[SleepsWithButterFlies]

I am NOT and seldom am even close to suicidal but have a few friends who's T 's have told them NOT to call them when suicidal..and I have noticed when I have called my T's office they have a crisis number but say if this is an emergency go to ER...so now I am wondering....Is not a legal deal now and T's will not talk or wanna be contacted on it??? AND I know my T doesn't work with anyone who is suicidal he told me once...So...whats the gig?

[SleepsWithButterFlies]

I should add I do not mean actively suicidal but like whatever you call so down youre thinking of it...seems they should be able to call their T

[(JD)]

I'm sorry that so many are in this situation. My suicidal ideation is part of the ptsd and chronic pain that I have... my T always wants me to call him when I am feeling so desperate...we decide together whether I can continue with his support only and be safe, or if I need more.

I don't know if it comes down to a liability/lawsuit issue with the Ts you are referring to, or not. And I don't know if my own T has some patients that (through agreement?) call / go to the ER first, but I would venture a guess and say yes.

If the T doesn't understand fully how you are feeling and why, that could be one reason...and it could also be that the T DOES understand fully and wants the ER to handle it. IDK..but I'm sure it's feeling lonely if your own T won't address it with you.

[SleepsWithButterFlies]

Exactly Sky that has me baffled cause to me that would make me personally feel abandoned or something...like an off limit topic thats that huge..I think it makes the client feel way worse.

[ashley22]

I have never been suicidal. But I think that if one has those thoughts and feelings it it essential to be able to talk about the in therapy, also to contact your T when you have this feeling...what is the purpose of therapy then? If you can't talk about something as serious as wanting to stop living.

I also understand some people, with specific personality disordes my use the suicide threat just to get their therapist attention. I guess in that case the T is trying to set some boundries/limits as to prevent acting out.(by refusing to handle suicidal crises) But this requires a very well trained T...to be able to asses the postential danger.
I guess suicidal thought are really hard to handle for both patient and T.

making threats of suicide is considered illegal in the united states, and by law anyone who is in active suicidal states of mind are supposed to be taken to the ER for a psych consult with two staff psychiatrists to see if the person is in fact a danger to themselves or others.

Another reason more and more therapy professionals are pulling themselves out of the suicidal situations and requiring the person to call emergency lines (police, ambulance and crisis intervention teams) is because calls going to a therapist about suicide threats or attempt are alot of times an attention/anger and or manipulation move - they didn't like what the therapist told them, want to keep the therapists attention focused on the negative instead of doing what they need to get better and so on.

This way (calling emergency protocals and going to the ER) if the client is threatening suicide and its for real they get the help they need with inpatient care. And the therapist and client don't get into a manipulative situation of using threats instead of getting work done.

[(JD)]

Yes, but having suicidal ideation and making a threat are two entirely different things imo. Someone who is having such thoughts often aren't wanting to end life, but to end...the pain (physical, psychological, emotional) and that is very much a good subject for psychotherapy, imo.

[kimmydawn]

I think what t's are doing that might be thinking that if a person is actively suicidal they need to be straight at the ER for safety reasons.

The brother said that they want that because with being on the phone, they're pretty helpless and feel that they might be wasting valuable time when the person should be getting safe first, talking later.

that's what he said. I'm really not sure because I've never really dealt with it.

I'm just sharing what brother told me. So, I'm guessing, it would be for person's safety first, liability second, or both equally?

Good question...

KD

Yea I believe thoughts are ok actions are not

but therapists and the crisis intervention teamswith the hotlines I volunteered on are trained with the idea and protocal of if someone is saying or thinking of suicide then actions soon follow so send them to the ER.

It sucks I know but thats how it is now.

I don't even bother discussing my suicidal thoughts with my present therapist for me theres no reason to I know I won't kill myself or attempt it ever again. I care too much for my freinds to do that to them.

[SleepsWithButterFlies]

But see gang I think you should be able to talk about what you are not going to act on like Sky said.,....I understand the legal stuff on those who are not just fearing or thinking but for those like even you said MYSELF you don't talk on the thoughts anymore but I think you should be able to if you wanted..

