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Tangerine87
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Trig Jan 05, 2014 at 09:34 PM
  #1
How much do you tell your therapist about suicidal thoughts? My therapist knows i have them, but i don't tell him details like about a plan but one time he did come pretty close….And i get scared how close he will get to me telling.

I get a lot of suicidal thoughts, and I have plans. I think about it all the time..I also have deep dark secrets that I can't tell anyone and I'm worried about how close I'll get to him that I will trust him, and he will have no choice but to break that trust. Does anyone have this problem too? I'm worried I'm starting to trust him a little too much…I know as soon as I mention anything about a plan, he has to break confidentiality.

Doe anyone have anything bad happen after trusting therapist too much?

Last edited by shezbut; Jan 06, 2014 at 02:53 AM.. Reason: Added a trigger icon
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Default Jan 05, 2014 at 10:19 PM
  #2
Therapists typically (NOT always) will work with you confidentially about suicidal ideations (thoughts, feelings, wishes) but will very often report suicidal plans due to legal liability to prevent you from harming yourself, of course, along with their understandable human desire to keep you safe.

As for other secrets, they'll keep those confidential as long as they don't involve a clear threat or real harm to yourself or others, things like that.

You can ask your therapist their policy to feel it out first, also make sure you work with someone experienced, licensed, recommended or carefully researched and familiar with your issues to minimize chances of harm.

Very sorry you're struggling with this.

As for me personally, yes, I've talked about suicide with my therapist more than once. She listened closely and was supportive. She did ask me in a couple separate instances if I was actively suicidal, i.e. if I had a plan, and it was clear to me that a yes answer would have meant she escalated the issue. I did not have a plan and answered honestly that I was feeling suicidal, not planning it. That's as far as it's gotten with me, but I know many others here may have more insight for you.

As for having bad things happen- yes, when I was 16 I saw a therapist and was dealing with past abuse. She was worried about me and broke confidentiality, talking with my mother and reading a journal my mother found and gave her. That was horrific for me, wrenching, a period of terrible anxiety and upset. That counselor was only an intern, not too experienced and I was not a good consumer then. I feel much safer as an adult working with a much more qualified therapist.
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Default Jan 05, 2014 at 10:32 PM
  #3
I think it depends upon how much intervention one is prepared to endure. I advise my clients to say very little if they want release. I tell the one I see very little. But if one does not mind the potential for forced intervention, then talking is probably not a bad idea. Therapists have a great deal of discretion in this area and I don't trust them, so I don't tell them. Others do trust more and/or are happy for intervention.

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Trig Jan 05, 2014 at 10:53 PM
  #4
It's really scary telling therapists about those thoughts or feelings. Honestly, they all react differently. Some are calm and more prepared and confident in dealing with it on their own and others slightly panic and jump the gun right away for liability reasons. I guess it kind of depends on their past experiences and if they've lost a client to suicide or have had clients make serious attempts. In those cases, they may be a little more hesitant to trust that a client will not hurt themselves.
It depends on how serious this feeling is for you, as well. If you get to a point where you sincerely feel you could do something or go through with a plan, you need to talk about it and please don't wait to bring it up with your T. Your life is the most important thing at stake, and any type of intervention - hospitalization, 52/50 hold, inpatient, contract for safety, etc. - will be absolutely worth it in the end, because you will still be here.

I have talked about SI with my T several times. She knows many of the thoughts and planning that goes on in my mind, and some of the triggers for them. One night when I was really serious, she cancelled another clients appointment to have me come in. I was completely distressed, told her what I planned on doing and that I have every intention on doing it. She responded with "It makes me so sad that you feel this way." She also said "you need to go to (insert hospital name here) and check yourself in. If you don't, then I need to intervene and call 911. Going on your own will be better than having the police bring you there". She then hugged me and said she'd promise to visit me the next day. In the end it made is so much closer, the trust grew tremendously, and she was proud that I made the right decision. She now trusts me 100% too, which could be scary sometimes.
Do what you feel is best for you.

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Default Jan 05, 2014 at 11:32 PM
  #5
I told my t about a really extreme reaction of a t that I read about here on PC... I think the client just mentioned somethign and the t called the cops. That let me gauge her reaction. She said she thinks hospitals can be harmful and only can help if they keep someone from killing themselves immediately. She was more worried about me not feeling like I could talk about things she said. I don't worry too much about the possibility of telling my therapist anything, though I don't initiate telling her. I figure if it comes up and I tell her my plans, if she reacts badly I can probably backpeddle and say that it isn't true and that I am doing well. However, I am somewhat cautious about telling her. If I made fairly a definite decision to go ahead, I think I would stop therapy at least a few weeks before it.
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Default Jan 05, 2014 at 11:37 PM
  #6
I am very honest with both my T and pdoc about my suicidal thoughts, ideations, and plans. They know me well, and know when I am in danger. Yes, they have asked me to go into the hospital on numerous occasions, but because I have always cooperated and gone in willingly I have never been involuntarily hospitalized.

Usually, my husband has already been aware that I was not doing well, so when my pdoc has picked up the phone to call (which he always does when it is time to take me to the hospital), it isn't particularly a surprise.

I would honestly advise you to have someone in your personal life, if possible, who you can make aware of how you are doing and that you might need there assistance if things become dangerous for you and you need to go to the hospital. Trust me. You don't want the police, paramedics, and legal system making that decision for you. It is better to be able to call a family member or friend to help you get to the hospital safely and voluntarily. Your T probably can't be that person by the way. I know mine would call the police to check on me. He's a fantastic T, but he won't put himself in the role of rescuer.

