I had a REALLY bad weekend this weekend and experienced something rather unpleasant on Friday evening that sent me into an almighty depression for the weekend. Today I was still stuck in this dark cloud, I wont see my therapist for antoher month so this morning I text her to say how I was feeling and that something awful happened on Friday and I didn't know how to cope or how to handle it, truth be told I wanted to just die this weekend... I told her I didnt ring because I couldn't physically talk about it. She didnt even reply, for all she knows I could be dead right now. I know that my actions aren't her responsibility but surely since you are paying her to care for your mental health she should at least check that you are ok. Its not like I text her all the time, i have text her a few times in the start of our therapy when I was going through soemthing very truamatic and genuinely didn't know what else to do, she didnt wb then either.
I am very confused as to what a therapists responsibilty is when a client says they are in distress and contemplating suicide??
Anyone got any ideas?

Perhaps you need to actually make a phone call to her if things are that bad rather than a text. Texting may be a boundary thing with her; it's hard to do therapy via text message as many won't go there at all. Have you talked to her about how she would want you to contact her in an emergency? My T doesn't do email or text, but I know I can either call the office, they will get a message to him and he will call me back, or if it is after hours there is an answering service that will get a message to him. Try a direct phone call/message.

One of my friends texted me and I never received the text. I know when I was traveling, I sent several texts that never went through. Your therapist most likely did not receive the text at all. Please contact her again using a reliable method that lets you know that she DID receive the message, like a telephone call! Good luck and I hope you feel better quickly.

thanks for your replies, the text was delivered as I got a notification to say it was delivered. I understand about the texting boundaries but I couldn't talk to her today, i couldnt speak what happend on the phone to her I told her that via text so thats probably why she didnt call but not to text back or even try and call...

[sunrise]

I agree, call her! Texts are not a good way to communicate such critical information--too unreliable and informal. If you can't call, I think an email would be better than a text, if you have established communicating that way. When you see her next, can you discuss how is the best way to reach her in a crisis? I hope you are doing OK and start to feel better soon. Good luck.

[mswinter]

I'm sorry you are experiencing so much pain and distress at this time. I can relate and I know many other members here can.

In all honesty, I'm still shocked when I read of therapists emailing their clients and/or responding to text messages. In my experience, both as a therapist in training and as a client, texting and emailing has never been an acceptable form of communication, especially when in crisis.

I do acknowledge that things are changing; in this forum alone I have read so many posts of people exchanging texts and emails with their therapists... so maybe I need to catch up with things a little. Though I have to say that I don't believe a therapist should be considered responsible for "saving" a client from a crisis whenever it happens because they would need to be on call 24 hours at day (who knows when a crisis is going to manifest or something horrible happen or trigger a memory). Even the best therapists would quickly burn out and, most importantly, they would be bound to fail (no one can always be there for another person).

Now as far as a therapist's responsibility when a client is telling them, in any form (text, email, voicemail) that they are contemplating suicide, their responsibility is to follow up and assess whether or not there is a real threat. I have to say though that, technically speaking, you would have to be extremely clear with your words. So while I don't think a therapist could ignore a text that reads, "I decided to end it all, I'm killing myself today," he or she could quite safely ignore a text that reads, "I feel so desperate, like I have no reason left to live." What I mean by "safely ignore," is that it would be very difficult to hold them accountable legally.

With all that being said, we all want our therapists to care for us, to care that we are in pain, to care that our world is falling apart, not because they are scared of losing a license but because they genuinely care.

Again, I'm really sorry you are hurting and I hope you can feel better soon.

You need to talk to her about how best to communicate with her. Get that clarified. Her not responding probably is more a boundary thing than a lack of caring thing. But without really discussing it, you'll keep questioning it (anyone would). Also, text delivery does not necessarily mean the text has actually been read. If she's like me, she can go hours without even looking at her phone. I'm one of those rare people who are not attached at the hip to my phone. Your T may be one of those too; you never know. My T, for instance, doesn't do email because by his own admission, he only looks at his email every few days and doesn't plan to change his habits. You just have to find these things out and figure out what the protocol is. Make it one of the topics for your next session.

