Accidentally communicated intent

I accidentally communicated intent to my therapist and I'm in so much trouble. I'm so scared. I thought it was minor but he was very threatening in the last session. Basically I'm doing something that's considered self harm and I'm really afraid of what he's going to do. I'm so pissed because he was just waiting to betray me. What's going to happen to me? I want to cry. Please help.

I see you interpreting your therapist as the enemy here. saying he was "threatening" you and "waiting to betray" you. you have to know that he is legally bound to do something if you intend to harm yourself or he will lose his job, he is not out to hurt or betray you. he is only concerned for your welfare and wants to keep you safe. please do not see him as the enemy.

as you are vague as to what form of self harm you are speaking of it is difficult to determine what will happen. if therapists think their client is a danger to themselves or others, the end goal is hospitalization. usually the danger part is the threat of suicide, not self harm. if your self harm is dangerous enough to accidently cause your death, then they would take action but therapist don't generally hospitalize for general self harm.

My last therapist did not threaten hospitalization for thoughts of self-harm, and we worked through it... but my current T did. I was pissed.

(Hugs)

I don't know what the outcome for you will be...

The last time I SI'ed it was severe enough where I needed medical attention. I got so many "threats" (as I like to call them). My T threatened hospital or crisis house. My Pdoc threatened hospital, crisis house, losing my T, and losing her and having to go to county clinic.

In the end, everything turned out okay...I just wound up learning many lessons and some boundaries. With my Pdoc, her threat was simply because they're not equipped to handle medical attention and it causes their services to become backed up by having to try to medically treat someone. So the threat was due to the severity and also how they have to operate.

When you accidentally communicate intent, you communicate that you are in great pain and need help. If self-harm or suicidality are among your symptoms, I personally think it is best to have a specific agreement with your therapist, stating if this happens, the consequences will be this, so there will be no hurtful surprises. You need to take responsibility for yourself and not give it away to someone else. By consequences, I don't mean punishment, but an agreement that safety comes first. It really is best for both of you because if you are feeling betrayed by him, then he is probably also stressed being forced to make a decision regarding your safety that is going to make you feel betrayed when safety, not betrayal is his intent.

When you agree to a plan, than you shift from randomly bringing trauma into your life by forcing others to respond to you, even accidently, to making a decision for yourself for what will happen next. The responsibility for your life returns to you where it belongs. I hope this doesn't sound judgmental because I have had to learn the same lesson.

When we have a hard time letting go of a behavior it is because it is doing something for us. You probably know what the harm is doing for you, and suicidality serves to make us feel in final control when we cannot get our life or emotions in control, but what does accidentally communicating intent do for you? If you could be completely honest with yourself, what is it that you want or need from him? Understanding this may be your first step in moving beyond this.

I think if any doctor or therapist threatens you for THOUGHTS, then it is time to get a new therapist. This communicates more about them than you. You need to be able to talk about your thoughts in a safe environment. Intent needs to be addressed because it is a safety issue.

He doesn't care and it hurts so much.

If your T didn't care at all, then they would ignore any signs and statements you would make that lean towards putting you at risk of harming yourself or others.

He's addressing it and trying to get you help, even if it isn't the way that you want it addressed or helped.

You said in your first message that you let him know about things you are doing that counts as self-harm. Which means that you're already doing it, and it's not just "thinking" about it. Which makes his response have to be different - he has to take action and get you the help that you need.

The thing is that the self harm that I'm doing is also an addiction, not something I can just quit in one day. He's known about it for a long time, it's not like he just found out. It was more like a bomb was dropped on me.

What do you guys think he's going to do? He's been ignoring me which Ofcourse makes me feel abandoned.

Mentioning suicidal intent is seen by a therapist as an aggressive move (even though it might be just honesty.) The therapist distancing you is pretty common. Just understand that if he perceives it as a gesture that's trying to manipulate him then the appropriate response is to not engage in that game.

I would ask him very directly if he thinks you're trying to manipulate him with the revelation. Tell him that's not your intention. Also mention that you feel a distancing and its hurtful.

Just say whats on your mind here, next session. It will be okay one way or the other.

If he didn't care at all I think he would ignore any sings that you are hurting at all; at some level communicating your intent was a good thing because he has heard you. Maybe talk to T about how he has addressed this and how it has bothered you.

Thinking of you.

Tangerine87 I think sometimes we just have trouble with the response that we get. I don't know if this helps much, but I feel the opposite of you. After my disclosure, I feel that my t is betraying me by his reaction.

I also felt betrayed because he overreacted majorly.

What would you do if someone threatened abuse on a person whom you cared about?

Would you be angry?

Think of it this way. You are like two people. The you that is being harmed and victimized who deserves to be protected, and the you that is being abusive. The you that is being harmed is the core of you, who you really are. His actions show that he cares about that core of you and cannot sit by and allow that core to be abused. You really are putting him in a powerless position.

My suggestion is to own responsibility for breaking whatever safety plan you had together. That is the only concrete tool he has to protect you.