I stay that honest with them both about all things. It is difficult and frightening and a leap of faith to be completely honest about so many difficult things, but that honesty has allowed me to trust, has allowed them to really know where I need help, and keep me safe and alive.
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Default Jan 05, 2014 at 11:45 PM
  #7
My T gives me the impression that she wouldn't take action for generally anything except a specific intent to act on a specific day, etc.

She knows about my ideations and says that just because I think about it doesn't mean that i'm going to do it and that there is such a wide spectrum of what is considered "suicidal" that she really explores before taking action. So I feel okay in mentioning it to her but it took a lot of reassurance from her (she seemed one step away from annoyed - she finally took the "ok, lets just go ahead and address this head on" approach).

I have told her though, that should I actually be planning to do it I probably wouldn't tell her; in that case she asked if she needed to be concerned about me doing anything.

Now I have told her i'd rather not discuss it at all because I don't want her to not take me seriously if by a tiny tiny tiny chance i'm really feeling suicidal and reach out to her for help (highly unlikely); I don't want her to mix my ideations with the real thing because that would tick me off and drive me to just say "ef it" and do it.

So while I no longer discuss it with her, I don't have to be as cautious about telling her whats on my mind if I desire to do so. She knows i've had impulsive suicidal thoughts without a definite plan and didn't take that any further than to question them for the next few visits. I also let her know that although i'm a "easy" client if she ever tried to "lock me up" (especially if she did so in secret) I would likely react in an extremely uncooperative way.

I think you should be cautious just because everyone reacts a different way and its better to be safe than sorry.

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Default Jan 06, 2014 at 12:52 AM
  #8
Maybe just ask a general question...like "If I talked to you about specific suicidal thoughts, how would you react?" "Where is the line drawn for hospitalization?"

My T asks me every session to rate my SI thoughts (1-10), my suicidal thoughts (1-10), if I'm going to okay the next week, if I'm going to SI. Last week, I answered her "maybe, idk" for if I was going to SI. Her response: "You know, most people who hospitalize you for that type of answer". My response: "I know that you can't hospitalize me for SI alone". Her response: "/sigh". LOL.

But me and her made a deal. She can hospitalize me involuntarily when I give up. Basically that means if I have a breakdown and she can't help me get out of it, if I stop communicating, or if I don't even have the strength to fight her over hospitalization. At that point, I belong in the hospital. Otherwise, I've suffered from suicidal ideation every single day for over 18 years...I'm still here. Thoughts alone aren't enough for hospitalization.

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Default Jan 06, 2014 at 01:43 AM
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Yes I worry that my therapist will call the police or send me to an institution.
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Default Jan 06, 2014 at 02:22 AM
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I SIed once outside of her office. This was in a residential setting and I was really upset and hardcore testing her. I had made a mistake a few days earlier and she wasn't angry with me. I felt like she should be angry with me because I deserved to be yelled at. She said there is nothing I can do to make her hate me. So I hurt myself outside of her office to see if she'd yell at me then. She sat next to me, cleaned up what I did, put some bandages on me, and told me I deserve to have someone take care of me.

We talk about suicide all the time. She is very good about not overreacting. She will double check that I have no intentions and say if I do have intentions, she will have to send me back to the hospital, but it's never gotten close to that.

Well I did scare her pretty badly once. I took too many pills not in a SA attempt but in an attempt to drown out my life and I emailed her this crazy noncoherant message and she panicked a little. She called me immediately to ask if I was okay. Then she was a little bit mad that I scared her so badly and said if I kept doing that, she would have to send me to the hospital. But it was all okay. She is good about talking about that stuff.
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Default Jan 06, 2014 at 03:21 PM
  #11
Quote:
Originally Posted by 1914sierra View Post
I am very honest with both my T and pdoc about my suicidal thoughts, ideations, and plans. They know me well, and know when I am in danger. Yes, they have asked me to go into the hospital on numerous occasions, but because I have always cooperated and gone in willingly I have never been involuntarily hospitalized.
I've been hospitalized 3x, always needing it long before they actually demanded it. (Demanded is a funny word. I could have refused, but then it would have been involuntary, and I was cognizant enough to know I didn't want that to happen).

I think it's a risk to tell how you're feeling, but it's a bigger risk not to.

My goes out to you.

Bub
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Default Jan 06, 2014 at 04:06 PM
  #12
My therapist knows all my suicidal thoughts, even when I walked in front of cars trying to get hit, etc. She never reported them or my self-harm.
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Default Jan 06, 2014 at 04:56 PM
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It seems like different therapists are very different. It took me almost a year to trust my T enough to be completely open about my sui thoughts. He'd told me at an early stage that he has never, in over 30 years, sent anybody to hospital against their will, and that helped. I think he knows that it would be a disastrous thing for me to be committed to a psych hospital. And I know that he trusts me to let him know if I do have suicidal thoughts, serious or not.
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Default Jan 06, 2014 at 05:07 PM
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It does seem like many T's work different.
I prefer to tell my nurse if I am struggling with SUI thoughts as she works along side my T and my Pdoc however if I don't have contact with my nurse then I will tell my T who then with contact my nurse, I have almost been admitted to hospital on a few occasions.
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Default Jan 06, 2014 at 07:39 PM
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It's my observation that Ts who work in private practice are better able to exercise reasonable judgment when it comes to this. Other therapists often have to abide by the policies of a hospital or organization, so they lose their autonomy or don't have a choice.

Human behavior is not predictable, but my T said there are 3 psychological profiles (as in forensics I think) of people who do harm themselves in this way, and that I don't fit either one of them, regardless of things I've said to him. I think experience also brings more seasoned decision-making.

I hope things pick up for you soon.
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