A Special Blog Post

This is my 500th blog post. I wanted it to be memorable. And it will be, I hope, to me anyways.

I thought I would talk about David Jobes. He is my idol in the field of suicidology. I talk a lot about his work on my blog because I want to spread the word that there are treatment plans and assessment scales available for those who are suicidal. It took twenty-five years for this to happen. It might not catch on like DBT (Dialectical Behavior Therapy) did for borderline personality disorder but I am hoping that through my blog, someone has at least an inkling about it.

His work is CAMS: the Collaborating Assessment and Managing of Suicide. It is a framework that allows the suicidal patient/client to work with the therapist in his or her treatment plan. By working together, therapist and client, it is hoped that suicidal thinking will decrease enough so a completed suicide is avoided. This does not mean that the suicidal thinking will go away completely. Nor does it totally prevent a suicide. During one of his talks, he spoke of a clinician in Texas that followed the CAMS and the assessment tool, SSF (suicide Status Form) to the letter with one of his suicidal clients. The client ended up killing himself. The clinician did everything that he could. But sometimes, there is still the risk.

The SSF is a seven page form that uses an initial, tracking, and outcome form to monitor and assess suicidality. It is based on the work of several clinicians. I won’t go into great detail about this because you can find out more in Dr. Jobes’s book, Managing Suicidal Risk. The link it to the Amazon website where you can purchase it. I would love to post the SSF one day but I would be violating copyrights, though in the book you can make copies of the form. I just can’t do it electronically, yet.

The wonderful thing about this form is that it is a self report about the client’s thinking about suicide and also has clinical information in the end so that both client and clinician fill it out to assess and document the suicide risk. It doesn’t take more than 10-15 minutes to fill it out (might take longer if the person has trouble understanding reading and writing English or has a disability that prevents that from happening, such as dyslexia). It is individualized for the client and that is a huge thing Jobes tries to do. It is not a fit all in one box, so to speak. It should broaden the thinking of the client and clinician to help bring together and work together to prevent the client from committing suicide. In the SSF, it talks about reasons for living and dying, assess psychological pain, hopelessness, the need to escape, and also asks the question, what would make you not kill yourself? I have used this form in my therapy sessions and that is the first question my therapist asks me when I am in the throws of a suicidal crisis, which happens more times than not for various reasons.
Mostly it has been my word that has kept me alive and I do hate myself for it at times. I have told my therapist that I would keep myself safe and I have, though sometimes, I overmedicate to do so.

Background information of Jobes is that he is a professor at the Catholic University of America and also has a private practice in the Washington, D.C. He has written in at least a half dozen books (some of which I own, if I could afford it I would own all) and countless research articles relating to his work and also to the field of suicidology. He not only write about his work but also about the legality and ethical matters of dealing with a suicidal client.

Paranoid troubles continue

I have been having a facial migraine all day. One side of my face is numb and tingling. I have had them before. They usually are caused by bright sunny days and being overtired. I have been up since very early this morning. I wanted to get my editing done on my book and get to Starbucks early to get a seat. I got there around eight-thirty this morning as I was up at seven. I got the migraine when I came home. I guess I am stressing about this book a little bit.

I’m getting tied up in the details and when I asked a friend about quoting she said it’s different than quoting for a paper or article. CRAP. I have to find out if I can use this information with consent or half my book goes bye-bye. Not helping my migraine today.

Then today as I was looking for my migraine medicine, I realized I have two packages of old birth control patches that I am never going to use. I called the pharmacy to find out what to do with them and they tell me to call my city for medication dump. Well, it’s too late now to call. I was annoyed because I was on hold for like five minutes but it felt longer than that because of this damn migraine. I just feel pressure all around me and I just can’t get a hold of myself. I hate feeling out of control. I don’t know what effect the migraine med and my anti-psychotic pill will have so I don’t want to mix the two right now. I just have to ride it out and I can’t tolerate it. I feel like I am being pulled into different directions. It’s not even eight o’clock yet and I am ready for bed, which I might do but am afraid I will wake up early in the morning again, but this time at two or three o’clock. I can’t win no matter how hard I try with sleep. My days of sleeping for more than 7 hrs straight are over.