This really says it all - well put and non-judgemental and is right on target. You take the responsibility of safety even while saying "i have this issue". Communication here is key. Of course T has to do something - they are required to. Hopefully they do more than just cover their a s s and threaten, but show some care and concern about your wellbeing as well as their theraputic relationship with you. Think of all the time they put in to helping us - if we sui or threaten sui, are we not betrying them in some way? Perhaps showing them that they weren't good enough, didn't do enough, didn't care enough? They (if they are unhealthy, and many Ts are) could see it that way. Hopefully T will see you are in pain and trying to deal with it. But like Froggy said, safety lies with us, ultimately. We contract with T or make plans to go inpatient if we can't commit to safety (i used to think that was the worst thing possible, but I no longer think that, havng had to do that). T's can really get to care about us as well... it is devastating for a T who loses a client to sui.
I hope you can be safe and care for you and find communication between the two of you so that you no longer feel there is a rift here. I guess this is also testimony to myself in my recovery process (when I thought I wasn't making any). I remember the first time this very thing came up between a T and myself and how panicked I was of what she would do. Shows that there is growth. You will move past this.
Granted, I haven't read the rest of the posts, so I don't know how things are for you at the moment....
Be well.

I'm confused. Is he ignoring you or did he overreact?

YES! YES! YES! This is a testimony to your recovery process. There is a point in recovery when our thought process begins to change, particularly from what is someone else doing to what am I doing to bring this into my life, from why am I being betrayed rejected and abandoned to why am I forcing and bringing upon myself betrayal rejection and abandonment from people who don't always have the answers and who are human themselves. It may be before we have figured out how to end what we are doing so we are unsure if we are making progress. When you get where you are, taking responsibility for your safety and for communication (a skill that needs to be learned and practiced), you see that others really care. You become open to the possibility of recovery. It may not feel great in the moment, but recovery is coming if you stay open to that change in your thought process.

That's really harsh to say that I'm being abusive. I don't think I am being abusive.

I think they mean you are abusing your ownself with your self destructive behaviour and your T is trying to protect you from the part of you that wants to self destruct.

This is not typical across all therapists. This is often true in DBT therapy, but is NOT reflective of all types of therapy. My God. You admit you're struggling and the response by the therapist is to distance themselves? Tell me how that is helpful?? Even for borderline patients, I think there is a better way to handle the situation.

Where is the incentive to be honest if this were to happen? Therapy should be a safe place to share ANYTHING.

Thank you, that is absolutely what I meant. I am in no position to judge anyone else. I had a breakdown over a decade ago. I never thought I would act on a suicidal thought, had never even had a gesture, had never self-harmed. My breakdown and the story surrounding it is way too long to explain, but I spent two years of my life actively suicidal and engaging in self-harm. I've been there. I understand all the whys, and I would never judge anyone else.

I apologize if my use of the word "abusive" has offended you. I am in no way judging you. I can only speak from my own experience, and I wouldn't want to project that experience onto you. I actually don't even know what it is that you intended to do, but I gathered from your therapist's response that it was in the realm of self-harm or suicidality, or maybe you are using and then my advise may be different.

If this is self-harm then this was my thought; in the two years that I was suicidal following a breakdown, I did some things that were harmful. They produced an adrenaline rush, perhaps a boost to my neurotransmitters and the pleasure center of my brain. This is how these things can become addictive, in addition to the psychological effects they have on us. I am a strong believer that we become stuck on negative behaviors because they provide something for us that we haven't yet figured out how to get in another positive way.

At the initial time of my breakdown, I was being treated for Major Depression with antidepressants that I wouldn't find out for another fifteen years was actually bipolar II disorder. The worse I got, because antidepressants alone will drive someone bipolar into a mixed or manic state, the more medications were given to me, including stimulants that made my bipolar disorder explode. I have hypomania, and the absence of mania made it difficult to diagnose me as bipolar when the irritability, and agitation could just be seen as symptoms of depression and PTSD. It was missed that I would spend days before my breakdown happily completing projects with an abnormal energy level because I thought that was happiness, that it was normal, and I didn't seem to need the sleep. I didn't report this behavior except to say that I was having a good week, but my hypomania is usually more of the irritable type. Part of my despair was that I thought I would never experience that "happiness" again. I couldn't get anyone to hear me about the antidepressants, and a new therapist insisted I stay on these medications, or she wouldn't work with me. This kept me in a mixed state for two years because I hadn't learned to be the leader in my own recovery yet. I was STUCK, and I became addicted to self-harm for the little bit of adrenaline rush that it would give to me; to feel better for just a moment was better than my HELL. Those behaviors create a new hell, however, as you are now experiencing with your own therapist. I should have gotten another new therapist, but I was in no shape having just ended a ten year relationship with my first therapist. I did, in my first hospital stay, receive a bipolar diagnosis, but I went into denial when my original therapist of ten years didn't agree. Every pdoc after continued to treat me for Major Depression. My original therapist of ten years and I ended because HUGE mistakes were made. It wasn't the mistakes that ended our relationship, but my therapist's inability to have the conversations we needed to be having over those mistakes. She was a wonderfully compassionate therapist despite the HUGE mistakes. I was devastate by our ending, but I value all that we did accomplish in our ten years together while I forgive her for being human and having a human response to me.

