Psycho-Babble Psychology Thread 846981

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Therapy tomorrow (**suicide triggers**)

Posted by Wittgensteinz on August 18, 2008, at 9:04:48

I haven't posted here for a long while. Just an update, I started therapy nearly a year and a half ago with a psychoanalyst. Before coming into therapy, I was very depressed and I ended up taking an overdose - that crisis led me to getting some help. When starting therapy, T made it clear that a condition of our working together was my not making any further suicide attempts or "anything like that", to which I agreed.

In myself I see a lot of improvement since starting therapy with him. I'm intensely attached to him and we have a very good relationship.

The week before last, a week after he returned from his summer holiday, I was going down hill, racing thoughts, very depressed. Then my partner went away on holiday - I really didn't want him to go and be alone but I had to stay at home to care for the dogs (too short notice to board them) and he felt he needed a break because his father died a short time ago and he's been very stressed.

So he was away and I was alone with my thoughts and I got worse and worse. I saw my T for two sessions and did say I felt suicidal but perhaps didn't make it clear enough how things were going. Then last Wednesday evening I took a large overdose. An hour or so later I had the sense to call for help and was taken to hospital by ambulance. I don't really remember much of it - just coming round the next afternoon in hospital with drips in each arm. During the night, I had no control over my body at all, I even wet myself, that much I remember - pretty embarrassing. When I woke up, it was really distressing - at first I didn't know where I was or remember what I'd done, it felt like a bad dream (and lately I've had horrible nightmares most nights). The next thing, a friend of mine is by my bed and tells me that my T is on his way to visit me (she brought me spare clothes, fortunately, as by this point, on my lower half, I was only wearing a pair of strange semi-see-through hospital underwear). Obviously, it was a caring thing for T to come, but I didn't want him to see me in such a mess. I felt so ashamed.

So he arrived and looked so sad and hurt. He looked awkward and out of place in the ward, asked what was in the drips (I didn't know) - before now, I've always seen him in his home office. I know some time ago, that if I would do something like this again, he said it would be devastating for me but would hurt him deeply too. The thing is, in the moment I acted on my feelings, all I could think of was making the pain go away. We talked some and I said I was sorry and asked him what now. First he said he didn't know - that I'd broken the rule, that he didn't know if he could work under this pressure/responsibility. I don't remember much else of the visit, but those words ring through my head.

Anyway, on the Friday I saw him again, for an appointment, and he made it clear he would only continue working with me if I would not do this again - he said he wanted to work with me but only if I promised this. I want to continue, he's helped me a lot - just it seems so ungrateful what I've done, I feel so bad about it, and I don't want him to feel pressured to work with me. It was his birthday this weekend too - not that relevant but makes me feel even more guilty. I see him again tomorrow and am feeling very anxious - I'm scared I've ruined the relationship - the trust. How can I look him in the face again? I feel bad enough anyway, but this feeling is so heavy to bear. I don't want him to think his hard work has been for nothing, that he hasn't helped me. I just feel I've damaged things between us.

I needed to share this. I hope no-one minds.

Witti

 

Re: Therapy tomorrow (**suicide triggers**) » Wittgensteinz

Posted by llurpsienoodle on August 18, 2008, at 12:08:20

In reply to Therapy tomorrow (**suicide triggers**), posted by Wittgensteinz on August 18, 2008, at 9:04:48

((((((((Witti))))))))))
I'm so sorry- I didn't realize that you were feeling so badly :(

I had the uncomfortable experience of T visiting me (in my hospital gown) at the hospital after an overdose. I thanked him profusely, and was very bewildered, and embarrassed.

I don't really remember much of that, only that I was happy to see *someone* I recognized. He said it was a "no-brainer"

As far as making promises to therapists... I've never been in that position before. It seems like it would be conducive to hiding things from your T, and suffering on your own. Actually, these are *exactly* the types of feelings that can benefit from therapy. It's no wonder you're anxious.

(((((Witti)))))

Well, if you're up to it, a candid discussion is probably the best thing you can do for the t-relationship at this point. I see no shame in postponing it, if you'd rather wait until you feel a bit stronger.

