Tag: suicide

Shneidman’s greatest questions: Where do you hurt and How can I help?

by Midnight Demon, posted in Bipolar Disorder, blogging, depression, mood disorders, suicide, suicide attempt

Shneidman’s greatest questions: Where do you hurt and How can I help?

After I had a meltdown in late 2005 and was slowly recovering in 2006, I was taking a psychometrics class at college to earn my psychology degree. Psychometrics is a fancy name for psychological testing and validating tests and assessments on various things. As I was recovering from a deep suicidal depression, I was curious to see if there were any measures on psychological pain in suicide. I wrote my first draft of the term paper with 20 some odd articles all doing various risk assessments and testing of suicide ideation but none of them dealt with psychological pain, which was what I was aiming for.

The professor tore my first draft apart and even, however vaguely, accused me of plagiarism. I wanted to get a good grade in this class because it would help my further advancement in psychology. I went back to the drawing board. I searched for pain and psychological pain in the library databank. About only 5 articles showed up, at the time. I am sure I was doing it wrong. I looked up the articles and found Shneidman and Holden. Dr. Holden was based out of Queen’s University in Canada. He came up with a psychache assessment that I found useful in my therapy. I kept that article and shared it with my therapist. Then I queried everything on Shneidman and hit the jackpot. His work was in psychache, psychological pain. I read everything I could on him and his followers. I saw my idol David Jobes’s early work on the Suicide Status Form. It wasn’t appealing to me at that time. I was more interested in the psychache of the matter.

I read Dr. Shneidman’s book, The Suicidal Mind. Holy crap! This was about “me”. I knew I had to read everything this guy wrote but it measured in the hundreds so I focused on what was available now. I tried to read his books that were solely written by him but they were few and outdated. He wrote many chapters. The two questions that I kept coming across were “where do you hurt” and “How can I help?” No one had ever asked me those questions all my years in therapy. Not even my current therapist at the time asked until I brought it up to her.

These questions were the basis of how he helped suicidal people over his career. He brought them other options for suicide by learning things about their predicament. Then he ranked them in order of importance. As he slowly worked with them, suicide became less of an option on the list, which was good. It didn’t mean their risk of attempting was any lower but they could see that it wasn’t something that had to do right then and there as there were other options. That is what suicide prevention is, finding other solutions to the problems someone is facing other than suicide. Sometimes it works, sometimes it doesn’t. There was a case in which Shneidman talked to a Hispanic male who attempted suicide by gun shot. He blew off half his face and needed multiple surgeries and was in intense pain from his injuries. Dr. Shneidman counseled this man until he was well enough to leave the hospital. They kept in touch but as time went on, the contact got fewer and fewer. The young man died by suicide by that method a few years later. It was a sad case. The importance of the story is that contact is useful even after the initial attempt has passed, be it with postcard or phone calls or text messages. This isn’t an entire protective factor but it can be. Some people who think of suicide and even go to plan it, get through their circumstances never to think about it again. Others make an attempt and it is a kind of “wake up” call and they never think about doing something like that again. Then you have the people that are chronically suicidal, who make multiple attempts. These are the people most at risk of ending their lives by their own hand. It is these people that need the most help and patience. This is where the framework CAMS (Collaborating, Assessment, and Managing Suicidality) comes in handy. Check out their website https://cams-care.com/?pgnc=1

my blogging adventures for the month

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, depression, mood disorders, suicide, suicide attempt

My blogging adventures for the month

In addition to my daily blah blah blogs, I will be writing about suicide prevention and about things related to it. A friend of mine gave me a few ideas on the subject as well as writing stories about what it is like being a patient in the hospital. I can go one for days with that one as I have had many hospitalizations spanning many years. I will also write some stuff on what I think works best to prevent suicide and why therapists NEED to be trained and use what they learn in their practice. Otherwise, what is the purpose of spending money or attending a seminar in suicide prevention and not use it?? That just irritates me.

I slept in three hour increments last night, giving up around 1000 or so. I washed up and shaved the back of my head to make it bald. I need to put in a new razor because it’s not as close as it should be. I’ll do that later. I then had a bowl of cereal before getting dressed and leaving to catch the bus. I brought my Bluetooth headset with me but I couldn’t get it to turn on. I think the battery died. I tried charging it while at the bus stop but couldn’t get it to work right. I put it away and pulled out my wired headset.

I dropped off the cookies I made to my barber. He loved the cookies. Then I went to Starbucks for my breakfast sandwich, espresso, and some cookies. I was able to charge my Bluetooth while there. I still have it charging on my laptop. I got kind of antsy after writing in my journal for a bit so went to CVS to look at shavers. I found one that I liked but it was $50. I made note of it on my phone and then went to catch the bus. Luckily it was late as they changed the time to 1220 not 1230 for the fall schedule. I got to the bus waiting area around 1222.

