discussing suicidal thoughts with a therapist

hi i posted in here a few days ago about wanting to start therapy, and thank you for all of your response. i did get a message today and will hopefully be able to set something up tomorrow appointment wise.

i have another question though. i was wondering if therapists are required by law to take any action if you tell them that you're having thoughts of suicide, like if they have to report it to someone or hospitalize you. i don't think that i'm actually "suicidal", as in i wouldn't really make an attempt but the thoughts keep creeping in and tonight has been the worst to date. i'm afraid that if i do let a therapist know they may try to intervene in a way that would seriously throw my life and career off track and i just can't deal with that.

if you explain what is causing those thouights they can help you need to them everything that is throwing your life off track so you a can be properly diognosed i was supposed to be seeing this psycologist and when they were doing an assement thought it would be better if i saw a different my appointment is this afternoon and because of my emotional state they dont think medications will be nessessary. i just need some counselling

There is a difference between suicidal thoughts and the actual intent to go through with it. Most therapists will want to keep you out of the hospital so that you can keep your life moving forward and learn to cope in the actual settings you need to cope in. If you can convincingly explain why you will not act on those thoughts, you won't have anything to worry about.

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all4themusic said:
hi i posted in here a few days ago about wanting to start therapy, and thank you for all of your response. i did get a message today and will hopefully be able to set something up tomorrow appointment wise.

i have another question though. i was wondering if therapists are required by law to take any action if you tell them that you're having thoughts of suicide, like if they have to report it to someone or hospitalize you. i don't think that i'm actually "suicidal", as in i wouldn't really make an attempt but the thoughts keep creeping in and tonight has been the worst to date. i'm afraid that if i do let a therapist know they may try to intervene in a way that would seriously throw my life and career off track and i just can't deal with that.

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A musician in my midst? Excellent.
No, therapists don't LIKE to put people in a hospital environment (LOL that's for those hospital crazy psychiatrists), and it's perfectly normal to have suicidal ideation AKA suicidal THOUGHTS. Talking about it with the therapist will usually make the person feel better, even if it's just a wee little bit at first. Your therapist hears this sort of thing, gosh... probably AT LEAST every day, and more than likely, more than once a day. They are experts at handling such volatile emotional states, and they will do their very best to keep you out of the psychiatric ward. Even homicidal ideation isn't that uncommon... INTENT is what matters. He'll probably be very direct in asking if you have any intentions or plans and means to do so, but don't be thrown off by his directness or the oddity of the discussion.

Please do talk about it though. There isn't anything to be scared of, and I promise he won't think you are acting stupid or belittle you or anything. Even the worst therapist I ever had never did that.
After you meet with him for the first time, will you come back and tell me what happened and if he met your expectations?

(((((((((( all4themusic ))))))))))))))
I agree with everybody else that there is a difference between thoughts about something and actually having plans. I was also worried about approaching this subject but when I asked my T about it she said the only way that they can force me to go to the hospital is if I have plans and can't be talked out of them. I hope your appointment goes well.

I've discussed suicidal thoughts frequently with my T, my addictions Dr. and my pdoc, and it's always been ok - in a weird way. They'll probably ask you if you have a plan. If you have a plan it's ok to talk about it, but they'll take that more seriously. You basically have to be able to say that you're feeling or thinking about suicide but won't act on it or have a safety plan. For example, I've made a deal with my T - that if I ever get serious about OD'ing, I'll take myself to my closest ER.

The only time I came close to be admitted involuntarily admitted was last summer, when I was seriously SU, looked a mess and was clearly not coping. My pdoc had been off ill for several months and was shocked when she saw me. She suggested hospitalization, and I said I'd think about it. I e-mailed her about 3 or 4 days later saying I thought it would be a good idea and was admitted within a week. it was only once I was in that she told me that she'd had considered admitting me on a form, which is actually kind of hard to do where I'm at.

Generally T's etc. want to work to keep you out of hospital, as other people have said, so be honest. It's the best way to get help.

Good luck.

--splitimage

This is a very interesting post. It's something I've often wondered myself.

In fact, one of the reasons I delayed seeking psychiatric/psychological treatment for so many years is that I had always been afraid that they would throw me in a psych ward and toss away the key if I so much as mentioned any thoughts of suicice. I found that this was not the case. I was even told by a p-doc that I would be surprised at how common suicidal thoughts/ideation actually is.

My question is this... what constitutes a 'plan'? I was asked this when I was assessed, but I'm not 100% sure what it means. If you've thought about how you would like to do it, is that a plan? Thanks.

Good luck all4themusic!

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Simcha said:

He'll probably be very direct in asking if you have any intentions or plans and means to do so, but don't be thrown off by his directness or the oddity of the discussion.

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Really? I just told my T this last week. I didn't want to tell him because I hate to show such desperation (for me not anyone here).

I told him I wrote about in my journal which I had there with me. Other than asking me why I felt that way and giving me some thoughts to replace those with, he didn't ask any other questions.

He never has actually but I've only stated it a few times.

the reality is that there aren't enough beds in psychiatric hospitals (or on private units) for people who are permanently severely disabled and unable to function at all because of their psychiatric issues much less for every one of us who thinks, "life would be easier if I ate kitty litter until I popped" (trying to be humorous, no plan/intent to eat kitty litter until I pop)

I'd say the most important thing you can do when discussing suicidal thoughts is to be transparent...

be real about the frequency, intensity, duration, etc (happening every minute/hour/month, reactive thought or so strong you had a knife in your hand, fleeting thought or something you can barely shake)

don't fear the hospital, it's not there to hurt if your professionals think you should go... you probably should go... a lot of clients I know see it as a vacation b/c it's a time where they can focus on their lives as individuals without responsibilities of the outside world (that being said, I advocate learning to solve crises in real world situations as the most successful treatment whenever possible)

I have heard everyone has those thoughts at some point, I've had them... most people I know have had them... one of my MOST STABLE friends (she's been a therapist for 7 years) told me one day a few years ago... "are you ever just driving down the road and have to fight the urge to swerve your car into a tree?"

ha...

so, hey, life is a part of death, control is a part of life, so at some point, trying to control death (in one way or another) is going to be a part of life... it's how we deal with it that counts... and being open to sharing that process with your therapist will be key to your survival if it turns out that your thoughts progress to a level you can't control

congrats on starting therapy, i'm doing so again myself within the next few months...and boy do I ever need it!!

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lauren_helene said:
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Simcha said:

He'll probably be very direct in asking if you have any intentions or plans and means to do so, but don't be thrown off by his directness or the oddity of the discussion.

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Really? I just told my T this last week. I didn't want to tell him because I hate to show such desperation (for me not anyone here).

I told him I wrote about in my journal which I had there with me. Other than asking me why I felt that way and giving me some thoughts to replace those with, he didn't ask any other questions.

He never has actually but I've only stated it a few times.

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Hi.
Interesting.
Did he read your journal? If so, he might not have had any other questions.

Usually they do ask you direct questions about suicidal thoughts and suicidal intent. If the therapist knows you pretty well, they might not need to be very blunt. Either way, it's good that you talk about it when you feel that way.