No Suicide And No Self Harm Contracts

[Jawn]

Iam I have a question for you. You previously stated that you had weaned yourself off your meds. Have your suicidal thoughts increased since going off the meds? I'm just wondering if maybe you still need them. I'm no doctor, but if your thoughts have increased since going off the meds, that seems like more than a coincidence to me.

Hang in there Iam and I will be praying for you.

Jawn

 

[Iam]

Hey Jawn,

I started weaning off in January, I think. It took me at least a couple of months maybe slightly longer. So it's been about 6 months that I have been off and no, my suicidal thoughts haven't increased at all until now. A conflict with my mother triggered me into those thoughts. Stupid isn't it? A normal person would have been upset and angry with what my mother did, but they certainly wouldn't have become suicidal. The good news there is that it sheds light on the fact that my past history with my mother is probably something that we need to focus on.

My T and I discussed my going back on medication. He suggested that I try some nutritional supplements to even me out. You can see which ones under that thread. He wants me to email him Monday as to how I am feeling. This is because I have a PCP appt for an annual physical on Tuesday. If I am not better he wants me to talk with my dr about going back on a very low dose, 5mg, of celexa. I really don't have to as I have over 90 40 mg tablets of it, which calculates out to 2 yrs supply, and a prescription for refills LOL. That being said, I suppose I should bring my PCP into the loop of all of this. I don't like revealing this crap to anybody so that is hard for me to do. Another stupid feeling/action on my part. Of course my PCP should know, it's just that I don't know him at all.

Thanks for the concern Jawn. Your posts are always so compassionate.

 

[freakofnurture]

He has repeatedly said that he is not a crisis counselor, that it would be too draining on him as opposed to T's who thrive on it. He did tell me that when he has a relationship with a client that he wants to be there for them if they go into crisis.

That's possibly a wink-wink-nudge-nudge that you should go to a full blown T with a higher psych degree and licenses. Your current T seems overwhelmed with the state of your ptsd and in a serious conflict because he knows he cannot adequately support you, but at the same time doesn't want to force you to go somewhere else.

He said he was insulted that I didn't call him 2 weeks ago when I was so bad off. Then emailed me after our last session asking me to please stay in contact with him as I processsed things in my mind and heart during the week.

He has slipped into 'relationship mode' towards you (as opposed to 'profession mode'); I think that's another sign of overwhelm. And it is not good and crossing a line that's in place to 1. protect T and client and 2. ensure a successful interaction.

I think the no-sucide contract is just another expression of his conflict. If you want to get better, you need a T who can really handle you.
Maybe you should ask your T if he wants to see you in more thoroughly trained hands.

 

[Iam]

Wow Nurture that's pretty hard hitting, but I do appreciate it. Funny though...I was actually looking online for a psychiatrist last week and plan on talking with my dr about it at my annual phsyical tomorrow. Though I am not terribly comfortable doing that as I have only seen him twice in 2 years.

When I accepted my T's "informal" diagnosis of PTSD a few months back (I had had a psychologist suggest the same 9 yrs ago) I asked my T how much experience he had in treating it. He got huffed (or so it appeared to me) and said "Well if you want a specialist" at which point I stopped him and said that I wasn't asking that, just what experience did he have with it. Maybe a sign that I should look elsewhere or at least get a formal diagnosis and go from there.

I disagree with you about his saying to stay in contact as I processed thruought the week. I was feeling suicidal and needed his reassurance to contact him between sessions. He knows it is easier for me to put my thoughts into an email and that I get tongue tied and disengage from my feelings in session. I send him occassional emails and then we discuss them at the next session. He always resonds to my emails with his own that is encouraging.

As you can see from the responses, suicide contracts seem to be a common thing with patients who suffer extreme depression. Not at all sure that I disagree with them. Especially given the fact that I won't sign one unless I mean to hold to it.

I like my T very much, neither of us has crossed professional bounds in my opinion. Not at all. I do think however that he does not have enough experience with PTSD and if that is truly what I am suffering from it may be time to move on. I HATE the thought of establishing another relationship though. It has taken me a year to fully open up to my T. The thought of starting all over again is VERY discouraging.

Thanks again for your honesty and sincere opinion Nurture.

 

[Jawn]

Iam, PM me if you want the contact info for the person treating my wife. They are located in West Salem.

Jawn

 

[changed]

Iam, my T told me that she was not a crisis councelor too! The impression I got from it was that she wanted to be there for me more than she was proffessionally alowed. She realises I dont have support outside her office and is always telling me to email her when I need to and she will reply as soon as she can.

I feel bad that she is concerned about me and she has said that she dosent want to worry about me when im not there (thats when the whole contract thing came up). I like knowing that she is there though, and she does have lots of qualifications for PTSD (I know by all the certificates in her room that I look at when im trying to avoid things!). It sounds like you are unsure about your T's experience, maybe ask him? I thought that I was alone and she had never seen anybody with my symptoms so I ask her in a round about kinda way, 'have you had anyone else with this?' etc and it reassured me.