It was muggy by the time I came home. I went to Walgreens as I had a prescription to pick up and I wanted some Reese’s peanut butter cups. They had them on sale so I grabbed 2 packages. My ankle was hurting by the time I got home. I was sweating and needed to clean my sneaker off on my “good” foot as I stepped in some gum. I couldn’t wait to get to my room to cool off.

I was talking more with my friend about suicide prevention and how it’s gone to hell. She was telling me how she lost friends on Facebook because of her new adventures that are away from suicide related stuff. She had made that decision a few years ago as she felt it was time to move on to what she wanted and not live in her sister’s death by suicide. Sibling suicide survivor is hard because it really doesn’t get talked about. She was a strong voice for a while. Now it’s mostly parents that have a voice. A few brothers or sisters have come forward but it’s rare. The stigma is so great that it’s not helping the situation, even though studies have shown that sibling survivors have also thought or attempted suicide. They need care too, not just the parents.

My friend had sent me her blog that she is posting tomorrow and wanted my feedback. I was struck that she included my mentor, Dr. Shneidman’s questions, where do you hurt and how can I help? The Zero Suicide squad has gone away from that concept and really have no substance in helping preventing suicide because they really have no clue other than asking about it and how to go about asking about it, least that is my perception of it. Something about that concept was bugging me and it wasn’t until she brought about those questions that I figured out why it was bothering me so much. The sense of asking where it hurts or what is the one thing that won’t make you suicidal, or how can we make this a life worth living despite the pain of living has been lost. Some are still advocating for it but I worry that for every say 20 therapists that go through a training on suicide prevention, only 1 or 2 will actually take it to heart and use it in their practice. I will write more about this for those that care.

Shneidman was an important man in the evolution of suicidology. I think about him more during this month than any other because he advocated for suicide prevention. Stay tuned to learn more about this great man.

in my brain, dial it up, everything I want to say

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, depression, mood disorders, suicide

In my brain, dial it up, everything I want to say

I am totally addicted to “One Number Away”. It has been on repeat since yesterday afternoon. It touches me every time I hear it.

I am going through withdrawal symptoms from my pain meds because it has been 11 hours since my last dose. I have been sleeping all day so didn’t bother to take them when I woke up two hours ago. Sucks being dependent on a drug. And NO, being depended and addicted are two separate things. Being addicted means you need higher amounts of something to feel good. I don’t need a higher dose of my pain meds when I go through withdrawal. I just need to take the dose I take to get relief from the dizziness and lightheadedness that I feel. I almost fell backwards twice today. I thought it was because I am in Neurontin fog but now I think it’s because of the withdrawal. I have just taken my meds so I should be feeling better in about a half hour.

My mother is making dinner right now. Sausages and potatoes. I have a funny relationship with sausages. I like them but sometimes the taste makes me not like them. It’s weird. I’ll probably eat more potatoes than sausages anyway.

I made coffee but couldn’t drink it. It was making me more sleepy so I decided not to drink it all. I had wanted to change my sheets today but I’m not feeling up to it. I bought these clips to hold them in place. I just hope they work and don’t rip the sheets or slip off. I got them cheap on Amazon, just $8. A catalog that my mother gets had them for $14, but it was just 2 clips. I got 3 clips. I hope it keeps my sheet from coming undone after a few days. I hate having to fix it.

I got my suicide prevention shirt from the American Association of Suicidology. I hate not being a member anymore but the fees are too much for my budget, even as a fixed budget fee. I have Twitter to keep me updated on things as people are now posting on social media the slides and stuff at conferences. It makes you feel like you are there.

I’m starting to feel better now that I took my pain meds and ate a little bit. The sweet potatoes weren’t cooked but the zucchini she made was. It was a good dinner. I love zucchini with bread crumbs. She baked it in the oven so it was crispy. Very yummy! I hope I am able to stay awake for a little bit now that the withdrawal symptoms have passed. I try not to let it happen but I have no control over my sleeping pattern. I had woken up in the early morning and didn’t go back to sleep until 0700 then woke up at 1400. It was a good sleep. I hope that I will be able to sleep tonight. I think I will because I am still tired. I’ll change my sheets tomorrow. I really don’t feel like doing that task today. I need to clear my bed off and then take the sheets off. That is the easy part. Finding a place to put my “office” is always difficult. It’s not so bad as mostly it’s just clothes more than books and notebooks like last time. I’ll do it but I need energy and I just don’t have it today.

Therapist’s choice or fear?

by Midnight Demon, posted in Bipolar Disorder, blogging, depression, mood disorders, suicide, suicide attempt

Therapist’s choice or fear?

