Help Can I tell my therapist about my fear of being committed on a 5150?

[nohopeforethefuture]

Hello everyone. I finally started therapy today. It was a terrifying experience and my best friend was there with me the whole time even tho they didnt really like that he was there. But without him I wouldn't have been able to speak at all, and he wont be able to come back (he made special arrangements for my first visit) so they will be happy with that I guess.

The thing I am afraid of the most - the one thing that will cut through everything and just cause me to skip all the steps and go straight to killing myself - is being committed. I am so terrified of it and absolutely I never ever want to. I have no one, I can't miss work, and I would be separated from my one friend who could help me through this.

I dont know how to tell my therapist this without raising all the red flags. I already opened up about my past suicide "attempts", but lied about having the means/intent to do it currently. I know enough to not bring that up. I am afraid that not being able to tell my therapist this will result in nothing being able to help, but my biggest fear is not being able to talk about how I'm currently feeling at all because I dont want to be committed.

Can I tell my therapist about my fear of being committed, or safely ask what would get me committed, without tipping the scales and actually getting committed right there? I'm scared.

 

[timf]

There are situations in life where one has to live with a sort of sword over your head. Even if the therapy is helpful, that help is greatly diminished by placing you in fear of losing your freedom. In a way it is like telling a person to relax while you hold a gun to their head.

That being said, some people can function under an oppressive situation like they did in the Soviet Union or East Germany. Even today in China people (like Christians) carry out their lives knowing what could happen to them if they reveal the truth about themselves.

This places you in a situation where you can only share partial or even made up information. This may not be enough to get anything useful from the therapist, however, you never know when you might run across a useful nugget of information.

On the positive side, due to financial limits, there is an institutional reluctance to admit or keep people confined. Building trust with a therapist can take a while. Before you share too much, you might want to see how the relationship develops.

 

[nohopeforethefuture]

There are situations in life where one has to live with a sort of sword over your head. Even if the therapy is helpful, that help is greatly diminished by placing you in fear of losing your freedom. In a way it is like telling a person to relax while you hold a gun to their head.

That being said, some people can function under an oppressive situation like they did in the Soviet Union or East Germany. Even today in China people (like Christians) carry out their lives knowing what could happen to them if they reveal the truth about themselves.

This places you in a situation where you can only share partial or even made up information. This may not be enough to get anything useful from the therapist, however, you never know when you might run across a useful nugget of information.

On the positive side, due to financial limits, there is an institutional reluctance to admit or keep people confined. Building trust with a therapist can take a while. Before you share too much, you might want to see how the relationship develops.

Well I might have already screwed up. I have little emotional regulation and so I either share nothing or too much.

I only had my first appointment yesterday and it was just the introductions and getting to know you "why are you here" type stuff. But I did put down that I was suicidal on the form, and I disclosed my past two attempts - but I emphasized that I would never try those ways again (it was two different methods, and I really wouldn't try those again).

I do have another method that I can use right now if I wanted to. And my ideation's been high lately. But I'm not going to tell my therapist that I have a method or that I'm partially actively suicidal. However I would like to discuss the feelings surrounding it and maybe even that I feel like I dont want to be here without being committed. I'm so scared that I dont know what to lie about or what I can admit.

Do you think it would be a bad idea to tell my therapist that I greatly fear being committed? Would that in and of itself - regardless of if we talk about how I feel right now honestly - get me committed? Do you think it would be safe to talk about "not wanting to be here" if I told him I have no means/way of carrying anything out?

Another obstacle is that he told me that if it was getting to the "passive suicidal" point (which I didnt say is already happening) that we could even do more than one session a week (which I want). But I dont know what I can disclose without being locked away. I can't be locked away. I would like to have more than one session a week. But I'm just afraid of what I could say to trigger the worst case scenario.

sorry for all the questions. I'm nervous and scared that I will not get any help because I can't be honest...

 

[Miss_Takes]

I would always advocate being as honest as you can be in therapy. This does not mean you have to share 'everything' all at once because you need to develop a relationship that enables you to feel safe ... and this may take a little time.
I understand the impulse to lay it all out there ... but its ok to ride that line that keeps you feeling safe too.
The therapist has offered an extra session each week if your ideation increases I understand ... was increased ideation a caveat to that or is it possible to ask for the extra session simply because you feel it may be helpful and prevent any increase in ideation? A good therapist will at least consider that the extra session may be helpful whether there is increased ideation or not at this time particularly as you have identified past suicide attempts. It is worth asking the question.
Its hard to say what you can comfortably disclose re current ideation before a therapist will consider there to be serious enough risk of harm to self to require a more intensive intervention.
In my experience (re suicidality in my country) inpatient treatment is mostly (but not exclusively) reserved for current acute and imminent (active intention, access to means, ability to complete) risk of harm to self or others. However there may be other factors that have not been identified that could have an impact on the level of intervention.
I would like to think that any intervention would begin at the lower end of the scale and move through a range of options before the most intensive are applied.
Im not sure if that has helped but I do hope you are able to find some help in therapy and I wish you well.

