Tag Archives: suicide attempt

About Therapists

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?

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?

About depression that I have to get off my chest

About depression that I have to get off my chest

There has been a LOT of talk lately about depression being treatable. Let me say first, that for some, it is. Therapy has been helpful to some in dealing with it. Medications and therapy still prove to be useful in treatment of depression or actually any mental illness. It was once thought that schizophrenia was a medication only illness. But I learned through one of my suicidologists that isn’t always true, as there was a paper written by him about he helped decrease an individual’s suicide risk by seeing him weekly or more if suicide was more present. It helped the patient feel cared for. If I find the article in my files, I will share it if you care to read it.

I am in no way saying you should NOT get help if you are feeling depressed. But my experiences (which are not the same to the whole depression population) beg to differ. I have yet to find anything that helps the mood shifts. Since my long time therapist stopped seeing me for reasons I have still yet to learn, I have been the most unstable and hopeless I have been in the 16 years I was in “treatment” with her. We had our disagreements about treatment. Transference and countertranferences were helpful at times but were no long lasting. She stuck with the way she was treating me and I stuck to being, well, depressed and suicidal.

What I have to get off my chest is that sometimes, depression is untreatable in a small percentage of people. There is such a thing as treatment resistant depression. Despite ECT (“shock” therapy), medication, and therapy, one can still feel depressed. There are a trillion reasons for this. Sometimes it has to do with the trauma one experienced. Some has to do with biology itself, that the genetic predisposition of a person makes them depressed. Other times it has nothing to do with a trauma or situation. It just happens that you start withdrawing from life, slowly at first and before you know it, you can’t go back to things you loved because, frankly, you are too depressed. Sometimes you maybe too depressed to seek help and a friend or family member needs to push you to get it. The thing is, depression still exists despite treatment. Some people have suffered depression for years and have never told a single soul. They are the small percentage that still go on with their episodes after they pass. They are less likely to die by suicide. Hell you don’t NEED depression to end your life. It has happened. Look at the Shawshank Redemption movie. The warden was “well” mentally and rather than be arrested and humiliated, he killed himself. Would anyone have thought he would do such a thing? No. And that is what my point is. Although we know what the risks are for suicide, depression and mental illness is only a small window into those risks. There are some people who die that have no history of mental illness yet die by suicide. I won’t go into more discussion about it because this is a loaded issue. I suggest reading the Myths and Facts of Suicide by Thomas Joiner. It is a really good book about what I am talking about.

I can only talk about my experience, no one else’s. I have been depressed since I was 8, maybe younger. I only know this because I started thinking suicide was a good idea at that age. I was 10 when I tried to end my life for the first time. I suffered from depression and after taking Prozac, became bipolar because the medication caused mania like symptoms. Not once during my years of being on medication AND therapy did my thoughts of suicide leave me fully. Neither did depression. There were brief times where I felt contentment. I honestly don’t believe in happiness. Like anger, it is a fleeting emotion and doesn’t last. But feeling contentment does happen for me and I sometimes feel comfortable in it. I know it isn’t going to last long. It never does. The depression always finds a way back, maybe not right away but it does come back. Despite some of my successes in life, graduating from high school, getting my Associate’s degree, publishing two books, I still was depressed. I was elated for a little while but it was fleeing. Just like when I wrote the article for the New York Times. I couldn’t believe and still don’t, that it happened. I still have the check that one day I will frame along with the article. But soon after all the paperwork was filed and I was waiting for it to be published, I was intensely depressed. The New York fucking Times was publishing something I wrote and instead of being happy as a pig in shit, I was depressed. I learned that no matter what my success in life was, no matter how much money I made, good job that I had, I was going to always be depressed. I could do one of two things. I could accept that this was the way it was always going to be or fight it. I chose to accept it.

I knew I had been fighting it since I was 16 that I would always have to take medication for my mental illness. It wasn’t easy but I knew if I was to avoid a lifetime of hospitalizations, I would need to take medicine to hold off the demons. Yet despite this theory, I was still hospitalized. Many times. Some times it was like a revolving door during my worst episodes. In 1994, I suffered a huge major depressive episode. I was hospitalized almost every two weeks and then for two months because I tried to end my life. It was one of the lowest periods of my life. I couldn’t bring myself to do anything. Showering didn’t matter. I gained a ton of weight from the meds I was put on. I started living an almost double life. The life the psychiatrists wanted to see and who I really was at home, when I was by myself. Hopelessness was rampant and totally lost on me. I can’t say that I got better. I just got better at hiding from myself, to keep the darkness at a minimum so I wouldn’t be committed at the age of 19 to a state hospital. Even then the façade I built was hard to put down. I just did what I was told to do and when I felt like acting on my feelings of suicide, I told my therapist or psychiatrist, which inevitably led to another hospitalization. But the hospitals in the 1990s were different than they are today. Today they are nothing but holding pens. Two maybe three days you are in and then you are out. If you need more help and have an outpatient therapist, you see them. You don’t need to be in. Maybe you stay for a week or two. But never more than that. Insurance won’t pay for it. And you don’t really get “treated”. You are watched 24/7 to make sure you don’t harm yourself. You might find a “treatment team” that listens but that is ALL THEY DO. They don’t help you in what you came in for. That is for you and your outpatient therapist to work out. If you don’t have one, you might get referred to someone. I’ve never been in that situation so not sure how that works.

