When do you tell your T about your suicidal ideation? Please don't tell me always otherwise i'd always be talking about it. I've always felt this way my whole life, b ut this week, it was bad. I know there has to be some rule. At what point do you bring it up? Would brining it up in an email subject me to more risk of being put inpatient? Is there a special way I can word things so I won't be put in the hospital? I always lie and say I'm not thinking about it, even when I am because I'm scared to tell. Since I tend to always have a "plan" and su ch, I figureits not a big deal enough to tell her, but i also feel like im lying.

[jennie]

esthersvirtue . . . I don't know the answer you want to hear . . . but, I had a similar question posted (click link to view) in this forum and had some excellent replies. That was the last time I have had suicidal ideations. Keep reaching out to others. ((((huggs))))

Is asking a T what would make them put me in a hospital too forward?

[allthegirls6]

No i dont think so. In a way it is a safety net for yourself. I have spoken to my T about going into hospital and we have a sort of rule that she will never call the hospital on me, it has to be a joint decision.

[jennie]

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esthersvirtue said:
Is asking a T what would make them put me in a hospital too forward?

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I think the link I posted above addresses this question. It has to do with the relationship you have established with your therapist.

[Rapunzel]

EV, there's nothing wrong with asking your T about under what circumstances they would put you in the hospital. Please be honest about your feelings. It's your T's job to make sure that you are safe. Since your T probably knows you pretty well, they aren't going to hospitalize you for ongoing ideation that you're not acting on. You should tell if it gets worse though.

They don't want to hospitalize you, especially if that isn't what you want, so if you can convincingly give reasons why you aren't going to act on that ideation (people you care about, goals for the future, things you want to do in life that you haven't done yet, ...), and you can promise not to act on those thoughts at least until the next time you check in with T, they won't need to hospitalized you. It's important to tell though, so they can monitor you and make sure that you are staying safe, as well as help you to get better.

Rap

[ErinBear]

Hi Esthersvirtue,

I think if it is scaring you to keep this information private....because you know you are not safe....then it is a good time to talk with your T about it, even though I know that is a difficult kind of conversation to have. Hopefully you've built up enough trust that you can talk about it with your T. If you are more comfortable writing, you could try writing about your feelings, and bringing those into therapy for your T to read. I've done that before. You could email the thoughts and feelings to your T, which is an option, but I tend to think this is better to discuss in person at least the first time, if you've never talked about it with your T before at all.

As hard as it is to talk about these important things, sometimes it is the best thing just to get these issues out on the table and share them with somebody, even though it is hard to talk about them. It is okay to talk with your T, too, and tell your T that you want to handle this without going into the hospital. I think many Ts will respect that decision if they think they safely can, once they can find out how you are doing, and if you can make a contract with them. I think for a lot of clients, it can help just to be able to talk with another person about the struggles they are having with these ideas, and that itself lets out some of the pressure, and the situation eases. I think a lot of Ts know that.

Thinking of you - wishing you well with this, I know it is hard.

Take care,
ErinBear

Thanks Jennie

Thanks Rapunzel. I worded my email as such. I just asked when she would hospitalize me basically. I'm not sure what the reaction is gunna be :/

[(JD)]

My T already KNOWS that I camp on that Roman Road...but it took my being able to tell him when the feelings began to consume me..thoughts and feelings. Ignoring it doesn't help. Talking it out, or at the very least disclosing it is good. Your T needs to know when, maybe the T can find a pattern when we can't. I wish there was something I could point at to say, ah, everytime..(my mom requires constant attention, i.e.) I become more depressed. So far, not for me...but what if there is something there for you?

My T is my best consultant, who cares about me and can help me more than anyone else in the world can right now. He can't get through to me on other matters if he doesn't know I'm not able to hear him due to my S.I.

((((hugs)))) this, too, shall pass... one foot in front of the other... the darkness does lift some.

LL and I don't discuss my suicide stuff. That is my choice that I made based on what I know about myself and the agency she works for and the state and USA laws and some very special friends in my life.

Here in the USA a person who threatens or attempts a Suicide threat or action can be arrested and or involluntarily committed to a local mental health unit for a 72 hour observational time period. At the end of that 72 hours the treatment team meets and decides if the person is still a threat of harm to themselves and or others if so they are held for 14 days. At the end of 14 days the treatment team again meets and d4ecides if the person is a threat of harm to themselves and or others. if so the person is sent to a more secure facility indefinately. The facility depends on type of insurance. State insurance gets state mental health facilities and those with private insurance can choose what facility they go to depending on the facility options from their insurance company

Most if not all therapy professionals and agencys have no choice but to follow the USA law of referring suicidal clients to the local ER for assessment with two hospital staff psychaitrists for possible volluntary or involluntary commitment.