[unaluna]

Are you sure your phone reports that the txt was received, or just that it finished sending it? I mean, what exactly does "delivered" mean? the other day, I received a phone call as I was sending a text, and I still got the notification of completion, but the text never actually got sent (yes, to T!), idk wtf happened.

I'm sorry pbutton for what you're going through emotionally. I know that I wish and want and need my therapist to respond and react to each and every demand. . . .wish or implied demand that I might make during my contact with her.

BUt guess what? It's not going to happen. No matter how much I want it to. No matter how much I anger and angst for it to happen, it isn't going to be. My therapist isn't my mother. . . .she isn't family . . . she isn't my guardian. She is my therapist and her role is to guide and assist me through the maze of my dysfunction. Jeez, but that's unfair!!!!!

I wanted a person who would give me their all!!!! Hell, I'm paying for her time!!!!! I expect results for my hard earned money . ... REality .. . I get that. . . just not in the way or form that I WANT it to be It is disconcerning. It is unsettling. It is not what I wanted it to be. . .. but I am learning. I am growing. . .. damn but I wish I could say otherwise but I guess I just have to say this to you and everyone else that is saying what you're saying? Are you expecting your therapist to read your mind? And if she's not reading your mind, do you expect her to respond to your every want and need. .. . Why? Because I've been there ... actually I"m still there and struggling and I wish that we could all get this whole idea of letting others KNOW WHAT WE NEED WHEN WE NEED IT!!!

Texting, emailing or leaving a voice message about "wanting to die", "not being able to take it anymore!", "being stuck in a dark cloud" or not being able to talk about what's going on, it's about US NOT BEING ABLE TO ASK FOR WHAT WE NEED!!!! We are just throwing out untamed emotion into the winds! I'm not saying that isn't how we feel, but the reality is, if we are honest with ourselves, we FEEL this way OFTEN. It isn't a single occurance. We are SWEPT away by these feelings often. They consumne us and we attempt to let others know how awful these feelings are for us. . . but then they pass and we manage to limp onward.

I'm not saying this is easy. I still struggle with it after almost three years of therapy. But if I continue to expect that my therapist or the people around me are going to just KNOW what I need or want, I"m doomed to failure. It doesn't matter if they are trained in trauma. Most haven't experienced trauma so their understanding is based on "book" knowledge . . .not a bad thing, but something that might set up a therapist to "think" that he/she understands and he/she doesn't! All I can say is SPEAK YOUR TRUTH and then stick around to find out how to deal with it!

Hi ((((Button)))) your thread really resonated with me, so I wanted to try to respond.

When I first started with my T, I was literally at the bottom. I was just exhausted, supremely depressed,SI, and suffering tremendously. I didnt hold anything back when filling out my intake form (I actually had to write in the margins and provide a family diagram!)I wanted her to know as much as possible so she knew what I went through as well as what I was going through. What brought me to T).

I was not doing well at all when I walked in that door.

The first few sessions we got to know each other, establishing a safe environment for me to begin on my / our journey. We also established with each other that we really felt like we could do some good work together. We were on the same page.

Because I was in such a bad way, too, she gave me her phone number in case I was having a crisis. It took a little working out because when I was doing HORRIBLY and really struggling, my text or vm's didnt really reflect that because I was trying to be polite, respect boundaries, not send the poor thing into a panic (in my mind at least) etc.

When we talked about it she said she had no idea because I wasnt portraying accurately what was really going on with me. Lol! Typical me-ness.

So we made an agreement that I would convey my true, real emotions, feelings in the future. And for me to not worry...SHE would be ok. It worked out really well.

As things progressed, and I felt better and more stable, we talked about how "no news was good news" so even if we had a rough session, if she didn't hear from me, then I was managing ok (along the way, she gave me tools: affirmations, breathing exercises and lots of homework (journal writing, books to read...kept me busy!)

The main thing I learned with her was to communicate, establish boundaries (for instance when she gave me her number she told me to call if I needed her. I promised I wouldn't take advantage and call at a crazy hour and only if it was important).

We really had to work out me distinguishing for her whether or not I needed to speak asap or if it could wait til the next day.

Expectations, needs changed as the months went on and we made sure to communicate so we were on the same page.

