Tag: mental pain

About Therapists

by Midnight Demon, posted in Bipolar Disorder, blogging, Chronic pain, chronic physical pain, CRPS, depression, mood disorders, suicide, suicide attempt

About therapists

I have been thinking about writing this for a while, just an overview about the many therapists I have had from all different degrees and orientations. I started off seeing a school counselor. She was getting her degree in counseling, though I am not sure if it was as a school counselor or a social worker. We only saw each other for a few months and then when school started again, I started seeing a social worker that worked at another school. She was good. Had the idea that I shouldn’t use drugs or alcohol. We had a “safety contract”, which my first 10 or so did. It mostly said I wouldn’t kill myself until the next meeting and if I did feel like acting to go to the emergency room or call 911. I only saw her for about 10 months. She left and I saw someone new, a person who was also seeking their degree. I basically feel like she took advantage of me and was only interested in collecting my insurance. Nothing got worked on. I was hospitalized every three months, the last one was when I came out as “gay”. Transgender was never talked about with any therapist until the one I saw prior to my current therapist.

As I had state insurance, therapists were coming and going. By the 10th one, I was tired of them leaving so I left the system for private as I then had private insurance. Only problem was that this therapist didn’t take my insurance. When I switched in 2001, we saw each other for a month before my disc blew and then I didn’t see her again for another three months. We kept in touch by phone. It was a lot to go through. I didn’t talk about my psych issues as I just had my physical health jeopardized. We worked together for sixteen years. All throughout, I was suicidal. But I had the odd hospitalization because we worked on stabilizing using frequent contact. We saw each other sometimes three times a week when I was bad. Then we saw each other twice a week. She moved offices until she moved 30 miles away from Boston. It was tough because I didn’t have a car. I did but it broke down. We just had phone therapy. This went on for about five years. I would get a zipcar once a month to see her but that took some planning around my pain and weather.

The suicidal ideation I had made my therapist nervous. We tried different things, but she never consistently held me to them. I chided away from it because I knew what she was looking for or rather had an idea. I knew it wasn’t going to change. During the last year of therapy we had, we were constantly fighting over my suicidality. She just wasn’t listening to me anymore. I couldn’t explain why I was suicidal. I just mentioned it and she would “hog” the rest of the session with her endless talk, which I just took as her anxiety. It was interfering. I found out she was seeking consultation over me and I felt threatened by that. Eventually we just called it quits. I didn’t see anyone for few months. I had to collect myself. She gave me a few therapists but they weren’t taking on new clients.
Enter my current therapist. He had called back within a few hours of me leaving a message and we had set a time up with in a few days. He sent me his paperwork and other insurance stuff. All throughout seeing the previous therapist, we had tried different suicidal safety planning and scales and whatnots. This guy was not for it. I think the less paperwork, the better. And it bugs me! He just wants to talk things out. For the first six months I didn’t know if this was going to work out. But I had no where else to go. I was tired of searching for therapists only to be told no when I revealed I had a suicidal history. He wasn’t afraid of me talking about suicide and I ease up. Even when I told him I had a plan, he didn’t freak out on me. He understood why I felt that way and we talked it out. It decreased my feelings so I didn’t feel like no one was on my side. I often felt better after sessions but there were a few where I was more frustrated. I texted him a few times and got supportive responses, something my previous therapist did not do, at all. She only responded if we had to change appointment times.

I have been seeing this guy for 16 months. I still find it totally weird that we have an understanding of why I am suicidal yet there is no plan in place, so to speak. He is okay if I live and okay if I die, as long as I don’t do it in his office. He hasn’t taught me things I don’t already know. He would like me to be more social, but that is kind of hard with my physical pain. I like being alone anyway as noise can irritate me, like it is today. Hell, just being in Starbucks when their music is loud is enough to have me leave after I finish eating or when I am ready to write. He doesn’t try to pin things down and my biggest annoyance is when he says we will work on something but doesn’t go further than that. And then when I bring it up next session (I have to bring things up, he won’t), it still doesn’t go anywhere. But I have had that happen with the last therapist I saw, too. She would say we need to work on this and we never did.

I don’t mean to write this to defer you from seeking therapy, that isn’t my goal. I just wanted to write about my experiences with therapists and how they react to suicidal thoughts. Everyone is different. And maybe you started seeing a therapist and then the suicide thoughts started happening. The therapist freaks out and you are then forced to see someone else. Or you attempted and now the therapist doesn’t want to work with you anymore. That is sad and unfortunate but I know it does happen. Suicide is like an elephant (or hippo as someone called it that the other day) in the room that you both know is there but don’t want to face. Or maybe your therapist is trained and does work with you on the issues as long as there is a safety plan in place first with contact numbers and you collaborate on what will work and what will not work. The focus has to be on YOU not the therapist’s comfort level. While my therapist does that and gives me the time to try and work things out as well as support me in any way he can, I still sometimes feel like he just doesn’t get it or dropped the ball on an issue that is never going to see light of day again. I know they are busy people. They have lives outside the office. They see so many patients per day and then deal with the wonderful insurance that can or cannot accept their claims. I don’t know. I am not making excuses for them but if you have a therapist that cares about you and takes your suicidal thoughts seriously, works with you on keeping you safe, and the chronicity of the matter, great. I just am still trying to work with someone and cope with a therapist that says you can kill yourself as long as it isn’t in my office.