The reason they do this if they did not they would lose their permits, certifications and licenses. In some cases alot of times therapy agencies work out of public buildings like crisis centers, domestic voilence centers, Department of human services and hospitals or other therapy agencies and share the rental costs in same building. If they didn't follow the USA law it endangers those other people and agencies not only to the threat of harm from some one elses client but also risks those other agencies permits and certifications and licenses to practice.

I found out all this the hard was - 3 involluntary commitments and 5 years ago I found myself sitting in a court hearing. lawyers and The Department of Human Services and a judge were discussing whether to arrest me, commit me or work with me when I became suicidal.

My lawyer and the judge explained to me the state and USA laws surrounding Suicide attempts and threats So that I would understand what the hearing was about.

I got VERY lucky. They decided to release me with a court order to remain in therapy at the discression of my therapist and court ordered to remain on medication at the discression of my family physician. Otherwise I would have been incarcerated in a prison mental health unit or the state mental health facility until I was deamed no longer a threat to myself and or others.

Later my friends all let me know what my death would mean to them and how selfish I was being. when I wanted to die I wasnt thinking about them I was thinking about me and taking the easy cowardous way out of my problems. It only take picking up a bottle of pills to kill yourself. but it takes so much more to stay and face the problem and take care of it. I may be out of the situation and problems but in killing myself I would have left so many people with a lifetime of anger at me. Yea they would have been hurt and feeling guilty and so on but those feelings pass and when they do what left is anger against the person who killed themselves. anger at their leaving, anger at their being so selfish that they didn't care if they leave their friends and family hurt and suffering PTSD, depression and so on for life sometimes even to the point where that person is pulled over the edge and spends the rest of their days in mental hospitals and so on., anger on top of more anger.

One person I'll call (((((((((((Marcy)))))))))) put everything on the line reminding me what all of us that knew her daughter when her daughter committed suicide went through. Then she woke me up big time by telling me to change the concept from what we all went through and still do because of her daughters death and place all that onto my child because that is what I would have done iff I had succeeded that day that lead to my court hearing. Imagine leaving my 7 year old child feeling and experiencing all of that. He had already lost his father to death of natural causes and he is now scarred for life and believes his dead father talks to him and tells him to do bad things. Imagine what tmy sucide would do to him. And then she sent me a paragraph wrote by her daughter when her daughter was alive.

I promised her that I would never again actively plan to commit siucide.

Another friend I will call (((((((((MBH)))))))))) Called me every possible chance she could and emailed me every day not letting me loose sight of what my life and friendship means to her. I have the same promise with her.

My ex therapist now friend ((((((((((SKR)))))))) Sat with me in her car and laid it all out what hers and my friendship means to her and what my committing suicide would mean to her. I have the same promise and commitment of no suicide with her

My friend I will call ((((((((CB))))))))))) gave me the lecture like the others of what my friendship and life and death means to her and then added her own comical edge to it by saying she would save me just to kick my ***** and then kill me if I ever scared her like this again - it was her and my son that saved my life by one keeping me on the phone and the other running for help.

My friends and I believe that thoughts are ok but actions are not.

Based on all this - I care more about my friends and my child then I do for myself. I don't want to hurt them in any way and my taking my life would be irrepairably hurting each one of them. So regardless of how bad it gets, I may think about it but I will never again acively attempt suicide.

As for LL. I know the state and USA law. And she knows my reson for refusing hospitalizations. If I brought my suicidal toughts to her I would be putting her in a very hard spot of following the law and agency protocal or following my wishes of no hospitalizations and do nothing while knowing I was in danger. That is not the right thing to do to a therapist let alone one you have spent 2 years developing a trust for and have the bonis of growing to like her. I wont do that to LL. She has asked for my promise but to me having a contract or promise with her that I won't kill myself when I already know I will never go to that point ever again seems kind of rediculas.

When I started with LL 2 years ago we talked about it one day so she knows the thoughts are always there and they will always be there until my child comes home. But I won't act on it. We haven't discussed it since and for me theres no need to.

With other therapists I told them face to face. I think of telling someone I am suicidal kind of like the idea of posting while in an active suicidal state- you tell someone in letter or email and if the person does not know who you are that is not being very respectful of that other person - telling them you want to die when you know full well they can't do anything about it. that leaves the person feeling helpless, angry and so on and distrusting the person who posts or writes an email to effect because the person obviously doesnt care about that other person friendship and so on if they are willing to make that person feel helpless and angry that they can't prevent you from killing yourself.

Emailing and writing to a therapist about suicidal thought - well that putting in writing and can be used against the person wring as proof of the persons need for arrest and hospitalization because writing them down can be considered as making a suicidal plan. By talking face to face with those I did tell I was able to talk it through so that they knew it was just thoughts and no actions and I just needed to talk. Face to face therapists not only have your words to guide them in making their decision of hospitalization or not but they also have tone of voice, body language and so on that they have been trained to listen to and look for.

Basically how a person tells their therapist depends on their own relationship with that therapist. Most clients in relatively short time especially abuse survivors who have had to rely on their gut insticts, facial expressions, tones of voice and so on of those in authority or their abusers pretty much know what type of words will set that therapist into "worry" mode.