I do talk about them just not with my therapist.

here I have at the least 2 friends that my son and I consider family that I know I can go to them at any time and talk to them.

I have a very special email friend that I know I can write to about this any time (day or night now that I have my computer.)

I have the very best friends that my son and I consider family on the east coast that I met in a very special group called HOPE (Helping Ourselves through Personal Empowerment) that have seen me through the worst part of fighting against one of my abusers, one of which is DID and had landed in the same hospital that I did, and another whos daughter was DID and died of suicide. They all understand where Im at and have no problems listening (and kicking my butt in gear) on the subject of suicide. I can call or email them any time day or night.

here when you have a child in foster care due to mental illness ( my sons first stay in foster care was because I was suicidal and was going to act on it) DHS has the parents meet with the DHS mental health consultant and draw up a mental health safety plan. Which includes getting names and numbers of frineds willing to be on an emergency list for the parents and children. And after its signed each person on the emergency list is contacted by DHS to varify they consent to being an emergency support person for the family. I have at the least 20 names on that list of people I can call day or night, and they will be here by phone or in person for me.

Plus I have Psych Central, NAMI and a couple other groups that I am in online and Theres also a monday night walk in support group here in town I can go to, plus I have been running a branch of the HOPE group here too so I have those contacts when needed.

Please don't worry I have many resources for things that I don't discuss with my therapist.

Thanks for caring.

[SleepsWithButterFlies]

Youre welcome Myself BUT see to me it should be an open option to you and or anyone who is just thinking on it...with your T's especially.

Yea Ideally it should be an open topic like it used to be years ago.

Course for me even if it was I probably wouldnt talk with her about it. not due to any problems just from past experiences I made a decision years ago that my friends know more about me then my therapists. The experience actually had nothing to do with suicide - a therapist was unjustly fired. she took them to court and won but her getting fired left me hanging on a very thin last thread not knowing where to turn from that day on I made myself a promise and also told that therapist I would never let another therapist in to that level of trust and dependancy for their being there ever again. She didn't like my saying that of course, and in the 15 therapy professionals that came after her only one was able to reach that level and thats only because we both knew when she was no longer my therapist we would be remaining friends and even then once she was no longer my therapist she got shocked by how much she didnt know until after we had chosen a new therapist.

For other survivors yea ideally suicidal thoughts should be ok to talk about. For me either way nothing would change. Im the one running my therapy program so I already get to choose what I do and discuss with my therapist. Sometimes having this much freedom actually leaves me with the "I can't make the decision syndrome" LOL but it works for me.

Night all.. trying to get myself back to sleeping nights so I can see if my nightmare pattern is still the same. Hopefully if my staying up all day worked I will not see you all until morning.Take care.

[bipolar_bear]

I think there is a distinct difference between suididal ideation and the I am going to perform the act now. If there is no imment danger to the client then they are not obligated to send the person to the ER. My therapist wants you to tell her if you are feeling this way so she can help when you are going through such a hard time. She assures herself that you are being honest, will be safe and will contact her if things get worse. I suppose that is a hard call for her to make but she thinks it is part of the job. If she thinks there is immenent danger she would tell you to go to the ER. I don't understand a therapists/client relationship that won't allow such an important part of what the client is feeling.

[JustBen]

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_Sky said:
Yes, but having suicidal ideation and making a threat are two entirely different things imo. Someone who is having such thoughts often aren't wanting to end life, but to end...the pain (physical, psychological, emotional) and that is very much a good subject for psychotherapy, imo.

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bipolar_bear said:
I think there is a distinct difference between suididal ideation and the I am going to perform the act now.

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Sure, we understand that distinction, but does a jury of 12 average folks? That, unfortunately, is what the whole issue hinges on I think. Let's say you're a therapist and a client calls you in the morning to discuss suicidal ideation. You talk it over with her for a while, and decide that she's not really a threat to herself. You schedule an appointment for the next morning and get on with your business.

All good...except later that night, the client slips much deeper into the hole. By this time, she doesn't have enough presence of mind to call her therapist or anyone else. She carries out a suicide attempt.

