Kicked Out Of Therapists Office

[gdf]

I decided to move my bulk comments on this to the blog section.

Cat, sorry, I'm not trying to one-up you but there are some states that do allow psychologists prescriptive privileges--Utah, Louisiana already there and Oregon passed their law this spring but I don't know if it's in effect yet. Right now this is in its infancy as a concept and it faces a lot of opposition from the medical profession but the shortage of psychiatrists will probably allow this concept to gain momentum just as the acceptance of PAs and APNs has this last decade.

apa.org is a good site to follow this kind of thing and there are a lot of public areas with information available to nonmembers.

 

[catjudo]

No worries about one-upping me. As you state, it's in its infancy and happens in less than 1% of our country...I was unaware. Sort of scary if you ask me, but to each their own.

My main point was, though, that therapists, psychologists and psychiatrists, regardless of whether they have the ability to prescribe medication, all have a legal responsibility to take action if they believe a patient is a risk to themselves or others.

 

[cherryblossom]

Personally, I think it's time people took responsibility for their own actions instead of blaming others. Yes seek help for problems, but stop blaming others for one's own actions.

I think this may have got a little off topic, but in my opinion SOL, you had the whole therapy session to tell your T that you were considering hurting yourself. YOU chose not to tell your T. I know only too well how hard it is to talk about such things, but really, what did you expect you T to do, right at the end of a session? Your T would have had a responsibility to their next client, so what would you have liked to happen? It IS tough, when you feel like crap, but unless you open up "during" your therapy sessions, how is your therapist supposed to help?

No-one is attacking you here, or hating you. Everyone is here trying to help you, to see what you've done, so that in the future you can get the help that you need.

 

[cherryblossom]

My main point was, though, that therapists, psychologists and psychiatrists, regardless of whether they have the ability to prescribe medication, all have a legal responsibility to take action if they believe a patient is a risk to themselves or others.

I've seen many psychiatrists, psychologists, and therapists here in the UK. While I have no knowledge of their legal obligations, they have always said to me that everything I say is in confidence, unless I suggest I may harm others, in particular children. They have never said that they would break my confidentiality if I were to harm myself. I don't know whether this was something they omitted to tell me, or whether their responsibility doesn't go that far. I have no idea of the legalities, and clearly they are different in every country and state.

 

[Tinyflame]

This thread disturbs me also.

I agree with Anthony, though forgive me for paraphrasing some earlier posts: Suicide is an individual's decision.

Perhaps a key to making things more manageable may be that if you want to discuss that with anyone, or you are asking for help because you feel compelled to harm yourself and don't know how 'not' to and don't want to, that is what has to be said. Then it can be 'picked apart', maybe a solution or something constructive attempted, even small.

 

[catjudo]

I do agree this has gotten somewhat off topic. Cherry--it's not so much that professionals are obligated to act if a patient is going to hurt themselves as it is if they are a danger to themselves, ie suicide. SOL wasn't completely clear as to whether she was talking about self-harm or suicide. I took her post to mean self-harm (which wouldn't necessarily have a legal obligation to be acted on by her therapist). But legalities aside, I completely agree that she needed to bring this up during her session and not at the very end. Indeed, what did she expect the therapist to do? Telling her therapist this at the end of the session seemed more like manipulation than truly seeking help.

Yes, I understand how difficult these things are to discuss. I've struggled with self-injury. I've struggled with suicidal feelings (very recently, even). Far in my past (seems like a lifetime ago) I made a couple of serious suicide attempts. I still feel that SOL's approach came across as more threatening and manipulative than truly asking for help. And if this wasn't SOL's intent, then hopefully she will take the information in this thread to heart and at her next therapy session start out with discussing her urge/need to self-injure and have a constructive conversation with her therapist.

 

[Lauren]

Wow, did this discussion ever snowball. I guess because most of us, if not all, struggle with thoughts of self harm and suicide. I believe SOL, that your telling your T at the end of the session was either manipulation or wanting help, but not really wanting to talk about it. I know I said this early in the discussion, but here goes again. When I was self harming and the time I truly tried to commit suicide...I told no one. During my breakdown I was taking handfuls of pills when I would feel suicidal. Somehow not taking enough to actually kill myself but knowing it was harming me kept me from going all the way. It took a long time for me to tell my T and when I did, I told him at the end of the session. Why? Because I wanted help, but I didn't want to talk about it. It was a relief when he said "Well I wish you hadn't brought this up at the end of the session. We'll talk about it next week." The fact that you were angry that our T did "nothing" about it suggests that it was more of a manipulation.

That is ok. He would understand that as a cry for help. Your self harming and your cry for help with it are both things that you and your T will work thru. It sounds to me like he has a pretty firm grasp on your motivations and won't be pushed around by them. That can be a real blessing and help to you. Keep working on it and KUDOS to you for being honest with your T, whatever the motivation for it was.


As far as legalities go.....Psychologists in the US are doctors but not MD's. Now, appearently (thank you gdf), in some states they can prescribe meds. Personally I think that is a good idea..I hated having to go from my psychologist to a pyschiatrist just to get a prescription. It was one more hoop to jump thru, one more person I had to talk to that I had built no trust with. I felt like a lab rat.