I hope you feel better soon
-Ll

 

Re: Therapy tomorrow (**suicide triggers**)

Posted by Phillipa on August 18, 2008, at 12:38:47

In reply to Re: Therapy tomorrow (**suicide triggers**) » Wittgensteinz, posted by llurpsienoodle on August 18, 2008, at 12:08:20

Do you feel that this is one of the reasons people keep their thoughts to themselves? Sometimes a contract is very hard to keep. If I may ask are you on meds and maybe a med change. Other than that I do relate with the feelings of acting on impulse. It just seems to happen. Phillipa

 

Re: Therapy tomorrow (**suicide triggers**) » llurpsienoodle

Posted by Wittgensteinz on August 18, 2008, at 13:53:37

In reply to Re: Therapy tomorrow (**suicide triggers**) » Wittgensteinz, posted by llurpsienoodle on August 18, 2008, at 12:08:20

I know I seemed quite chirpy in chat the other day - it was good to chat with you and others - I'm rather good at hiding my feelings.

This is a problem for me too - I understand why this 'no suicide contract' is so important for him. A suicidal patient must put a great deal of pressure on a therapist. That said, the effect of the agreement is that I feel unable to talk about it - maybe it's just difficult to talk about it anyhow. I did tell him I'd felt suicidal earlier on the day it heppened, but whenever I've brought it up, he's at the most said "that's not an option" or "if you feel that way, you should phone the crisis service". The difference this time was that he said "that is an option but not a good one" - not sure if unconsciously that affected my actions. Kind of a 'not my problem' response in a way. I could have phoned him, I have his home number but I didn't see what good that would have done. I guess I have to talk all this through. I just don't know where it's going to go.

The last session I said, I would promise not to do it again, but that I had made the same promise before and with the same sincerity and yet not kept to it - i.e. within my power to keep such a promise I will... but.

It's a pity, that the worst of my depression is somewhat of a non-topic in my therapy.

Llurpsie, thank you for your kind and thoughtful words - I'm sorry you've been through this too.

I see my pdoc on Wednesday - need to discuss meds again - he frustrates me because he does so little. I've said for a long time the ADs were doing nothing even on the highest dose grrr and now he wants me just to go back to the same dose again.

Thanks for your support.

Witti

 

Re: Therapy tomorrow (**suicide triggers**) » Phillipa

Posted by Wittgensteinz on August 18, 2008, at 14:03:46

In reply to Re: Therapy tomorrow (**suicide triggers**), posted by Phillipa on August 18, 2008, at 12:38:47

I think it could be. Such a contract makes the topic unspeakable. The problem with promising not to commit suicide is that, when you are doing such a thing, or having those thoughts, the consequences of an unsuccessful attempt go out of the window - in fact most things go out of the window - the pain is simply so great that, well in my case, my desire to end it all, make it stop, get away from it, is at the forefront. If I was burdened by a conscience of the feelings of those around me, then I wouldn't feel so alone as to be suicidal in the first place, I guess. Basically such a promise is to sabotage ones own strongest desires, and that requires quite some strength.

It seems to be a bit of a paradox. I am curious if my T has ever been in such a place as that - if so, then he would possibly understand this paradox.

I am on meds - although, now there are no meds at all in the house (except for my dogs' de-worming tablets lol) as I consumed all of the others. I was on ADs and had benzos and Seroquel and some other stuff left over. I think a med change could be a good thing - but my pdoc just wants to put me back on the same as before, with some seroquel too (for obsessive thoughts, not psychosis). Maybe I should find a different pdoc. Another thought is to ask to be hospitalised in order to have the meds sorted out. But T doesn't think hospital would be a good place for me to be.

Sorry for a rambling reply. Thanks for your comments.

Witti

 

Re: Therapy tomorrow (**suicide triggers**) » Wittgensteinz

Posted by rskontos on August 18, 2008, at 15:14:17

In reply to Therapy tomorrow (**suicide triggers**), posted by Wittgensteinz on August 18, 2008, at 9:04:48

Oh Witti,

This is so strange. I was sitting at the doctor's office awaiting her to see me, and I was thinking about you. Wondering how you were and I told myself when I get home I am going to try to email or babblemail you and what happens is I open babble to try and search for you and here is this thread. I guess I had you on my mind for a reason.

