to skip this, feel free)
my psychiatrist is not my therapist, and I think that is part of the reason I feel frustrated that she has not changed my meds or suggested more options. I have been seeing her since last sept or so. I went in and told her that I was not expected to be completely cured of my depression. I stated that what I wanted from our sessions what I wanted ideally was just to be able to feel like I was content with my life. I didn't need to be happy or never sad, but just wanted to feel content more than sad.

Now, at our last session 2 weeks ago, I told her that since meds don't seem to do anything and my situation seems to be deteriorating (which she agreed with) I would be content with just being able to function in the world. My ideal for my life at this point would be able to attend classes and pass them. To leave my house when I need to and get to work on time. I would like to be able to wake up in the morning and not feel like I truly don't want to live my life any more.

I have an appointment with her in a few days, and I will try to be more direct and blunt with my expectations and my feeling that she isn't being quite honest with me. I guess that I am honestly just so afraid of being put on a hold that it is really hard for me to be honest. I do realize that I may need to consider entering a facility voluntarily, but I am trying to hold on a little longer because I promised my family that I would let them see me graduate. My mom said that if my health is in danger, that's more important, but I know how much they all want to see me walk across the stage. I feel as if I have been such a huge disappointment and pain to them that I would at least like to give them this before I hurt them again by signing myself into treatment.

I am sorry, this is turning really long and I think is less of a solution oriented post and is turning more into a venting session for which I apologize.

+++ back to process and solution, less venting I hope +++

My psychiatrist is only there to prescribe meds. I think that this is why I feel that she is wasting my time by not being completely honest with me. I have an appointment with her in a few days, and I will try to be much more honest with her and much more direct. Because honestly, I am so tired of feeling this way, so much of me just wants to give in and give up. She does know that the meds are not working, and has even stated herself that I don't seem to respond to meds. We lowered my current dose of effexor because I was getting worse and I'd rather not take meds that are obviously not doing anything (they can't even keep me stable).

Now that I reflect, I think the emotion was so strong because I realize deep down that I am losing hope. If meds, and psychotherapy aren't helping even though I am actually trying for the first time, actually putting in the work; I worry that I may not be able to over come this. Before when it didn't work, I had the comfort of knowing that I wasn't actually trying or being completely honest.

It is good to know that meds don't help suicidal thoughts. I do think that if they could help my depression my suicidal thoughts would be less severe; however, right now I am having a hard time remembering what it feels like to be ok, it seems so far away.

The external validation thing:
I think that I do not allow myself comforts because I feel unworthy and like a bad person who hurts others. Getting external validation has been the only validation that I have received (whether I accepted it or not)

For some reason I've always felt like I am wrong and bad and that unless someone else validates me, it is not really true or ok. I was always one of those kids that would run up to the teacher and ask how I did.

If youve gotten this far. Thanks for your patience and time.

First things first-- you are not wasting my time (or others that I can tell) or space on the forum. This type of thread is exactly what we are here for. I'm glad it's helping you sort through some stuff and yes, it helps me too.

What would have been more clear is if I had said "the reactions I get from others are usually not on par with my own wants or expectations of what their reaction should be". Well, what that means to me is that in most cases, the reaction or responses from others that I expected was unrealistic or at least only coming from my own perspective/experience base. It's how I would have reacted if someone said such things to me, not how they would have reacted, given their own history. It was placing my own feelings/needs onto another person-- expecting them to react the way I wanted them to rather than the way they normally would. What I expected in terms of a reaction from someone else just wasn't usually what I got. I had to learn to let go of the 'shoulds' in my mind-- I've found they are never really helpful in my recovery process.
For me it also means that sometimes the reaction I was expecting/wanting wasn't in fact what I really needed. If they had given me that reaction I wished for......well, it just wouldn't have helped. I would have found another drama-centered way to continue to get the reaction rather than learning how to stop the cycle.

