Couch 218: Northern Minnesota 2050

Is it that he really trusts me to keep my promise and call him before hurting myself? Or does he just think I’ll never actually do it?

Not because I was feeling suicidal at the time, but because the thing from last summer came up, where I'd emailed him on a Friday night saying I was feeling suicidal and also wanting to SH. At the time, he seemed really concerned, though handled it poorly in his email replies, which led to our rupture and my brief termination with him. But then in talking about it recently, he was saying he didn't think I was particularly high risk. And I asked if he just meant in general, like did he think I'd just never do that? Because it concerned me, if he just assumed that about me. That he might not take me seriously if it gets that bad again. Partly because I'm the sort who doesn't want to bother someone, so I'd be more likely to downplay my feelings or say, "I'll be OK" or "I'll stay safe" so that I don't worry them.


He said how much of it is that I tend to tell him about things after the fact, like that I was having ideation the night before or that I had wanted to or engaged in SH (been a while since I've done that though). So the risk had already passed. But he did confirm that he'd take me seriously and not just assume I'd be OK. That he would do a risk assessment, come up with a safety plan if needed, tell me I needed to go to the hospital, etc. Which all made me feel better and "safer" with him.


Something else to consider asking your T--though he may decline to answer--is whether he's ever lost a patient to possible suicide. I think I'd assumed that Dr. T hadn't (which could lead to him being more arrogant about it), then asked him at one point, and he surprisingly answered, and said there had been a few. But that a couple were cases that were unclear, that may have been accidental.