Has your therapist had a client...[TRIGGER]

Actually the psychiatrist more or less said it was a choice in her view. And as she's the one with the malpractice insurance, I'm not sure about a party line.

Do therapists have malpractice insurance? I mean, I assume anyone can get it if they pay for it, but do therapists commonly use it? (I guess I mean solo or private practitioners here.)

The phds and lcsws I know obtain malpractice insurance.

"The therapist said they would see their job as preventing her from commiting suicide "

This is the party line to which I was referring

But isn't that everyone's party line? The state's, the law's, society's? Even some of those who are suicidal talking to other people who are suicidal?

I said it was the party line - not their's exclusively.

It is not my personal one - but further than that here would get me censored if not outright banned.

I know we're not Woody Allen fans here, but a line from Annie Hall i think sticks with me: "as long as there is one miserable person in the world, i cant be happy." So along the same lines, its two things for me - i dont want any of my younger relatives to see it as an option because of my example; and as long as there is someone who i could help, its kinda my duty to stay. So its not so much, or just, who i affect by leaving, but who i could have affected by staying. You never know. Obviously i think pretty highly of my potential, because my reality is crap.

I had a psychiatrist who practiced without malpractice insurance. He was a solo practitioner not connected to a hospital. Unfortunately.

The question never came up before I saw him.

Apparently, it's not against the law to practice psychiatry without malpractice insurance in some states.

Buyer beware..

That's something T pointed out to me...my grandmother's sui showed me that it was possible...it was a viable option.

There have been surveys done of medical personnel in general who have been involved in unexpected patient deaths, whether from known but unexpected factors or accidental factors, that reveal increased rates of emotional distress, substance abuse, etc, among practitioners. Many hospitals have instituted mandatory counseling for those involved, even as observers.

I never asked my T while in therapy. But in his position as the director of a University counseling center, and knowing there have been a number of suicides on campus over the years, I assume he had some involvement, even if the individuals were not in therapy with him, his interns, or at the center. I know when I came close, and only informed him after the fact (it was during a vacation break), he took it very seriously and compassionately, put some safety measures in place, and made it very clear that he wanted me to contact him immediately if that urge arose, 3AM or not.

He did tell me a couple of years ago, post retirement, of the suicide of one of his friends. Although the man's friends had no inkling, he had apparently told his wife of his intention, as a result of a number of health problems with poor prognosis. My T seemed to take it with regret, yet acceptance.

I've never asked my T, but based on his prior practice and amount of years in the field I'm pretty sure it happened to him at least once. He's pretty stand-offish outside of the room, so I'm sure he has his walls in place. (Or at least his wife makes him have it, from the last time I called him at home.)

Apologies for not knowing how to insert a trigger. I hope the mods will. This is what my T is doing with me. She wishes/ hopes I won't, but accepts it's my choice and very likely. I specifically asked her to keep me company on that journey. She said it's hard but she has a good clinical supervisor. It is the most reassuring thing anyone has ever said to me, and has helped me the most.

T1 had a nephew commit suicide. He was not seeing the nephew as a T, obviously, but he had referred the nephew to professionals he knew for help and was setting it up for nephew to go to Mayo Clinic (big state of the art diagnostic/treatment place in the US that clients go to from all over). It pretty much wrecked him. I learned of the suicide from someone else and it came up in session several times as I was leaning in that direction myself.

Pdoc shared about a patient's suicide in an Alcoholics Anonymous meeting that we both attended. He cried. That fact helped keep me alive. It kind of ruined the "nobody will care if I am gone" thought for me.

yes, and it devastated her

I don't understand what difference it makes about how a therapist feels about anything a client does - including suicide.(This is not an endorsement of any sort - just that I don't see what the therapist's response has to do with it)
Does the mere act of hiring one of them somehow give them a vote about what a client chooses to do with their own life? If they become upset that a client gives up custody of a child or drinks or takes drugs a therapist does not approve of or anything else - so what?

I think they tend to become a bit melodramatic over certain areas (csa comes to mind in my experience) but I think some (or in my case all of it from the therapist) of that is for effect.

Is this the sort of thing where people use the therapist for a reason as a safe placeholder? If it works - I think it is a good idea - I am just trying to understand it.
(Ps. I always think we are talking about voldemort in threads where he who must not be named is mentioned)

Well, I think most would prefer that their clients stay alive because fairly or not, if they die, there is a connotation that the T wasn't effective. There is also the potential for legal action that most would prefer to avoid. And I think implicit in the profession's philosophy--not every individual practitioner necessarily--is to protect life. That even holds true within most mainstream medical practice philosophy, even among those involved strictly with palliative care.

