[SarahSweden]

I have recurring suicide thoughts and thoughts about that I don´t want to live but I´ve never attempted to kill myself nor do I plan to do it in a close future. It´s more of comforting thoughts to know there is "a way out".


I´ve told my current T about my thoughts several times and I´m a bit afraid that she´ll think that I need another therapist and that my suicide thoughts are a sign therapy isn´t working.

I don´t see it that way though as my suicide thoughts would be there even if I didn´t meet with my T as they have grounds in how I grew up, in loneliness and such.

[Carmina]

I don't see why, I have these sort of thoughts most days. I've come to realise they are a way of giving myself an option more than a desire to kill myself. Often I feel trapped and have no way out so if anything this is not a sign of therapy not working, but a coping mechanism which you have become aware of (which may be a sign that you are becoming more insightful and also are able to live with them better - whether that is attributable to therapy or just you is another question)

[Anne2.0]

Nobody is in charge of what another person thinks, but my T seems to think that suicidal thoughts, even if repeated, are normal within the population of people that go to therapy.

Whether it has anything to do with progress in therapy, that's an individual consideration. But why not have a conversation about this with your T?

[Salmon77]

It seems unlikely to me that this would be cause for termination. What did she say when you told her about these thoughts?

A couple of your recent threads have brought up termination, either you thinking about terminating or worried she will terminate... maybe it would be good to think about why you're worrying about how therapy will end, and talk to her about it.

[SlumberKitty]

I don't think re-occurring suicidal thoughts are a reason for termination. I have them all the time and none of my t's (currently I am on T4) has ever terminated me for suicidal thoughts. But no one can really know the answer to this question besides your T. Why not bring it up in therapy and see what happens? You may be surprised at what your T says and it may give you some reassurance.

[velcro003]

Not for me, they aren’t. My T knows suicidal thoughts are always at least lurking around, even if i’m not talking about it. She also knows i find comfort in knowing there is a way out. She has yet to kick me out

[peacelizard]

I can't imagine why. If anything, it's more about how hard you work in therapy, not whether they go away. Because for some people, they never do and you have to learn how to cope with it.

I could also see potential cause for concern depending on your track record of acting or not acting on these thoughts and the level of lethality used.. But even then, I don't think most therapists would drop you

[Ididitmyway]

I believe, everyone has suicidal thoughts every now and then and many people have recurrent suicidal thoughts. It's a perfectly normal reaction to the world that is harsh, largely unjust and certainly not conducive for unfolding our true potential.

I don't see why this would be a reason for terminating therapy. Moreover, it'd be unethical for a T to terminate a client who is currently feeling suicidal. It's incredibly inhumane to terminate a person who is in such a vulnerable state. Here, in the US, this would qualify as client abandonment and would be a subject for a disciplinary action.

[mostlylurking]

Originally Posted by Ididitmyway

Moreover, it'd be unethical for a T to terminate a client who is currently feeling suicidal. It's incredibly inhumane to terminate a person who is in such a vulnerable state. Here, in the US, this would qualify as client abandonment and would be a subject for a disciplinary action.

I'm surprised to learn this is the case, as I think I remember a few people here on the forum who were terminated following a suicide attempt, because their serious thoughts had not diminished, or due to increasing self-harm, all under the theory that they must need different or more specialized care.

I absolutely agree with you that it is incredibly inhumane. But that's never given the professional organizations pause when writing their guidelines for treatment. Give a referral and you're golden -- that's "continuity of care". Not trying to argue with you Ididitmyway, my surprise here is genuine and not sarcastic. I didn't think they saw anything wrong with termination for virtually any reason at any time.

[mostlylurking]

Originally Posted by SarahSweden

I have recurring suicide thoughts and thoughts about that I don´t want to live but I´ve never attempted to kill myself nor do I plan to do it in a close future. It´s more of comforting thoughts to know there is "a way out".

I think if / when you bring this up to her you should explain it's a comfort to you, to think there is a theoretical escape. It's not about making plans -- it's just about feeling less trapped, it sounds like. I don't think those feelings are unusual, I agree with others here that they are quite common.

[PurpleBlur]

Originally Posted by SarahSweden

I have recurring suicide thoughts and thoughts about that I don´t want to live but I´ve never attempted to kill myself nor do I plan to do it in a close future. It´s more of comforting thoughts to know there is "a way out".


I´ve told my current T about my thoughts several times and I´m a bit afraid that she´ll think that I need another therapist and that my suicide thoughts are a sign therapy isn´t working.