I suppose in the end, what I've done is to just try to let other people be themselves and have that be 'enough' for me. Just because they don't react to a situation in a way that I would find validating doesn't necessarily mean it's not validating. Shifting perspective I suppose and maybe throwing in a little empathy as in seeing things from their point of view rather than just my own. And maybe looking more at the bigger picture rather than the urgent here-and-now problem. Really, I think I've just let go of exptectations of certain responses from others-- I can't possibly know how what I do or say will effect them or what they see in my actions, so how could I know how they would react? It's part of not assuming (the 4 agreements!!!) for me. I hope some of the above helps to clarify what I'm trying to say, but if not please let me know and I'll try again.

There is always the possibility that there are no more options in terms of medication or that they haven't had enough time to begin to 'work'. Some meds take months before you start to feel the effects. I know for me, I never found one that did it for me. If you have tried various types (classes) of meds with no success.....meds just may not work for you. Also, therapy takes time and a real effort on your part. It's possible therapy IS working, maybe just not as fast as you would like or dare I say- expect it to. Baby steps.

I'm coming from a place of concern and caring, so please take this in that light. No one and no med can "make" you better-- they are just tools we use to help ourselves. In the end, it's all up to you (hard as that may be to hear). To get where it sounds like you want to go.......it has to come from within (in my experience). For me, I had to break it down in my own mind into what specifically made me not want to live and then progressively change those things in my life-- it's a slow, gradual process. I felt like a burden on my family and friends and that I was just worthless. In order to want to live, I had to become self-sufficient so that I didn't feel like a burden (to the extent that I can; I have physical health issues) and to do things I found 'worthy' or things in line with my own standards. A BIG part of that for me is still listing and remembering things that I have/do in life that I am grateful about. It can be small stuff (on a bad day) or sometimes surprising stuff (on a good day). By keeping a 'gratitude' journal, on those bad days I can look back over some of my entries and realize I really do have a lot going for me. Would that help you?

Can you articulate what specifically makes you feel like you want to die? What can you specifically do to change those things? Is there a physical reason you can't attend classes on time or get to work on time or is it because of your emotional turmoil?
For me at least, the more I gave in to my depression/anxiety and missed class or was late to work, the worse I felt emotionally. So, the solution for me was to make those things my top priority-- even if I didn't feel like getting dressed or leaving the house, I made myself do it. What I found was that when I actually successfully met those goals, my emotional self was more stable. I felt proud of those accomplishments and I bet you would too. I know it's hard (understatement), especially when every fiber in your being is saying that you can't, but the reality is that you CAN and it's all a choice. A choice to stay in bed, to procrastinate, to skip a class. For me those choices made me feel guilty and like a failure, which made my depression and sense of worthlessness worse-- so I changed them. Slowly, over time-- it didn't happen overnight. Feel the fear and do it anyway!


Losing hope is tough-- but if your "loosing hope" and haven't totally "lost hope", there is still some hope left-- focus on that sliver! I'm also hearing you say that meds and psychotherapy (with the work therein) are your only options? What else could you do to help yourself? How long have you been actively trying/participating? Are you in psychotherapy or another form of therapy (some work for some people, other forms work for others)-- maybe you just need to switch the type of therapy? Are you really trying and being completely honest (with yourself and your pdoc and your therpist and your family) now?

I'm trying to say that I know there IS hope. That I believe you can overcome this, but it will take a monumental effort on your part (hard to do when defeated). Just start small and it won't seem so overwhelming. l know all this because I was once in your shoes (suicidal-- in fact I made a real attempt that technically 'succeeded'; my heart stopped for 4 min and I was in a coma for 3 days). But now, after a lot of introspection, discovery of who I am and who I want to be, what's important to me (and what's not)......well, I haven't even been to therapy for over a year and I'm considered recovered from BPD. Life is not all roses, but I roll with the punches better and the good definitely outweighs the bad. I know you can get there too. It begins with the choice to not allow your behaviors to keep you in your funk-- to choose healthy, happy living. I know it sounds simple, but as I'm sure you know it's not. But it IS possible, and I firmly believe you can come out on the other side of this.

