Posted by fallsfall on June 13, 2004, at 10:54:44
In reply to Suicidal ideation question - *trigger potential*, posted by daisym on June 12, 2004, at 20:00:35
>This makes no sense to me. How can you go from really suicidal thinking and feeling to this flat emotional place so fast?
I think that the emotionally flat place is a coping mechanism. The pain has been so great that you have been desperate for a way to make it stop - this is the suicidal planning. But then (fortunately) you are able to push the pain away and bury it - leaving you in the emotional void. So while the void is not a comfortable place to be (you *know* that it is not how you truly feel - it is not natural), it protects you from taking irreversible actions. This is good.
It speaks to your strength that you can get to this place and forbid the suidical intent. When you are with your therapist, you can try to deal with the causes of the pain. The hope is that eventually you can come to terms with things so that the pain is not so intense. But until you can do that you *must* find ways to protect yourself. And this is what you have done. If you couldn't get yourself out of the suicidal place - if you were still planning today, and collecting items and cleaning up loose ends - then it would be time to go into a hospital. The hospital can help provide the structure and holding and support that you need to see that there is a life worth living.
So, since the planning and preparing stages can be paralyzing this is when you must get help. My experience has been that the periods of being submerged get longer as the process continues. This means that in the beginning I might submerge for 15 minutes, and later in the day I might submerge again for 30 - 45 minutes etc. But in between the submersions, I am aware of what is happening. This is the time when I need to call my therapist or go to the hospital - because I can't be sure that I won't submerge again, but not come back up.
There are ways of working to be able to "tolerate the distress". Getting involved in life (also known as distraction) is a very important tool because it can break up the focus on ending the pain. It can give you hope that there are parts of life that you do want to be able to stay with. This is what you did when you left your house - you took action to break the "spell".
And, of course, you do need to face the pain (with your therapist) so that you can eventually resolve it, and not have to keep trying to find ways to protect yourself from it.
Yes, talking about certain things in therapy can increase suicidal ideation. Make sure your therapist knows what things do cause this increase for you. This doesn't mean that you will want to avoid these topics, but it does mean that both you and your therapist should be aware of the topics that are dangerous for you and use caution when they are being discussed.
When you are back into a more stable place, please have a serious talk with yourself and promise yourself that you will ask for help when things start getting serious (when you are planning and preparing). You need to make this decision BEFORE you are in that place because you won't be able to decide this when you are inside. It will be hard enough to ask for help.
You will need to have a strategy for asking for help - write it down - what are the phone numbers you can call? You won't be able to look them up. What will you say? Come up with 3 or 4 words that will let the person you contact understand that you need help. How long will you wait for a return call before you try calling someone else? You won't be able to make these decisions when you are in the middle of things. You need at least one action that you can take that will not rely on an individual person being available - like calling your local crisis line or dialing 911. You need to take this action when the people you are counting on can't come through for some reason (they are on vacation, or sick, or dealing with their own crises, or they didn't pay their phone bill).
You need to decide that you *will* ask for help, and know *how* to do that. This decision needs to be made *before* things get really bad. Aphrodite is so right when she says that isolation feeds the flames.
I'm so sad that you know about this place.
poster:fallsfall
thread:356168
URL: http://www.dr-bob.org/babble/psycho/20040603/msgs/356276.html