My Therapist Did Nothing When I Reached Out For Help

[GWhizz]

I am over it now but I've had a few really rough weeks. I don't know how much I'm allowed to discuss here but I had recently put everything in order to end things.

My therapist knew how bad things were becoming and that things were mounting and so I thought that it was worth the risk to give her a chance to help me. I am not good at help seeking. Anyway she basically skirted around the issue, then told me that there was nothing she could do if that was my intent. She put no plan in place and pretty much treated me like it wasn't serious or irrational enough to waste her time or effort.

I was eventually talked down by my partner and police on the night I had planned to do it.

I'm just at a loss. I see my therapist's logic but then I don't see the point in continuing treatment with someone who completely invalidated my intense urges. If I go back to see her, will it be an "I told you so" ie. her getting it right that it wasn't serious?

I am just afraid of feeling that way again and having no support, being made feel like I'm attention seeking when I'm actually crying out for real help. I have made serious attempts previously and my self harming isn't getting any better especially when dissociated. The only reason I seek help is thoughts of what this would mean to my children.

I hope I haven't said anything upsetting to others. I guess my real question is whether my therapist's reaction or lack of, is questionable therapy or perfectly acceptable?

 

[scout86]

I guess my real question is whether my therapist's reaction or lack of, is questionable therapy or perfectly acceptable?

If you understood what she meant, it doesn't seem very acceptable to me. And I guess I'd go back at least once to share the feelings you shared here. I'm glad you made it through all that and I hope things are better now!

 

[Friday]

Glad you're still with us!

I'm just at a loss. I see my therapist's logic but then I don't see the point in continuing treatment with someone who completely invalidated my intense urges. If I go back to see her, will it be an "I told you so" ie. her getting it right that it wasn't serious?

I told you so on who's part, though, are you sure? Hers because you're alive, or yours because it took the level of having police involved to back you down?

I think it would be valid to go in with the concern... So what I was afraid of? Happened. And the night I tried to attempt ended up with police intervention. So if we're going to continue we need to have some kind of plan in place for if/when I get that suicidal, again. What would you suggest? (IE lob that ball completely and squarely back into her corner. Find out, now that you're doing better what options are even available, what she's prepared to do & how, and how to press go on that action plan.)

I hope I haven't said anything upsetting to others. I guess my real question is whether my therapist's reaction or lack of, is questionable therapy or perfectly acceptable?

Yes & No. It sounds like she misread you. Reliably NOT sending the dogs after you & going to full alert at every warning sign of suicide is something people who struggle with ideation, but aren't at the attempt-stage, really need in order to be honest. But same token, there's a time to pull out all the stops. In order for a therapist to know "this is the level of ideation that's normal & fairly harmless, this is the level where we start getting concerned, & this is where we break out all the stops"... Is a learned skillset. Some never learn it, and always suck at it. Some are freaking brilliant at it. Some have had a bad experience recently, and overreact. Some have gotten jaded and under-react.

While misreading happens, it's one of those things that IMO needs a gauge put on is-this-therapist-just-crap-at-suicide, or did-this-therapist-just-miss-something? The second one can be corrected. The first one, when you're dealing with suicide, needs a new therapist. Someone who doesn't overreact when you're fine, or undereeact when you're not fine.

 

[Gs172003]

I made my counselor promise not to hospitalize me if I tell her I'm thinking about suicide. She told me that if I'm actively pursuing death she will do everything in her power to stop me even if she has to drive me to the hospital herself. I'm glad for that.

 

[PinkBunny]

Completely unacceptable I do believe.

I honestly think it's their job to ensue our well being.

Every therapist I've ever had has done a variety of things:

Safety contracts

Lists of things to do when in crisis including calling a crisis line, calling a friend or family member, calling emergency services, and so on.

To knowingly leave a client or patient high and dry when in a state of crisis, in a life and death sort of situation is not acceptable therapy, it's not even tough love. It's highly morally and ethically wrong, and in many jurisdictions it's also legally wrong, too.

I hope you find a new therapist. No therapist can do everything, but at a bare minimum a therapist should know how to get their client the minimum resources to stay alive.

Throwing ones hands in the air simply is not good enough.

Please find a new therapist.

You most certainly deserve better!

 

[Justmehere]

:hug: @GWhizz - I am so glad you found a way through it.

Was the relationship with the therapist working well before this? The fact that things were going downhill for awhile, suggests that perhaps things were not working well before this. Has she every worked through a safety plan with you? This isn't a safety contract - it's a plan of what to do when things become unsafe. Good trauma therapists are very reluctant to forcibly hospitalize a patient against their will because it can be re traumatizing. It is good though when someone needs help to stay alive.

