I'm not making light of this issue by stating that it is a "Catch 22" or a "cunundrum".

However, you cannot remain stagnant and must move forward. So the issue should be how to control the SI urges. Can you let it all out in the presence of a therapist? Are there no meds. that can help you with the SI? Ever tried xanax/alprazolam? I use it for panic and anxiety attacks and it mellows me out immediately.