Telling therapist about suicide thoughts/plan

[cyan]

I'm working with a fairly new therapist and really like her. Our main work is to heal childhood trauma, sexual abuse, and my dad's suicide. I am afraid to tell her about my suicidal thoughts and plan to ctb since I don't know how she'll respond. Have any of you talked with your therapist about your plans to ctb? What is their mandate when this is brought up?

 

[Jolene40]

Are you in the UK? I was highly suicidal a year ago and spoke in depth about it with therapist. I've seen her over ten years. I knew she would allow me to be honest. She didn't try talk me out of it. Just supported me.
I saw one other therapist whilst in hospital with severe illness. I knew immediately I couldn't tell her when she gave this script about safeguarding at the beginning of appointment.

 

[cyan]

I'm in the US.

 

[Jolene40]

I'm in the US.

I see how it may be different there. They do everything to keep you away from being sectioned here so no incentive. You are probably therefore more free to admit suicidal feelings in this country. The system in the USA is horrendous when it comes to this

 

[nerve]

When someone expresses suicidal thoughts to a mental health professional, their job (typically) is to go into a risk assessment and ask questions to figure out how likely it might be for you to act on those thoughts once you leave their office.

Some of the bigger questions they ask are if you have a plan in mind, if you have lethal means, and if you've set a specific day or time for your attempt. The amount of wiggle room a therapist/etc. will give you before panicking depends on the individual, but you can admit to these things gradually and test the water to see how they react and go from there.

You can't get locked away just for wanting to die or wishing you didn't wake up. If somebody tried, all they really could do is send you to the ER and then it becomes the hospital's decision. "I think I was just having a panic attack and now I'm starting to see things clearly again!" will usually get them off your back if it actually gets that far. It usually doesn't.

"Yes, I want to die. No, I don't have a plan. Yes, I'll tell you if that changes. I'm still alive for x, y, z reasons." has served me well over the years. The truth is that most of the time, these people would rather not involve hospitals and stuff if they don't have to. Ethical therapists & doctors know it's usually a traumatic experience that damages trust, and the non-ethical ones just want to go on with their day and get paid.

You don't have to tell her anything if you decide you don't want to, and you always have the choice to wait until you're sure you're ready one of the few neat things about therapy is that you're supposed to go at your own pace without being harassed about it.

 

[Deleted member 17949]

Are you in the UK? I was highly suicidal a year ago and spoke in depth about it with therapist. I've seen her over ten years. I knew she would allow me to be honest. She didn't try talk me out of it. Just supported me.
I saw one other therapist whilst in hospital with severe illness. I knew immediately I couldn't tell her when she gave this script about safeguarding at the beginning of appointment.

This tbh. I am also in the UK, and it seems here getting section instantly isn't hugely common, but it heavily depends on the safeguarding procedures of the place.

 

[faraway_beach]

I'm in the U.S. and mentioned to my therapist that I wished I was dead. At once she began a fairly obvious risk-assessment script, and I was able to back out by saying that I don't have a plan. It does damage trust, and now I know I won't be able to speak freely, which makes continuing the therapy nearly pointless. I hope yours is more helpful!

 

[cyan]

Thanks @faraway_beach. I'm sorry for this loss of trust. I was just reading an article how most therapists are neither trained nor adept at talking about suicide with patients and defer to risk assessment for fear of being sued. Our litigious society proves that money rules over empathy and compassion.

I see how it may be different there. They do everything to keep you away from being sectioned here so no incentive. You are probably therefore more free to admit suicidal feelings in this country. The system in the USA is horrendous when it comes to this

@Jolene40 What does "being sectioned" mean?

 

[Desideratum]

I'm working with a fairly new therapist and really like her. Our main work is to heal childhood trauma, sexual abuse, and my dad's suicide. I am afraid to tell her about my suicidal thoughts and plan to ctb since I don't know how she'll respond. Have any of you talked with your therapist about your plans to ctb? What is their mandate when this is brought up?

Why did your dad commit suicide?

 

[cyan]

Why did your dad commit suicide?

He was a very successful doctor but raged a lot and scared the shit out of me. My mom eventually kicked him out and seeing him after that was sad; I could feel his loneliness and deeply sense his emptiness. He lived with a colleague for about six months but eventually had to move. The night he moved out of the colleague's house he called my mom and asked to come back home. She said no, so he went to our horse farm and overdosed on phenobarbital and seconal.

 

[Desideratum]

He was a very successful doctor but raged a lot and scared the shit out of me. My mom eventually kicked him out and seeing him after that was sad; I could feel his loneliness and deeply sense his emptiness. He lived with a colleague for about six months but eventually had to move. The night he moved out of the colleague's house he called my mom and asked to come back home. She said no, so he went to our horse farm and overdosed on phenobarbital and seconal.