Now you're being sued by the family and it goes to trial. That jury hears that on the morning of her attempt, the client called you to talk about suicide, and you didn't refer her to the ER for treatment. Do they understand the difference between ideation and a threat? Do they even care?

[ErinBear]

Hi Sleeps and everyone,

Thanks for bringing this up and talking about this - I really appreciate it because it's an issue I'm wrestling with in counseling right now. My counselor did have a policy that I could call him in an emergency, but last week he finally said that he's decided it would be a boundary violation on his part to return calls when there is an emergency. This is after a number of incidences this past two years when he did not return calls without explanation, and it was really confusing. His clinic is small and there are no backup plans in an emergency, or in fact when he is traveling (which is frequent) and it feels unsafe to me. Like some of you have mentioned, I'm just supposed to go to the ER if I am in a big emergency, but my problem is that I know I can't afford that. So I try to deal with it alone as best I can, I guess, but I don't think that's the ideal solution.

I also know that with me, at least historically, if I've dealt with things along the way before it gets to that point, sometimes I can avert that extreme emergency. I can see it coming, and I can "stem the tide" if I work on it. But that does generally involve some contact with other people and some various activities and never seems to be a simple process. I don't know if this is just me or if it is true for other people as well. I guess I wish contacting my counselor could be part of the process, but even if it isn't, I wish we could discuss the process of trying to deal with these thoughts and feelings better, and at this point, he doesn't really want to discuss how I can deal with it independently. This also feels unsafe to me, because it seems like it is important to have a plan for dealing with it one way or another, even if my counselor isn't involved. It just seems like that would be healthy planning.

Thanks for listening.

Take care,
ErinBear

[LMo]

Before you read this, keep in mind that I'm open to editing or deleting my post if anyone finds it to be too off-base. PM me privately, please, and I'll modify or delete immediately if you wish...
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Actually, I am trying to see it from the T's point of view. There is the liability issue, sure. But, think about it. An ER staff is not emotionally attached to the suicidal person, and if someone is really determined, then nobody -- not a T, not an ER staff -- can stop them. However, your T is someone who knows you pretty well. It's their profession, yeah, but they are also human. Let's say you called your T when you're feeling suicidal, and they tried to talk you through it but in the end, failed at stopping you. Can you imagine how much that would mess with their head? I mean, suicide is EXCRUCIATINGLY PAINFUL for those left behind. In itself, it can cause PTSD. Our Ts are human beings with feelings. They do have professional training and an ethical responsibility to help, but our of consideration of their feelings, I don't know that I would contact my T. I'd much rather have an ER or hotline staff help me. I wouldn't want my T to suffer from my inability to cope.

That is exactly what happened with one of my relatives. she was seeing a therapist for depression and one night called her therapist. She told her therapist she was ok after a three hour conversation. The therapist allowed her to go home she mixed pills and alcohol in a glass and took them not an hour after leaving her therapist. luckily that therapist had recorded the conversation and her receptionist had co signed a no suicide agreement between the therapist and my relative or the therapist would have been convicted of assisting a suicide and manslaughter when the relatives husband tried to sue for wrongful death and anything else he could come up with.

[(JD)]

In the situation that the communication with the T is not reliable, I think it's best to make the plan for the ER. How can the T possibly be there for the emergency call when they might not even receive it???

If the money factor enters in, or any other factor, then the actual act is not imminent, imo. (Though it's feelings might be very strong.)Being able to consider some of the consequences to such an action, is a good thing.

As Ben suggested, and I agree, when the person sinks so low as to really consider the act, there is nothing else on their mind. T's have to take the safest (for the patient) route.

No problem here in fact this is exactly why I no longer follow through and no longer even attempt suicide.

One evening one of my past therapists sat with me in her car and told me in no uncertain terms what losing me would mean to her .

