[SheHulk07]

I just want other people's experiences when it comes to talking about SI or SH. It seems like every week, we end up talking about the thoughts within the last 5-10 minutes. Today in my session, my T asked at the last few minutes if there was anything else I needed to say before we ended. I told him there wasn't enough time to talk about it, but he urged me to say what I wanted so I did for 10 minutes and then I left.

I don't know if this is a common thing for Ts not to focus on these issues. He told me the main things he wants to focus on and the SH/SI he knows I have the skills to get through at the least the SI thoughts, and he just checks in.

But the thoughts and urges are getting worse and more frequent (which I told him that). I don't have any other outlet to get these thoughts out, so maybe it's worth spending more time on.

[skeksi]

This has been a topic for me recently, as I've struggled with thoughts. T never brings it up, but when I do, he mostly just listens. Sometimes I talk about how ashamed I am of the thoughts and he will say something like he's with me (which helps--I worry a lot about him being disgusted by this stuff).

I think he doesn't talk a lot about the SI so I don't fixate on it and because it's related to the other stuff we are doing in therapy--it's a symptom of how much is stirred up for me. So he focuses on helping managing the other stuff, I guess.

[SheHulk07]

Originally Posted by skeksi

This has been a topic for me recently, as I've struggled with thoughts. T never Briggs it up, but when I do, he mostly just listens. Sometimes I talk about how ashamed I am of the thoughts and he will say something like he's with me (which helps--I worry a lot about him being disgusted by this stuff).

I think he doesn't talk a lot about the SI so I don't fixate on it and early because it's related to the other stuff we are doing in therapy--it's a symptom of how much is stirred up for me. So he focuses on helping managing the other stuff, I guess.

I think that's how my T views it, as it's a reflection of how overwhelmed and hurt I am right now. So he tries to help me manage that stuff.

[MobiusPsyche]

We don't focus on it; we do check in about it though. My t says it can be a way of me avoiding dealing with other things. That does match my experience in some ways but she is supportive if I say that I really do need to talk about the urges in more detail. We did that today, after talking about the issue that brought up the self-harm urges to begin with.

[SheHulk07]

Originally Posted by MobiusPsyche

We don't focus on it; we do check in about it though. My t says it can be a way of me avoiding dealing with other things. That does match my experience in some ways but she is supportive if I say that I really do need to talk about the urges in more detail. We did that today, after talking about the issue that brought up the self-harm urges to begin with.

Do you just say you need to talk more in detail? Or does your T push for more details based on what you say? I don't really know how to bring it up besides at the end in our check in/out thing.

[MobiusPsyche]

My t doesn't push for details beyond what is necessary to determine how safe I am. It's very important that I be safe from suicidal behavior, that I verbalize that I will call the hotline if I need to. We generally don't talk about my plans or my ideas on how to hurt myself unless I express the need to do so.

My t wants to be sure I'm safe and she helps me come up with alternatives, and evaluate how well those alternatives work (or don't work), and come up with more alternatives. It's all about dealing with and tolerating negative emotions and urges to self-harm.

We don't usually talk about how exactly I want to self-harm...but if I said I needed to talk about that we could. That has happened in the past when I was having disturbing images about self-harm.

[SheHulk07]

Originally Posted by MobiusPsyche

My t doesn't push for details beyond what is necessary to determine how safe I am. It's very important that I be safe from suicidal behavior, that I verbalize that I will call the hotline if I need to. We generally don't talk about my plans or my ideas on how to hurt myself unless I express the need to do so.

My t wants to be sure I'm safe and she helps me come up with alternatives, and evaluate how well those alternatives work (or don't work), and come up with more alternatives. It's all about dealing with and tolerating negative emotions and urges to self-harm.

We don't usually talk about how exactly I want to self-harm...but if I said I needed to talk about that we could. That has happened in the past when I was having disturbing images about self-harm.

That's seems to be what my T does about emphasizing to keep using the hotlines if I need to, and let him know if the thoughts are worse. We do talk about the thoughts and the ways I think of doing things, because it helps me not feel so ashamed of them.

[ScarletPimpernel]

My T only checks-in about the SI/SUI thoughts if I bring up that I'm struggling with them. And then she only makes sure I'm safe. If I can't promise my safety then she'll call the police on me if I don't agree to take myself to the hospital. Only in the beginning of our relationship did I talk details about the thoughts. She said she needed to know how "bad" bad is. Every once in a while I'll still tell her though.

My Pdoc is slightly different. She doesn't go into much detail either. But she wants to keep me out of the hospital at all costs even if that means I have to leave her and go to county. The only benefit county has is emergency appts.

[BlessedRhiannon]

My T has always let me set the pace when it comes to SH/SI thoughts and actions. If I want to talk about it, she's more than willing to listen. If I don't want to talk about it, that's okay too. When I'm really struggling emotionally, she will just check in and see how I'm doing with SH and if we need to devote some time to it. My T knows what kind of situations can trigger my SH, so if I'm dealing with one of those situations, she will make sure that I remember my alternate coping skills, and just ask me about the SH urges.

Mostly, my T has tried to focus on the reasons why I self harm. What purpose does it serve for me. How can I get those needs met with something less harmful. She doesn't focus on the act itself so much as the reasons behind the act.

[kecanoe]

If I am troubled by strong SI I tell t1. He will talk about it as much as I want to. Today I said that I didn't want to talk about it. He did ask me if I would stay safe. I told him probably.
I figure no t's knows what is going on in my head as much as I do, so I bring it up early in the session. I would not like to tell t that I was suicidal in the last few minutes of a session. But for me, it is always hard to leave. I am afraid to do anything to make leaving worse.