My Pdoc however is totally different...he really doesnt want to chit chat, is not available after hours (6pm) unless it is a true emergency and if i am the last appt of the day and i am even 5 minutes late, i can count on him being gone for the day. Even when I call to say i will be 5 min late! Hah! (I have been seeing him for 8 years so i find it kind of funny)

I hope this helps even a teeny bit and didnt come off as a ramble.

Best wishes, Rose

[rainboots87]

Even if your phone says the text was sent, she may not have actually gotten the text. It has happened to me with my T (and with friends) before with texts and voice messages. Also, some people just don't get texts, which your T may not, or she may not check her phone very often. I know my T didn't check her phone much if at all on the weekend or trips. Another thing to consider is that regardless of whether she received the text or not, many Ts do not allow crisis messages in that way. My group T said I could leave her voice or text msgs, but I could not make mention or threats of suicide- if I felt that way, I needed to call a crisis line or the hospital, etc. Just something to consider. I hope thinsg are looking up for you and, if not, I'd call a crisis line because they can help you more immediately.

Originally Posted by rainboots87

Even if your phone says the text was sent, she may not have actually gotten the text. It has happened to me with my T (and with friends) before with texts and voice messages. Also, some people just don't get texts, which your T may not, or she may not check her phone very often. I know my T didn't check her phone much if at all on the weekend or trips. Another thing to consider is that regardless of whether she received the text or not, many Ts do not allow crisis messages in that way. My group T said I could leave her voice or text msgs, but I could not make mention or threats of suicide- if I felt that way, I needed to call a crisis line or the hospital, etc. Just something to consider. I hope thinsg are looking up for you and, if not, I'd call a crisis line because they can help you more immediately.

Rainboots, points taken true so true re technology. However unless those boundaries have been clearly established, how are we to know? Every T is different. Simply not responding with no specific discussion about it leaves it open for interpretation. Which I personally think is unfair to the client and does a great dis- service. We are there because we are struggling to find ourselves and to fill in blanks and repair damage.
Or to make discoveries with out T. If the T makes her or his number available simply to provide a sounding board then that should be communicated. We shouldn't have to be left guessing. We arent mindreaders.

Sorry I didnt mention that my T always reminded me that I could call an emergency hotline or go to the ER if I felt it was warranted. (And to not worry or be ashamed for continuing to reach out for help from others. I was still safe. And in that way she helped me learn to trust, honor and believe in myself. And my abilities. I wasnt alone.)

Kind regards

[SoupDragon]

I have always assumed that my T wouldn't be there for me in a crisis, as someone else posted, this would mean him being on call 24 / 7. I do e-mail if I am feeling overwhelmed and want to get something out of my head, but in a real life or death situation I do not think I would contact him, I would contact the emergency services / mental health services. I see T's role as working with me when I am not in crisis.

Thank for all the replies, I am starting to see what you all mean now! We can't expect them to be there for every waking moment or every crisis, it's their job to give us the tools to cope with these crisis and to encourage self help not let us get too attached!

[WikidPissah]

hey button...
I am just going to echo what others have said. If T hasn't responded to text in the past then they are probably not going to respond to it now. I know when my T doesn't respond it means he didn't get it, "text sent" doesn't actually mean "text read". Work it out with your T, find out the preferred means of communication.

Next session is our last session:-( I feel like she just doesn't care anymore and is trying to just get rid of me! She has said all along I don't have depression when it's as obvious as the the earth spins round I have depression! So last session she said I think you have depression and recommended a book to read and gave me a name for it with the wrong author! Not the first time she has provided incorrect information, such as wrong phone numbers and websites that don't exist anymore!

Originally Posted by button30

Next session is our last session:-( I feel like she just doesn't care anymore and is trying to just get rid of me! She has said all along I don't have depression when it's as obvious as the the earth spins round I have depression! So last session she said I think you have depression and recommended a book to read and gave me a name for it with the wrong author! Not the first time she has provided incorrect information, such as wrong phone numbers and websites that don't exist anymore!

((((Button)))) can you think of her actions in a different (more kind way to yourself) .
If you feel she isnt up to the task or if you arent receiving the support that you need, maybe it is her. And not you! Especially if she continues to negate your feelings and is sending you on a wild goose chase / instead of providing real homework that would be useful in your healing.

Have you asked her why specifically she feels you are not depressed? Has she offered other Dx for you to think about and work on?