Sorry my posts are so long....I'm really terrible about condensing my thoughts. I hope you were able to get through it and glean something useful to you. Remember, take what you like and leave the rest.

Here are a series of questions for your consideration. You needn't post about them unless you want to. They're really just based off your "angier" post, with the hopes that the thoughts you come up with as a result will lead you closer to recovery stuff.

How do you think other people self-validate? Do you know anyone in your life that you would consider to be a paragon of self-validation that you might use as a role model? (Basically "What would my role model do in this situation?")

Why do you want the drama? Do you not feel alive when things are "dull"? Do you recognize any "roller coaster" effects from the drama - that you're always chasing the next high, therefore compelled to create the drama which will elicit that next high?

Do you feel that you can only define yourself through the drama? That unless there's drama, you don't exist? That you've closely aligned your sense of self with the drama over the years and without it, you feel empty or drifting?

Do you feel that when you create the drama & worry about your well-being, you're eliciting expressions of compassion from others? That perhaps you don't feel loved or appreciated without overly-dramatic expressions of concern/compassion from other people? That because you're so focused on the big splashy events, the quiet, subtle signals that people care about you just don't even register?

When you look at other people in your life, how do they show each other (or those they love) that they care? Do they get gratification from a simple hug or do they require a grandiose display of undying affection and sympathy?

Do you think it's more important for someone else to address the fact that you feel the way you do (like you don't want to live) or for YOU to address that fact? If someone else were to address your feelings, what would that look or feel like or accomplish for you? What would it look, feel like or accomplish if YOU were the one to address those feelings?

Have you heard the expression "toot your own horn"? What would it be like if, during the next conversation / meeting, you tooted your own horn by way of saying something like "I'm really proud of myself for keeping things passive, not actively forming a plan, for allowing the thoughts to just flow in & out again without taking action. Are you proud of me too?" What would happen if you took some responsibility in "The Praise of Sapere Aude" (starting with offering praise to yourself both in public and private) and took a more direct approach at eliciting external praise from those around you?

Have you asked the psychiatrist "Do these meds have 'suicidal ideation' as a side effect?" or "Are there any alternate medications that might lessen the 'suicidal ideation' component because it's very difficult for me to deal with every day?"

Have you done any research on medications yourself? Have you heard of the "crazymeds" website which offers up side effects and positive impacts on all sorts of medications, in regular plain words that make sense? Have you considered that psychiatrists generally "play chemistry set" with these meds, that humanity still has no clear, definite understanding (cause & effect) of how the brain works or what can be expected of medications? Have you worked on accepting the trial-and-nature aspect of p-drugs?

If the psychiatrist is changing the doses and even brands of medications, why do you see it as "leading you on" rather than "continue to persevere in her quest to find the right balance for me to feel better"? Is the negativity an automatic thing for you? Is there a chance that the negativity might be a side effect of the medications?

(For what it's worth, I don't know that I'd be thrilled with going every 2 weeks because these meds generally take a while to establish efficacy (begin showing noticeable results one way or another.)

Have you asked her "Why do I need to come back every two weeks?" or "If we plan for me to come back in 4 or 6 weeks, would you be willing to see me after hours or work through email or over the phone if things get really bad in the meantime?"?

(I've told doctors outright - "I'm broke, work with me here - what kind of compromise can we reach here?")

Again, aside from my last two comments, these are mostly questions for you to consider, ponder, think about, carry with you for a while & let your subconscious work on.

I would challenge you to keep asking yourself "What would ....." - like "What would ___ do in this situation?" or "What would it feel like if I just came out & said it?" or "What would be the worst case scenario if I were absolutely honest here, and is that worst case really that much worse than feeling the way I feel right now?"