[SeekerOfLife]

Still trying to figure this one out. About a month ago I went to the mental health clinic in a very distressed condition. The "clinician" asked me 2X if I had any plans to kill myself or anyone else. I said absolutely not. I was afraid of being alone because I thought I might hurt myself. To make a long story short, he let me leave before I felt OK with myself. So, as I understand it, a "clinician" will only get concerned if I intend to kill, but not if I may possibly do self harm?! BTW, I was seriously considering shooting my foot off. Anyway, I got through this. I was not seeking hospitalization, but, I guess, some sensible counseling.
So, in the eyes of the "clinician", hurting myself is my problem, not his? Or is there some gray, fuzzy area I am not aware of ?

[Daeva]

It differs on state/therapist. However most of the time it's if you intend to kill yourself or someone else. I self-harm and my T knows about it, but she doesn't report me etc and i don't want her to. We have an understanding that my intentions aren't to kill myself, it's just an unhealthy coping mechanism that we have to work on.

Did you actually specifically tell the clinician you were considering shooting your foot off, or did you just say you were thinking of hurting yourself. A vague "I may hurt myself" without specificity probably wouldn't raise the alarm to the point of hospitalization as usually that just means cutting, etc. where the danger of actually do so much damage that your life is in danger is low.

[Perna]

I think hurting is a broad concept; one can physically, psychologically, emotionally, etc. hurt one's self but dead is dead? If you did not tell him, "I think I am going to shoot my foot off" and show him the gun, it would be hard to tell whether you were just trying to express how much pain/confusion you were in and how much you were trying to ask for help (you say you were seeking some "sensible counseling") versus whether you were going to actually go through the act.

Our heads can think of really horrible things? Think of writers of horror or crime novels? They have to actually write out realistic scenes? I think talking about hurting one's self can be kind of like that, not a goal in itself but a shorthand way to tell ourselves (and possibly others) how bad we feel. Think of physical pain, "It feels like someone is sticking a knife in my belly" when we know there is no knife there. There are degrees.

Do you have a therapist? I would find one, get someone to talk to about your pain and what is causing it and see if you and they can work to lessen/resolve it?

[SeekerOfLife]

Thanks you all. I was very specific with the crisis clinician. I guess this falls into one of those gray areas.
I saw my regular therapist yesterday. I wanted to discuss this some more. She said if I ever felt the need to come in again, but did not want to see the crisis counselor, I could see her instead, I could let them know at the window, and wait in the waiting area. I am to tell them I feel unsafe with myself/being alone, etc. They will let her know, and if she can spare the time she will see me for a few minutes. To me this is encouraging.

[Daeva]

That's wonderful!!! Sounds like you have a very nice, understanding and caring T!