Tag Archives: therapy

Things that annoyed me and other stuff

Things that annoyed me and other stuff

I woke up around 0330 in pain. Took me a while to get back to sleep. I think it was around 5 when I did. I woke up next because of my med alarm. I took them and then my bladder had to go. I went downstairs and it was already muggy. I used the bathroom and brushed my teeth. I didn’t feel like showering. I know I need one but I am just being lazy at this point. I went back up to my room and fell back to sleep. I set my alarm for noon so I wouldn’t sleep late. That was for waste as my dumbass cousin kept calling me. He must have called like four times. I let it go to voicemail. I stayed in bed until it was 1230 and then got dressed.

I went downstairs and put my shoes on when I realized I forgot my insulated cup. Oh well. I didn’t feel like going back upstairs for it. I grabbed by bag and then went out. My cousin was pulling up and my mother was getting out of the car. I started yelling at him for calling so many times. He said my mother had bags and I needed to help my mother out. What was wrong with him?? He has no problems with his legs. He is just a lazy fuck that refuses to go up one friggen flight of stairs. I walked away after he said that I should help my mother and he asked where I was going. Fuck you. I put Taylor Swift on my headphones and went to the bus stop. Bus came because I got the bus driver that likes gas. She drives fast and you better sit or brace yourself once you get on the bus or you’ll go flying.

I ordered my Starbucks. I wanted a cheese Danish but the store was out of them. I had a coffee cake instead. After I ate, I wrote in my journal for a bit, but was not too focused. My thoughts were all over the place, making it hard to write them down. I used the restroom and then left for my therapy appt.

I got there and he was running late. I had so much to talk about. I told him about my cousin and what he said. Then started talking about how my father has been on my mind a lot lately. It’s been more than two years since his death yet I can practically remember every detail of the day he died and it plays at least unexpected times. I told him how I felt about not being able to do enough for him, but knew also, there was not much I could do to save a dying man. Even if I altered the DNR to get him fluids or other care, it wouldn’t benefit him. It might actually cause him more pain. We talked about how I felt about him and the abuse he did to me on so many levels. I nearly broke down at least three times but didn’t. I somehow kept the tears back. I don’t know how to process this. It sucks big time. He let me talk. He didn’t say too much. Told him how my uncle died, my father’s brother. I didn’t find out the truth about how he died until a few years ago, before my father died. I forgot who told me. It made sense to me though I didn’t say anything more about it to anyone. I was five when he died and really don’t remember him that well.

My therapist had to change our time for next week. So I have a double header next week. PT in the morning, therapy in the afternoon. Fun! I should be a fucking wreck physically. My mother called after therapy. I had just missed her call by a few minutes as my phone ringer was off. I called her back and she asked when I was going home. I told her I was on my way but it could be an hour or so depending on the bus. She said when I got home to tell my niece to come upstairs. I said okay.

The bus was late and I think something was wrong with the back doors as the driver had to get out of the bus to fix it or do something to it. I was hoping things went okay as we were a few stops away from where I was to get off. It would be a LONG walk if the bus was broken down. But whatever he did fixed the problem and I got off at my stop. I went to Walgreens to get some protein bars but the price went up. It was 2 for $3. Now it was 2 for $4. I didn’t have the other dollar and I wasn’t going to pay $2.49 for one. My friend told me I can sometimes get coupons for these things so I will check out the website she recommended.

I had dinner and then went up to my room to change. I was so tired. I was hungry again but thirsty too so I drank some powerade. I wanted to make some fried eggs and toast. That has been my kick the past few weeks. I took a shower instead. BAD MOVE. My back protested violently. I am still hurting. I had to shave my underarms so the extra standing just annoyed my back. My trimmer ran out of juice and had to be charged so it was the old fashioned way of razor and shaving cream. It took longer but was worth it. I then washed off in the shower until my back had enough. I think it was the fastest shower I ever took. Getting into my PJs was hard. My feet did not want to go through the pant legs. I was getting so annoyed. My back was ready to kill me. My legs are also hurting. My left thigh is beyond sore. I have one appointment tomorrow in the afternoon to see my PCP and then 4 days off of doing NOTHING. Least I hope so. My legs are going to need to rest.

hot and annoyed

Hot and annoyed

Temps were close to 90 today. I was annoyed most of the day. I called my mother to ask her if she needed anything while I was out. She said just look at the price of the eggs. Okay. I go downstairs and she wants me to go to the bank. If she said so when I called her, I would be able to go. Now it was too close to the bus schedule and it isn’t going to happen. I asked when the bank closes and she said 4. Sorry no can do. I won’t be home till after 4.

