Category: suicide attempt

new journal and Crisis Response Plan

by Midnight Demon, posted in depression, mood disorders, suicide, suicide attempt, writing

I started a new journal tonight. And like every other journal before it, the first two things that go into it is my crisis response plan and the Holden psychache scale, though lately it just is my response plan.

I tried finding the response plan online but all I found was emergency planning and a very LONG one that the Navy cooked up, most likely from the article I read about military suicide crisis training. I tried to find the article but I am unable to locate it in my files. I haven’t searched my thumb drive because I can’t locate that either. GGGRRRR so I hope I am not plagiarizing when I post this plan here on my blog:

Crisis response plan:
When thinking about suicide, I agree to do the following:

Step 1: Try to identify my thoughts and specifically what’s upsetting me
Step 2: Write out and review more reasonable responses to my suicidal thoughts
Step 3: Do things that help you feel better for at least 30 mins (examples can include, trying to sleep, play internet games, brush hair 100 times, write in a journal, listen to music, etc)
Step 4: Repeat all of the above
Step 5: if thoughts continue, get specific and I find myself preparing to do something, I will call XXX @ 555-555-5555 or suicide hotline
Step 6: if I cannot reach above I will call my therapist or psychiatrist
Step 7: if I am still feeling suicidal and I don’t feel like I can control my behavior, I go to the ER or call 911 (or whatever the local emergency line is for your country)
I have found having this in my journal useful when I have been hospitalized because it provides a plan of something that they need for discharge and I don’t always carry the card or the paper with me but I do carry my journal.

The second thing is Holden’s(Holden, Mehta, Cunningham, & McLeod, 2001) psychache scale and I don’t feel comfortable posting that here but you can look it up in the reference I have posted if you have access to the library.

I tend to hold off on it because I haven’t been using it lately. I know what the scale looks like and after a while you can manipulate it to whatever you want it to be from high to low. Plus when I feel numb or “fine” it’s hard to tell what kind of psychological pain I am in. My therapist and I used to use it to gauge how suicidal I was but then it just got to be like a joke. Or that the tables have turned on me because I was the one that brought in the scales and the response plan. My therapist didn’t have a clue about suicidality, which is typical of most therapists. That is why they like to pawn you off or come up with lame “safety contract” that is really a legal form for THEM not YOU. Least with the Response plan it give you something to take home with and is more detailed than anything I have come across.

Holden, R. R., Mehta, K., Cunningham, E., & McLeod, L. D. (2001). Development and preliminary validation of a scale of psychache. Canadian Journal of Behavioural Science, 33(4), 224-232.

exciting article

by Midnight Demon, posted in depression, mental disorders, mental illness, mood disorders, psychache, psychosis, suicide, suicide attempt

Just read an interesting article about the Collaborating and Management of Suicidality (CAMS). I can’t believe this theory is 25 years old. It is gaining more acceptance as time goes on as more countries are using it as a treatment modality in suicidal people. It is a clinical intervention that is used as a collaboration between client and therapist in the treatment and care of a suicidal person. I find it one of the best out there and it is the best because it can be used across the disciplines in the mental health field.

I will be writing more about this. I write a lot about Jobes, the creator of CAMS and the SSF (suicide status form). He is the most brilliant person I have ever met. The fact that this is going to electronic way I think will be used across mediums and will be easier to deliver. Most clinicians have gone the electronic way but not all. This makes me want to go back to school and get my degree.

shame of living

by Midnight Demon, posted in Chronic pain, chronic physical pain, depression, mood disorders, physical pain, psychache, suicide, suicide attempt