I am so sorry you have been in such a bad place. ((((((Witti))))))
It is so hard to be alone and hurting. I wished you had told him just how bad you were feeling but you did not.

Now I have two thoughts. The first is this, I think or thought that at first it is hard and maybe not fair for him to tell you that you can only work with him if you promise not to do this. I think a better tactic is for you and him to discuss deeply how and why you might be feeling this low. Maybe he can help you come up with some things to do, versus just to promise not to. I am not sure a promise is all that it will take, since you did attempt it again. Maybe if you knew you could call anytime you felt like you might feel like you have some to turn to.

Then I thought after thinking some more, maybe he is just really trying to scare you and might not follow through with the I can't continue to work with you if this happens, I think he cares about you very deeply. I think this really scares him, but still you need some guidance on what to do.

I am glad so thankful you did call the emergency number.

Please get some help. I don't wånt to lose you.

rsk

 

Re: Therapy tomorrow (**suicide triggers**) » rskontos

Posted by Wittgensteinz on August 18, 2008, at 17:47:17

In reply to Re: Therapy tomorrow (**suicide triggers**) » Wittgensteinz, posted by rskontos on August 18, 2008, at 15:14:17

Rskontos,

I'm sorry I didn't keep in touch since before. I still think about you too and hope everything is going well. I've never been that good at keeping up with contacts.

The fact is, in theory I can call whenever I need to - there's never been a time when I haven't been able to get in touch when I've wanted/needed to. But at the same time, I don't want to intrude on him. He works from home and his phone is his home phone. I've phoned on occasion and his wife has picked up. It easily feels like I'm being intrusive because of that set-up. There was one time I phoned and it was clear he had a lot of visitors in the background and I felt I was being bothersome, although he'd never suggest that. When the thing happened last Wednesday, phoning him would have likely meant waking him up - the idea of doing that and disturbing his wife at the same time, doesn't sit easily with me.

But I will talk to him about this and try to get further with this topic. I know it's very important to have some good strategies in place. A promise not to do something isn't enough and in some ways doesn't make that much sense - if I feel like doing something like that, then whether or not I've made a promise to him will have little significance in such a moment. I think he has a responsibility to help me more to deal with my suicidal feelings.

I think it is a scare tactic on his part, as he is continuing to work with me despite my breaking the rule. He needs to know that when I'm in that state of mind, the threat of not being able to continue treatment with him is irrelevant.

I will just have to try and talk this all out tomorrow. It's helped posting here and getting these responses.

Thanks for thinking of me.

Witti

 

Re: Therapy tomorrow (**suicide triggers**) » Wittgensteinz

Posted by daveuk08 on August 18, 2008, at 17:57:48

In reply to Therapy tomorrow (**suicide triggers**), posted by Wittgensteinz on August 18, 2008, at 9:04:48

Hiya Witt,

Firstly let me give you a big ((((((Witt)))))).

This may hurt,but I have to say it,Having lost my Slinky 15weeks ago to the "S" word.

I fully understand the pains you must be going through in your head,mine may not be as great as yours but they shaw aint easy.

So you attempt doing a "S",(sorry I can`t say that word),I know it may seem the only way out for you to get rid of the pain.

Consider this,your t wanted you to make him a promise,your t is human and has feelings,how would he feel if he was doing therapy with you for who knows how long,and then you do the "S" thing,do you not think how emotionly this could affect him,I know how slinky`s death has affected me ,so what must it be like for him,and if you are only just one of his patiants,imagin if more than one did it, or maybe one has done it in the past,so thats why he wants that promise,thats why I think that what he is asking is not unfair.

Secondly, you say your partner recently lost his father,can you imagin how he would feel if when he returned not only having lost his father,he would have lost you in a much worse way,and that could possbly send him over the edge.

Please please,please,not only make a promise to your t,you wont take your own life, make it to us as well,we have already had 2 this year,and most of all make a promise yourself aswell,I know you don`t want to do it because you are seeking help from your t and us.
Lastly,remember those that get left behind hurt more from what you do than you`ve ever hurt in your life,I know because I`m hurting reel bad.

