![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by Racer on May 4, 2008, at 2:50:48
My therapist would like me to go into residential treatment, at Renfrew in Florida. I'm not sure I want to do it, but wanted to know if anyone else had any experience with it.
Anything you could tell me about residential treatment would be great -- especially Renfrew, and especially information on how your insurance handled it.
Posted by MidnightBlue on May 4, 2008, at 21:20:55
In reply to Anyone done residential treatment?, posted by Racer on May 4, 2008, at 2:50:48
Racer,
I have no experience with this, but wanted you to know I'm thinking about you. This might really help you.
MidnightBlue
Posted by ClearSkies on May 7, 2008, at 11:04:45
In reply to Anyone done residential treatment?, posted by Racer on May 4, 2008, at 2:50:48
I just want to add my vote of support for this opportunity for treatment for you.
((((Racer))))
CS
Posted by Racer on May 7, 2008, at 23:30:18
In reply to Re: Anyone done residential treatment?, posted by ClearSkies on May 7, 2008, at 11:04:45
My husband is very much against it, partly for financial reasons, partly because he doesn't think my therapist is right about me needing it. In fact, he reacted to it by saying he's "starting not to trust" her.
I haven't mentioned that half her reason is to get me away from him.
Then again, on Saturday, after I'd been crying most of the day, he came in while I was on the telephone with someone, talking about feeling suicidal, and said, "wow -- I guess you're not doing so well. That came on so suddenly..." It's not as though I haven't been telling him this for MONTHS. And telling him in so many words. And telling him in our marriage counselor's office.
Oh, hell.
I'm having enough trouble with the whole idea. And the timing. And honestly? Hearing him say, "I don't want this to end up with nothing except the expense to show for it, and you worse."
Which, when you come right down to it, is why my therapist wants me to go in the first place. To get me away from that level of support.
Posted by Sigismund on May 8, 2008, at 3:21:19
In reply to Not getting real world support on it..., posted by Racer on May 7, 2008, at 23:30:18
> (he) said, "wow -- I guess you're not doing so well. That came on so suddenly..."
Really!
How do you explain this?
Men?
Posted by Racer on May 8, 2008, at 5:19:58
In reply to Re: Not getting real world support on it... » Racer, posted by Sigismund on May 8, 2008, at 3:21:19
> > (he) said, "wow -- I guess you're not doing so well. That came on so suddenly..."
>
> Really!
>
> How do you explain this?
>
> Men?No -- I'm just not on his radar. He says I'm important to him, but he doesn't even see me, doesn't hear me, doesn't really know I exist. He has no idea how his behavior affects me, even though he's been told by our marriage counselors.
I'm torn -- I have been suicidal lately, so it makes sense to get treatment in a structured environment, but I don't know that that can happen now. On the other hand, if it doesn't happen now, and I get that much worse, I don't know if I can survive that.
I am so alone, and I am dying from it. I have no one to turn to -- hell, I went to talk to my mother, see if maybe I could stay with her for a few days. Not move in, just spend a few nights. I should have known better. If she'd ever been able to extend herself for me, I wouldn't have ended up married to a man like this.
Posted by MidnightBlue on May 8, 2008, at 13:05:27
In reply to Not getting real world support on it..., posted by Racer on May 7, 2008, at 23:30:18
Racer,
If there is any way you can go I think you should GO.
MB
Posted by Maxime on May 8, 2008, at 22:21:07
In reply to Anyone done residential treatment?, posted by Racer on May 4, 2008, at 2:50:48
F*ck. Don't listen to your husband ... you need to do this if you can. Living in Canada I have often wanted to go resisdential in the USA but it would be impossible. If your insurance will cover it, then just do it!
Thinking of you.
Maxime
Posted by twinleaf on May 11, 2008, at 8:28:37
In reply to Re: Not getting real world support on it... » Sigismund, posted by Racer on May 8, 2008, at 5:19:58
now that you have described it to us more fully. It sounds as though you are willing and able to do whatever it takes to make your mental health, and your life, better. But your husband appears to be almost inhabiting a different world. He apparently has a difficult time recognizing and responding adequately to things right in front of him- like your recent struggles with suicidality.