[rothfan6]

I only bring up SI when its bothering me, my T doesnt usually ask about it. But hes willing to talk about it and go over a safety plan if I need to. Remind me I can reach out to him or a crisis line. He will bring up SH if i'm stressed and have a lot going on. He knows half the time I wont tell him I did SH or am struggling with the urge unless he asks.

[Cinnamon_Stick]

I openly talk to my T about SI/SH. She asked about it at first and now she waits for me to bring it up. She is wiling to talk about it and has helped me make a crisis plan.

[SheHulk07]

I appreciate everyone's experiences about it. My T knows that the thoughts and urges reflect how much I'm anxious/depressed, so we've been focusing on what I can do about the situation. I desperately need to bring it up next session before the end of the appointment.

[rothfan6]

Originally Posted by SheHulk07

I appreciate everyone's experiences about it. My T knows that the thoughts and urges reflect how much I'm anxious/depressed, so we've been focusing on what I can do about the situation. I desperately need to bring it up next session before the end of the appointment.

Can you write ahead of time and tell them that's what you want to talk about that session? Then maybe they can bring it up. Mine usually asks at the beginning what's on my mind or what do I want to talk about but it's not always easy to answer in the moment.

[Chummy2]

I have only talked to my other T about it. Last year (2015) it was very bad. I had a lot of thoughts about it, every day several times. Also lots of urges. I've told my T about it, but we haven't really talked about it. She didn't really asked questions about it, she focused more on why I was feeling so bad and such. I got the feeling she didn't really want to talk about those thoughts (not just from one time). She never asked about it herself. And I didn't brought it up again, while I did felt the need to talk about it.
Maybe she's still too young and unexperienced with clients with SI thoughts?

Current T has asked me about it, but I haven't have those thoughts/urges that often anymore (just the wish to be dead, but not really active thoughts about it).

Previous T's has also not asked me about it. I've only been asked about it in those intake-forms.

[SheHulk07]

Originally Posted by rothfan6

Can you write ahead of time and tell them that's what you want to talk about that session? Then maybe they can bring it up. Mine usually asks at the beginning what's on my mind or what do I want to talk about but it's not always easy to answer in the moment.

He does ask me what's on my mind, or what I want to talk about. I always veer off, because I'm ashamed and scared of how bad the thoughts have been. I just need to bite the bullet and say it thenI need to talk about it. Or take your suggestion and write it down and give it to him.

[SheHulk07]

Originally Posted by Chummy2

I have only talked to my other T about it. Last year (2015) it was very bad. I had a lot of thoughts about it, every day several times. Also lots of urges. I've told my T about it, but we haven't really talked about it. She didn't really asked questions about it, she focused more on why I was feeling so bad and such. I got the feeling she didn't really want to talk about those thoughts (not just from one time). She never asked about it herself. And I didn't brought it up again, while I did felt the need to talk about it.
Maybe she's still too young and unexperienced with clients with SI thoughts?

Current T has asked me about it, but I haven't have those thoughts/urges that often anymore (just the wish to be dead, but not really active thoughts about it).

Previous T's has also not asked me about it. I've only been asked about it in those intake-forms.

He does ask about it a lot without me bringing it up, which is helpful, but we seem to get so into the main reason why I'm having the thoughts in the first place. He'll definitely talk through the thoughts with me if we have time, but it's usually been at the end. Like how's the thoughts been, how about the SH type thing.

[rothfan6]

Its tough to do. Ive sat there for a lot of long silences trying to say whats on my mind. Sometimes it works, other times I write it and send it later. Sometimes it helps to just say one word related to the topic and my T will try to help ask questions to fill in the rest. Like if its a topic we talked about recently or a feeling. Maybe ask him if he could bring it up more often. Check in with you on how the thoughts are.

[rothfan6]

You could also do a code word. Sounds silly but I have two with my T. One for being withdrawn and disconnected and not able to reach out and the other for when he's getting close to a trigger or I have been triggered. Yours could be for SI/SH thoughts that you want to bring up and talk about.

[SheHulk07]

Originally Posted by rothfan6

You could also do a code word. Sounds silly but I have two with my T. One for being withdrawn and disconnected and not able to reach out and the other for when he's getting close to a trigger or I have been triggered. Yours could be for SI/SH thoughts that you want to bring up and talk about.

I like that idea of using a word, it might be an easier way into the topic.

[HereAndThere]

I brought it up once to my (recently terminated) T, and the first word out of his mouth was liability. He's said if I kill myself he could be taken to court. My last appointment I tried to bring it up again, and he was still worried about liability.

[kecanoe]

Originally Posted by HereAndThere

I brought it up once to my (recently terminated) T, and the first word out of his mouth was liability. He's said if I kill myself he could be taken to court. My last appointment I tried to bring it up again, and he was still worried about liability.

jerk. Total jerk

[TishaBuv]

I got into a hitting myself SH over extreme stress and frustration over one problem within one relationship. I've done it approx. a dozen times in ten years.

When I told my last psych about it, and said I want to stop doing it, he said 'Stop doing it!'

I self harm infrequently. I usually confess per email and then we talk about it and dissect it next session.

We talk about suicidality sometimes, always brought up by T - I've been suicidal for about 2,5 years now, and I really don't see the point in talking about it. T wants to bring it up every once in a while to make sure there's space to talk about it if I want to, but it's not really important to me.

[SheHulk07]

Originally Posted by kecanoe

jerk. Total jerk

That's bull. I don't think I could work with a T that was worried about liability. I know my T tells me, "that won't kill you", but it's done in a way to determine me from it.