I went to Starbucks and had a sandwich and espresso. I had five shots as I didn’t sleep well last night due to pain. Not really physical pain, but nerve pain, which is a different beast. I wrote while at Starbucks. Then I left for therapy. The train car I was on did not have air on. It was stuffy for the few stops I went. I reported it when I got off the train. I got to my therapy appt a half hour early. I just played with my phone until my therapist called me in.

I told him I would like to try twice a week. He said we can do it this week but then the next time won’t be until middle of July. He is going away after the fourth and won’t return until the third week, I think. I am okay with that. Hopefully but then my meds will be adjusted and PT will helped somewhat so I can make twice a week. We then talked about random stuff.

I left and walked to the station. Temp was higher but the humidity wasn’t bad as I thought it was. The train was delayed and I missed my connecting bus home. I had to go to another bus stop. I was careful on the walk home, avoiding that stupid ramp in the sidewalk that caused my ankle to flare Friday. By the time I walked in the door, I was sweating. The house was hotter than outside. I was kind of grumpy as I was hungry. My mother said what she was making and I told her I wasn’t hungry. She asked what did I say so I yelled I wasn’t hungry. Then she yelled back saying she wasn’t making it now (even though it was after 4PM, her dinner time). I got so annoyed. I just went upstairs and turned on the AC to cool down. My T-shirt was soaked. I used a towel to dry off. I didn’t feel like a shower as my ankle was acting up slightly.

I got a package and it was from China. I thought it was the ice genie I bought. It wasn’t. It was the Pride bracelet. I thought it was cool. I tried opening the clasp and it wouldn’t open. My mother tried and we used different things but it wouldn’t budge. I have no idea how to open it. I took some pics and sent it to a crafty friend. I also emailed the place I bought it from to see what the trick was. Hope my $25 didn’t go to waste or I want a refund.

I checked what the new schedule would be for the bus I take to PT. I will either be 45 minutes early or 10 minutes or more late. Great. I am looking into Uber. I don’t know how I am going to swing it as I don’t have extra cash during this month because of my bill pay mistake. I owe my mother money that she let me borrow to fix my account. I am still pissed. I never called them to argue because I hate conflict.

I took my night meds without problems. Weird because the past few nights I have had trouble swallowing them. I switched Powerades so maybe that was why. Fricken thunderstorm has taken my back out. Lovely. I can’t take my pain meds for another hour. I hate this shit. I really do. Hope I don’t have pain like I did last night. Sox are off so I hope to be asleep before midnight. Not sure what I will be doing after I finish this blog. Maybe read the new book I started yesterday. Or maybe try and read some Neverwhere. Neil Gaiman has another book out called how to talk to girl at parties. I thought it was a play or something and it is a book. I never know with him. I might get it, if it isn’t a graphic novel.

day 5 and a flare

Day 5 and a flare (warning, long post)

Last night, I had to go to the bathroom kind of late, around 2300 or so. I was also hungry so went downstairs. I must have went down four steps and my ankle went out on me. It became really painful. I stopped and hung on the bannister to prevent falling. Pain subsided a little and I went down a few more steps only for it to happen again. Shit. I held on again to the bannister and waited for my ankle to calm down a bit. I knew the downward motion of my ankle was causing it to get annoyed. I finally went down the rest of the stairs and did my business.

When I came back up to my room, my ankle felt okay. The game was late as it was on the west coast and I couldn’t stay up as I needed to be up at 6. Around midnight, I turned in, or tried to. My body pillow was a mess and was not making me comfortable. I must have flung it off the bed as when I came up to my room today, the whole side of it was on the floor. It collected all the dust that surrounded it. Great. I used a lint roller to get it off. I just decided to use a regular pillow and somehow fell asleep. I woke up about three hours later in pain. It was too early to take the 12 hr pill so I took the immediate release. Two hours later I was still in pain so took the longer acting med. I was early but oh well. I then slept for about an hour until my alarm went off.

I took my morning meds and then went downstairs to brush my teeth and wash my face. I was deciding on what to wear. I thought I could wear shorts but it was too cold and it was kind of rainy. I decided sweatpants and a long sleeve shirt were in order. Except, I couldn’t find the one I wanted to wear. I scrounged my bed and it was nowhere. Oh well, just go with the one I usually sleep in. I left to catch the bus. As I got to the corner, the bus I was to take rolled by. Luckily, another one soon followed so I didn’t have to wait long.