What if I live?

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, CRPS, depression, mood disorders, suicide

What if I live?

Been thinking seriously of ending my life in a few weeks. I plan dates. It helps me cope knowing I have some date to look forward to so I know the misery will end. Usually this happens in a state of despair when my pain levels are high and all I can think about is death.

But the next morning, after a few hours or more of sleep, I feel differently. Some mornings I cannot believe I sunk so low. Yet usually there is some record of it—a blog or email or social media post. It brings me back, temporarily, to that place and I wonder what if I live rather than go through the plan to die?

I have few events coming up in the next few months. Something to look forward to, so to speak, yet on the nights of despair, they are far from reach, unable to be thought about. Someone said that I should write goodbye letters. I wrote one to my psychiatrist. The other 19 people on my list is a little harder. I don’t have all my ducks in a row, so to speak, to end my life like I had planned way back in March. I was supposed to die in June. It is now the middle of July and I am still here. I do’t feel that getting help would be helpful to me. I have been in therapy for 27 years, that is nearly half of my lifetime. Yet I still remain as suicidally trapped as I did when I was 15 years old and wanted to seriously end my life then.

What if I live?

I don’t know the answer to this question. I just keep going, hoping the day won’t come where I’ll say I’ve had enough and go through with my plan. I don’t want to live. I am in too much physical pain. CRPS has taken so much from me. Might as well take my life as well. I’m not worth living.

I feel like I am crying wolf too many times. I don’t think anyone believes just how serious I am this time. But even I am not 100% convinced I will end my life on the day I planned. What if I live? What if I die? What if I am rescued in time? No one knows my plan. Hell, I don’t even know it completely. I’ve been too afraid of putting it forward because that will make it more real. Do I have to end my life? I feel I have to. I feel no one cares how bad I hurt. And not one medical professional wants to see my suffering end. I’ve had enough of fighting for my care. I had to do this since I was 16. I can’t do it anymore. I’ve run out of gas. If I live, I’ll continue to suffer just so my family and friends aren’t in pain. What kind of life is that?

I’ve been pushing through trying to hang on. I know the demons will pass in the morning. Hence I live to see another day. Hence I live, least until despair grabs a hold of me once again.

What if I live?

What I started writing yesterday and stuff I did today

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, CRPS, depression, mood disorders, suicide

What I started writing yesterday and stuff I did today

So this is what I wrote yesterday:

I am so flipping enraged. Just came from seeing my pcp. He was interested in how I was doing with the med change. Jerk said he was extremely skeptical about opioids helping me at all. Well take this chickenshit, my pain is reduced 50% aside from flares, which nothing seems to help. He was glad he was wrong. But can you imagine the big “I told you so” if I got no relief? I can’t believe the ignorance. Totally dumbfounded and hurt I would left to deal with excruciating pain and nothing to treat it with when there is something to treat it. So anyone who says opioids don’t work for CRPS, THEY ARE FULL OF CRAP!! So I then tell him my back has been acting up due to weather changes. My lumbar spine and sacrum do not want to move. Asked if taking ibuprofen was ok and he says it has risks of heart problems and hypertension. But mostly stomach issues. I should use it sparingly. Why the fuck is this over the counter if it causes so many problems? And doctors prescribe it like candy or more potent NSAIDs like naproxen or diclofenac?? Idiot. I just rolled my eyes. I cannot believe this idiot is practicing medicine at a world class hospital.

Today I find out that he is worried about my sodium levels as they dropped again since the last time I had them checked. He is going to talk to my psychiatrist and has ordered blood and urine tests to rule out what is causing my blood sodium to drop other than medication. I wrote back to him and asked what the tests were (I am a lab geek, after all) and if the PCOS I have might be affecting my pituitary, thus messing up my blood levels. I don’t think I will get an answer tonight as I thought of this around 1900. He did tell me that if I felt ill to go to the urgent care.

I spent most of the day clearing off my bed so I can change my bed sheets. I had to do it in increments because my back kept flaring if I stood longer than 10-15 minutes. Then I couldn’t find my reacher on my bed so finally cleared off nearly everything except my office essentials like my journal, laptop, and book that I am reading. I made pancakes this morning and then had buffalo wings for dinner. I was so sleepy after dinner that I had to lay down. I was hoping to sleep but I couldn’t.