It is really jumping out at me: I don't think you can build a good marriage with this man unless he gets some therapy- probably quite a lot of it. There is the present inability to recognize and respond helpfully to the crisis you have been having, but there is also the inability to retain a normal sex drive after marriage- a big red flag right there! It's convenient, and reassuring, for him that you wear the label of the "sick" person in the marriage; in fact, although you do suffer from "emotional dysregulation" (to use the most current term), your thinking and judgement are responsible and razor-sharp, while his seems quite defensive.
I'm offering an opinion about something I don't know very much about, but my overall impression about places like Renfrew is that they are good. You would have an opportunity to work on your eating disorder within an expert setting, get on-going help with medication decisions, and also get a chance to have some distance from your marital situation. It appears as though your husband has a rather gloomy, "blame Racer" outlook; just getting away from that, and being with professionals who are informed, supportive and hopeful about you would probably be tremendously helpful. You come across, here, as a person with a tremendous amount going for her - honest, responsible, intelligent, hard-working (and somehow we know that you are attractive and beautiful, too!)- you just need a personal environment which meets some- not all!- of your basic needs as a human being. You will do the rest.
Posted by Racer on May 11, 2008, at 12:38:34
In reply to it's a heart-breaking situation.... » Racer, posted by twinleaf on May 11, 2008, at 8:28:37
Thank you. Your post gave me so much validation -- nearly everything you said is what I *think* I see, but have that history of being told I don't really see it. (Did that even make sense? I suspect it does, but it sounds weird...)
Yes -- going there would give me intensive therapy in a safe and structured environment. I am not happy about the eating/weight gain, but I have been clear about that to the intake people, and if it becomes a huge battle about eating, so be it -- as long as I can get the daily therapy and try to get past the huge wall I have built up against facing my emotions. That's the real problem, anyway -- not my weight. (Right now, yes, my weight is under the DSM criteria. That does not mean I'm in danger -- only that I'm under an arbitrary line, you know?) I'm afraid of a lot of things, including my insurance dumping me out before I get what I need most. My insurance, though, is said to be good about that.
Thank you so much for the validation, and for caring. And, of course, for the nice things you've said. Right now, I've been having days of feeling attractive, even beautiful, so I liked hearing that.
And anyway -- you've "known" me here long enough to know that it appealed greatly to my sense of humor!
Posted by twinleaf on May 11, 2008, at 15:32:26
In reply to Re: it's a heart-breaking situation.... » twinleaf, posted by Racer on May 11, 2008, at 12:38:34
Racer, I really hope that you go. The therapists in a place like Renfrew are going to really understand all the torment and conflict that you go through when you gain or lose weight, and, if anyone has worked out helpful and constructive ways of dealing with it, it will be them. And just getting some distance from your marriage will probably make you feel much stronger and confident about your own feelings and opinions concerning it.
How long do people usually stay there? (just curious)
Posted by Racer on May 11, 2008, at 16:02:10
In reply to Re: it's a heart-breaking situation.... » Racer, posted by twinleaf on May 11, 2008, at 15:32:26
>
> How long do people usually stay there? (just curious)I have no idea. I think the cynical answer is -- "As long as insurance pays, or their money holds out." I have no idea how expensive it is, but do know that it's expensive. They have special rates for once your insurance runs out, but that would still mean more than we could swing. My insurance covers a maximum of 30 days inpatient, and considers this inpatient. (It's not -- it's a lower level of care than that, but for insurance purposes it's the same.)
I'm assuming that, if my insurance goes by more than a magic number on a scale, I'll be there two to three weeks. If they go by the scale, though -- well, probably less than a week, which would be a terrible thing. The insurance is the worst part -- the center can't even call for authorization until they've seen me in person, so if my psychiatrist and/or therapist can't or won't get the authorization before I leave, I might get there and find out I'm not covered.
