Reaction from T after expressing sui thoughts

Hi all,

I slowly started telling my T about my sui thoughts over the course of a couple of sessions. I was scared, thought T would send me to a psychiatrist and not want to talk to me anymore. But instead something else happened. We talked and I'm sure I was clear about it this time, but no freaking out, no sending me somewhere else... Just a question at the end of the session, wondering how I'll find a strategy for this. I said I'd think about it and that seemed to be good enough.

How would you feel about this? I feel as if I'm absolutely not being taken seriously. Of course I would have hated if my T would have advised me to get some special help, but shouldn't that be what had to happen here? Or is this only a sign of the fact my T thinks I'm not really in danger? I don't know how to feel about this session at all... :-(

Anyne had some similar experiences? How did you deal with it?

My t responded in a similar way. I think she trusted in me to stay safe until our next session - and knew me well enough that I would more than likely survive until the next week, even if it meant taking it hour by hour. I don't believe she thought taking my freedom away from me was necessary at that point. She made sure she wad there for me if it got worse and she and I worked out a plan for when I needed immediate help.

The only time she has intervened was when I had a clear, doable and set plan to act on my thoughts.

Ts often, but not always, distinguish between sui ideation and a clear sui plan with the intent to act. Hope that helps in understanding your t's response.

I think it depends on how your t interpreted your explanation. I think in general, t's know how much of a threat is really there.
I have sui thoughts too, I've had them my whole life. But I've never acted on them. I tell my t about them and she's never seen a reason to seek "special" help. She's capable of handling it and talking through it with me.

Thank you. Yes, it helps me to understand it a bit better. For me it's scary, because it's rather new. For a T it might not be and that makes it harder for someone like me to understand something that might seem 'indifferent'. Maybe for my T it's a lot clearer.

I am glad my T doesn't send me away, but I can't help but feeling misunderstood. As if not being taken seriously. It's probably a very hard differentiation to make for the one having these thoughts. I'm aware of that.

I'm sorry you felt invalidated by your T's response, Elkino. I can understand your reaction, even though my own feelings and reactions in the same situation have been different. For me, it is crucial that I know that my T would never send me to hospital - he has never had anybody involuntarily committed in 30 years as a psychiatrist and psychotherapist, and knowing that is what makes it possible for me to tell him at all. He shares my deep distrust of the county psych hospital, I think.

Still, I have never felt that he didn't take me seriously. And that is super important. Could you raise this with your T, do you think? I'm sure s/he does take you seriously, but you are the one who needs to feel that s/he does. One thing I like about therapy, and that happens in no other relationship I'm aware of, is that it is perfectly all right to revisit old topics as much as necessary.

Your T is watching and thinking more carefully than he's letting on. He's being respectful and treating you as an adult while judging the level of threat to your safety.

I've implied to my T that I might take some risky action, and that I have done so in the past. To her credit she doesnt bat an eyelash. She is watching for signs that I am about to do something borderline but generally trusts I'll be back in a week. It's infuriating and reassuring at the same time!

So your thoughts and feelings are understandable. Your T sounds like a good one. Stick this out and keep exploring these thoughts you have. It's hard but can get better.

I've had a similar situation. My ex-T used to always ask to see my SI and ask questions. One day, she didn't. I thought she stopped caring or had given up on me. Next session, I sat in silence. She told me I could go because I was wasting both of our time. I broke down and told her my thoughts/feelings. Her response? That she trusted me to be honest with her if it was bad and I needed help. But she didn't want to keep focusing on the SI because she cared about me as a whole and not just someone who SI's. It was the first time I have ever felt truly understood and cared about.

Current T and Pdoc don't fuss much about the suicidal ideation. They trust me to be honest with them and to tell them when it starts getting bad. The main thing they worry about is if I SI again or if I'm not safe, that I won't tell them. But my T has come up with a system to easily clarify my moods:

10. Action
9. Desperation, withdrawal, not talking
8. Breakdown, crying, uncontrollable emotions
7. Severe depression, but no crying
6, 5, 4, 3, 2, and 1: I'm not at any risk.

My goal is to be at a 7 or lower. If at an 8 or 9, I need to contact her or call the police. We have a deal that I'm not allowed to act on anything until she responds, if I choose to call her in a crisis and not the police. She's only called the police on me once, but it was because I didn't pick up the phone after calling her in a crisis.

I think for anyone suffering from SI or suicidal thoughts that it is best to have a clear discussion about expectations and when/if additional care is needed. It will only help both the client and T trust each other more.

You need to go back to your T and tell them exactly what you said here. My T will ask me what I need. That's the biggest thing I've learned about therapy. Sometimes it's up to me to figure out what I need and ask for it. There is also value in saying that I know I need something but I don't know what it is.

When I was at my lowest, really struggling with my depression, my T and I discussed what we could do. He said that there were options before hospital like checking in every day, having an appointment daily, etc.

The biggest part of this is to learn to ask for what you need. That's a powerful key.

Thoughts are different than intent and plan. I can talk thoughts all day with my T and he will keep a watchful eye, but he won't overreact. That isn't indifference or lack of concern, just him knowing me and knowing at what point his level of concern needs to move from observation to action.

There's a large difference between thoughts about suicide, and intentions to act on it.

It sounds like your T is accepting your feelings and demonstrating trust in you; which sound like things you don't have in yourself. It's ok to be confused by their reaction and totally fine to ask about it when you see them next.

Your T is likely paying a lot closer attention to you right now, and will do so for the next while even if they don't say anything, they're probably trying to show you that you can trust them. If a T was going to overreact and freak out, it would make the client feel ashamed, angry, or decide to never disclose again. Which wouldn't be helpful.

A lot of the time, opening up and talking about the suicidal thoughts can be enough to help curb them.

I'm sorry that you feel like you weren't being taken seriously. Sometimes it's just a shock to our systems when someone accepts us and doesn't react in a more cruel/unsensitive manner (which is what a lot of people who deal with suicide are used to).

My T even knows my plan - it's not an easy one to act out so it sort of works as a prevention plan for me. He's made jokes about my typical horrid coping skill (overdosing on over-the-counter-meds). I don't feel invalidated at all by those; I actually feel more validated. He's heard what I've said and he apparently trusts me enough to not make any stupid choices even when he knows I might want to. He knows that death doesn't worry me, he knows a lot of things actually that could sound like I'm in serious trouble. All of which I said within one session I think. He told me what part of my conversation concerned him the most - that I can talk about it rather matter-of-factly.

Wow, thank you all for the replies. I helps a lot to read other points of view.
And it all makes a lot of sense.

It definitely is great that someone doesn't freak out, doesn't send me away... Especially when it's a T who helped me so very much in the past. When I only had the thoughts and never experienced making real plans, this would have been what I wished for.
Now it feels as if I became too afraid of myself and my thoughts turning into plans. As if I'd like for someone to 'get it' and shake me. Although I do know it's good that my T is still there, not sending me somewhere else and helps me to get through this in her own kind of way.

I'm almost sure it will pass without any harm, guess she does too and trusts me with that. But I think I'll eventually talk about what I wrote here. It's indeed very important to feel understood by your T and I'm not sure whether that's the case right now... even though I can see logical explanations for the behavior. I'm probably not the most logical thinking person at the moment though.