It’s a terrible feeling being watched by an unknown entity. Thankfully the voices aren’t chiming in with banter or I would really be losing it. Not that I would harm myself, just feel like I need to be back in the hospital again or something for fear of losing control. Maybe this book is just too much for me. I am starting to have second thoughts about it. I already feel like it will suck anyways. My therapist keeps trying to tell me that my book will be good like my blog is but my blog is different. I can write what I want to without being censored, per se. And I can quote pretty well to promote that things are not my ideas, least I hope that comes across. Maybe I am just worrying about nothing. My friend wants me to contact my idol about his stuff and the Aeschi model that I wrote. I just have to find it and make it in a document that is readable to him and pray he has time to read it and consent and then me not have a heart attack if he says yea or nay. This is the big leagues and I don’t want to fuck up on my first book. I would be utterly devastated if I got sued or something for what I wrote. I am like totally paranoid, and possibly with good reason. I wish I had my therapy appointment tomorrow but I don’t. I had to cancel because I am seeing my PCP. My monthly pain management appointment. I know he just is going to comment about my weight again. I put on a few pounds while I was in the hospital, I know I did. I haven’t weighed myself because I am too scared. I hate myself for it but sometimes I have no control over my eating. I sometimes eat when I feel it and other times I don’t eat at all because I have no appetite. Such is the struggle with depression. You would think a medical professional would know this but they don’t. They just want you in their set guidelines of a healthy weight, which is ridiculous. Technically I should be 125, at the most, and I haven’t weighed that much since high school. Medication is to blame and my back and ankle issues. It’s hard to exercise when it hurts. I try to push through it but it always backfires on me. Like today after I came home, my sister asked me to pick up my niece. It was a good walk from my house and now I am hurting because of the hills in my area. I don’t do inclinations too well with my bad ankle and there was no other way to get to my house without going downhill, unless I wanted to walk another three blocks or so. I know I shouldn’t be complaining because other people have it worse than I do with CES. But being in chronic pain every day changes you. For two and half years I have had pain nearly every single day, all day on some level. It gets worse at night, part of the reason I wake up in the middle of the night. My doctor calls this “inactivity” while I call it trying to sleep!! Sometimes I really think he doesn’t get it when he says he does. Did I also mention that he stresses me out going to see him? I never know what new thing he will come up with about my ankle pain or what kind of doctor he will refer me to next. I won’t go. I am tired of seeing new doctors and they always tell me the same thing, nothing is wrong with my foot or they don’t know why I am having pain as there is nothing wrong with my foot/ankle. I have seen them all and I am DONE. I just want my pain medication and just send me on my merry way. The end.

I am just tired. Plain and simple.

I have done a lot today. I started the editing process of my book and shouldn’t have added some pieces but then I took away some things, so things evened out a little bit. The page numbers do not correspond to anything right now so I have to go through page by page which is a hassle. The title chapters are becoming clearer so I am happy about that. If I stay on course, I should be ok with a Nov 16th publishing date so stay tuned!!

After the editing, I decided to watch the football game. At half time we were leading 21-13. Or maybe it was 21-17. I don’t know. I was kind of sleepy and not interested in watching the game but felt I had to. I had some French fries for my lunch/dinner and then retired to my room where it is fricken cold. I am waiting for my brother in law to come take the AC out of the window. I just texted him to let him know that I want it done today. I am so proud that he has learned to text. When he got his new phone, he had no clue and thought it was a game. I guess they text him a lot at work and he got a little aggravated one day, saying to my sister that this game just won’t stop. She laughed and said that is the text messaging. He can be a little old fashioned but I love him. He really is a good guy.

It has been good that I am home. I didn’t do too much yesterday as I was so sleepy. I said I was going to sleep for a half hour before the game and the next thing I knew we won and the game was over thanks to Victorino’s grand slam! I can’t believe I missed the game!! I am so mad at myself.

I think I kind of got my therapist worried a little bit. She asked if I was suicidal and instead of giving her an answer, I said that I don’t care, which is true. I don’t care if I am suicidal or not anymore. It’s not like I am going to act on it so who cares! If I was going to act on it, I think it would be more dangerous. So I just don’t care if I feel suicidal anymore. It’s not like they lock you away in the hospital anymore for days on end. In fact, unless you actually act in the hospital to harm yourself, they will just discharge you no matter how bad you say you are going to harm yourself. So I am just DONE with the whole business of it all. And it’s not like she helps me while I am suicidal. She doesn’t implement the SSF or safety plan or any of the other things that will ease the tension of suicidality. She just increases sessions where we don’t really talk about anything. My psychiatrist just relies on me to tell her about my symptoms. If I am not telling her I am having symptoms, then to her, I am fine. I just am so sick of being in a constant suicidal state and not being able to do anything about it. I can’t take my life so why bother being suicidal? I mean I can take it, but it’s too much of a damn hassle. I am tired of the planning that goes into a suicidal plan. I am tired of the contracts for safety telling my therapist I will not act on it no matter how bad I really want to kill myself. I am just tired. Plain and simple.

decision has been made

Decision has been made

I will be going to the hospital today for an evaluation. If they deem that I will be hospitalized, then I am not going to fight them on it. My therapist is still wicked concerned that this hasn’t stopped in over a week. I know that once they talk to her, I will most likely be in anyways.

I woke up kind of late today so I didn’t have my breakfast like I wanted. Now I am on my way to the hospital but will be making a Starbucks run first. I need coffee and something to eat. Consider it my last meal in the outside world! Haha.

I don’t know if I will be able to post while I am in the hospital. It all depends on where I will be going. I am nervous about that because they don’t always know where there is a bed available. I hope there is one available locally so I don’t have to worry about a big ambulance bill if I have to be transferred to another hospital. Don’t know if I will have my cell phone access. Different units, different rules.