should I leave T a message?

I met with T again today. For various reasons, I ended up speaking with her again over the phone. Both in session and over the phone, I noticed that she seems to be on "high alert" in regards to my safety. We have talked about my past around suicide attempts and ideation. I have also admitted to her that the sui ideation is constant, but at this time managable.

She doesn't know me well. I don't know her well. This was maybe the 5th session. I get why she doesn't trust me. But I don't want to make her more worried than "necessary" (ie: if I tell her I'm going to off myself, ok, be worried. But if I don't say or do anything, I don't want to cause undue stress simply by existing or being honest). I worry about "crying wolf" without actually meaning to. I don't want to be brushed off if I ever do get to a point of disclosing actual intent.

So my question is: do I call T and leave her a message apologizing if I have come off as being unsafe (or potentially so)? Do I try to explain that I would reach out if things got really bad? Is there a way to help T trust me on this? I know she has access to the file from my other T at this agency, but I am not sure that T put anything in writing around my safety... Is there anything other than building trust over time that I can do to help T feel better about this? I really don't want to stress her out...

Personally I think it is up to her to express to you if she is concerned about your safety. I would try not to worry about her worrying. That is not on you. Just be open and honest with how you are feeling and what you're thinking if she asks you. Or if you feel really in danger then let her know. I probably don't make much sense, but I don't think you should worry about this too much.

I would say to just be honest and don't worry about stressing her out. That shouldn't be your concern.

I don't think you need to contact her unless you really want to. You are still at the 'getting to know you' stage and like you say it's understandable she is on high alert, but from what you say she's not intending to take any action, so perhaps this is one of those trust-building opportunities where she can see that you don't act on the ideation and not be on such high alert next time. Try not to worry about stressing her out; she didn't go into this line of work unaware that it would sometimes be stressful and/or worrying.

Try not to think about it being about her not trusting you. My T and Pdoc have never expressed it in terms of trust, but rather in terms of serious concern. Since you are a new client, she hasn't gotten a good feel for your symptoms yet, so she will be watchful while she gets to know you.

In my case, in my worst depressions I could become very impulsive. They both witnessed me go from seemingly safe enough in session, to suicide attempts literally just a few hours later, so as they "learned" me, their concern was how quickly my condition could deteriorate.

I would simply have a frank discussion about this in your next session. It can really help to sit and talk about what symptoms signal true danger for you as opposed to thoughts and feelings without that kind of danger. We had many of those kinds of discussions, and they helped me clarify in my mind what steps I need to take at what points so that I can reach for the appropriate help at the appropriate time. Those kinds of honest discussions may be the best way to develop a mutual understanding of the situation.

I get the impression that she thinks I'm minimizing and lying. She asks me literally any time we talk (even when she called simply to reschedule earlier today) if I was safe... it's a bit triggering. I just don't want to be seen as a drama queen or as constantly in crisis. I'm not right now, so I don't want that impression over everything I do or say. I know I can't control how she reacts to me, but I wonder how much of what I say and do comes off so far from my intent. Maybe that's the conversation I need to have with her?

I would absolutely have this conversation with her. Especially to say you don't need her asking if you're safe every time you speak to her.

Here is my two cents and a couple of points I want to emphasize.

1. It's not your responsibility to make your T feel better. As a professional, she is in a position to take care of her feelings.

2. As far as I see, there is no reason for you to apologize. You didn't do anything wrong. You honestly told her about your mental state and, if anything, she, as a therapist, should appreciate it.

If I were you I would talk to her about the difference between you feeling SI and wanting to act on your feelings. I would not leave a message about that. This is a kind of conversation that needs to take place in person IMO. Explain to her nicely that you appreciate her concern, but that as long as you are not actively SI she doesn't have to check on you regularly and that it would help you to know that she is ok with your SI feelings as long as those are just feelings. Tell her that if you experience the urge to act on your feelings, you'd contact her and ask for help.

Oftentimes, therapists just need to have a peace of mind and to know that clients will not act on SI feelings and that if the client is in a tough place they won't hesitate to contact T and ask for help.