Tag: psychache

Mentioning of suicide, therapist panics

I had been seeing an interim therapist while waiting to go to college after I graduated high school. I was seeing someone in the local mental health center and I was supposed to see her for the summer as my current therapist got laid off due to budget cuts.

Some where in the middle of that summer, I reach the lowest point in my life, about three weeks away from when I was going to leave for college up in Maine. Like anyone else would do, I told my therapist that I was having suicidal feelings. She then did something totally unexpected. She took a deep breath, held it, let it go, and then sat there stunned like I shot her with a taser or something. She didn’t know what to do. She asked if I needed to be seen by someone in the emergency room and I forget if I did or not. I think I did because I got to the local hospital and was admitted for two weeks. I was glad my summer job had come to a close so I didn’t have to worry about work.

What I didn’t realize was that suicide is a big deal in the mental health field. The therapist didn’t want to take me back after my admission so I was stuck seeing a resident who basically said it was her or the hospital. I didn’t have a choice of people to talk about my feelings of being suicidal. Sure they were fine in the confined settings of a hospital stay but were taboo on an outpatient setting. I always knew I was high risk and it wasn’t until I entered into the field of suicidology did I really understand what it meant to be suicidal not just as a patient but as a clinician as well. I am not a clinician but I do have a clinical way of thinking about things. I might not be trained (yet) but I have more experience in therapy than a new graduate or even someone who has spent their lifetime doing this. I like to think of myself as an expert but then all people who have attempted suicide feel that they are.

What strikes me is the legality of the dreaded no-suicide contracts, the risk for malpractice, the ethical responsibility of the patient in the course of therapy, and the risk of losing the patient. Those are some pretty big reasons NOT to take on a client but what if you were in the situation that I was in. I already had an “established” therapist and she got cold feet when I told her I was thinking about killing myself. And in the age of the internet, I find that I am not the only one who has had this experience. I also have had trouble finding another therapist. My current therapist, though she still gets anxious when I talk about suicide, is thirty miles from me and I don’t have a car. We communicate solely by phone unless I can take my sister’s car every so often to drive out the forty-five minute to hour drive both ways. I have tried to find a therapist within a five mile radius of my house and have failed, not once, not twice, not three time, but ten fucking times!!! That is right, I called ten different therapists and they all turned me down because I had a history of being suicidal. It hurts and sucks. They just asked the question, I answered honestly, and got either referred to another therapist or was turned down outright. So I was stuck with the far away therapist. I then got hospitalized during the course of trying to find a therapist I could see face to face and when I did, he was scared of me. I mean beads of sweat were coming down his face and he had a high pitched, nervous laugh. I could tell he did not want to treat me. He didn’t want to lose me because I was such a high risk person. What makes you high risk? Having a significant history of suicide attempts, history of being abused either physically, emotionally or sexually or all three, constant suicide thoughts, and feeling hopeless. There are other criteria but those jump out at me as the most significant. I once went to a suicidology conference where I listed the prominent symptoms of my condition and had it reviewed by one of the suicidologists at the conference. He didn’t want to touch this person with a ten foot pole. I never felt so hopeless before in my life. I knew at that point that there was no hope for me, that I was destined to always be suicidal, or at least have suicidal thoughts. But it shocked me that this expert had no advice for me other than good luck.

To be a suicidal patient and have no where to go is a tough situation. You depend on the therapist to be there for you and to talk openly about any topic you want to talk about, including suicide. But what do you do when the therapist has no clue? You would think that the therapist would know how to handle the situation. You are after all trusting this person to give you advice about your life. It seems kind of too late to start the training now while you are in crisis on what to do. It’s not like you can put your life on hold while the therapist gets a clue. All I can say is to be patient. Don’t buy into a no suicide contract, they don’t work. Go to the American Association of Suicidology’s website to help both you and your therapist. There are not too many therapists that know how to handle suicidal crises every where and each state has their own rules regarding suicidal safety. The best advice I can offer is to both be honest with one another and to listen to each to whether out the storm of the suicidal feelings. Have a safety plan in place. Use a crisis response plan. Pick up a book on Managing Suicidal Risk by David Jobes and give it to your therapist. If the therapist says she or he cannot work with you anymore, find someone who can. That might take some doing and some time but you can find someone that is not afraid of suicide.