I brought my Dostoevsky book with me. I had 45 minutes before PT. I got coffee at the lower end coffee shop and a coffee roll. When I finished the roll, I got to reading until it was time to leave for PT. PT was not so great. She gave me a few new exercises but I think I am going to have trouble doing it on my left side due to moving my damn ankle/foot. I might have to wear the AFO (ankle foot orthotic) to keep it stable. We just did the right side and she explained what muscles were moving. Then she massaged my hip. She said my muscles were hard as a rock. I said like a tennis ball and she said yes. Some parts of where she was touching was bothersome to my thigh muscle. I had to remind her that my L2/L3 surgery fucked it up. We talked about the PTSD and stuff that surrounded my pain issues and she offered some concrete grounding techniques which I will try as the ones I were using were not working. I chiefly use distraction and music. She had me laying on my back under some kind of box thing. As we were ending, she moved my knee to my chest and my back cramped up badly. It hurt so much. I was able to walk out of there but I was hurting. I came home because my next appointment wasn’t until 1500. I made a fried egg that I kind of overcooked the yolk. Then I went upstairs and was hoping to catch a nap. Well my ankle said no to that soon as I laid down. I left an hour early than I wanted to. I went to Starbucks for espresso and a Danish.

I read my book as I brought that with me. I was going to get some serious reading done. But my god, did Dostoevsky talk and talk and talk. It was about 4 chapters of the prosecutor giving his closing argument. When he was finished, so was I. I have about 8 chapters left in the book and I should be able to finish the book this weekend. Progress. I promised one of my suicidologists that I would read her book so I will. It should be somewhat easy reading once I remember where I put it. HA. Don’t know if it is buried on my bed or I put it somewhere else.

I went to my psychiatrist appt. I gave her the run down of being hypomanic without euphoria and the cycle I seem to be in. She didn’t read anything I sent her but she said she would read it as she always does. I felt kind of deflated because I really wanted to talk about the article I sent her. I couldn’t bring it up if she didn’t read it. I actually was not really present. I just glossed over things and she accepted it. I told her my therapist wanted to meet with me twice a week but I am not sure if I can do it physically, especially with physical therapy sessions going on as well. I had told him I would think about it and get back to him. She thought it was good to be seen twice a week. Then we made an appt for two weeks and I left.

My ankle was kind of giving me grief but it wasn’t bad until I got within two blocks of home. Before the Walgreens by my house, there is this dead end street that leads to some houses. The sidewalk has a little handicapped ramp that, to me, is very inclined. I walked down it and it brought me almost to my knees. Pain was so fricken bad. I had to stand in place until it settle down. It was the same as last night when I was going down the stairs but 10 times worse. I didn’t know what to do. My sister was away (or so I thought) and there wasn’t anyone else I could call for a ride. I took my blessed time limping home. The block that lead to the final block to my street was hilly and downward. OMG did it hurt to walk downhill. I had to stop a few times to catch myself. I finally made it home and my sister’s apartment door was wide open as well as my door. I called for my niece but there was no answer. I stuck my head in my sister’s apartment and called for her again. My sister was home making dinner. My other sister was there as well eating some kind of cheese plate. I had some cheese and pepperoni and chatted with my sisters. I then went upstairs. I took my things up the stairs carefully. I took a seat in the kitchen and my ankle just went berserk. I had no idea how I was going to walk down the hallway to my room. I was in a serious flare. I have been on the new med for five fucking days. I have no idea if CRPS doesn’t care if you take meds or not. I posted the question in my support group. I am still waiting for an answer or support. I had to take the med when I finally got to my room. It was two hours early but I didn’t care. After I made dinner with a boot on, my ankle still flared again. I took the breakthrough med. It is going to be a long night and I have been up for 15 hours so far. I cried in pain while I was in the kitchen. My mother was oblivious.

I don’t know what to do to make this pain go the fuck away. I thought the new meds would work and they did for a bit. Until I walked that handicap ramp, which I will never fucking do again. I wish I could say the same of the stupid stairs but I live in a two floor house so that isn’t possible. Even wearing the boot didn’t help. More than a few weeks till my date. I wasn’t going to go through with it. But I change my mind. I could still change it, again. I haven’t told anyone about this because people keep saying they need me and that makes me feel guilty. Someone also reminded me of the ripple effect and I told her to stop talking to me. I don’t want to hear it. I just want to be left alone in my misery that no one understands. I am so done with explaining about how suicidal I am and not getting any understanding about it. Not that I want support for it. That would be ridiculous. But to know at least where I am coming from rather than have supposed opinions. I just have become callous to anyone that thinks they know me.

I did ask my psychiatrist if she thought I was “treatable”. She said yes. But that is all she said without any elaboration. I am in too much pain, both mentally and physically, to tell her what I am thinking. I am also afraid of telling her what I am thinking for fear of another hospitalization. I won’t go this time, not unless I make an attempt. That is the only way I will go back. I just hope to be successful. Things will be really bad if I don’t succeed. I am scared though. I’ve never tried this method before. And if I don’t get it right on the first try, I am kind of screwed. I am just messed up.

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*.