Tag: David Jobes

Aeschi model and ramblings

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

Just woke up after a morning of pain. I decided to take my pain meds and go back to sleep. Like I figured, I woke up around 1400, which left me a half hour to shower and get dressed before the bus came. Well I did take a shower but going down the stairs to my sister’s apartment for coffee put a kink in me going out. I still plan on going out with my cane to Walgreens for some soda. I know I shouldn’t as I am trying to diet but I need something to drink other than water. I also need to get another bottle of water as I drank the one I had while watching the Sox game.

I am feeling energized by the coffee. I hope it doesn’t lead to a crash because I don’t want another nap today. I need to work on my writing today. I have been amiss doing so the past few weeks but now I think I know what to write about and I’ll just stick it in. I want to write about the Aeschi model for suicide and also how Dr. Jobes came into my life through his work. I really believe that if more clinicians took this approach to their clients or at least they had this approach in inpatient settings, there might be less suicides.

Aeschi model (pronounced Eshi) is a patient-oriented model, meaning that the patient has a say over treatment more than the clinician does. What has been found is that the provider-oriented model doesn’t work as patients can get frustrated over the “provider knows best” thinking. The Aeschi works toward a collaborative effort with the patient and provider working together to finding out what is at the heart of suicidality of the client.

Today I was at Starbucks taking notes on my Aeschi book. I was writing down what I had highlighted but there is too much information that I didn’t highlight that I needed to share so I gave up on it, for now. This book is so powerful that you really need time and energy not only to read it but to digest its contents.

The gist of it is to have the client be the person in charge of treatment and therapy, a novel idea when so many clinicians think they know it all better than the client and therefore take charge due do their discipline (CT, CBT, DBT, Etc.) I know that if my therapist had been in this category, I probably would not be here, or I would be seeing another therapist. I believe that if there is a collaborative effort of the therapist and client, there will be a higher success rate than if the therapist has the one track mind of he/she knows best. But the nice thing is that the Aeschi model doesn’t have to focus on one discipline. It can work for social workers, psychologists, psychiatrists, mental health workers, etc. It just takes a little courage to step out of the normal boundaries and put the client first. To let the client tell their story without being judgmental or critical.

After the client tells their story, there is an openness that can be trusted. Once the client has a sympathetic and empathic ear that is open to whatever the client is saying, the real journey begins.

This model is the new age of what therapy should be about. I know that if I didn’t develop a relationship with my therapist, I probably wouldn’t be here.

On another note: I did go out today and wasn’t in too much pain. I was able to walk a block with my AFO on. Now I don’t know if the brace is what calmed the pain down or if my ankle is finally calming down. I had a wicked bad night last night. Ice and pain meds were just not working for me. Usually ice helps but this time it didn’t. I am going to try again tonight. I have my foot elevated on a foam block. Best $60 I ever spent for a foam device. It really helps my back and legs.

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.