I happen to work with individuals whom I take on their own psychiatric appointments. There I met my pdoc to be... I shared with her that I needed to go on short-term disability. I had already tried everything I could think to do, and I was just going deeper and deeper into despair.

While on sick leave, she called me out of the blue to see if there was anything she could do. That day changed my life. I had been through so much in the previous years that I started by being incredibly honest with everything I did, everything I thought, and everything I felt great shame over. I wanted to give her a way out or to know exactly what she was taken on, as well as to protect myself from any more negative experiences. My self-esteem was in the gutter, no sewer. I presented with Major Depression. First one trial of antidepressants - felt horrible, agitated, irritable, increase in suididal thoughts. Second trial of antidepressants - felt horrible, agitated, irritable, increase in suicidal thoughts. Third trial - you can guess. Just three months after sixteen long years to be told that I needed to be taken off all antidepressants and put on a mood stabilizer, that I was bipolar. This time I embraced the diagnosis that gave me some peace of mind that life could be better.

I learned to be incredibly honest about myself, and to communicate my needs effectively.

This is my incredibly shortened version of why I would want to offer you advice. I learned a lot during those sixteen years of HELL, and I would want to try to shorten anyone else's hell if I had some advice to offer that could be helpful. Ultimately, we are responsible for our own recovery, and it is up to you if you want to hear what I have to say or if you want to focus on a single word. I am sorry for the length of this post.

First, recovery is not possible if we are not incredibly honest about ourselves, our behaviors, or our needs. Personally, as an adult, I was too ashamed of my own needs from a past wounded child, but unless we start exactly were we are at the present moment, we cannot move forward.

Recovery is not possible if we do not learn to communicate effectively with our helpers, but first we need to communicate effectively with ourselves. Denial is a wonderful coping mechanism to which I held on tightly.

Second, recovery is NEVER possible if we remain stuck on SAFETY. Safety needs to be addressed first. If there is a relapse, then you have to get up and start again. If you cannot be honest with the above, you will not be able to figure out why you continue to relapse.

Repeat

I can only speak for MYSELF. I was sexually abused by four people before the age of five. I was emotionally abused by my mother who was never treated for her own mental health issues. I didn't even know about her trauma background until I was an adult, most of which I learned after her death. In hindsight, now that I understand bipolar disorder, she had the same type. I was physically abused, emotionally as well by my father. I actually consider myself lucky. I have heard far worse stories than my own.

I had nobody to teach me healthy coping skills. Emotions were not spoken about, and usually when expressed brought on negative consequences. I did the best I could, and when I had my breakdown, I had to go back to square one and parent myself.

So here is the deal. I was STUCK in HELL. When I finally received the help I needed, it required me to look at what I was doing to MYSELF, to that little girl inside of me that had gone through all of this STUFF. I was literally, physically beating her up. I don't know of another word for it but ABUSE. I am speaking for myself. Like I said, I don't know what self-harm you are intending or have done.

I offered you a way to look at what you are doing. If you would do whatever you are doing to another child, and you are OK with doing whatever you are doing to yourself to another child, and if doing this to another child would not get you placed in jail, then of course, I would apologize for using the word "abuse". If you think your actions on some random child would get you thrown in jail, then start being honest with yourself. It is abuse.

I am NOT JUDGING YOU. You can take what I have to offer or leave it. I am just a random person in cyber space. If I am not helpful, then let what I have to say go.

The written word is sometimes difficult to interpret without tone of voice and facial expressions. Again, I am not being judgmental.

From the Oxford Textbook of Suicidology and Suicide Prevention:

"Intense countertransference reactions often occur during the treatment of suicidal patients. Lack of awareness of countertransference reactions of malice and aversion may be suicide-inviting."

Suicide is probably the most provocative reaction, and elicits either distancing or aggressive feelings in response in the therapist. There are far more suicide attempts than completed suicides, and they can be seen as a cry for help (or a demand for more attention, ultimately.) Therapists are caught in a double bind, if they reward suicidal ideation with extra attention, because doing so will only increase that behavior in the client.

To guard against this, many therapists will react strongly to suicidal ideation, particularly where its occured before.

It should be mentioned that the majority of therapists today use non-transferential techniques, like CBT, and have much less practice in detecting countertransference, and if you can't detect it, the feelings evoked will shape therapy. Although its part of the curriculum, theory alone is insufficient to teach something as experential as transference.

I'm not saying its a good thing or how it should be. Just talking about reality.

The reason why so many BPD clients get pushed into DBT is precisely because the countertransference can be too strong for "regular therapy." DBT has just formalized what the natural instinct of the therapist based on countertransference to do; to not reward self-harm, actual or imagined.

"It should be mentioned that the majority of therapists today use non-transferential techniques, like CBT, and have much less practice in detecting countertransference, and if you can't detect it, the feelings evoked will shape therapy. Although its part of the curriculum, theory alone is insufficient to teach something as experential as transference."

I have not found this to be true concerning the majority of therapists across the board.