2019May09 Fearing the Worst

2019May09 fearing the worst

I have been having pain (yes, once again) and it has brought out the suicidal feelings once again. I had this insane idea to take a pic of the means I want to use and send it to my psychiatrist. Lately, (or maybe fortunately) I have been holding off on sending her an email unless I think it through. I thought of the consequences and it would be a huge deal and almost certainly, cause me to be in the hospital. I held off after talking with a friend on Twitter. We instead talked about other things while my heart was feeling like it was being stabbed a thousand times. She told me about her boyfriend wasn’t going to get back with her and I felt immensely sad for her. She and I had been hoping they would get back together again but I guess it isn’t meant to be.

I fell asleep for an hour and woke up with my elbow hurting. I somehow had fallen asleep in the nook of my arm and my elbow didn’t like it. My friend had sent me a message again and we talked. I felt so messed up still. Her meds kicked and she wished me good night. I was left with my thoughts. I again thought about sending her the pic of the means. Instead, I wrote to her about the struggle I am having and also sent her a pic of the cubic model of suicide. I told her where I was on the scale. I told her the father of suicidology, Dr. Edwin Shneidman, had never really written on chronic suicidality and what to do about it. He just wanted to decrease the psychache and you decrease the suicide. I told her this and also that there is no anodyne to help with the psychache. I have no idea if she will understand all this. I told her I probably need to go in the hospital but my sisters are going away for a few days and if I go in, my mother will be left alone, which would not be a good thing. My nephew will be here but he wouldn’t know what to do if her sugar went low. He has never seen her when her sugar is low and I am sort of protecting him from that. As much as I hate this woman right now, a low sugar and the other potential that could happen would make me so fricken guilty I wouldn’t be able to stand it. Yet here I am wanting to fucking die…jesus I am messed up.

In sort of closing I told her I wanted to push her away so she doesn’t see me like this. I hate having her see me like this. I don’t recall a time when I have been like this for so damn long, well sort of. I was like this 25 years ago, a few months after I graduated high school. Unfortunately then, she was on maternity leave and when she was back, I was in the hospital for a long stay. I fear that once she reads the email, I will be asked to go to the hospital anyways, even though I explained the situation with my sisters not being available. I told her I don’t know if I can hang on till then. I also fear that she won’t give a shit and just hospitalize me involuntarily if I don’t go in voluntarily. Either way I will be sectioned. If I do go in, I hope that it is on the unit I am familiar with. If I do end up there, I hope I don’t have the “team” I had a couple years ago. They are the worst team ever and don’t help you at all. They dance around like they are but once they ignore the can you help me with this and be told we will deal with it tomorrow but it never does; then they ask when would I like to be discharged and I say okay tomorrow. Fuck you too. Nothing gets done there but it will possibly give me some space away from home enough to gather myself up so I can bear living in this hell hole.

I checked my blocked text messages tonight and found that my ex texted me Apr 30 asking for me to send her my books. She was in the hospital after a suicide attempt for 3 weeks and someone stole them. Yeah, okay. Like she can’t go to Amazon and get them or a bookstore? I mean really! I know she just wants to get back in my life in some way shape or form but it isn’t happening this time. I am done with her. She broke my heart long ago and she can’t mend it. Part of me wants to respond but I know if I do, it would be a huge mistake.

I had emailed the social worker the beginning of the week to find out about therapy. I still haven’t heard from her. It would be nice to talk to someone as I feel like such a burden to my psych right now with my craziness. I hope to hear from her sometime today. It is 415 right now so I think I am going to try and go back to sleep.

Protected: When the cubic model of suicide is 5

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My Thoughts on Zero Suicide as a Person with Lived Experience

My thoughts about Zero Suicide as a person with Lived Experience

There has been a lot of talk on Twitter about Zero Suicide and it’s mission to reduce the suicide rate to zero, because 1 is just too many. At first, I was appalled that clinicians think that is possible. I for one think that it is outrageous because there is always going to be someone who dies by suicide. Maybe not in their organization but outside their organization. But then I learned that it’s not an individual’s practice but an organization or health system that strives to achieve this goal. They have trainings and meeting with those in the suicidology world.

Something kept bugging me about this. I kept quiet because I didn’t want to anger those that are for it, though I think there are a few blogs that I wrote about it before I understood the mission. While talking to a friend that is a suicide loss survivor, the bells went off. She said that it goes against Shneidman’s questions, where do you hurt and how can I help?

I am a big supporter of Dr. David Jobes work with his framework called CAMS (Collaborating, Assessment, and Management of Suicidality). I don’t know if Dr. Jobes trains these Zero Suicide clinicians. And even if they are trained, I am not sure it will be used. Most clinicians have the attitude that their skills on suicide risk are good enough when it could be faulty. Worse, they go through the training yet don’t use what they are taught. That drives me up the wall. Why bother going to a training (unless it’s a mandatory thing) if you aren’t going to take away from it?

I really think CAMS is a tried and true framework to prevent suicide based on my experience of using it in my former therapy. I also used the Suicide Status Form. Unfortunately, my therapist did not want training in CAMS and we drifted apart, thus ending our relationship. We did, while we worked together, use the initial and tracking forms but unfortunately, we never got to the outcome form. She wasn’t committed enough to see it through and that kind of pissed me off. Every time I had a suicidal episode, she just wanted to know one question on the form, The one thing that would help me no longer feel suicidal. It is an open ended statement where the client fills in their thoughts on the matter. Unfortunately, I could never come up with a satisfactory answer as I really didn’t know the reason for my suicidality. I just wanted to die and that was that. I wrote a blog about CAMS if you would like more information about how it is formed and the use of the Suicide Status Form.

