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Do you have a suicide safety plan?

Roland

MyPTSD Pro
Do you have a suicide safety plan? If so, what is it? Did you use a template or make your own? Does anyone use an app, if so which one is recommended and why?

Most of the things I see on suicide safety things are basically things I never feel like I can use. I never want to go to call 911, go to the emergency room, or self admit to a mental hospital, because I don't have much money nor good insurance and I'm kinda afraid of the healthcare industry as a whole (I'm sorry, I'm extremely cynical, I hate society and people, I'm aware that these people are "good and help people" but I don't trust).

I have called a suicide hotline before and I found it somewhat helpful, she referred me to another hotline after understanding what I was dealing with. NAMI was much more helpful, but it's mental health resources and answers, not a crisis hotline.

I could definitely make my environment safer, last time I was suicidal I bought knives and they've been stashed in my car ever since because I don't want to ever be stuck with a dull knife again.

As far as contacting people I love and trust and are there for me, I don't like bothering people when I'm in a crisis, but also I do have people I will contact if I really need it (but only if I decide I'm not going to do it).

I'd love to hear about what others do, because I always feel like I'm in checkmate when I'm suicidal, afraid to get help, afraid to tell anyone, afraid of myself, afraid to do it, afraid not to do it.

I'm aware that this post is riddled with cognitive distortions, but that's actual things I believe and think when I'm suicidal and I really just don't want to be in that place again, but I see the threat of it spurring back up again. I'm not currently dealing with this, but the last "episode" was last March. So I know I'm not completely out of the woods yet.
 
I have one, have had for years. I keep it handy (even tho I'm not a risk atm at all), and I update it regularly.

The things that I need to keep in mind when I tweek it: it needs to reflect my pattern depression, not just what I think people should do. Knowing yourself, your risk factors, how and when SI becomes real, becomes problematic, how you personally respond to different supports (I can do this, but I'll definitely never do that) - that's gold for safety plans. It not only makes the plan genuinely helpful, but you can rely on it being a realistic support - when I pull out my plan, I know there's things on it that I will do.

Clear trigger points are super helpful: when I'm thinking this..., when I'm doing this..., etc. This comes from your experience of suicidality as it plays out for you, made as specific as possible so that it requires zero brain power to determine if you need to take specific action when you're at your most unwell (because you will try and talk yourself out of doing things you need to, right?!).

Mine has 3 different levels, which reflect how my SI tends to escalate, and the interventions at each level are things that I know are my best chance at something being helpful for me.

I never want to go to call 911, go to the emergency room, or self admit to a mental hospital,
I'd reframe this, from being a bad thing, to being a good thing. Not wanting to go to hospital is actually the healthy way to feel about hospital (and...a surprising number of people don't actually feel this way). This is how you're supposed to feel about hospital.

The trick is going to be coming to an agreement with yourself about when, irrespective of how much you don't want to go, you know the ED is necessary. And take yourself there in spite of how you feel (acting in spite of how you feel is big part of depression management, because if you feel anything at all? It's usually to not do any of those things that will help).

For me, going to the ED was the final step on my safety plan for years. And it sucks. No two ways about it. Sometimes it simply amounted to an overnight hold, which kept me alive. Sometimes it was far more dramatic and awful - that also kept me alive.

These days? I know me, and I know what I can and can't commit to in those emergency moments. I've had a lot of hospitalisations (cough...a lot!) and there's specific hospitals I won't go back to. So it's not on my plan anymore.

I now have a safe chair, and when I hit the red light on my safety plan, I sit in my safe chair with my dog, and message my pdoc about where I'm at (frankly, and with her knowing in advance about my safety plan). The deal is that I don't get out of the chair until I hear back from her about what to do next, or I can keep myself alive again. I have that as my final step now because I know that I can, and will, do that when I need to. I've slept in the chair overnight many times. It sucks. But I'm still alive.

Safety plans are the best. But they do need to be current, and reflect the realities of you, your typical symptoms, and what you actually can commit to when it comes to the crunch. If you can figure that out? It's one of the most important things a person with a history of depression and suidality will ever do as part of their recovery.
 
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I have one, have had for years. I keep it handy (even tho I'm not a risk atm at all), and I update it regularly.