My therapist of sixteen years had decided sometime while on our three week break that she couldn’t work with me anymore for what reasons are still not quite clear. We had been arguing over various things the last several months, including my suicidality and it was becoming apparent that she refused to seek the given evidence based practices I was telling her about to deal with my suicidality. I was becoming more and more frustrated and wrote a blog about it that “opened her eyes”. Our engagement ended in February of this year. I was gutted. I had no choice but to end things with her if she had no idea how to work with me any more. So the hunt for a new therapist began, once I could manage it.

It is very difficult to find someone willing to work with a high risk suicidal patient, such as myself. When my therapist moved to her office thirty miles away and I had no means of getting there, I called ten therapists in a five mile radius of my house. I kept getting the run around. I couldn’t be seen by them because I was high risk and so they referred me to someone else. That someone else then referred me to someone else. I became distraught and just stayed with my therapist event though it meant more phone sessions and text messages.

Now I had the same problem, except I had no back up. There was no one. I had asked some therapist friends on Twitter in my area if they knew anyone seeking new clients. One responded and gave me a name. That therapist never returned my calls. After three weeks (one call a week), I gave up and moved to therapist number two. Same deal. It took me until April to find someone that a) took my insurance and b) wasn’t afraid of suicide. I’ve been seeing this guy for about three months now and it is getting obvious to me that we just aren’t clicking. You need a certain chemistry to work with someone is this guy is lacking. I thought I could work with him but he is my back up right now. I am looking for someone else.

The day that I had my first meeting with him back in April, two therapists returned my phone calls. One had taken three weeks to call me back so I was not in a rush to call her back even though her qualifications seemed like it would match what I was looking for. The other organization I didn’t know too much about but knew they offered CBT, a therapy modality known to work with some people but didn’t for me. I kindly told them I was not looking at this time but if that changed (I hadn’t met the guy yet so it could be possible not to work out), I’d be in touch.

So when I was hospitalized a few weeks ago and my current therapist told the social worker that I was there because of “family conflict” instead of a psychotic episode that happened that weekend, I got pissed off and realized I wasn’t going to waste 16 years with this guy to know it was wrong. I called the other therapist and she never called me back. Then I got in touch with the organization. I had a phone interview with them last week. He first went over my insurance as he didn’t take one of them. OK, but he took the other so I was okay with that. Then we talked about clinical stuff. He asked when was the last time I was hospitalized and I truthfully told him a few weeks ago. He ended the conversation saying his group would be unable to help me as I needed “intensive outpatient” treatment after a hospitalization. He basically said I was “too sick” to work with one of his therapists.

I was floored this happens in 2017. I have been studying suicidology since 2007, reading countless articles about how clinicians, particularly psychiatrists, are more prone to have a suicide during their career than any other profession. Psychologists are second to that. Yet despite the advancements in evidence based practices (EBP), there is still the fear of losing someone to suicide. I can’t make that go away and if I ever become a therapist, I too will have that fear. But there are measures you can take to decrease that risk in the high risk client, if there is a willingness to work with one. That opportunity is lost if you slam the door like countless therapists have done to me. Suicide is inherent in any psychotherapy, regardless of risk factors. It can “appear out of the blue” or not noticed until an attempt is made or a death occurs. The suicide rate keeps climbing. And one of these days, I will become part of that yearly statistic.

I look for help and get denied because of my risk factors, which are history of previous attempts, history of abuse, history of hospitalizations, and history of self harm. These factors I deem “high risk” can also be viewed as severe mental illness or “being too sick”. It was the director of the organization’s choice not to take me on as a client. Pissed me off but his choice regardless. But was it also his fear that I would take on a certain liability because I was chronically suicidal and mentally ill? I will never know but my gut says fear altered his choice. I understand that therapist want to have the kind of practice where things go smoothly and stuff like suicide is dusted under the rug. Suicide is a dirty word. I get that. I have lived it since I was eight, when I first thought of ending my life. No one wants to touch it with a ten foot pole. But excluding these people from these practices, what the hell did you enter the field for?? I have to wonder.

The therapist I work with now doesn’t follow a lick of EBP. I still don’t know what kind of therapist he is. Frankly, he just lets me ramble for 45 mins then it’s see you next week. He has explained what he does but he has yet to actually do it, which is why I want to see someone else, if I can find that person. I live in the hub of academia where there are thousands of therapists. The biggest problem I come across, other than their fear of suicide, is not taking new clients. OK. I get it but can you refer me to someone who IS taking them? No answer or try Susie Q who isn’t within my area of accessibility.

Anyways, these are my thoughts on the matter. Getting screwed by those that are supposed to help mental health patients but don’t want to deal with mental health patients that fit a certain criteria. I think that sums it up nicely.