Today I got my bi-monthly journal of the American Association of Suicidology, Suicide and Life Threatening Behavior. My cousin came over and my mother said to him that I like reading that kind of material. I do but on another level, I feel embarrassed. I know I am taking it personally because it is personal. I attempted suicide many times over the years and each time I fail it is not only a failure, but it also is an embarrassment to my ego. I have the scars to show of the self injurious behavior I have had over the years. Again, an embarrassment of my illness. I don’t know why I feel this way. Or maybe shame is another reason I feel embarrassed. I don’t know. But it hurts. It hurts knowing that I failed and I am still here. I don’t know why it does but it hurts like hell. I have not told anyone about the shame that I feel other than my blog and maybe my therapist. There is so much I tell her that I sometimes forget if I tell her about the shame of living. I know people who have attempted don’t like to talk openly to the person in front of them about their story of attempt. I don’t think I can speak openly in front of a crowd of people and tell them I have attempted and failed and now I feel like a complete and utter failure. That I want to try again and succeed just to try to cheat death. But I have people that rely on me to be here and though I sometimes resent them for it and even hate them for it, I still continue living. I don’t enjoy living. It’s a constant struggle for me for one thing to another. It’s more of a hassle living than anything. Between the chronic pain that I feel physically to the chronic pain I feel emotionally, why bother? But I do because I don’t think I can ever again act on my feelings. I lost what is called lethality. And until I get it back, I am still going to be living this so called hell called life.

stigma and suicide

by Midnight Demon, posted in depression, mood disorders, psychache, suicide, suicide attempt, writing

Stigma and suicidality
“Among the 10 leading causes of death in the U.S. most are claiming fewer lives each year but sadly suicide is on of the few that continues to rise. Depression and other diseases of the mind that contribute to suicide are real illnesses, not weaknesses. Not character flaws. People battling these illnesses deserve understanding and treatment afforded people with any other llness.” Robert Gabbia AFSP Executive Director.

There is a stigma out there that mental illnesses are not real. That if you just pull your boot straps up you will be ok and not suffer from depression. I have a friend in Canada, a place where the suicide rate is higher than the US because they are still in the dark about treating depression and other mental illnesses. Like Mr. Gabbhia states this is not a character flaw or a weakness. This is real. It takes character and strength to admit there is something wrong and to see help for it. And if you don’t succeed the first time try again until you do.

If I didn’t try and try again, I probably wouldn’t be here today. I probably would have taken my life. I have seen over 10 therapists over the course of my treatment for my mental illness. My current therapist I have been with for the past twelve years and it has been the a huge difference. With the stability of treatment providers I don’t go to the hospital as much and with the value of trust between us, I can state my suicidal feelings without being held against my will in some treatment facility. I am open about how I feel with my therapist but it took a long time to get to where I was. It took about 3-4 years to really trust her and for her to trust me.

I say that it takes trust between us because most therapist are under the believe that all people that have suicidal thoughts should be hospitalized immediately if they cannot be held to safety contracts, which are worthless. Therapist think this is the way to go but it is not. It just takes the legality of it all away from the therapist and really does not put trust in the relationship. Nor does it build an alliance with the therapist because the client is always in fear of being put into the hospital for fear of stating their true feelings. Is that how therapy is supposed to go? Again you have the stigma that if you talk about suicide, you will cause suicide. That is a common myth that everyone still believes is true except for those that actually deal with it. Like me and other suicidologists around the country. Those that deal with suicide are afraid of being sued but there are measures that can be taken so that it is not as frightening as it is. I am not saying that the person with a loaded gun or is in eminent danger and threatening suicide should not be hospitalized and that that gun or other means NOT be taken away. I am saying for those that are chronically suicidal be given a chance that doesn’t include the hospital all the time. In the course of my therapy over the past twelve years I have been hospitalized 4-6 times, compared to twice a year for the previous ten years.

For resources on dealing with suicide:
http://www.suicidology.org the American Association of Suicidology.

Jobes, D. A. (2006). Managing suicidal risk: A collaborative approach. New York, NY: Guilford Press.
Michel, K., & Jobes, D. A. (2011). Building a therapeutic alliance with the suicidal patient. Washington, DC: American Psychological Association; US.