Tomorrow, I will be able to change my sheets. I plan on washing them and my blanket. I have another set of blankets that I will put on. They won’t be as warm as the Red Sox fleece I am using now. I think I am going to put the hospital blanket on and then the Red Sox. That should keep me warm and if I am too warm, I can always take it off. I have to keep my leg warm because the AC might make my foot cold. Plus I get cold and like to get cozy under the blankets at night.

I was feeling really down last night. Pain was elevated and so was my suicidality. I wrote a blog. When I finished it, I sent it off to a couple of suicidologists, including the president of the American Association of Suicidology because something she posted on Twitter bothered me and I had written about it. She tweeted me in the morning and we had a discussion but I could tell she wasn’t getting what I was trying to say. It amazes me that these people want to prevent suicide yet belittle the thoughts of those who actually live with chronic suicide ideation. She had written a study that had showed more than 132 people are affected per suicide. It was dispel the thoughts that Dr. Shneidman had that at least six people were affected. He said this but never studied it. No one knows where he got this number and he is deceased so we will never know. Her study was important. But what the bereaved suicide loss persons don’t realize is that saying loved ones will be hurt and others will be affected, some how guilt trips them into staying when they do not wish to live anymore. I was trying to explain this and we weren’t getting anywhere. Depression already caused excessive amounts of guilt. Add this information and it is overwhelming, which is what I was trying to get at but obviously wasn’t explaining right. She is a very intelligent person but I really think that lived experienced people and others who think of ending their lives might be too painful for her to deal with and so gets offended. I have seen it happen to me one too many times. Yes, it does make you stop and think of who you are hurting when you are thinking of taking your life. But then you (the suicidal person) have to wonder, is my suffering greater than those I love? And if this was a physical, terminal illness like cancer, would they still feel the same?

It just bothers me so much that people who are already suffering from huge amounts of pain, physically and mentally, still go on with their lives because they basically feel trapped. I know I do. I feel trapped by not want to cause pain to my family and friends with my death and the pain I already have that I was so desperately to end. It is tearing me apart some days, especially when the dawn approaches and I no longer have such intense feelings of ending my life. One of the suicidologists was glad I had made it through the night. She was the only one that said that. I am sure the others would have thrown my ass in the hospital if they could. I write a lot about my feelings because I don’t have a lot of support. It is also cathartic for me to write. If I lose this, for whatever reason, I know I will die. I think I even emailed my psychiatrist last night about why am I still around? Why am I still here. And will she let me go? I was half expecting a response or a phone call. I got neither. I see her next week so I know I will talk about it, least I hope to if I am not chickenshit. She sometimes scares me because she has this way about her that when she says something, I have to listen and “follow orders”. I have never not done what she said when she says it in that tone she has. She has known me for a long time. I respect her a lot and she respects me a lot. She looks up a lot to me because I have been through so much.

Next week is going to be difficult as I have a lot going on. But right now, all I care about is changing my sheets and reading Harry Potter as well as keeping track of the Sox. Oh, almost forgot, the blog that I wrote early this morning was chosen by some paper and published on their platform. Pretty cool!

suicidal turmoil

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, CRPS, depression, mood disorders, suicide

Suicidal turmoil

***note this is just talk. No action. Just expression of feelings of suicide. If this bothers you, do not read***

My mood has been all over the place today. Last night I was feeling really suicidal. I was exhausted after a chat and wanted to sleep but my thoughts wouldn’t let me rest peacefully. I wanted to email my psychiatrist but I couldn’t come up with the words as my exhaustion out ranked my thought process. Eventually, I did find sleep.

I woke up in the middle of the night because of pain. I took my pain meds, made note of the time, and then went back to sleep. I woke up before my med alarm as I had to use the bathroom. I decided to stay up because I knew that if I went back to sleep, I’d feel like shit.

I got hungry and so made breakfast. I then had time to catch the bus, even though it was an hour earlier than I wanted to go to the square. Oh well. I took my time getting dressed. It was cool out so I had to switch things to my jeans from my shorts. I decided to wear a long sleeve T shirt rather than a sweatshirt. I figure it would be light and if I got hot, I could take it off. It was a beautiful day out. My pain was there but it was manageable. I got to Starbucks and had my espresso. Then I got my journal out and started writing as I wanted to keep it updated with what happened with my appt with the pain doc.

As I was writing, my mind kept going to suicidal thoughts. I wanted to write some more about suicide but I didn’t know what to write. It kept forming in my head. I looked in my bag for a notebook or notepad and there wasn’t one. GAH! Seriously??? I had bought a million notebooks and notepads and this bag was “empty”??? Guess I was off to Bob Slate in Harvard Square to get my favorite kind. I wrote down some more things in my journal and then went to get my med scripts before going to Harvard.