Anyway she basically skirted around the issue, then told me that there was nothing she could do if that was my intent. She put no plan in place and pretty much treated me like it wasn't serious or irrational enough to waste her time or effort.

If she told you point blank that there is nothing she can do for you when you are an imminent danger to yourself, she is not doing her job as a professional, and I'd possibly consider reporting her to the proper professional agency. (Not sure how it all works in your country though.)

I get really super scared of asking for help. When I ask for help, I tend to minimize what I need help with, because it's that scary for me to ask for help from my own therapist. Is it possible you were at all unintentionally downplaying how serious things were? Not saying at all that you were...

There was one time I was struggling badly and my therapist didn't really get what I was trying so hard to tell her. I had to tell my therapist point blank, "I'm headed to the hospital now, and I need your help to get an evaluation. I am not safe to myself." She totally got it and helped a lot.

If your therapist knows you had a plan and intended to act on that plan and end your life, and said there was nothing she can do, it's incredibly off. She may not be the right professional to help on a long term basis, but she could have helped you get emergency help from the proper folks.

If I go back to see her, will it be an "I told you so" ie. her getting it right that it wasn't serious?

Does she know that the police had to intervene to stop you? If she knows that and STILL blows it off, then this is more than her misreading you

I'd make it very clear that you need more responsive support, and more effective solutions and relief for how much pain you are in. If she can't provide that, it may be time to ask her for help finding someone who can.

I'm so sorry you are in so much pain. :hug:

 

[Marymickaela]

I had suicide ideation for years, over for many years now, but my therapist could always tell the difference and no way would she have left me leave her office if she thought I was serious. Once while posting on a bipolar site I'd taken too much Vicodin, the police were called, I ended p in the ER, and the next day H took me to my psych who asked me if I felt I was safe until Monday until I could enter a partial Hosp Program. You never just let it go.

Thank God the suicidal ideation has been gone for a long time as nobody can understand how excruciating it is, however, when I actually did make an attempt I only told my H after the fact. He took me to the ER and I ended up in the psych ward.

Only you can decide if this therapist is the right fit for you, if she isn't able to read the signs. I've moved on several times until I found the right therapist.

 

[GWhizz]

Thanks all for your very helpful insights.

To clarify a bit more and hopefully answer your questions, I'll try to elaborate as concisely as I can.

I have been attending this T over the course of the past couple of years. She diagnosed me with a brief history and after I later gave more details she stated that she would refer me onto a more specialist T if such existed, but that unfortunately there are no trauma specific therapists over here but she is undertaking specific training on my behalf. She is part of a community outpatient service and works within a multidisciplinary team led by a psychiatrist. They also link to the inpatient services and can refer you onwards in that direction if necessary.

I definitely minimise things and find it next to impossible to "put my shit onto anyone else" so to speak. A lot of what I have disclosed is only through writing.

Lately, I have had a lot of extra stressors and she kept alluding that these issues were the source of my SI. I tried to be clear, that whilst those issues of course were not helpful and having PTSD makes it harder to negotiate "normal" life ups and downs, that there was one clear reason why I was giving up, and that that was because I wasn't seeing any improvements in symptoms after giving myself extended leave from work, putting my family through the stress of it all etc without any notable success. In fact, I have been feeling worse for some time now and returning to work with all of this ongoing just leaves me hopeless for the future. She looks at the bigger picture imo, that my life isn't currently awful. But overlooking the fact that I'm not managing dissociation, insomnia, flashbacks or self harm.

So I initially stated I wanted to quit, that I saw no point when I knew suicide was inevitable, knew when and how etc. She left it at that until my partner contacted her asking for her to provide support and reinstate therapy. I then sent her an explicit letter detailing my intent and plan and told her to only contact me if she saw a point in bothering to try to rethink things with her. She did call and ask me to come see her. But when I met her all she asked about was making another appointment to see her in the new year should I "still be alive" and going back to work. I find it almost impossible to speak in therapy but towards the end I did tell her that she wasn't taking me seriously or understanding me, wishing me a Merry Christmas etc. She said that she understood me but that there is nothing she can do if I'm intent on it, that she'd discussed it with the MDT and they felt hospital wasn't for me because I'd had a bad experience before. I left without making an appointment, basically hearing that there is no help if you are truly suicidal. Not once did she attempt to rationalise my thoughts or intent. Or tell me that there was hope for symptom improvement/management.