I have lost faith that my illness is “treatable”. Seems no matter what I do, I end up depressed or just stay depressed. I am okay with that. I’ve known for a while that there is no longer an antidepressant out there for me. I am grateful my mood stabilizer still works. I just hope that it does fuck up my sodium levels and I need to some off it. Then I will be really screwed. In that sense, I still take my meds because they help. I no longer have commanding voices every day and the accompanying paranoia and delusions. I have to take a med for that every day. But therapy is still elusive. I honestly don’t know if it helps. Talking with someone honestly, like writing this blog, has been useful. Sometimes it feels good to talk to my therapist and leave knowing that someone understands, even if he thinks I am crazy. He said that he is “taking my lead”, which I am not sure about but it is a learning curve like anything else. And I will stress again, that if you aren’t comfortable with the person you are talking to, if they make you uncomfortable or just not getting it, find someone else. There are a lot of different therapists out there. A lot of different degrees as well (but all should be licensed by the state you are in, if they aren’t, I wouldn’t see them). It will take some time to know if they fit with you. The average is about 3 or 4 sessions. Any more than that might be a waste of time if there is no connection.

suicidal turmoil

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*.

in a hopeless state of mind

In a hopeless state of mind

I can’t sleep because of pain and too much on my mind. I keep reading people’s messages about the two people that died by suicide this week and the CDC supposed data that suicide is increasing. I don’t trust the CDC anymore because it fudged data just to push an agenda that hurt people like me with chronic pain.

Some of the messages I read concerned helplines. Do people think that talking with someone for five minutes can help a lifetime of anguish? Probably not. Can it bring enough hope so that person can see to tomorrow? Maybe.

The past few months I have wrestled and anguished with my own thoughts of death. Hell, the beginning of the week, I was tormented with psychache, spoke about it on social media, and then was reported. In the email from Twitter, it said that I could speak to a hotline and there are resources. I deleted the email. What it comes down to, is whether I seek help or not. My choice, really. No one else’s to make. Just like you, reading this. You don’t have to read my blog. No one is holding a gun to head saying to read Midnight Demon. We all have battles that we face, some bigger than others but that doesn’t make them any less of a battle. It could be drugs, alcohol, depression, suicide, mania, voices, paranoia, etc. Some times someone feels too good to get help. Some times someone feels too bad to get help. Others may not think they are worthy or are too afraid what others might think of them if they seek help.

If you have a problem, whatever it is, someone else might have it too. You are not alone. There are people who have alcohol issues, mania issues, depression, trauma, sexual abuse, physical abuse, etc. and live to face another day though they may not want to. Some people, like me, think of suicide often. And that is really scary to some people, so much so they think by reporting them or calling the cops on them is the answer. But let me tell you what happens when you don’t face that person and ask, how can I help or if you need to talk I am here. It shuts them down. That was their one chance of opening up these vulnerable feelings and you just slammed the door, possibly forever, of them ever talking about their dark side ever again. Reporting does not help. I got an email with a hotline and a link to a resource. Did I use it? No, I deleted it. Someone once reported my online activities to the police. The local cops came and scared the crap out of my aunt and pissed me the fuck off. You think I am going to write in my blog the same way again? Fuck no. And why? Because of people like you who are too stupid to understand someone else’s pain and despair. To sit with it and deal with it rather than throwing it at someone else because you can’t be the better person.

I may end my life one day and sadly, even though I talk about it on my blog, you will never know about it because of this one person that sent cops to my door one morning a few years ago. It shuts people down. So I understand why Kate Spade didn’t seek help. She was afraid. I can’t say anything about the other guy. I never heard of him until he died a couple days after Kate. Would either of them have called a hotline? Would either of them have opened the link to the resources that were provided to them? Probably not. Their battle was theirs alone. Their decision was theirs to make. I understand it because I have lived it time and time again. In one of the legal pads I was trying to find to write this down on, I came across a story I wrote that I later published. It is also on my blog (I think). It was about a night where I was in so much pain, I wanted to end my life. And though I had promised my therapist and psychiatrist that I would call them should I feel like ending my life, I didn’t. I had hotlines to call. I had coping skills to use. Instead I wanted to end my life right there and then because of the agony of my foot and ankle but because I couldn’t walk three friggen feet to my bureau, 36 inches away from me to get more pills to take to end my life, it saved me. I woke up and wondered what I did. I will never forget that fear and the shame I felt. I was scared to tell my therapist and psychiatrist what I went through. Terrified that I would be once again be on the psych unit of some hospital never to breathe fresh air again.

Lately, I have been saying, Always be kind. You never know who might need it and is depending on it to survive another day. If you are still reading this and not dialing 911, reach out in other ways. Call that friend you haven’t spoke to in a while that seemed to have stopped posting on social media. Or that friend that was supposed to go to a cookout but didn’t show up. They just might need to know that someone other than the demons in their head care for them. And be kind and non-judgmental. Ask them if they need help with something that is important to them. They might not tell you everything or they might not even want to talk, just listen. Sit with their darkness. It will mean the world to them.