It would be difficult to start over but if its what you need it will make you stronger in the long run. I admire your strenth, I was freaking out about having to see a psychiatrist who didnt know me, it was horrible. My psychologist realised how worried I was and sat in on the appointment with me, but it was still hard.

I hope you manage to be reassured or get someone who has a better understanding.
Hugs x

 

[Iam]

Thanks Jawn and Changed. I really like my T.....just don't know and don't want to make stressful changes. Guess I am going to have to ask my regular dr what he thinks....damn I don't want to talk to him about this! I see him tomorrow at 12:30. Then have my session with my T at 5pm. I am supposed to email my T today about if I think the supplements are helping me. I asked him in an email last week why and he hasn't anwered back so I'm not going to. I don't want to lie and I don't want him contacting my dr unless we discuss it first.

 

[seedling]

Iam,

Hope all goes well tomorrow. You are really getting a lot of help for yourself and asking for it - eek!

I have to say that Freakofnurture's post hit a nerve with me in that I agreed with a lot of it. Being new to all this and not knowing what everyone else's T is like, I still felt there was something maybe -lacking-(?) in your T's ability/experience?

My T is very experienced in helping Vietnam Vets and I feel like he has handled just about everything PTSD-wise. He went away for a week and made sure to let me know who would be covering for him in case of emergency, who to call.

He was adamant about arranging my first psychiatrist's visit and was concerned when it couldn't be for 3 weeks. He said that was OK, as long as this wasn't "a psychiatric emergency" and gave me the sharpest, most penetrating look. I didn't know then what the deal was but I do know now.

Your T sounds truly sincere in helping you and from what you've posted has done a lot of great work with you. If there is a need to go anywhere else, you'll know what to do and when.

Take care :)

 

[Iam]

Thanks Seedling. I am not sure that I trust myself to know where and when is if at all. On top of that, like many of us, I am a pleasure. The thought of hurting somebody's feelings, even someone whom I have hired to help me, is a paralyzing thought for me. I do truly like my T and don't want him to feel insulted. Stupid, I know. All that matters is that I get well. We will see. I have no idea if my Primary Dr. knows anything about psychiatric issues let alone specifically about PTSD. I do realize that I should want and encourage my providers to work together on my behalf, but can't stand the idea of them communicating for some reason. Trust....ahhh.....that is a hard one for me!

 

[This Ends Now]

Fire Him

I really think that my problems are way too much for him to handle. He has repeatedly said that he is not a crisis counselor, that it would be too draining on him as opposed to T's who thrive on it. He did tell me that when he has a relationship with a client that he wants to be there for them if they go into crisis. He said he was insulted that I didn't call him 2 weeks ago when I was so bad off. Then emailed me after our last session asking me to please stay in contact with him as I processed things in my mind and heart during the week. He emailed me with a surprise opening on our normal session day. We hadn't scheduled one for that week because I was originally going to be out of town. All that to say that he is obviously concerned.....but somehow that contract thing just raised a bunch of questions for me. I am so afraid of what he is going to do with what I told him.

Maybe I'll have the guts to tell him what I am thinking about it.....i.e. what is his true motivation.

If you think your case is too much for him to handle then he is probably under qualified. The fact that he told you that this was "too draining for him" is a giant red flag. Him talking about a relationship with another patient is an even bigger red flag and an appalling breach of ethics. You are completely right in questioning his motivation but I would also question his ability and ethics.

I would strongly suggest finding another shrink fast!

 

[This Ends Now]

Iam,

Sorry about the outburst. I think I should try taking a deep breath before posting sometimes. You are clearly a caring and considerate person. You deserve the best treatment you can get. I know its painful and intimidating to open up to a new person. Its quite possible that I put some of my own bad experiences into that last post and for that I am sorry. Please let us know how your appointment goes and remember there are lots of people who care about you.

I wish you well,

Liz

 

[Iam]

No Problem Liz, but thanks for your apology. Just to be clear.....He did not say that "he has a relationship with a client that he wants to be there for in crisis", he was stating that when he already has a client and if that client goes into crisis he wants them to contact him. Guess I didn't state that very well. He clarified also that he does not dub himself a crisis counselor because that is all he would get and it would become more crisis management vs helping clients become the people they want to be. My questioning of his true motivation has more to do with my trust issues I think. I DID however email him my questions and concerns. It will be interesting to hear what he says tomorrow!

It's interesting that our forum members are getting so riled up by my questions and frustration. I do not blame that on my T, I blame it on myself.

That being said, I am going to bite the bullet and talk with my primary dr about all of this tomorrow. God I do not want to do it, but think it will be in my best interest.

Thanks for caring Liz and I am sorry that you have had bad experiences with T's, or a T, in the past.