Anyway, I have had my "drs." from, psychologists, to pyschiatrist to therapist (who does have his doctorate BTW) all tell me that they are legally bound to do something if they "believe" (the operative word here) that I am going to "harm" myself or others. My T also believes that is a "moral" obligation. I take that to mean that I don't have to say anything, but if my symptoms show that I may do something along those lines they would be obligated to take action on my behalf. Conversely, I could say something about feeling like I want to harm myself or others and if my T did not believe that I would follow thru with it, that I was just spouting for whatever reason, he would not have to take action. Again the key being what the Dr/T "believes" I will and am capable of doing.

Even so...nobody can stop another person if they really want to hurt or kill themselves. And if somebody really wants to kill themselves...they are not going to tell anyone because they don't want to be stopped or helped. It is our own choice and our own responsibility to decide if we want to push thru this hell or give up.

It is your choice SOL. Sometimes getting angry at our T is just displacement of the anger inside us. Again, KUDOS to you for telling your T. That means that you choose to get help and to push thru. I know how hard it is, I know that sometimes you want to give up, I know that sometimes the only way to at least relieve some of the pain seems to be to hurt yourself. I don't understand why it does, but the reality is that it has helped you stay alive for today. Keep working towards wholeness, keep asking for help and you will get thru this to a better you.

Good luck and my prayers are with you.

 

[Lucycat]

Lauren, I whole heartedly agree with what you say. That 'belief' in what the Health Professional thinks you may or may not do comes down to a risk assessment. This is something all Health Professionals do every day in all areas of practice. They don't send all headaches off for a scan- they capture the multitude of posssible symptoms and signs, and patient history etc and then make a judgement. Some will be a simple headache. Some will have a brain tumour. Some will have a scan and some will not. They also know that just occasionally they will get it wrong.

I remember when I was first seeing my T. he asked me if I'd considered harming myself. I was completely dumfounded and looked at him blankly. I told him I had barely thought of anything else. I could not have volunteered this information at the time, as I had not previously analysed the thought processes. I just knew I wanted to get out, any which way I could. Now I have more insight and if/when the thoughts return, I still struggle to share it with anyone, but I am able to better protect myself. My husband is more able to recognise the signs and to reach out to me. Together we will get through this.

In the original post I think the T. assessed the situation and dealt with it. I think the legal/ethical/moral debate is somewhat off at a tangent.

just as a point of interest here in the UK it is not just Doctors who can prescribe. Other (Registered) Health Care Providers can become prescribers in their own right with further training.

 

[Deleted member 1860]

FYI I didn't want to hurt myself until the end of the sessio and that's why I told her when I did. Like I said before, I was reaching out for help, something that is very hard for me to do. I have been a self injured for at least the last 15 years and most of the time I don't tell anybody. And NO, this is NOT a suicide post. What part of ASKING for help is not taking responsibility for my actions? Was I supposed to hold it all inside? It is painfully clear that none of you suffer with self injury to the extent that I do. And I resent the statement that I was only doing it for attention. Please educate youselves on the issue of self injury before making any accusations.

 

[catjudo]

First, we realize it's not a "suicide post" or it would have been removed not discussed. Secondly, people took the time to try to offer you their perspective. We were trying to let you know that if you approached your therapist the way that you described it here, she may have felt like you were not serious but rather being manipulative and attention-seeking. Instead of getting defensive, take the information and consider it...could you have approached this differently with your therapist to get a different response from her? If you feel like we didn't have all of the needed information, come in and give us additional information. You never did let us know how things went at your psychiatrist's office that same day. I'm assuming it didn't go well since you say you ended up going home and self-injuring, but you didn't really let us know how that visit went for you.

There is no need to come here looking for a pity party..."none of you suffer with self injury to the extent that I do" or telling us that we need to educate ourselves on the issue of self injury. You don't know the circumstances that all of us come from. I assure you that plenty of people on this forum struggle with self-injury and to great extents. I'm not going to go tit for tat and compare stories with you, but as I said in a previous post, I am very well aware of the struggles with self injury. I also know that I am not alone.

 

[Iam]

I appreciate what you are saying Catjudo. I think we can all be hypersensitive and become defensive. We come here for understanding, insight and to vent. It's so easy to take advice and opinions as criticism, when all the people here are trying to do is help us see things from a different perspective.

Sol I hope that you can let your defenses down even just a little bit to see that we all commented because we care and wanted to help. We can't heal and move towards wholeness (if any of us can reach that state IDK) without being willing to look at ourselves honestly. Because of our skewed perceptiosn we can say something and not even realize how it comes across to others. Please understand we were only trying to point that out to you SOL. You are completely free to take or leave any perspective here, but don't take it as a personal attack. Please consider what was said so that you can grow and heal.

 

[James B.]

May the radiant light of the heavens shine upon you ScaredOfLonley and may angels of happiness dance with joy around your beautiful smile, for you are a child of the universe...

And it has been a long and very rough road, with storms and bitter weather and many evils wearing you down...it is time to come in from the storm...
ScaredOfLoney, it has been such a savage and such a long and tiring jouney,
Hasn't it? I know it has, and so has mine.

And the swords I picked up, to protect me along the way, as I battled unspeakable evils through my terrible storm, have finally fallen from my exhausted hands, I have finally dropped the weight of all that armour. And now, I am beginning to feel the light shine upon my tired and broken body. I am still shaking from my ordeal, shaking, but it is finally, bit by bit beginning to subside because,

war was all I ever knew...

And so it will for you too, ScaredOfLoney, so it will...you don't need that heavy sword, anymore. You don't need the worn and rusty armor, anymore. It is baggage, and it is time to let it go...