Top that off a friend had died of suicide and her mother one of my best friends cared so much for me that she laid it all on the line and flat out reminded me of What we all went through and still go through because of Dorene's suicide (her daughter and a friend of mine and a member of a support group we were all in). And then she reminded me how selfish the act of suicide was - a person who is suicidal isn't thinking about other people. They are thinking about what the easiest way out of dealing with their problems, the person who made them angry and the people they want to punish or get back at. Those that succeed don't tell anyone they are suicidal they plan it out and make their attempt when they know no one is going to be around to save them. They don't want to hear from anyone or do anything to help others or themselves. She then told me that most people think suicide it the hardest decision to make but its actually the easiest and most cowardious way. And people think that if they die others will regret how they didn't help them or how they treated them but the one lasting feeling a person left behind has for the person that committed suicide is anger. Anger at the person for not caring, anger for them leaving, anger at them for making them go through the funeral and bills to match that funeral that takes years to pay off She said "it takes but a few seconds to swollow those pills, tie that knot on the sheets, and step off the chair, tub whatever but it takes someone with courage and caring to meet the challenges head on and do whatever they need to do to take care of that problem so that they can come out the other side on top and be there for their friends and family. And then she asked me if I wanted my life to mean nothing but the fact that I killed myself and Did I want to leave my son a legacy of anger and guilt of why he wan't good enough for me to love enough to be here when he came home. Then she sent me the following paragraph wrote by Dorene. Dorene wrote this for a friend that had experienced a death and was crashing. I could either let this paragraph die with me or see to it that Dorene's words lived on in me - We've lost Dorene. I'll be damned if she died in vain. Her mother feels the same as does many of the people that Dorene helped over the years of her short life.........

Strength.. Something of the human soal that you're never born with. It is gradually molded and shaped over time and with experiences it grows. There are two different kinds of strength - the physical and the mental. The latter of the two will outlast the physical kind any day. Strength shows up when you least expect it, but always when you need it. The strong know that it is not a sign of weakness to cry or lean on someone, but instead is the sign of courage. The great thing about strength is that once you have it, it stays with you forever, flourishing itself into a life of its own Be strong and brave. With all your sarrow, remember there is a tomorrow. The sun will rise again.

love always and forever
Dorene

Dorene Boynton
December 31, 1978 - June 16, 2001

Her words will live on hopefully doing what she was doing in her short life - helping others to survive.

[LMo]

Your welcome.

[(JD)]

Not all suicide reasons include getting even with others. I personally don't like the term "selfish" either. We were taught many things were selfish, when indeed, they are not. IMO the thought of suicide is for a way out of something... making something stop, to end it. I have no anger issues with others when I consider such a thing... it's all about ending the pain and suffering. And while yes, that might not be considerate of others, they aren't trying to live with what I live with, either.

I am still around because of my T. While consideration of his feelings are not usually in the mix, I am "programmed," now, to call him, and once talking with him, remember his professional involvement in my welfare. I guess it really is his hope for my future that keeps me around

I think one could make that attachment and connection with those at the ER, too. They can get to know you, and help you through tough times.

[LMo]

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_Sky said:
I have no anger issues with others when I consider such a thing... it's all about ending the pain and suffering.

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That's a good point, _Sky, because while I'm not sure if you're referring to physical pain/disability or emotional pain, I consider the physical pain to be a valid reason. However, it's still pretty scarring for those left behind, which is why I wish that our legal/ethical system in the US would reconsider assisted suicide. But that's another topic.

But if you're referring to emotional pain, then (this is getting philosophical now) how can a person feel emotional pain without coincidental anger? I'm not saying that you're wrong -- I just want to understand it. Again, this is a more general question and I'm not doubting or questioning your statement about yourself in any way, ok?

[(JD)]

Physical pain and suffering. The stuff that no T can change or take away I think the double whammy is tougher to deal with. The chronic pain brings the depression... but without the pain, would there be nearly as much psychological and emotional pain? Probably not. sigh.

Yeah, the assisted suicide is quite another topic (wanna begin it in Health Support or do you think some mod would remove it for political reasons. lol) I'm afraid that some doctors might use it (assisted) to "clean out" a race or country, you know? Kind of like planned parenthood with the poor & blacks. OOps did I say that? censor my post! [i] naughty sky, naughty naughty.