Honestly -- in my case, this isn't exactly a matter of life and death, more about quality of life. In so many cases, though, it is -- and this sort of excrement is hardly helpful. I do feel righteously indignant about that. Remember that story at the next election, right?
I'm frightened, and I'm still waffling, but I'm moving forward on it. Thanks for your encouragement.
Posted by twinleaf on May 11, 2008, at 19:40:51
In reply to Re: it's a heart-breaking situation.... » twinleaf, posted by Racer on May 11, 2008, at 16:02:10
it sounds as though you would have between two and four weeks covered by insurance, if I understood. I guess that's once you are seen in person and accepted into the program. But can't they find out everything they need to know by phone or e-mail, plus by a recommendation from your therapist?
Like anything worthwhile, a bit longer is probably better than shorter. It will take time to orient yourself, and to discover what is really valuable in that program for you. Do people kind of "graduate" into less expensive out-patient treatment?
Posted by Racer on May 11, 2008, at 22:21:18
In reply to If you go... » Racer, posted by twinleaf on May 11, 2008, at 19:40:51
Time won't be up to me -- it'll be up to insurance. The good news is that my insurance seems to be one that doesn't limit the criteria to weight, so there's a good chance of the three weeks -- I doubt very much they'll go four. And I may decide that it's not right for me and come home sooner, too.
I'm told they have a policy of asking you to create an outpatient team for when you leave, consisting of dietitian, therapist, group therapy, and a psychiatrist. That's not going to happen for me -- especially the part about twice a week therapy. I just can't afford it, and insurance doesn't cover it all. I've seen a dietitian, and taken nutritional science courses, so I think I'll be OK on that front. I do have a psychiatrist, and a therapist, and I'll continue seeing both. I'll do what I can.
They do have a sort of halfway house style program, but I can't afford something like that, and can't be away that long anyway. So, I'm looking at two to three weeks, and then back to my life. At least maybe I'll get back having had a respite from my marriage and my life.
Thanks for caring, Twinleaf.
Posted by twinleaf on May 11, 2008, at 22:51:52
In reply to If you go... » Racer, posted by twinleaf on May 11, 2008, at 19:40:51
I do care...it would be wonderful if you could find treatment which really helps after trying to for so long.. And I think it takes a lot of courage to leave home and go to any kind of treatment center. Even though you know it will probably be very good, it's STILL extremely scary. Easier not to even try, really.
From my own experience, having therapy twice rather than once a week made all the difference in mentally taking in a new "good object", and really starting to feel better. When I was at my worst, just after the painful rupture with the first analyst, I went three times a week. I know you said that it's not possible now, but in case it does become possible later, it's an excellent recommendation to keep in mind.
I wish you lots of luck! If you go, it would be fascinating to receive an occasional note telling us about Renfrew.
Posted by Racer on May 11, 2008, at 23:00:37
In reply to Re: If you go... » twinleaf, posted by twinleaf on May 11, 2008, at 22:51:52
When I need to, I do go more than once a week. It's just that insurance covers x visits per year, of therapist and psychiatrist combined, so I run out fast. It does make a difference, though, I agree.
Thanks again. I'm off to lie down now...
Posted by MidnightBlue on May 12, 2008, at 15:33:49
In reply to Re: it's a heart-breaking situation.... » twinleaf, posted by Racer on May 11, 2008, at 16:02:10
Racer,
It may not be a matter of life and death, but it is about LIVING. And you deserve to live not just exist.
Hope that makes sense.
And hope you go.....
MidnightBlue
Posted by llurpsienoodle on May 21, 2008, at 10:46:20
In reply to Re: it's a heart-breaking situation.... » Racer, posted by MidnightBlue on May 12, 2008, at 15:33:49
Racer,
I just joined onto this thread, so I'm not sure if what I say has any usefulness at this point...When I went to the hospital a few mos ago, I found that it was a real wake-up call to my H. For one thing-- he had to see the marriageT by himself. He got a lot of psycho-education about what it means to be depressed, to have an anxiety disorder, etc.
