[stolen_innocence08]

I was just wondering here who attempted suicide/made a serious attempt at self harm whilst seeing their T? How did they react, how did you move forward? How did they find out?
I see a T in private practice and I came quite close to seriously injuring myself and have been pondering suicide/overdoses frequently. I was just wondering if he'd actually stop seeing me.

[woods girl]

My T was called by a relative as I was being taken to the hospital. It was horrible... I had to put up with a doctor and staff that were total strangers and knew nothing of my complicated history and changed my meds around. I couldn't see my T until after I was released because he wasn't affiliated with that particular hospital.

After, at first he said he wouldn't be able to see me anymore if I attempted it again, because it meant his help wasn't helping. I kind of think he was trying to "scare me straight" because he's mellowed since and says I should feel free to talk about the urge and to be sure to call for help first.

He was TICKED though.

[stolen_innocence08]

That sounds horrible. I doubt my T would see me if I attempted as shes in private practice, I am just assuming.

[PinkFlamingo99]

My T specializes in bad cases of SH so she's never told me she won't see me. She has, however, temporarily moved me up to the PHP because I'm not "functioning well enough for outpatient treatment."

[kecanoe]

My ts would all see me if I attempted suicide. They might call the police if they thought the threat was intense, but they wouldn't drop me for that. All are in private practice. I have shared pretty intense feelings about wanting to die, and have admitted having a plan. T1 would ask me to hold off for 24 hours at a time, and I was seeing him daily, with texts and calls over the weekend. I saw my pdoc cry about someone who had suicided and that helped me to stay safe.

Why would a t drop you if you were in that much pain? Would it help to ask your t if they would drop you for suicidal/self harming thoughts?

I think it is part of the job to help people who are tormented to the point of self injury.

Some will refer or refuse treatment due to liability. It seems odd but some are just not comfortable or qualified to deal with suicidal clients.

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[LonesomeTonight]

I would ask your T how he deals with suicidal clients. Have you shared any of your feelings with him?

And I agree with what a few people said where a T might want to refer you out if they thought they weren't helping you. Or if you could only see that T once a week, then they might think you'd need a higher level of support like a day program/PHP or inpatient. I know my T was concerned at one point that she wasn't helping me enough and mentioned hospitalization. I kind of freaked out about her suggestion, and it was then that she said she was concerned she wasn't being helpful and that I might need a higher level of care than what she, my p-doc, and marriage counselor could provide.

[ruh roh]

There is no way for anyone here to know how your therapist will respond. They all vary when it comes to this sort of thing. I have had bad experiences with past therapists around this topic, so when it is serious, I keep it to myself. But that's me. My current therapist has never said what her policy is, but her voicemail states to go to the hospital, so I have come to some peace and acceptance that I travel alone when it comes to this issue. (I do share when I'm down, however, just not if I have plans or means.)

Others will have different experiences, though, so if it's a concern and your therapist hasn't said, you might want to just come out and ask.

When I first started seeing my T he actually said he wouldn't stop seeing me if I attempted again. And he has held true to that. He said he has that rule because otherwise some people might attempt just to get out of therapy. Or something like that. It was nearly 4 years ago now so I don't fully remember...

[MobiusPsyche]

If they are so uncomfortable with the topic or behavior that they'd refer you out, it's probably for the best because they really wouldn't be able to help you. They need to be comfortable talking about it as needed.

The two I've talked about it with have both been in private practice and neither would refer me out for it.

It also depends on what disorders a T is comfortable treating. Not all can/will treat BPD, for instance, but if they do you can be pretty sure they're able to talk about s-i and suicidal feelings. I'm not sure how I could benefit if I couldn't talk honestly with my T about such things.

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[LonesomeTonight]

Originally Posted by ruh roh

There is no way for anyone here to know how your therapist will respond. They all vary when it comes to this sort of thing. I have had bad experiences with past therapists around this topic, so when it is serious, I keep it to myself. But that's me. My current therapist has never said what her policy is, but her voicemail states to go to the hospital, so I have come to some peace and acceptance that I travel alone when it comes to this issue. (I do share when I'm down, however, just not if I have plans or means.)

Others will have different experiences, though, so if it's a concern and your therapist hasn't said, you might want to just come out and ask.

I think the "go to the hospital/ER/call 911" thing if it's an emergency is fairly standard in T voicemail messages--at least, both my T and MC have it on theirs, and I think it's on the practice's voicemail too. I think they don't want a client to count on them getting the voicemail in time (especially if it's on the office phone, like in the middle of the night). The two times I've called a T's cell late at night (once T, once MC), one of the first things they each was "Is this an emergency?" or "Do you need to go to the ER?" I think that must be standard protocol for them, too. (Though I initially interpreted the "is this an emergency" to be "Why are you calling me at midnight if it's not an emergency?" but later I realized that he was just checking.)

So I don't think the presence of that on the voicemail means anything about how the T would be if you hurt yourself in a way that would require the hospital. Though whether a T could visit you or not would probably depend on hospital policy (and in the case of a p-doc, whether they had privileges at that hospital).

[Argonautomobile]

You know, I can't say I ever really thought about what would happen after an attempt. I sort of figured the whole idea was to be dead, and therefore no longer in need of a therapist.

When you ponder suicide, are you planning on surviving? What would you hope to gain, if not death?

