I started an intensive outpatient program about two weeks ago. I am having a lot of misgivings about starting this program and I don't really know what to do about it.

First, I feel like I am in a better place with my ED than most of the girls there are. I had a rock bottom moment before I started the IOP program that sort of supercharged my recovery. My eating is better than it has been in over a year. So I find it really hard to relate to the other girls in the program that I go to therapy groups with. I actually found myself purposely doing worse a few times just so that I could sort of "fit in" with them. And also feeling really guilty that I am not struggling as they are.. I feel like I *should* be struggling like that. So just being there, in some ways, is triggering.

Second.. these girls are caddy. I have heard them whispering about other girls in the group behind their backs and also bad-mouthing the therapists to everyone as well. There are a lot of side-conversations during groups and even if they aren't snickering about someone else , it still makes me feel left out. Like, even if I am not being made fun of behind my back (which I am afraid is happening, since they do it to so many other girls) I still feel like I am not accepted enough to be a part of these cliquey conversations. High school all over again. All of the therapy in IOP is done in groups, so with all of this going on, I certainly don't feel comfortable enough to open up to them about my Issues. So how am I supposed to get anywhere?

Third.. because I spend 4 hours a day in IOP four times a week, I hardly ever get to see my own therapist (who is not part of the IOP program). I feel like I was maybe just getting somewhere with her and now I am lucky if I see her every other week. Because all the therapy in IOP is done in groups, it is very hard to get anywhere with any one person's Issues because everyone needs to talk. It's all very superficial and I feel like I am putting my real therapy on hold for something that isn't working. We get about five minutes a day alone with a real doctor and they ask the same questions.

So I am thinking that I have made the wrong decision about this treatment program. But the IOP treatment team are the people who decide if I can be discharged. I don't think they would discharge me just because I don't feel this treatment is right for me. If they did, it would probably be a discharge Against Medical Advice, which, I've been told, means that I would have to pay for the treatment because it won't be covered by my insurance company. I don't know how true this is but I am honestly afraid to ask. So I feel very stuck. I find myself lying on my food logs and thought logs and in group just so they think I am better and I can be discharged sooner. This is so stupid. I've heard about people lying so they can get out of treatment and get worse with their ED.. but not lying so they can get into a different treatment. But if I tell them any of the truth, like that my SI thoughts haven't gone away or that I had a slip with my meals here or there, they will keep me longer, which I don't feel will help me. And if I tell them that I don't think this treatment is working and they still want to keep me in IOP (probably because they think that it is the ED talking and just trying to get out of treatment to rum rampant), then they might suspect that I am lying about how well I am doing.

Bleh, this is such a mess..

i'm so sorry you're having a rough time, sweetie! i know how hard (and brave!) of a decision going into this treatment was for you, and it sucks that it doesn't seem to be offering you the support you need. i really think you need to talk to someone about the problems. you need to sit down one on one with both your therapist and someone from the program (actually if you could talk to both at the same time, that would be really awesome). you've gotta be TOTALLY honest and tell them everything you just wrote here. especially about the feeling uncomfortable because the girls are so immature and catty and how you feel like you are further along in recovery than they are so you don't feel like you fit in. no lies, make sure you tell them everything about the SI and slipping with a meal here or there.

you need to convince them that you WANT to recover and you really, really don't think this situation is helping you along the recovery road. the whole point of the outpatient program was to speed up your recovery and if it's not doing that (and ESPECIALLY if it's not helping you recover any faster than you were with just your therapist), then it's simply not the right situation for you at this time. i think if you can logically and matureally (sp?) explain everything that's going on to them, they'll have to try to help you.

this is a really major thing and i'm so sorry you have to go through it in a way that seems so frustrating and unproductive. it might be hard to get one on one appointments (and even harder to get your other therapist there too) but you gotta just keep nagging (but in a very polite, mature manner) until they will at least hear your case. i really think it would help if you can get your therapist there, because she probably knows you better and can vouch for you and agree to work on certain things, etc.

i really hope this helps and i hope you can find a more suitable arrangement. my heart is going out to you 100% and keep talking whenever you get a chance. i'm here for support whenever you need it.

First of all I want you to know that I am an addict in recovery and suffering from bulemia and I am also bi-polar. I know a lot about IOP, therapy, hospitalizations and rehabs. When I first started going to Narcotics Anonymous meetings, I thought I am not as bad as these other people. My drug use wasn't THAT bad. I learned after more than six years clean that an addict is an addict is an addict. There is no "she's worse than me, etc". You have an eating disorder, as do I, and it is as bad as it is for YOU. Whether you are not struggling right now, as the other girls are should be something you should be proud of. Be an inspiration to these other girls. Your being further along in recovery is something to be shared with the group as help for those who are still struggling. There may come a time when you slip and need more help. Try to embrace where you are at and just accept the other girls for who they are. You may not realize it but they may be jealous of where you are and that is part of why they are acting the way they are. I hope I was helpful. Good luck. MONA