The recurring question - to contact T or not to contact T

Sigh...My T wants me to contact her if I start having sui thoughts. The last time I had those thoughts, I waited three days before saying anything to T and she was very disappointed that I didn't contact her sooner. My T has agreed to be there for me and work through things with me, but I have to hold up my end of the bargain, which is to contact her. Last time I started having those thoughts, my anxiety and depression were both sky high. I was in an almost constant state of panic and dissociation.

Now, this time, I've started having those thoughts again, but emotionally, I'm very calm. I don't feel frantic or anxious or dissociated. I know I'm not going to act on the thoughts, but they are becoming rather intrusive. I don't want T to be disappointed in me or say that I'm not holding up my end of our bargain. I just really don't know whether it's appropriate to contact her now or not.

My T says that I tend to err on the side of not contacting her when I should. I just don't know. I've already waited 24 hours since I started feeling this way, but if I can distract myself, then I'm fine and I stop thinking about it. If my T really wanted me to contact her every time I have sui thoughts, I'd be calling her daily. So, I think she wants me to contact her when the urges or thoughts are becoming strong and intrusive. I know I should have this conversation with my T, but we've talked about it before, and I'm embarrassed to say that I just can't seem to relate what we've talked about to how I feel. I almost feel like I need her to tell me - when you have felt this way for more than x number of hours, contact me.

I dunno, I guess I just needed to get these thoughts out of my head while I try to decide what to do.

I did a couple of weeks ago, a couple weeks after coming out of a very dark place. I sent my T an email, just said I am starting to feel those things again and I want you to know. He emailed me back thanked me for emailing him and asked if I could think of something that may have triggered, and reassured me. I am glad I did in that.

If T reassures you that it is what you should do.. just do it. It may help, it may not, but it will keep T in the loop! Hope things get better for you!

It doesn't sound like a daily thing if you describe having started those thoughts again, which means this is different and worth contacting your therapist about. It could be an early warning sign that she can help you nip in the bud or at least mitigate. And, if you contact your therapist with this, it's a good way to identify what needing help feels like.

It sounds to me like further clarification of the contract with your therapist is necessary. If your SI thoughts don't result in SI urges, in other words, if they don't transform into SI feelings, it may not be necessary for you to contact her immediately as they come.

It's understandable when therapists get a little anxious around client's suicidality. Just like anyone else, they feel the natural urge and also the professional obligation to prevent client's from hurting themselves. But sometimes this urge, as understandable as it is, may obstruct the natural flow of therapy because it gives the client a message that their SI is something abnormal and to be scared of. It is necessary to attend to suicidal urges immediately, but as long as the suicidal contemplation is in the realm of thought only, it can be processed in therapy just like everything else.

SI, in and of itself, is not something abnormal and something to be scared of. It's a natural part of life and it's a very common occurrence. We all have those type of thoughts cross our mind when things get tough and we start wondering "what's the point of all this?"..

I think you would have to list the draw-backs and benefits for yourself, which I think you have already. You understand your T has asked this of you and felt 'disappointed' when you did not contact her in the past.
If you choose to contact her you could always leave a short voice mail saying that you are having those thoughts, explaining your emotions and how bad the thoughts are.

Thanks all. I still haven't decided whether or not to contact T. At this point, I think I'll probably end up waiting until my appointment with her later this week.

I keep getting to the point where I think I will contact her, and then I get distracted and feel fine for a while, and then it gets to be late and I decide to just go to bed. When I wake up, I find myself still trying to decide. I suspect that if I bring this up with my T, she'll say I should have contacted her, but I think maybe I'm just not ready to yet.

If your T is anything like my T then she definitely would want you to call.

I say well done for managing your thoughts so well. Don't ever be afraid to ask for help when they get too overwhelming. You could call and just say "I need you to know I am having these thoughts but right now they are under control and I don't want help. " then you've let them know but let them know how you feel.

It's ok to say that you don't know yet if yuou can ask for or receive help but that you acknowledge the presence of these intrusive thoughts.

Hope you keep well.

Thanks Jane - yes, I've done that before: sent T a text and said "just so you know, this is going on, but I don't want to talk about it." She's okay with that. I think, for right now, I'm not feeling desperate, I'm feeling more confused and I need space to think about it. I'm not going to do anything drastic and talking to her now won't help any more than waiting until my next session. I always have the option to change my mind, though.

Sometimes, I hate how quickly my mood can spiral out of control. Yesterday afternoon, I was...well, not fine, but managing okay and didn't feel the need to reach out. Last night, my mood switched drastically, and I was feeling very sui. I texted T at 9:45 PM. I knew she wouldn't see it until this morning, so I just went to bed. T texted me back this morning and offered a session or phone call today. By the time I woke up, I was feeling a bit better, but it seems like lately, evenings are just kicking my butt. I sent her another text and asked if we could talk tonight.

I'm thinking I need to talk to T and pdoc about how hard evenings are for me right now. I'm not sure if I'm switching from depression back to hypomania or if I'm just really stressed right now, or if my meds need adjusting or what. I was very worried last night. It took me forever to fall asleep and today has just been hard!