Sometimes I think it just isnt a good fit in T. Nobodys fault really but does she know how you feel? Have you asked her to provide a referral for another T that perhaps would be a better "fit"
Rose

Im so sorry its been so hard.
My therapist has texted me several times in the past week and ive only gotten one of them. Maybe your t didnt get it. I hope you can call her

Hi rose panache,
She said I am not depressed because I can go to work and go about my life, this is true but in work I cry constantly for no reason and at home I cry, I force myself to go to work and leave the house! The pain I feel gorge is very real and it feels very condescending for her to just dismiss it! Don't get me wrong, she is very kind and has always treated me with respect but sometimes it just feels like she doesn't care or try with me anymore! Maybe our journey is over! But I don't feel like we worked through anything, I am still depressed and don't know how to cope with most things I went to her with in the first place! I know it's a hard job that t has but come on if you don't like a patient or don't care just refer them or tell them straight out don't waste all their money!

button, it sounds like it is time for a different therapist. I know it's incredibly difficult to change therapists (like many other things in life), but to really take care of yourself and get the help you need, you should consider seeing someone else.

You are right My kids are cool, it is time to find a new therapist. I really liked her though in a strange sort of way, she is very good at her job maybe it was just me, maybe she couldn't work with me. I know it happens sometimes and that is way the "relationship" is so important.

button, she isn't that great at her job if she thinks you need to be completely incapacitated to be depressed. I hope you find someone really good, very quickly. Psychology Today has a therapist finder that some people on here have used to find help.

I kind of feel like we aren't getting the whole picture here which I'm sure is probably true. It feels like somehow you two aren't communicating well with each other, but I don't get a good sense why that is; it does seem to be a two-way issue. Not every T/client relationship works well, so if you aren't feeling secure with this t it may be time to find one you feel more able to communicate with clearly and thoroughly. Best of luck if that is the path you take.

[critterlady]

Originally Posted by My kids are cool

button, she isn't that great at her job if she thinks you need to be completely incapacitated to be depressed.

Absolutely agree. I argued with my T that I did not have depression because I was getting out of bed every day and going into the office. He went down the list of symptoms and I had nearly all of them.

Originally Posted by button30

Hi rose panache,
She said I am not depressed because I can go to work and go about my life, this is true but in work I cry constantly for no reason and at home I cry, I force myself to go to work and leave the house! The pain I feel gorge is very real and it feels very condescending for her to just dismiss it! Don't get me wrong, she is very kind and has always treated me with respect but sometimes it just feels like she doesn't care or try with me anymore! Maybe our journey is over! But I don't feel like we worked through anything, I am still depressed and don't know how to cope with most things I went to her with in the first place! I know it's a hard job that t has but come on if you don't like a patient or don't care just refer them or tell them straight out don't waste all their money!

Wow.

Deep breath (because I feel a little triggered by her reply to you, an defensive for you. For all of us that suffer from depression)...

I will first start out by saying, while I do not like to make disparaging remarks about others' Ts...and I am sure she is a lovely person in some ways...HOWEVER professionally...

- did she offer another Dx for you (or did she leave that up to you to go the DSM-IV to figure it out on your own?)

I have been depressed for ages and dragging myself out of bed to work at the same time. So for her to say that one thing in a complete sentence. period. It is poppycock!

(I also suffered from an assortment of other Dx's all of which led me to meds and therapy. I've been seeing Ts for what feels like forever)

It wasn't until my current T that I was diagnosed with something that made sense, and
(I think I posted this before) what a huge relief! It was like a little lightbulb went off over my head and a weight was lifted off my shoulders. Not only did she NOT discount my oDx's (depression, anx, etc), she obviously was really paying attention and had the knowledge to throw another option out there. And it soo made sense. Everything just sort of came together.

That said, perhaps you have gone as far as you can go in terms of T. with this person. Perhaps she doesn't have the tools to help you further in your journey. Perhaps she hasn't done her homework and gone to the next steps (you know, talking to HER T. to try to help figure it out).

(anybody, though, that would tell me I don't have depression would have to be from the 1st Century BC! I am sorry but I would probably tell the T. that she has to pay me for that hour so I could refresh her memory on the criteria for depression! )