I got to Harvard and the place had change. I don’t remember the last time I was there. The newspaper stand had closed and it kind of changed the whole place. There was a new CVS next to the bank, which was also new. It was a jewelry place before. Starbucks was besides it. There was still construction going on in front of the Au Bon Pain. I still have no clue what they are doing. The construction has been going on for a couple years now. I went to Bob’s and got two notebooks. I only needed one but the other one was a composition type and was for quick notes. I thought it was cool so I bought it. I stayed away from the pen aisle but talked with the guy at the pen desk about refills. There are a couple of pens where I want black ink as they have blue ink right now. The lady became insistent that I bring in the pen to make sure I buy the right one. I am not a naïve pen person but thought it a good idea to do so. I asked what the price range for them were and she said $5 and up. I said I would be back. I’ll probably go Friday before my psychiatrist’s appointment.

I started walking down Mass Ave, not sure if I wanted to catch the bus down to my therapist’s office or just walk there. I got to the corner where there were some benches and sat down for a bit to drink some water. My bladder was telling me it had to go so I waited a little more, just taking in the surroundings and nice weather. I miss being in that part of town so much. It was like going down memory lane. I just started walking toward my therapist’s office. It was farther than I thought it was. I kind of figured that as the numbers were higher at Harvard than the other train station I usually get off. That part of Mass Ave had changed a lot. There was an Indian buffet restaurant, a Domino’s, a Dunkin Donuts. It was amazing to see all these new businesses.

By the time I reached my therapist’s office, I had walked off my suicidal writing energy. I went up to the floor and used the bathroom, then sat in the waiting room for an hour. I played on my phone for a bit and then I took out my journal to write some more. I tried to remember what I wanted to write about but nothing was coming to me. The bug had worn off. I wish I could walk off those feeling whenever ever they occurred. It would be a huge help to me but I know that might not always work due to pain.

I told my therapist right away about my suicidality and how my week went. A lot of stuff was stirred up. I forgot how much my PTSD was flared because of what happened in PT and then with the pain that activated the Cauda Equina Syndrome memories and surgeries, relearning to walk, etc. We talked about it and he listened to my suicidal ramblings. He didn’t ask if I was safe, didn’t get me off topic with plans or crisis stuff. He just listened and inputted his thoughts when I had finished. He does want me to see him twice a week just to have someone to talk to. He thinks I am too isolated. I explored it a little bit and I told him that was scary to me. I don’t know why. He playfully said that he shaves down the horns. LOL I told him I would think about it and let him know next week. I told him I would be on the new pain medicine and hope that would calm down flares and help me regain some things that I have lost.

When I got home and was thinking over the session, I wanted to cry. I never had a therapist that listened to my suicidal thoughts, plans, and other stuff before, in detail. I felt good about it and it made me feel better knowing I had someone to talk to about this stuff, the hardest stuff I can possibly talk about. He told me he wouldn’t be able to stop me unless I was telling him right then and there I was going to end my life after I left his office. It is Massachusetts law to protect someone from themselves or others. He didn’t give me an ultimatum, a do this or else scenario. I was appreciative because I never had that before. I never talked about how much I was feeling about suicide because safety was always first and foremost. Then add in a therapist’s anxiety and the whole thoughts about why you are suicidal are lost, never to be spoken about. For 27 years, no one heard me out after I said the “S” word. It was like the why are you suicidal didn’t matter and containment was more important. By then, the session was over and you were more frustrated because you were in this bind where you promised if you were going to act on your feelings, this and that had to happen and if it didn’t, you were on your way to the hospital to be admitted for a few days or more.

This is where suicide prevention gets mucky. You have a suicidal person and instead of listening to what they are going through that is making them think about ending their lives, they need to “prove” they are safe when they walk out that door until the next session with the therapist or psychiatrist. The client/patient may get angry they are being put in a bind and not heard. This has happened my entire suicidal career. Now I have someone that cares about me, wants to listen to me, and knows that if I really want to end my life, there is nothing he can do to really stop me. He is the perfect therapist for me and it is scaring me because I am expecting metaphorical handcuffs on my thoughts but they aren’t coming. I am free to talk about suicide as long as I don’t act on these feelings. It is freeing. It is validating. It is helpful. And I am grateful that I have someone like this.

I don’t know if I can see him twice a week because financially, that will be double the copay a month. Not to say that I will be able to make every session because I can’t always do that. We talked about that too. He understands that I have a chronic health condition that makes going out impossible some days. But he still wants to help me. He isn’t going to slam the door or give me an ultimatum saying I need to see him every week or else, which was what I was fearful about. He is a laid back therapist and I like this. I have to admit that my suicidologist instincts about him not using CAMS or some other EBP was freaking me out. How could I talk to him if he wasn’t going to measure the level of suicidality on a piece of paper? But I realized today, you don’t need that stuff to make suicide prevention/intervention happen. You just *need to talk*.