***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*.