 

[nohopeforethefuture]

I would always advocate being as honest as you can be in therapy. This does not mean you have to share 'everything' all at once because you need to develop a relationship that enables you to feel safe ... and this may take a little time.
I understand the impulse to lay it all out there ... but its ok to ride that line that keeps you feeling safe too.
The therapist has offered an extra session each week if your ideation increases I understand ... was increased ideation a caveat to that or is it possible to ask for the extra session simply because you feel it may be helpful and prevent any increase in ideation? A good therapist will at least consider that the extra session may be helpful whether there is increased ideation or not at this time particularly as you have identified past suicide attempts. It is worth asking the question.
Its hard to say what you can comfortably disclose re current ideation before a therapist will consider there to be serious enough risk of harm to self to require a more intensive intervention.
In my experience (re suicidality in my country) inpatient treatment is mostly (but not exclusively) reserved for current acute and imminent (active intention, access to means, ability to complete) risk of harm to self or others. However there may be other factors that have not been identified that could have an impact on the level of intervention.
I would like to think that any intervention would begin at the lower end of the scale and move through a range of options before the most intensive are applied.
Im not sure if that has helped but I do hope you are able to find some help in therapy and I wish you well.

Thank you for your detailed reply. I will admit I'm not in a great emotional place, and especially recently I've little to no emotional control. My ideation is actually more active than usual right now (been high for over a week), but I'm going to wait (or try) anyways. I need to feel like something is going to change...

I will ask my therapist next week about the extra sessions. He made it sound like it was just because of the ideation, but maybe I can present it like you said - to prevent it and that will hopefully work.

I think as long as I lie about having the means then I will hopefully be fine. I will try not to reveal too much about how I feel too. Not straight away at least. I tend to trust hard and fall harder. Its a bad trait of mine which has made me choosy about who I trust. But there's not really a choice in therapy. If its going to work I need to be as honest as possible. at least my therapist seems nice and like he might help. I'm just afraid and not doing well atm.

 

[Spiral]

Are you having therapy because you want to get help to change your mind about cbt?
I think if that's the case you can tell your therapist that you think about suicide a lot, as long as you are not holding the knife or saying you will ctb right now it should be ok. Usually (depending on what country you are in) they will only commit you if you are an immediate danger to yourself or others so if you are not violent or literally about to cbt right now than it should be safe to open up to your therapist. A good way to get reassurance from them without telling them about your fear is to ask about confidentiality and under what circumstances they would have to share information about you.
Hope that helps to ease your mind a bit

 

[nohopeforethefuture]

Are you having therapy because you want to get help to change your mind about cbt?
I think if that's the case you can tell your therapist that you think about suicide a lot, as long as you are not holding the knife or saying you will ctb right now it should be ok. Usually (depending on what country you are in) they will only commit you if you are an immediate danger to yourself or others so if you are not violent or literally about to cbt right now than it should be safe to open up to your therapist. A good way to get reassurance from them without telling them about your fear is to ask about confidentiality and under what circumstances they would have to share information about you.
Hope that helps to ease your mind a bit

Thank you <3

I'm not specifically having therapy because I dont want to die, but because I can't live this way. Suicide for me is the realist ending. The saddest, most alone, hopeless, and inevitable ending to my life. I have no desire to do anything, no future that keeps me going, I have nothing to live for. My religion has done nothing but cause an existential crisis that I can't escape, and no secular therapist is going to be able to cure that. Living every day is monumental. Its crushing. And recently its gotten to the point I'm skipping work again and slowing down.

Honestly he might have even said the confidentiality thing to me yesterday. But my memory is shit recently so I will have to ask again most likely. I waited too long I think. I'm too far gone and nothing is going to help. Sorry, this is the recovery section. Not very recovery like thinking. I can't quit my job because its paying for the therapy. My job isn't even the problem. My life is great on the outside. Its the inside thats fucked up. I just can't see life the way everyone else does. I know they dont want me to die but living like this is killing me. One hour weekly sessions aren't going to help fast enough...if at all...

 

[Spiral]

I feel you, I am in a similar headspace right now, I want counselling just so I can understand myself better before I go, I have no hope that it will save me. It's nice to be able to try it though. I wish you the best and even if your counsellor cant make everything better at least he can give you a confidential space to talk without you having to fear being committed

 

[nohopeforethefuture]

I feel you, I am in a similar headspace right now, I want counselling just so I can understand myself better before I go, I have no hope that it will save me. It's nice to be able to try it though. I wish you the best and even if your counsellor cant make everything better at least he can give you a confidential space to talk without you having to fear being committed

Thank you so much. I wish you the best too. =) i will be nervous to see how my next session goes.