I was really dissociated afterwards. I usually don't tell my partner anything about therapy as I'm not good at sharing personal stuff, but I couldn't keep it in and told him a little about how bad I felt and how dismissive she appeared. He felt she was unprofessional and told me we can find someone better. He doesn't care that I've built a relationship with her and shared things I never wish to go through with another T again. So later on I called to tell her what I thought of her not even broaching the subject and telling me hospital is only for those who "want to be stopped". I explained how I'm obviously telling her because of my children etc. She basically convinced me that hospital wasn't what I wanted and of course I agreed!

Over the next week, as the planned date approached, I contacted the on call team who were surprised there was no plan in place. As it was Christmas, familiar staff were on leave. My psychiatrist did eventually get in touch only to offer a med that takes days to kick in and that I wasn't able to get dispensed as my GP was unavailable to provide the script after they faxed him the details (closed over Christmas also). When I rang the team back, I left messages to get the script directly but no one called me back. I did call my T on her personal number but when she returned my call I told her I'd realised contacting her on her personal time was pointless as she can't do anything from home in this situation. I basically minimised everything because I felt guilty contacting her while she was literally powerless in helping me. So I got through to the on call again who advised that that med was unsuitable for acute symptoms and when I asked for alternative immediate help, told me that was between me and my T who knows me best, even though she was still on leave for the next week!

I went to see her today and told her that I felt the police, although not a mental health service, were more supportive and helpful than her or the team. She said she understood the seriousness and that I am still affected by being told I was attention seeking when I made an attempt as a child when trying to escape abuse. I told her I saw no point continuing to see the team if they cannot provide help when I'm really struggling and most need it. She basically said she is offering all they can, ie a weekly session with her! I told her I probably won't be back. She told me I seemed angry with her. I actually wasn't. She admitted she was angry, I think it was at me expressing disappointment and telling her she isn't helping me.

I don't know what to do. I feel so let down. She knows why I don't want to be in my life at times, that it's down to symptoms and how I feel this is having a knock on effect on loved ones.. I have invested so much hope in her being able to help me. I don't want to accept that she can't or that she may be in fact making me feel worse..

 

[recoveringfromptsd]

I made my counselor promise not to hospitalize me if I tell her I'm thinking about suicide. She told me...

I have sort of a similar arrangement with all the clinicians who work with me. I have a brutal honesty policy with all of them, that I am going to be upfront and clear about what I am feeling and my needs. And this includes safety issues. Thus I can tell them I am suicidal or wanting to self-harm and they won't do anything but help me through it. Because they also know I want them to trust me on safety issues so they don't have to assume anything that would have them go with more caution (like hospitalization), and that if I can't control my urge and impulses or have gotten to the planning stage that I will tell them (again brutal honesty).

So even now I have shared with all of them that with what I am currently going thru I have had the urge to cut to get relief. And it's no longer the big deal it would have been if I was vague. Instead I have gotten the support I need to continue to use DBT skills to keep from cutting.

 

[BuckarooBanzai]

my real question is whether my therapist's reaction or lack of, is questionable therapy or perfectly acceptable?

One highly experienced therapist I've known for some thirty-plus years once told me that, despite all his best efforts, some of his clients committed suicide. He now realizes safety contracts - and even hospitalizations - cannot save a client if he is truly determined to end his life. Safety contracts and hospitalizations only 'work' for those who want to survive. So now, when a client talks about suicide he is quite blunt about all of this.

 

[recoveringfromptsd]

@BuckarooBanzai The problem I have with that approach is there are some who are truly determined, unsuccessful, and later improve to where the determination is nil. A therapist who uses an oh well response, is not giving the chance that the person might later not determined. Even when I have been suicidal and come close to being impulsive enough, there was always a part of wanting someone to stop me. Also such a response does not send a caring message to the recipient. If a therapist was to say that to me when I was suicidal it would have actually pushed me to actually commit suicide. So I have real issues with a therapist who is dismissive of suicidal ideation.

I know my therapist would instead ask me what can be done to help me with the moment.

 

[BuckarooBanzai]

So I have real issues with a therapist who is dismissive of suicidal ideation.

He wasn't truly dismissive but rather pragmatic.

Having faced continuous suicidal ideation and a number of serious attempts over the years, I actually appreciated his stance and candor.

If I were truly suicidal, I would commit to a safety contract - lie outright - and then go home to off myself. Not even hospitalization would save me. I know how to kill myself on a psych unit; it's really not hard to do.

So, actually, I was relieved to hear him admit the truth: If I wanted to die, he couldn't stop me. Once we had that on the table, we could discuss the issue pragmatically.