Either way, I would talk to your T about the ideation. It sounds terrible. Hang in there.

[ruh roh]

Originally Posted by Argonautomobile

You know, I can't say I ever really thought about what would happen after an attempt. I sort of figured the whole idea was to be dead, and therefore no longer in need of a therapist.

When you ponder suicide, are you planning on surviving? What would you hope to gain, if not death?

It's harder to do than you would think, even when you've been thorough. The last thing anyone needs is to have their commitment questioned.

[Argonautomobile]

Originally Posted by ruh roh

It's harder to do than you would think, even when you've been thorough. The last thing anyone needs is to have their commitment questioned.

I wasn't trying to be an asshole, I was trying to understand. I apologize if my comment was unsupportive.

[bounceback]

I know the clinic where I used to go they didn't like dealing with suicidal clients much. Usually when you start there you are made to do a safety plan and given the crisis number hotline to call. I had a friend who made several suicide attempts. The clinic I was at dealt with people who were higher functioning mentally ill. Anyway this person got sent back to the other clinic where they treated lower functioning mentally ill clients. That kind of prevented me when I had suicidal urges and self harm from doing anything too serious. Not saying I hadn't tried. I almost got (demoted) a few times.

Originally Posted by ruh roh

There is no way for anyone here to know how your therapist will respond. They all vary when it comes to this sort of thing. I have had bad experiences with past therapists around this topic, so when it is serious, I keep it to myself. But that's me. My current therapist has never said what her policy is, but her voicemail states to go to the hospital, so I have come to some peace and acceptance that I travel alone when it comes to this issue. (I do share when I'm down, however, just not if I have plans or means.)

Others will have different experiences, though, so if it's a concern and your therapist hasn't said, you might want to just come out and ask.

I did know how my therapist would respond. We planned it out in advance: no police, no hospitals, no legal holds. I had the right to control my life — and death. This was hard for me to believe, but she proved time and again, that I could trust her. Just that fact of having her trust, over time, conquered a life long tape reel that continuously said to kill myself. I know many other licensed professionals would have terminated me ASAP. I had one psychiatrist want my parents to sign a waiver that they would not sue her, in the event of my death by suicide.

Much depends on the therapist and their training and experience with clients who make suicidal gestures or self harm. Some will take it in stride and actually not give it much attention. Others will take it quite seriously and insist on hospitalization which could be an over-reaction if it was just a gesture.

Your questions doesn't seem to be asking about how therapists deal with clients who are truly suicidal and/or seriously harm themselves which is what I based the above answer on.

I was never one to make suicidal gestures and I didn't self-harm. If I made a suicide plan or an attempt, it was not a gesture at all and my therapist and pdoc were very aware of that, so they took any discussion of suicide seriously, but we had really good lines of communication particularly after some time working together. We all learned to distinguish between simply having really down, dark thoughts vs. suicidal thinking vs. suicidal ideation vs suicidal plan. How they responded depended on where I was in that range of thinking. They weren't too concerned if I was just really depressed or even when I had suicidal thoughts, but when I they saw it turn into ideation and rumination their level of concern increased because I could act very quickly and impulsively at that point, and their response changed proportionately. I knew when I was in that range and in trouble though and was pretty willing at that point to do what I needed to do to stay safe, including hospitalization.

[ruh roh]

Originally Posted by Walkedthatroad

I did know how my therapist would respond. We planned it out in advance: no police, no hospitals, no legal holds. I had the right to control my life — and death. This was hard for me to believe, but she proved time and again, that I could trust her. Just that fact of having her trust, over time, conquered a life long tape reel that continuously said to kill myself. I know many other licensed professionals would have terminated me ASAP. I had one psychiatrist want my parents to sign a waiver that they would not sue her, in the event of my death by suicide.

Just to be clear (since you quoted me in your reply): I was saying that no one here can tell the OP how her therapist will respond (which she seemed to be asking at the end of her post), not that no one here knows how their own therapist will respond. That's why I suggested she ask.

Your therapist is very unusual. I like that approach, but I don't know any who would honor it.

Originally Posted by ruh roh

Just to be clear (since you quoted me in your reply): I was saying that no one here can tell the OP how her therapist will respond (which she seemed to be asking at the end of her post), not that no one here knows how their own therapist will respond. That's why I suggested she ask.

Your therapist is very unusual. I like that approach, but I don't know any who would honor it.

Sorry, misread.

[SheHulk07]

I know when I first began seeing T1, and was overdosing for self harm, there got a point where he said I'd need to do residential or inpatient before he'd continue to see me. It was just the need for a higher level of care that he knew he wouldn't be able to provide at that time.

After I ended up in the hospital for severe SH, he saw me the day I was released, and never mentioned dropping me as a patient again. He has occasionally talked about hospitalization again, especially lately, but he says he'd only do it if he thought I was going to try something that day or the next day.

[ThisWayOut]

Totally dependant on the t. I had one leave me after my suicide attempt saying I was "too much of a liability". She told me while I was still inpatient.
Current t has seen me through he'll. She still took me back after I returned to the region. She works well with "intense" clients.

[BudFox]

Sorry you are going through this. I think it's a reasonable question and concern. Seems if a T bolted on you in that circumstance, it would be awfully dangerous. Did your T know you were in that place when you started? Hang in there.

I made allusions to sui despair following termination, and in conversation with my T on the phone she responded with defensiveness.