I don´t see it that way though as my suicide thoughts would be there even if I didn´t meet with my T as they have grounds in how I grew up, in loneliness and such.

only if they scare the T and they cany handle it (interns, or poorly skilled licensed therapists)

[amandalouise]

I cant speak for your location, Sweden, but here in america each mental health agency has their own rules that they must follow when they have a client with suicidal thoughts or actions.

sometimes that does mean they have to stop seeing them for a bit.
sometimes it means the person needs to go into a mental hospital so that they can get the special help that they need to stop the thoughts.

my suggestion is talk with your therapist and ask them whether they have tos top seeing you if you continue to be suicidal and whether it may mean you might have to go in the hospital and get seen by hospital psychiatrists/ therapists for a bit.

your therapist will let you what rules they have to follow when they have a suicidal person.

[nottrustin]

I don't think most Ts will if they are just thoughts with no intentions or plans. Both my Ts know I have them but they both know I would never do it because I couldn't hurt my children like that.

In my job I have seen it happen a couple of times over the years. It has been after serious attempts where the Ts feel unable to provide the level of care for the client

[Ididitmyway]

Originally Posted by mostlylurking

I'm surprised to learn this is the case, as I think I remember a few people here on the forum who were terminated following a suicide attempt, because their serious thoughts had not diminished, or due to increasing self-harm, all under the theory that they must need different or more specialized care.

I absolutely agree with you that it is incredibly inhumane. But that's never given the professional organizations pause when writing their guidelines for treatment. Give a referral and you're golden -- that's "continuity of care". Not trying to argue with you Ididitmyway, my surprise here is genuine and not sarcastic. I didn't think they saw anything wrong with termination for virtually any reason at any time.

You are right in the sense that if a T has given a referral then it's not considered an abandonment and the T is off the hook, which is a ridiculously low standard for abandonment IMO. When I said it was unethical for a T to terminate a client in a vulnerable state I was speaking of the "spirit" of the law as opposed to the "letter" of the law.

The way a non-abandonment "should" work IMO is that suicidal ideations need to be taken more seriously than they are currently being taken. That is to say that a T really needs to encourage a deep conversation about it instead of brushing it off just because they feel uncomfortable with the subject, which is what often happens. Also, clients who are currently experiencing suicidal feelings need to be seen more often so they would feel more supported. I believe, these steps would prevent suicidal feelings developing into the next stage when the person would feel the urge to act on them. When the person is actively suicidal and has the intention and the plan to do that, this already goes beyond therapy talk. This is the time when more serious measures need to be taken such as admitting the person to a hospital, but this, again, is the duty of the current therapist to alert authorities such as PET and police who can initiate hospitalization and after the person gets stable, the T should meet with them again to assess how they would proceed and if it's necessary to change the level of care.

After the suicide attempt, I can understand logically why the current T would want to refer the client out. In the sense, the suicidal attempt is the evidence of the T's failure to help the client and ethically they cannot continue to work with the client if they believe they are unable to help them. But the way people are referred out is very much like dumping them. There has to be a transition period from the old T to a new one and, at the very least, the old T should make sure that the new one has openings in their schedule and is willing to take on a new commitment.

Also, if things have gotten to a point of an actual suicidal attempt, the T needs to take a very hard look at how they've been working with the client and why they weren't able to detect the danger earlier.

But what the OP is discussing is not even close to that dangerous situation. It looks like a very common manifestation of depression which many people have. This is something for the T to take seriously but not to "freak out" about. As I said before, suicidal feelings IMO are an indication for a therapist to be more engaged with and supportive of the client, which is the opposite of terminating their work with them.

[amandalouise]

yes I agree that its common for people to have suicidal thoughts.... and that sometimes the wrong things happen when a person has just thoughts....

that said when I was having suicidal thoughts and a past treatment provider took the time to explain to me why he was doing what he was doing. slowing down therapy and referring me out to the hospital, I saw exactly what he was doing, not to mention witnessed the situaiton myself on a job related problem.

things have changed in the world we live in now. many times when you see things on the news or go through it where someone has committed violent crimes and took or tried to take their own life or forced the police to take that life. it comes out that that persons treatment providers and sometimes family and friends knew this person had a history of suicidal not act upon thoughts. and have told people. evidence of this is the many school shootings, college shootings and other such situaitons.

its sad to say but we live in a world where having suicidal thoughts and then later acting on them happens when everyone just chalked it up to things like its common, dont get the person specialized help, keep therapy going as is and thats what therapy is for right ... you know all those odd remarks a person may hear when someone they know says something like I am thinking of.... I feel like I want to... my therapist knows i...