I hope this is of some help.

Dave.(Say no to the "S" word)

 

Re: Therapy tomorrow (**suicide triggers**) » Wittgensteinz

Posted by rskontos on August 18, 2008, at 20:05:31

In reply to Re: Therapy tomorrow (**suicide triggers**) » rskontos, posted by Wittgensteinz on August 18, 2008, at 17:47:17

No worries my friend. I agree that he has some responsibility in this and helping you keep yourself safe. You do need strategies for those rough times. Please babblemail me anytime you need to!

I know how dark things can get. Again no worries about not keeping in contact, just wanted you to know I think of you often.
I worry about you too.

I am glad posting here helps. Keep on posting!

rsk

 

Re: Therapy tomorrow (**suicide triggers**) » daveuk08

Posted by Wittgensteinz on August 19, 2008, at 1:20:06

In reply to Re: Therapy tomorrow (**suicide triggers**) » Wittgensteinz, posted by daveuk08 on August 18, 2008, at 17:57:48

I'm very sorry to hear of the loss of your friend. I have experienced the same with a close friend who unexpectedly took his life - he was much loved by many, highly talented and the sense of loss was terrible. I know for those left behind it's deeply painful and traumatic.

At the moment I feel that pain - the pain doing such things puts on others - I do have a social conscience. The thing is, in the moment when one is taking such a decision about their life, they are so alone with their own pain (and I'm speaking from my own experience), that the thought of those left behind pales into insignificance. Taking ones life is not really a rational course of action - for the most part not weighed up in terms of the consequences to those left behind - it is an absurd act. It is a very selfish thing to do, perhaps the most selfish thing one can do - I know this - but in my darkest moments there's something driving me so raw and painful that all of those things are forgotten or irrelevant. The desire to end, escape is the only one that dominates - for the rest one feels numb and alone. Perhaps this has to do with my past - growing up, being abused and being alone with it.

I see my T in a few hours and I will work on a way to prevent me from doing this again.

I doubt Slinky could comprehend the pain he/she brought on others when he/she took his life - if he/she could, then he/she would have been healthy enough to go without doing such a thing (I'm guessing). I'm very sorry for your loss.

Thanks for your post.

Witti

 

Re: Therapy tomorrow (**suicide triggers**)

Posted by Cecilia on August 19, 2008, at 5:45:14

In reply to Therapy tomorrow (**suicide triggers**), posted by Wittgensteinz on August 18, 2008, at 9:04:48

In my opinion, a T has no ethical right to say he won't work with a patient who talks about or attempts suicide. Suicidal thoughts are a symptom of depression, which is surely the most common reason people see T's. It makes no more sense than an oncologist saying to a patient, sorry, you have to promise your cancer will go into remission, otherwise I'll stop working with you. A T who doesn't want to work with suicidal patients needs to find another job. Cecilia

 

Re: Therapy tomorrow (**suicide triggers**) » Cecilia

Posted by Wittgensteinz on August 19, 2008, at 8:11:40

In reply to Re: Therapy tomorrow (**suicide triggers**), posted by Cecilia on August 19, 2008, at 5:45:14

Cecilia, I know what you mean. There's no rule not to have suicidal thoughts - it's acting on those thoughts that he will not tolerate.

It's not that uncommon for Ts to make such no-suicide contracts with their clients. It is devastating for a therapist when one of his patients dies - I'm quite sure of that. There has to be some level of self-preservation on his part. Perhaps if my therapist and I were less attached, he wouldn't feel a need to insist on this rule, but given our closeness and the dedicated way in which he works, it's clear why such a thing is necessary. He only sees patients for about 10 or so sessions per week as he's past retirement - so he only has a small number of us. He's never once failed to schedule me in for an extra session the next day if I needed it. He's never failed to respond to a phone call or mail, and has even sent me mails while he was away on holiday. He's lent me books that he thought I'd find interesting. One time I was cold, so he got me a blanket. Another time my stomach was rumbling, so he got me something to eat. And in lots of other ways, subtle ways, he shows how dedicated he is to my recovery. Sometimes when I feel really down, I just ask him to tell me a story - and that's what he does. I'm sure I'm very lucky to have him as my therapist. He's well respected in the Netherlands - one of the most acclaimed analysts and academics in psychoanalysis.