He found that he missed me, missed my presence. And he worried. The worrying was probably a shock to his system. He was used to being concerned, but probably not WORRIED, scared.
I can cross my fingers that you can use this opportunity to create a new direction for yourself and your relationship.
take good care,
-Ll
Posted by Phillipa on May 22, 2008, at 13:29:59
In reply to Re: it's a heart-breaking situation...., posted by llurpsienoodle on May 21, 2008, at 10:46:20
Got on later than you so please post the status. Phillipa
Posted by overtheedge on May 23, 2008, at 21:06:12
In reply to Re: it's a heart-breaking situation...., posted by Phillipa on May 22, 2008, at 13:29:59
Hi racer,
i have been to renfrew in philly twice, and what a great experience both times. what i can tell you about the insurance is they surprise you , you can be a low weight and still want to send you home, that happened to me the last time but thankfully we had family pay for it, so i could stay, and yes it was at a discount rate. you are in therapy all day, which is a good thing and on friday nights it is a group therapy where you and your family with others in the program go and i tell you everyone learns something. well i think i spoke enough if there is anyhting else you need to know just ask, and good luck to you, and your husband he will come around.
Posted by Racer on May 26, 2008, at 11:16:17
In reply to Re: it's a heart-breaking situation...., posted by overtheedge on May 23, 2008, at 21:06:12
Thanks for telling me about your experience. I'm doing the "Oh, I can't go -- I'm too fat, they'll never believe me" thing, AND the "I'll go, but I will do my best not to gain weight" thing -- but I think I am going. My psychiatrist is out of town this week, so I have to see if his office can do the insurance thing without him, or if we have to wait for him to get back. I'm hoping they can get it going without him. Or, maybe I'll talk to my GP and my therapist about having them get together on the insurance.
In my case, it's much less about weight gain -- I'm roughly at the BMI that many insurance companies use for discharge criteria, so it's not critical at all. The problem I'm having, which triggered this idea, is that I don't have enough support at home to get through some of what I have to do in therapy. Mostly having to do with childhood trauma, which I understand Renfrew actually has a special track for? That's what my therapist wants me to go to Renfrew for -- here at home, I fall apart over some of this stuff, and have no one to help me get through it. My therapist can't come home with me -- hell, she only works three days a week, so she can't even see me the following day in most cases. So, being in a safe, secure environment, without having to deal with the responsibilities at home, might allow me to get through this stuff safely.
See, at home, my husband isn't just neutral -- the pattern is like a little kid with his mother: if I'm upset, he won't help out or try to take care of me -- he will get clingy, and keep coming to me to do something for him, and that makes things worse. It's gotten so bad once or twice -- years back -- that I've actually had him take me to the ER to get away from him. And if I'm checking into a psych ward to get away from him because I'm going through a rough patch myself -- well, there's something wrong.
And, frankly, I've been so depressed lately, and feeling so hopeless, I think just getting away would be a godsend for me about now...
Thanks again for sharing your experience with me. How did you find the therapy there? I'm told it's pretty much psychodynamic? Not the straight CBT style? What else can you tell me?
Posted by overtheedge on May 26, 2008, at 18:27:19
In reply to Thanks for your experience » overtheedge, posted by Racer on May 26, 2008, at 11:16:17
Hi Racer,
gonna try this again, i just typed a novel and it never showed up. oh well let me start by saying i did the same thing i am not skinny enough, everyone will think i am too fat, let me lose more weight before i go.....but ya know what will i ever be skinny enough? nope.
they have this therapy group that is psychodrama where you get to tell your trama and then relive it with the other people in the group. its like role playing , its pretty dramatic. but i do know they have tracks and if you miss any they ask you to leave them, they are strict with them.they also have the counslers that work in the office well not really and office well call it walk around the floor and if you need to talk they are right there for you, you will be assigned one everyday. and need to check in with them before the day is over. you also have after meals support therapy, you and a small group of girls sit around with a counsler and talk about how the meal went and how you feel.
so thats all i can think of right now if you have anymore questions please feel free to ask, do u know when u will be going?