as a result of this many USA towns, cities and mental health agencies have whats called zero tolerance laws/ rules. protocals where Suicidal thoughts are treated very seriously and certain things must happen in order to diffuse the situation.

in my situation that meant stopping therapy, until those thoughts were no more of an issue.

another personal situation. I was a volunteer with a domestic violence program. the spouse of the programs client had a history of suicidal thoughts. never in decades acted on those thoughts. the spouses therapist treated is as a here we go again he's not going to do anything to hurt himself these are just thoughts because of his life situations. that therapist is now dead. that spouse of the programs client, went to a therapy session with a gun. then he proceeded to the local hospital where I and the client were waiting to be seen. the programs client is now dead, along with the spouse that had suicidal thoughts that were not being resolved. a Er room full of witnesses now had to deal with PTSD from witnessing this crime. I still have PTSD issues because of this and quit volunteering with domestic violence agencies.

my point yes its hard having suicidal thoughts and being told a therapist cant see you/ me and anyone else aany more because these thoughts are not being resolved. but for the safety of that therapist and others that may encounter this situation those zero tolerance laws/ rules./ protocals have to be followed.

how my own treatment providers and I worked out this situation is/ was that any time I see a new treatment provider I ask them what their responsibilities are, what mine are, and what their rules are on things like self injury and suicide, both thoughts and actions. that way from the beginning I know what is expected of me and what I can expect from the mental health agency and my therapist, and what resources there are for helping me in this situation.

[velcro003]

i am not sure how suicidal thoughts suddenly turn into homicidal thoughts in all of your examples.

[amandalouise]

Originally Posted by velcro003

i am not sure how suicidal thoughts suddenly turn into homicidal thoughts in all of your examples.

sometimes people want to commit suicide but they dont want to do it themselves so they force others to do it for them by hurting others. some places call this suicide by cop, where someone who has suicidal thoughts and because of those thoughts wants to act on them, they go to public places and harm others foring the police to protect the public and bring them down with lethal force. thats what happened ... this spouse had these suicidal thoughts for many years that never got resolved, and like an unhealing sore it just kept festering/ building and staying in there until finally this person couldnt stand it anymore, went and killed their therapist and then went to the hospital ER killed the wife (client of the domestic violence program I was volunteering with) and threatened others in the ER. which forced the police to use lethal force. (death by cop/ suicide by cop situation)

if you would like more information on how unresolved suicidal thoughts can turn into homicide contact your local police department, they can go through actual cases to help you to understand how and why this happens.

you can also watch headline news, CNN and your local news networks that do stories where someone has committed crimes and then while doing their investigations the police discover the person was having these thoughts.

I cant go into any further details here because it could trigger others.

[velcro003]

Oh, i mean i understand the phenomenon, but you made it sound like most suicidal people will turn homicidal.

[amandalouise]

Originally Posted by velcro003

Oh, i mean i understand the phenomenon, but you made it sound like most suicidal people will turn homicidal.

Im sorry I thought I was clear by including the wording....

"sometimes when you watch the news..."

"many times when....."

"when I was...."

"Another personal situation...."

"sometimes people want to......."

"some places call this......"

"many USA towns....."

my point Im sorry you thought my post meant in every single situation in the whole world..... but thats not what I meant.

I was speaking about the situaitons I have actually gone through, the situaitons that I watched on tv (school shootings and so on) as it was unfolding on live tv. and the reports and investigations after the crimes.

I was not saying every single person with suicidal thoughts are going to do this....

my post was just explaining how and why mental health agencies do terminate when they have someone with suicidal thoughts that dont get better. in some locations its the state and city laws and mental health agencies have to follow set rules on what to do in order to follow those laws.

you can find out where your location stands on zero tolerance laws, and mental health agency rules are for when their therapists have clients that dont get better, or have unresolved suicidal thoughts that never get better.

[Taylor27]

I have mentioned suicide thoughts to my therapist quite often and he has never mentioned termination. He has helped me by increasing sessions, day program. I highly doubt your therapist will terminate you infact she might be able to help you more hugs

[kecanoe]

From reading this, obviously there is a wide variety of how Ts respond. T1 has hung in there with me being intensely suicidal for years. So some Ts will do that.

I feel a need to say that being hospitalized (in my experience) does not help with the thoughts. It does give a safe place and allow for some time to pass which often helps a suicidal person to figure something else out. But it is not a long term solution for a person who wants to suicide.