I went on the website for Zero Suicide but could not seem to find the specific training that they went through. From what I gathered on Twitter from their live tweets, some of it is CAMS and some of it is using risk factors for suicide. Unfortunately, risk factors alone are not predictive of a suicide attempt. CBT has been useful in reducing suicide attempts but not all clinicians are trained in this modality. The book by Craig Bryan on CBT for preventing suicide attempts is a good book to learn more about it. I also wrote a review on the book that you can see here.
The other thing that gets me is that no where among Zero Suicide is there talk of a person’s psychological pain. There are measures, if you look for it. Dr. Holden at Queen University in Canada has created a scale to measure what Dr. Shneidman calls psychache. See my review on the research article for more information. I think it is a good psychometric to gauge a person’s level of suicidality and pain, which ultimately leads to thoughts of suicide. This must be included in any talk of preventing or intervention of suicide and also postvention, should a suicide attempt occur.

My final thoughts of Zero Suicide is that it is a novel idea but as Dr. Shneidman says, “How many suicides do you want, and I say I don’t want any, but I want there to be the freedom to do it. I study suicide but I am not pro-suicide. I’m for suicide prevention.” I share his sentiments. I do not like the talk of “suicide is not an option”. To me, that is hindering free will. I do hope the rate of suicides goes down, but the way that health care and mental health are going, I think there will be more before it lowers, especially among the chronic pain patient population.

never ending. It just goes on and on

Never ending. It just goes on and on

I’m trying to settle down for sleep but a new pain keeps popping up when I lie down, when I sit up, when I take my meds, when I move it, etc. It is fucking never ending. I am not doing a damn thing tomorrow, least that is the plan for now.

I sent an email to my psychiatrist asking her if I was a difficult patient. I briefly discussed my therapy session with my therapist and that the therapy group down the hall from him contacted me. Unfortunately, it got filtered to my junk mail so I didn’t get it until I got home. My phone doesn’t get junk mail for they could be viruses embedded in what they send. Last thing I need is a virus on my phone.

I just sent an email to my neurologist asking her if she could help me out by confirming that I do indeed have CRPS as my PCP just wants to pass me off to another doctor. I am tired of seeing new doctors who aren’t helpful and then just want to pass me off or not treat/see me anymore. I see my neuro in two weeks. It was kind of a long email but I don’t care. My stupid phone kept on inserting different words as I typed, which annoyed the crap out of me. I should have just typed it on my laptop so I wouldn’t get aggravated. Lesson learned.

My foot feels like it is being strangled. There is such a pressure on it like it’s going to burst. I am so tired that I am reaching the over tired stage, which is dangerous because I could catch my second wind and then be up all night. I took an Ativan because along with the strangulation, my ankle is pulsating. The little muscles are twitching. This condition is so frustrating because there is never ending different kinds of pain. I wish I could see a doctor at this hour so they can see or I can try to explain to them what living with this condition is like. All I can do is send them an email and then not get a response. But at least by writing it out, it helps me because at least I have documentation that I wrote this to a doctor.

I still am shocked that in the great medical hub of Boston, I have not found a doctor that is willing to help me. Sure, my PCP gives me pain meds to alleviate my pain. I appreciate that. But he doesn’t want to stop there. Right now my diagnosis is in the air and it is making everything seem like we haven’t tried enough. I am tired of this merry go round. I want off. I asked my neuro if she could possible give me a concrete diagnosis and staple it on my PCP’s head. Well, I didn’t say that. But if she could send a note to him saying I have this dreaded condition, then maybe I don’t have to see yet another new doc. There is no treatment for this condition. I know this. My PCP knows this, my neuro knows this. But opioids help me and if I don’t have them, I am good as dead. I have exhausted physical therapy. I have tried injections. I have tried rest. This is no longer a case of tendonitis. It is deeper than that.

The pain is changing all the fucking time, all over my ankle, foot, toes, bones. It hurts every where. Normally, at this hour, I would be writing a morbid story about ending my life. That is what this blog was about. My suicidal thoughts in the cybersphere. But then one day someone took it too far and called the cops on me so I no longer talk about those things, even though it relieves the tendencies to act. Thoughts are NOT the same as feelings. And feelings does not mean act upon them. It is okay to feel. It is ok to think. Here is a quote from the father of suicidology, Edwin Shneidman that I had the pleasure of talking to him before he died.

“Never kill yourself while you are suicidal. You can, if you must, think about suicide as much as your wishes and let the thoughts of suicide –the possibility that you could do it- carry you through the dark night. Night after night. Day after day, until the thoughts of self-destruction runs its course and a fresh view of your own frustrated needs comes into clearer form in your mind and you can, at last, pursue the realistic aspects, however dire, of your natural life”. –Edwin Shneidman, Suicidal Mind, p166

I write these blogs because I still am struggling night after night, day after day. Pain increases my vulnerability to think of self-destruction. I have the means though no one talks about restricting them. I told my psychiatrist I have something that will end my life but still, she doesn’t ask about it when I see her. She never does. Poor assessment of risks. So does my therapist who knows damn well that I have chronic suicidal thoughts. It makes me angry that I am not treated the way I was with my former therapist, Bozo. She was annoying, I will give her that, but she fucking cared and if I had a method she damn well tried to take it away from me the best she could. I really miss her. Yesterday was her birthday. I wonder if I will be alive to see mine. I really am surprised that you CAN get anything off of Amazon. While I was searching for my method, they had machetes. Machetes!! I don’t think I would have the will power to use it to chop my ankle off but I know a chainsaw would do the job. I refuse to search for it because I know in my darkest of moments, I may just buy it. I’ll go all Scarface on my ankle and groin to sever my artery.

I am once again plagued by dark thoughts. All because I can’t sleep and I am in pain that is never ending. It just goes on and on.