I told him today how the no-suicide contract in itself makes the topic of suicide more taboo than it already is. We talked at length about all that happened last Wednesday and how to go on from here. It was a good session and confidence is somewhat restored on both sides. He said he forgives me (when I asked him), and that that was easy.

He made it clear that before acting on suicidal thoughts, I should phone him. I don't like to bother him outside of sessions - I have this aversion to phoning people anyway. I sometimes mail him if I have thoughts/questions between sessions but not often. I said he would probably have been sleeping had I phoned last Wednesday evening. He said it didn't matter. He'd rather I phoned him 100 times during the night sooner than attempt suicide again.

I still feel bad - I'm not an easy patient. Non-suicidal patients surely are easier to deal with. I don't want to be an out-of-hours problem for him. I said I felt a desire to be shut away somewhere so not to be a burden to anyone. I also said how I didn't think it was fair for him to have to continue to work with me, as it was likely putting a lot of strain on him. He said firmly, that was his responsibility to decide, not mine, and he wanted to work with me. I think things will be shaky for a while, but I'll guess we'll get through this. I feel the same connection as before, and that's the most important.

Thanks again for all your support - it really did help me put my thoughts into words, especially today when talking it through in session. So, thank you.

Witti

 

Above post is an update of today's session (nm)

Posted by Wittgensteinz on August 19, 2008, at 8:13:13

In reply to Re: Therapy tomorrow (**suicide triggers**) » Cecilia, posted by Wittgensteinz on August 19, 2008, at 8:11:40

 

Re: Therapy (**suicide triggers**) » Wittgensteinz

Posted by B2chica on August 19, 2008, at 12:46:36

In reply to Re: Therapy tomorrow (**suicide triggers**) » Cecilia, posted by Wittgensteinz on August 19, 2008, at 8:11:40

a few years ago i was chronically suicidal and made several attempts.
i then started seeing a T who wanted me to sign a "contract" with him. but he knew that wasnt going to hold with me.
what DID help was that he told me that it was OK to think about suicide, to go to that dark place, but to do it with him. to go there when we are in session. to describe every ache, every lure, every relief about it but to do it with him. that it was ok to talk about it, but it was NOT ok to act on it.
even if i wanted to describe how i would do it, how it would feel, how i imagine people would react afterward is ok.
Just NOT ACT. again, its the act, that jump from it being in your head to making it real where it needed to stop.

remember this when you see your T next. ask him if getting this deep with him would be ok. maybe you need to express this with him.
but you know yourself best, maybe talking that deep could make you worse also, so please be careful. and do what is comfortable for you.

so sorry about your experience, but a few of us have similar memories. so we understand.
thank you for being so open.

(((((((((cares))))))))))

b2c.

 

Re: Therapy (**suicide triggers**) » B2chica

Posted by Wittgensteinz on August 21, 2008, at 10:34:52

In reply to Re: Therapy (**suicide triggers**) » Wittgensteinz, posted by B2chica on August 19, 2008, at 12:46:36

Thanks for your sweet message B2chica. I think you're right - I talked it through with my T, how although I want to keep such a promise and mean it sincerely when I say "I promise not to do X", in the moment when I feel so strongly suicidal I can't keep such a promise anymore. I was able to talk more about it than I have in the past, and I guess I'll have to try and dare to talk more about these difficult feelings. I think perhaps at the moment that's one of the problems - I just don't know how to put this side of me into words.

I'm sorry you had to go through this too - it's a very hard place to be - good for you for surviving and working through it.

Witti

 

Re: Therapy (**suicide triggers**) » Wittgensteinz

Posted by B2chica on August 21, 2008, at 10:44:37

In reply to Re: Therapy (**suicide triggers**) » B2chica, posted by Wittgensteinz on August 21, 2008, at 10:34:52


>good for you for surviving and working through it.
> Witti

same to you Witti...same to you.
you are stronger than you know.
you have more fight left than you know. hang on to that. when you find you cant fight anymore, let that part out, let that part reach out to others also.

b2c


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