Posted by Midnightblue on May 27, 2008, at 15:15:40
In reply to Thanks for your experience » overtheedge, posted by Racer on May 26, 2008, at 11:16:17
Racer,
Will be thinking about you and praying for you. Hope that is okay....
MB
Posted by Racer on June 3, 2008, at 10:55:21
In reply to Re: Thanks for your experience, posted by overtheedge on May 26, 2008, at 18:27:19
Insurance has been a fun experience -- the insurance company first told my doctor's office that Renfrew was out of network, and I could only go if there wasn't a facility within 30 miles. The office told them, "Well, there is a facility within 30 miles -- but everyone we've ever sent there has gotten worse, so we don't want to send her there. If she goes there, you'll be paying more and more and more as a result." Then they found out that Renfrew *is* in network, called back -- and it took three people to find out that, oh, gee, Renfrew is in network after all.
Then insurance told the doctor's office, "Oh, and Renfrew already got pre-certification for her, so all she has to do is show up." Renfrew said, "Oh, no -- they like to say that, because they're in the business of NOT paying for treatment. If you show up with pre-certification, we ask for authorization, and they can deny you. You'd have spent all the money to get here, the money to check in -- and then get a nice shock." So, back to the telephones.
Right this minute, my doctor's office was supposed to send off various progress notes, etc, to insurance, and should have an answer today. Once I have that answer, I have to send on the medical and psychiatric clearance forms, the results of various lab tests, and some financial paperwork. As soon as that happens, and Renfrew gives me a confirmed bed number -- I have to scurry to find a flight I can afford and get my lumpy @$$ onto it.
And the travel arrangements have my in a state of emotional turmoil -- I don't know when I'll be coming home, so I can't make round trip reservations unless I can change the return trip. Mind you, most of the flights I've looked at do allow for that -- at a price. That's the problem -- fees up to $250 to change the flight. I don't know if I'm better off getting one way tickets, or what. And that's got me nearly paralyzed.
I wish so much I could turn that over to someone else -- and there's no one. I am just not sure what to do. So, typically, I'm sucking back, withdrawing, and playing the Scarlett O'Hara tape -- "I won't think about that now. I'll think of that tomorrow." I guess I'm taking it one step at a time.
Meanwhile, I got a call from the head of their nutrition department yesterday, which freaked me out a lot. I finally told her, while we were talking, "You know -- you're really interfering with my denial right now..." She said that she thought I'd be OK, because I had a sense of humor about it. Of course, she was saying, "Oh, a lot of women with eating disorders are picky eaters. You'll learn to be more flexible here." I don't want to hear that -- I am flexible enough, and being picky doesn't cause that much difficulty for me anymore. I've done as much in that area as I feel the need to do. I'm a picky eater, and that's just who and how I am. But -- they don't agree...
So, that's where it all stands right now.
And the dessert I get for doing this nasty, scary thing is that my dear friend ClearSkies, who is good for my soul, will visit me while I'm there in her state. It's a horribly long drive for her, and the visiting hours are short, and she says she'll do it anyway. I'm actually crying while I write that, because it means that she really does care about me, and that means so much to me. If anyone ever wonders -- ClearSkies is a wonderful person, and we're all very fortunate to have her here. And I'm most fortunate, since I get to see her in real life, too.
Posted by llurpsienoodle on June 3, 2008, at 11:01:46
In reply to Still waiting for insurance..., posted by Racer on June 3, 2008, at 10:55:21
Racer,
I hope ducks get in a row. Sounds like you need a *nice* surprise right now. Isn't it wonderful how ClearSkies is there for you? I agree that she is one of the kindest truest friends around.Please take good care of yourself, and do things Scarlett style. One thing at a time. Think about it tomorrow.
-Ll
Go forward in thread:
Psycho-Babble Eating | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.