Beyond the cultural logistics, I think it can be much the same in any "helping" profession. I would prefer that my students not kill themselves. Have I experienced student suicides: yes. While there was no reason for me to feel any responsibility for their actions, I felt regret about their actions; and had they confided in me, I would have done whatever I could have to support them in finding other alternatives. I don't know why Ts would be exempt from such a basic response.

I don't not understand various reasons why a therapist does not stray from the party line. What I don't understand is why their reaction (even if I grant that they may express a true one) matters.

I have known people (ranging from a very close friend to a student -both when I was a student and since I have been a teacher- to clients of mine) who made such a choice. Certainly I was not happy - but I can't honestly say I was devastated or unhinged in any way over the manner of passing. Cancer or car wreck would have induced the same degree of sadness for my close friend. The others it was more of a general that is too bad - but I personally was not distraught. I don't consider it to even be my place to have been such. I feel the same way about the therapist. It just is not their place.

Isnt it kinda like giving yourself a haircut? My hairdresser is always like, what did you do to yourself this time?

Well some people can feel overwhelmed with guilt. If I was too busy to give my friend a ride when she asked, then she later got killed in a train accident, I might feel it is partly my fault that she died. My actions could have prevented it (not that any of my actions were right or wrong).

Maybe some would want to protect another from those kinds of feelings.

I would not feel guilty in those circumstances. I can't really think of a situation where I would think I could (or really even would try - I believe in respecting choice) have prevented anything. But how someone else feels is not my problem unless I have actively undertaken to do something to them directly. I don't think it is a client's job to take care of a therapist's feelings

But I think good therapists for the right reasons--and bad therapists for the wrong reasons--do feel more of an emotional investment in their clients' lives than you recognize or want. Part of their assessment (echoed by the culture, I think) of their role is about the degree to which the personal is engaged within the professional. More so than with teachers in most situations. Interestingly, this is culturally determined: teachers at all levels in Japan are seen and see themselves as far more personally engaged as professionals.

As far as the level of investment and emotional reaction, I suppose for me personally, as well as professionally, the reason suicide feels different from a car wreck or disease is that I have more belief that the suicide decision could be subject to influence, whereas the disease or accident feels more beyond influence. In personal circumstances, I have no professional relationship to feel an obligation towards. In a professional capacity, my feelings are subject to my role.

I am not, for the purposes of this discussion, questioning the therapist's feelings or that they might (for whatever reasons they might have) become upset. What I am questioning is what/why difference those feelings make to a client. It is not a consideration on my radar when making decisions and I don't believe there is any reason or anything that would ever make it part of my decision making process.

Sure, its not the client's job. But perhaps some in therapy have patterns of enmeshment from FOO hx.

It's not the client's job to take care of a T's feelings ever. But being invested in what one's T feels is not always pathological. It can be a very healthy human response. I don't believe that the usual suicidal client encountered by a T is making a conscious and rational decision. If they were, then it probably wouldn't matter to them what the T thought or felt. If there were no internal conflict about the decision, why involve a T at all, unless one is in a state where planned suicide is legal--but that would entirely change the dynamic of the interaction on both sides.

I don't know if any T I've ever worked with faced this problem, I didn't ask. I do know a friend who was a T, who was working with a high school student, who committed S. She had a very hard time following the young man's death. She questioned everything she did professionally after this happened; she ended up changing careers about two years later and although she never said this career change was due to what happened, I think it did have some impact on her decision. I'm not saying that she complained or whined about what happened to everyone who interacted with her, on the contrary, she rarely talked about the incident, but I and a few other friends knew that it shook her to her core.

I do think that people have varying degrees of empathy or understanding for incidents such as this. Personally, I think that teachers, doctors, massage therapists, hairdressers, neighbors, family members etc. can all have different levels of response to the S of someone that they know or care about. Some will react with a deep personal level of understanding/horror/regret/sadness whatever. Some will feel a fleeting degree of emotion and move on, seeing it as a personal choice of someone who was suffering and decided on a course of action that differed from what he/she might decide (and of course there are some who will brush it off as cowardly or a moral failing--not my choice and difficult for me to understand) But in any case, the way a person react is individual and personal. I don't think that any one group can claim a lesser or greater degree of pain or regret. I think each of us react individually and at a level we, personally feel connected to the individual and no one else can tell us what we feel is wrong or out of proportion.

I do feel, however, that in our litigious society, many professionals feel a gut wrenching fear when someone they are working with commits S (whether that be the general practitioner who has a patient who comes into the office complaining of being depressed or a T who is actively working with a client contemplating or expressing S ideation). No person wants to face the possibility that they might lose their license to practice and earn a living.