The things that I need to keep in mind when I tweek it: it needs to reflect my pattern depression, not just what I think people should do. Knowing yourself, your risk factors, how and when SI becomes real, becomes problematic, how you personally respond to different supports (I can do this, but I'll definitely never do that) - that's gold for safety plans. It not only makes the plan genuinely helpful, but you can rely on it being a realistic support - when I pull out my plan, I know there's things on it that I will do.

Clear trigger points are super helpful: when I'm thinking this..., when I'm doing this..., etc. This comes from your experience of suicidality as it plays out for you, made as specific as possible so that it requires zero brain power to determine if you need to take specific action when you're at your most unwell (because you will try and talk yourself out of doing things you need to, right?!).

Mine has 3 different levels, which reflect how my SI tends to escalate, and the interventions at each level are things that I know are my best chance at something being helpful for me.


I'd reframe this, from being a bad thing, to being a good thing. Not wanting to go to hospital is actually the healthy way to feel about hospital (and...a surprising number of people don't actually feel this way). This is how you're supposed to feel about hospital.

The trick is going to be coming to an agreement with yourself about when, irrespective of how much you don't want to go, you know the ED is necessary. And take yourself there in spite of how you feel (acting in spite of how you feel is big part of depression management, because if you feel anything at all? It's usually to not do any of those things that will help).

For me, going to the ED was the final step on my safety plan for years. And it sucks. No two ways about it. Sometimes it simply amounted to an overnight hold, which kept me alive. Sometimes it was far more dramatic and awful - that also kept me alive.

These days? I know me, and I know what I can and can't commit to in those emergency moments. I've had a lot of hospitalisations (cough...a lot!) and there's specific hospitals I won't go back to. So it's not on my plan anymore.

I now have a safe chair, and when I hit the red light on my safety plan, I sit in my safe chair with my dog, and message my pdoc about where I'm at (frankly, and with her knowing in advance about my safety plan). The deal is that I don't get out of the chair until I hear back from her about what to do next, or I can keep myself alive again. I have that as my final step now because I know that I can, and will, do that when I need to. I've slept in the chair overnight many times. It sucks. But I'm still alive.

Safety plans are the best. But they do need to be current, and reflect the realities of you, your typical symptoms, and what you actually can commit to when it comes to the crunch. If you can figure that out? It's one of the most important things a person with a history of depression and suidality will ever do as part of their recovery.
There's a ton of wisdom packed in there. I really appreciate that you spent the time to write out that response. Thank you
 
Yes to everything @Sideways said! I have one as well. I made it myself (using lots of colored pencils) and shared it with my T. Mine includes a few sections:

-personal warning signs
-grounding exercises (that work best for me)
-a list of people/things I’m grateful for
-reminder of the people I can call/go see
-a list of things to remember (positive cognitions I’m working on and some positive truths about my life).
-crisis intervention section (reminder to leave my house and go somewhere public, T’s #, backup T’s #, crisis line #, go to ER-even if it’s just to sit in the waiting room, 911)

I agree with updating as needed. And good idea moving knives out of easy access. For me, just sitting down somewhere public (or the ER) can be helpful. You don’t necessarily need to be admitted unless things escalate.

Sometimes it’s just doing something else for a while until the suicidal feeling passes. I always tell myself “beginning, middle, end” as that’s the way it goes with all emotions - they don’t last forever. I’m learning to ride out the suicidal feelings. For me, my suicidal urges are just “feelings communicating a message.” I have actually become friends with my “suicidal part” (because not all parts of me want to die) - which seemed super strange (and a little scary) initially, but I realized my suicidal part just wants the pain to stop and is reminding me there’s always a way out. I now just notice the suicidal part of me, thank them for the reminder, and then I remind them it’s just not a good option for today, but thank you for trying to help me feel better. Then ride it out. It still sucks, but has helped me immensely. Sorry if this last bit is off topic. It’s been such a good strategy for me so I wanted to share.
 
Yes to everything @Sideways said! I have one as well. I made it myself (using lots of colored pencils) and shared it with my T. Mine includes a few sections:

-personal warning signs
-grounding exercises (that work best for me)
-a list of people/things I’m grateful for
-reminder of the people I can call/go see
-a list of things to remember (positive cognitions I’m working on and some positive truths about my life).
-crisis intervention section (reminder to leave my house and go somewhere public, T’s #, backup T’s #, crisis line #, go to ER-even if it’s just to sit in the waiting room, 911)

I agree with updating as needed. And good idea moving knives out of easy access. For me, just sitting down somewhere public (or the ER) can be helpful. You don’t necessarily need to be admitted unless things escalate.