Sorry to hear that, loneliness is becoming a serious epidemic globally. How old were you?

 

[cyan]

Sorry to hear that, loneliness is becoming a serious epidemic globally. How old were you?

Thanks is for your interest, @Desideratum; I appreciate it. I was 13 when all this went down. It was a long time ago but my dad's suicide, sexual abuse, and mom's emotional abuse never left me. Now I'm lonely and alone, and completely hopeless.

 

[AngelGirl]

Kind of interesting that the system is different in the UK and people can talk about suicidal ideation relatively more freely than they can in the US.

In the US if you want to avoid involuntary hospitalization, you have to avoid telling them having any specific plans or thoughts. Don't tell them you are on a suicide forum. Don't say that you have searched for methods on the internet. If you have actually done anything, don't tell them that. But I would say that it is just really difficult to openly talk about suicidal ideation with a therapist. Especially if you don't know them very well, you might want to stay away from saying anything directly about suicide.
Before I read one person on this forum saying that you can try saying "depression" instead of "suicide".

Kind of redundant, but I'll write down few things I know of.
-don't mention you know about any specific chemicals, like SN or N
- don't talk about how you want to kill yourself. Ex) hanging, jumping, chemicals, etc. "how are you planning to kill yourself?" Say, "i don't know!"
- don't tell them you've actually done anything to kill yourself. (It would be ok if you've done things long ago, but you are going to make them think that you don't think of Doing things to kill yourself all now)
- don't tell them you used the internet to find ways to suicide. Ex. Don't tell them you searched for painless ways to die on google

If they believe you are an imminent threat to yourself, they are required to seek emergency help for you. If they think you are not an imminent threat to yourself, you might be able to get away with talking about your suicidal ideation. You have to prove them that. However, different mental health practitioners might have different ideas on what makes a person an imminent threat to oneself, so you always have to be careful when you are talking about wanting to harm yourself.

They are also trained to pick up subtle nuances, so I'm just going to say that you really have to be extra careful.

 

[ebt88]

Out of curiosity, what's your plan?

 

[JustLosingMyself]

Out of curiosity, what's your plan?

H2SO4 + HCOOH --> H2SO4 + H2O + CO + some heat

 

[Secrets1]

In US, agree with a lot of posts about not divulging details for imminent plan or self harm. However if you have a plan for 4 months from now that is 100% not legal grounds to be sectioned. Sometimes it can happen but if you stand up for your rights, and clearly state intent as in "not anytime this week" you will come across someone in the process to avoid, or shorten any time under supervision. Whether that be a nurse, doctor, or insurance agent. And by "supervision" I mean in a regular hospital for 24-48 hours, not psych ward.

I talk openly with my healthcare team about this stuff because it's a distressing issue I need help with. When/if I decide to kill myself I would not discuss it with them and stop therapy since there would no longer be any use for it. Pretty sure I've mentioned this verbatim in therapy as well...

 

[Thinking]

I'm in the U.S. and mentioned to my therapist that I wished I was dead. At once she began a fairly obvious risk-assessment script, and I was able to back out by saying that I don't have a plan. It does damage trust, and now I know I won't be able to speak freely, which makes continuing the therapy nearly pointless. I hope yours is more helpful!

The same thing happened with my therapist. We talked about it for one session and she seemed super intense about it so I just talked really vaguely about it and assured her that I would never actually do it. Meanwhile, she's the one who's supposed to be reassuring me?!! Anyway, I haven't mentioned it since and she hasn't asked

 

[ceelo]

Your dad suiciding is very important to your position as suicide brain types that make it possible are genetically inherited thus it doesnt mean you will suicide but that if push comes to shove you most likely could.

 

[TAW122]

@nnnerve and @AngelGirl are both correct in that if you mention anything about suicide, therapists (since they are considered a mandated reporter) would go into threat assessment mode and start looking for signs and red flags as well as assessing whether you would pose a danger to yourself or others. It's really a risky move and even @faraway_beach had a close call.

There are at least two occasions when I did see a mental health professional (a social worker/therapist and another one a psychologist) and they both pulled threat assessments on me even though I had not mentioned suicide or any desire to harm others. One of them asked if I had anything that could harm others (like a weapon or something, and truthfully I did not - even if I did, I wouldn't come out 100% because that would just get me locked up), and another one asked me to form a safety plan of some sort. While I managed to avoid any further probes from them, it certainly is a very risky situation where a misunderstanding can lead to some inconvenient and awful consequences (even being temporarily held for evaluation and infringement on personal civil liberties).

Therefore, I would say just be very careful of what you say and always be verbally vigilant too.