Is Suicide A Reason For Therapist To Terminate?

[bluedressinggown]

Hi,

Very new to therapy. My therapist cancelled on me very short notice last week- he said he had possibly broken his wrist- so it is a genuine reason. However, I did not expect to be so gutted when I realised I wouldn't see him. It started me thinking how bad I would feel if I stopped seeing him. So I googled- 'reasons for therapist to stop seeing clients' and found an article on Psych central. It listed a load of reasons why a therapist would terminate a client. One of the reasons was the suicidal client.

Thing is I've been very suicidal recently. I'm starting to pluck up the courage to tell him, but I don't want to tell him if he won't be able to handle it. I've noticed that when I've tried to broach the subject before, he has steered clear of it. I really need to be able to talk about it. It makes me worry now that I can't tell him truthfully how I feel.

What do you think? Surely this is something therapists deal with a lot/ are trained to deal with?

 

[Lady of Longbourn]

You don't want to start 'mind-reading' your therapist to much. They are trained to deal with it, mostly by asking how bad the thoughts are on a scale and then judging if the patient needs to be hospitalized.

 

[somuchpain]

You could consider talking to someone on a hotline at first. But get the help you need. I don't know enough to comment except to say that your life is a valuable and beautyful thing and that you will feel that way in the future.

 

[franciemarnie]

I would tell him exactly what you said here and that you really need to talk about it.

You might also discuss whether you have a tendency to be a caretaker and put others' needs before your own. Sounds a teensy bit like you are doing this here, but I could be misinterpreting.

Also you are guessing at reality here. Perhaps your reality was denied like mine was as a kid and/or certain subjects could not be discussed so I ended up trying to read minds. Impossible and exhausting.

In therapy - as in your life - you are number one! If any T can't handle an aspect of his profession, he needs to get out.

 

[Jane.l]

I don't know where you live so I guess it might vary for different countries. I am in the uk and I discuss it with my T without it being an issue - it must be really common if you are a T dealing in trauma ? I think therapy is pretty pointless if you can't bring up suicide . I would also think it's really important for your T to know - to keep you safe and tailor your therapy to your unstable thoughts

You really need to try to talk about it - I know it's hard but it really has to come top of list of what you need help with .

 

[bluedressinggown]

Thanks. I'm in the UK too. I do feel a bit better about broaching the subject now... I thought the same- what is the point if you can't bring up such thoughts?

I don't feel like I would actually do anything. I just feel like I need to be knocked out- I feel envious of those in a coma. If there was a drug or something I could take that would have that effect for a long time then that would be perfect. Unfortunately I know that isn't possible which is where I start thinking the nasty thoughts. What has disturbed me most is that a few weeks ago, I felt worse, I felt very depressed, and suicide would pop into my head and I would quickly push it away, shocked that I would think such things. I was more upset too, felt more hopeless and overwhelmed. I've started to feel better recently. A bit more cheerful, doing things, seeing people. But I think about suicide a lot more. I have allowed the thought to progress in my head. And the bad thing is that I'm not even really scared by it. I feel quite at peace with it. That in itself is what scares me. I guess this isn't normal to start getting used to the thoughts? I'm not on any medication, although the last few weeks I have asked and asked for them, scared for my safety. However, I haven't dared take them, as I think they might give me the motivation to do something. At the moment I'm in control, and I know I'm not going to do anything- who knows what would happen if I started taking the drugs. It is sertraline that I have been prescribed and I know what the risks are. I'm definately going to talk to therapist on Thursday. I just wish it was sooner.

 

[Lucycat]

You are quite right to discuss it with your T.

I can only imagine a T terminating a suicidal client if this had been previously discussed and agreed. For example a T who 'only' deals with relationship issues - such a marriage guidance counselor - might feel suicidal thoughts were out of their sphere of expertise. For a Trauma therapist I would expect it to be a perfectly normal discussion.

I have discussed such things with my T, in the UK also. He is great and is never judgmental nor makes me feel silly for admitting to such thoughts.

 

[Jane.l]

I don't like to take meds so don't know much about them.

I understand what you mean about the suicidal thoughts and them not feeling as scary as you think they should . it's good to hear you are feeling a little better at the moment . I find I get worse if I start to try and look at the bigger picture - it's all more manageable if I just stick to day to day or even hour to hour - it's when I feel trapped and can't see a way out that I start to think it seems like the only way out - when I have had enough of all that ptsd has to throw at me and don't feel I can face it anymore but know I can't stop it - that's the kind of thing that gets me messed up - but just getting through to the next hour isn 't so daunting .

Glad you feel you can speak to your T - it's really important and I am sure they will help you with these feelings

 

[bluedressinggown]

Thank you so much everyone. I feel much better knowing you guys think it's ok to bring his up with him. Having read on here it seems to be a common fear- that your therapist will stop seeing you. I just find the therapy relationship hard to deal with. I didn't think it would help or have much of an effect on me when I started it. But I had no idea I would be so worried about not being able to see him after just a few sessions.

I guess it's a wierd relationship opening up about this stuff with someone you don't hardly know. But then maybe that helps as I can't speak to anyone else about it regardless.

 

[Jane.l]

I agree with you and I find getting the balance right in the relationship with your T is sooooo hard . You have open up and let them in which makes you vulnerable and for most of us that's intensely uncomfortable . To trust i need closeness and security and to feel understood and cared about - we spend a lot of time trying to get it right and sometimes when we don't it is incredibly painful .

I too 'do abandonment' and that's a hard feeling to have . I just keep hoping that at some point it will click the balance will be sorted and it will be a little smoother . I really wish it was a lot simpler !

 

[bluedressinggown]

Hi all,

Just thought I would update you because I feel quite relieved after today. Went to therapy. It was much better than I thought it would be. Was honest for once- don't feel like I have been honest the whole last 6 sessions. Not intentionally, but just felt I was hitting a brick wall. Basically, I just told my therapist all of this. I didn't dare tell him the suicide stuff. Then with about 5 minutes to go, I finally plucked up the courage to tell him. It was such a massive relief. A MASSIVE huge relief to tell him. And he was concerned, just the right ammount of concern. It's important to get the balance right I guess- someone not listening or avoiding it or not taking you seriously would be bad- but then if he sent me to hospital that would also be awful and would make me worse I know for sure. He discussed drugs with me, as I am unsure about taking the ones I have been given, although I know I NEED something. So it was good to get his insight.

Thank you everyone who encouraged me to tell him this stuff. Really was the best thing I could do.

 

[Jane.l]

Well done that was brave coz it's very hard but so glad you are getting the support you need - your T is the one person you don't need to hide anything from - you took a great step forwards today !