Sometimes it’s just doing something else for a while until the suicidal feeling passes. I always tell myself “beginning, middle, end” as that’s the way it goes with all emotions - they don’t last forever. I’m learning to ride out the suicidal feelings. For me, my suicidal urges are just “feelings communicating a message.” I have actually become friends with my “suicidal part” (because not all parts of me want to die) - which seemed super strange (and a little scary) initially, but I realized my suicidal part just wants the pain to stop and is reminding me there’s always a way out. I now just notice the suicidal part of me, thank them for the reminder, and then I remind them it’s just not a good option for today, but thank you for trying to help me feel better. Then ride it out. It still sucks, but has helped me immensely. Sorry if this last bit is off topic. It’s been such a good strategy for me so I wanted to share.
The suicidal part bit is actually very timely, I have parts too and I've been thinking about identifying other parts besides the ones my psychologist was able to identify. Suicide probably is it's own part, I always think to myself "I won't be able to do it later, it's now or never" because I know my "main personality" isn't suicidal. So I appreciate what you mentioned about that and honestly I'd love to hear more about that aspect. Also the "sitting it out" concept, that urge will go away. It's just scary that it'll come back too.
 
Suicide probably is it's own part, I always think to myself "I won't be able to do it later, it's now or never" because I know my "main personality" isn't suicidal. So I appreciate what you mentioned about that and honestly I'd love to hear more about that aspect.
Yes, my suicidal part is it’s own part, too. And that makes sense about “now or never.” I am learning to be the leader of my parts instead of letting them be in control of me. It’s been a messy and uncomfortable process, but it’s working and I am getting better.

I am learning that all my parts (even the ones that feel scary and bad) serve a purpose and are trying to help me. Some of them just need to learn new strategies and gather new tools, their old ways aren’t helping anymore.

I’d be happy to answer any questions you have.

Also the "sitting it out" concept, that urge will go away. It's just scary that it'll come back too.
I still hold out some hope that my suicidal feelings will go away forever and never come back, but that may not happen. So I remind myself that all feelings come and go (happiness, sadness, joy, grief, arousal, numbness, suicidality…etc.). And that ALL feelings run their course. They are messengers giving me a message. I just need to listen and interpret. Not always act.

For me, with much practice, the suicidal feelings aren’t so scary anymore. They still suck…but, my suicidal part really is my friend now. Some days the feelings last a short time, sometimes a long time…but they never last forever.
 
Yes, my suicidal part is it’s own part, too. And that makes sense about “now or never.” I am learning to be the leader of my parts instead of letting them be in control of me. It’s been a messy and uncomfortable process, but it’s working and I am getting better.

I am learning that all my parts (even the ones that feel scary and bad) serve a purpose and are trying to help me. Some of them just need to learn new strategies and gather new tools, their old ways aren’t helping anymore.

I’d be happy to answer any questions you have.


I still hold out some hope that my suicidal feelings will go away forever and never come back, but that may not happen. So I remind myself that all feelings come and go (happiness, sadness, joy, grief, arousal, numbness, suicidality…etc.). And that ALL feelings run their course. They are messengers giving me a message. I just need to listen and interpret. Not always act.

For me, with much practice, the suicidal feelings aren’t so scary anymore. They still suck…but, my suicidal part really is my friend now. Some days the feelings last a short time, sometimes a long time…but they never last forever.
Have you been in therapy for parts work, or have you done it yourself?
 
@Roland, I really want to answer with mine, but I have to go to work now, so I'll come back later to post. Know you're not alone...I feel this exact same way when I'm in SI.
I'd love to hear about what others do, because I always feel like I'm in checkmate when I'm suicidal, afraid to get help, afraid to tell anyone, afraid of myself, afraid to do it, afraid not to do it.
 
Are there like resources to be able to do it on your own? I know there's a book
There is a book based on IFS called Self Therapy by Jay Earley (he worked with Dick Schwartz). In the introduction he says you can do the work with a trusted friend. The main thing for that book is having someone who can listen to you talk about your parts as you discover and work with them, I think. And they say it can be a therapist, friend, minister, coach, etc.
 
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