Think about your sessions and when you have seen or picked up on the attitudes and body language that told you your therapist was in unfamiliar territory or may have not fully understood a situation and in doing so you will know how to tell her without her hosptializing you.

[kimmydawn]

(((((((((((((((((( EV )))))))))))))))))))))

I think it's a good idea to tell t that you've dealt with the thoughts for a long time and have never followed through with an attempt while you tell her of the almost continual ideation. That will help you and her.

I want to tell you that I'm now wrapping up therapy successfully and during my therapy (twice in fact) I had t write down what would warrant involuntary hospitalization. He agreed with no problems...both times. He knew I was asking for specific reason and had to calm me before I would talk (mine wasn't about thoughts of suicide though - it was basically a fear here. t, however, didn't know that when i asked).

So, I would ask t what SPECIFICALLY would get an involuntary hospitalization and even ask her to write it down, or you do it yourself as a reminder to you... It helped me alot.

From what others have told me, their t's don't consider hospitalization unless they're afraid the client are losing the fight in managing the thoughts. The thoughts alone weren't what led to hospital.

I hope that helps a bit.

KD

[kimmydawn]

I would also base my telling t on how t has handled situations with me in the past. From everything I've read from you, your t doesn't tend to "overreact" or make hasty decisions. It seems she would monitor and follow-up and keep a steady dialogue on this with you in order to truly "know" when you might need additional help.

My brother deals with almost constant suicidal ideation. Both times he was hospitalized was due to actual attempts...not in telling a professional about the ideation, even after he'd been hospitalized once before for a very serious attempt, and he'd seen several t's and was honest about that.

I just wanted to share that too, and hope it helps to calm your anxiety when and if you decide to talk with t.

Again ((((((((((((((((((((((((( EV ))))))))))))))))))))))))))

kd

Thanks sky, myself, and kimmydawn.

I emailed her about the question and now Tomorrow i have an appt and am a little worried. I'm not sure what I will say.. I'm not sure what she will say. Its all a bit embarrassing. Makes me feel very weak, needy, and burdensome. Hopefully things will go well.

[kimmydawn]

That was very brave, EV.

I think you made a good decision. I think your t will handle it well and this will open the door to another level of trust and understanding.

Please let us know and PM if you want to at all.

Love,

KD

[drunksunflower]

I know it's not T-related, but what if you don't see a T and your point of contact is just your normal doctor?

At what point would they have to do something?

/curious.

My physician knowing I am in therapy asked me to sign a release form so that my therapist and him are treating me according to the same treatment plans and so on.

If I called him he or his nurse would keep me on the phone and the one not keeping me on the phone would place a call to my therapist to see if she was aware that I was suicidal and if she felt medication would help. If not he had no choice but to follow the state and USA laws that state a person who is a danger to themselves or others has to be taken to the ER for an evaluation as to commitment or not because that is the laws and the protocal for the medical agency he works for.

Today I had my session. Even thoguh I asked my T, "what kinds of things warrent hospitalization?" in an email, she had no idea why i asked. I think she thought that I meant voluntarry inpatient eating disorder programs.

Which made it more difficult because I had to directly ask about suicide. UGHHHHHH I was so nervous it was embarrassing. It made me feel better to know how she views things and that she has NEVER involuntarily put someone in the hospital. She did ask me alot of details of my plan and stuff that I didn't answer b/c I just don't feel comfortable doing that but she understood. I think on the whole I realized that I have allot of strong things keepign me from doing it even if I do think about it alot.

Anyways... thank you so much everyone for encouraging me to talk about it.

[(JD)]

Drunksunflower, it definitely has a lot to do with the way you word things, and whether you share your feelings or hold them in. If you say you ARE going to do this, and then don't say anything, they have no choice but to keep you safe.

If you say you are so sad or depressed that you want it all to end..and then allow the doctor to ask questions and share with them honestly, that allows them to find alternative solutions, as you may be able to agree and work with the MD.

If you are having trouble being stablized on meds, that might be another good reason to go into hospital, btw. Hospitalization is really only for a temporary time to allow you to stablize...and make long term plans with psychologist/therapist for when you leave hospital.

Talking about SI does not mean you have to be committed against your will. In fact, only psychiatrists and police officers that I know of are so "fearful"? to protect their good name are the ones to slap someone into lock up against their will. I don't know of any MDs or Psychologists that do that unless you tie their hands... usually they work out a way to keep contact, alternate plans if you can't get in touch with them, and ways to help you get through the dark times.

Talking about it doesn't make someone do this. We all keep getting through these dark times... with help from each other. ((((hugs))))

[Dezdemona]

Always. For me, the thought of wanting to die by my own hand is much scarier than the thought of what will happen if I tell. The worst that can happen is, they stop you from killing yourself. That's a good thing. I know its scary. But if it means a difference between killing yourself and saving yourself...