I know when I am expecting to do something important I can't sleep well the night before, the brain just goes into overdrive with thoughts and I toss and turn.

I gather from your post something that you were smiling while talking-

"The last time I saw him one of the things he threw at me was how I had talked about a suicide attempt but smiled while talking about it."

As you are studying for a psychiatric degree, I think one of the things they probably look at is emotions of the therapist, in other words the therapist cant display things like shock, disgust etc to things a client says or I imagine it could be very detrimental to the client.

"Even here, I'm more likely to include a story of my own when responding to someone else, but I rarely start my own thread. I really wanted to call someone today, but couldn't think of anyone to call. Sometimes I call someone about whatever I can think of, but I can't say that I really just need to talk or I need a friend. I don't have any real life friends who are like that, "

Same here to a tee, I simply do not go over to someone's house to just "visit" nor call just to talk.