Help Advice needed. Want to get better but don’t want to disappoint therapist

[siouxsie]

I usually only read here and don't post much. But I could really use some advice.


I'm in my early thirties. Diagnosed borderline and anorexia (been living with those two for about 2 decades). I've been suicidal since the age of 12. many halfhearted attempts (pills usually and always ending with me waking up half a day later in my own vomit. Never sought medical attention afterwards).
I'm married to what most likely is a narcissist. I also have kids. So ctb is not really an option yet always on my mind. I'm a university student still and will be for a while, which isn't easy with kids and my mental health but it's the only way to eventually be financially stable at some point.

I have been in therapy for a little over a year. My therapist is great, I like him and trust him. The past few months I finally managed to not self harm at all.
But i still have a lot of suicidal ideation. Last night I was writing good bye letters, self harming worse than I usually do and considering taking an OD that actually would have been enough to ctb if not found fast enough. My husband threatened to have me sectioned, I told him I didn't care (and it probably would have been a good idea really) and eventually calmed down a little some hours later. The strong impulse to ctb is gone now but I still feel latently suicidal.

I know I need to discuss this in therapy. Thing is my therapist doesn't know about past attempts and only knows vaguely about my suicidal ideation. I never mentioned the strong impulses I get and the fact that I do have the means to do it safely stored in my bedroom. I know the only way to get help is to be honest with him. Which I am when it comes to everything other than suicide. But I just can't seem to open up about it. It's definitely a shame issue. And a feeling of weakness and admitting to that. I'm a perfectionist. Admitting needing help is really hard for me. Also I feel like I will disappoint him by telling him. Like making him feel like he failed me. Which he didn't. Yet it still feels like it.
Does anyone have any advice on how to approach the issue in therapy and open up and be completely honest? Any advice is greatly appreciated

 

[Dot]

Hpe cn undrstnd typng

U wll nt b failng ur therpst

B-ing abl t/ opn up abt th/ deepr thngs = sgn of progrss & hlps longr-trm recvry

Thy wld prbbly C u trustng thm wth tht knd of infrmatn as a postve

Mght b wrth checkng wth thm abt mandtry reportng tho - talkng abt suicdl feelngs = 1 thng bt thy mght ask abt imminnt plns etc whch thy mght hve t/ rport - bt if thy r a gd therpst thy wll wnt t/ hlp u thru ur suicdl feelngs bcse mny ppl hve thm imo

 

[siouxsie]

Hpe cn undrstnd typng

U wll nt b failng ur therpst

B-ing abl t/ opn up abt th/ deepr thngs = sgn of progrss & hlps longr-trm recvry

Thy wld prbbly C u trustng thm wth tht knd of infrmatn as a postve

Mght b wrth checkng wth thm abt mandtry reportng tho - talkng abt suicdl feelngs = 1 thng bt thy mght ask abt imminnt plns etc whch thy mght hve t/ rport - bt if thy r a gd therpst thy wll wnt t/ hlp u thru ur suicdl feelngs bcse mny ppl hve thm imo

Thank u for your reply. I understood your typing just fine.
I'm not too worried about mandatory reporting. I'm from the medical field, so I know the laws. They would have to report if they think I'm an immediate danger to myself. Which I'm not. Usually. But with bpd I can be quite unpredictable. Also, I wouldn't mind a trip to the psych ward if they think it really would benefit me. I do trust their opinion very much. As I said, I really do want to get better. Bpd sucks. I have a bunch of long term health issues caused by my eating disorder, so I very much would like to get my bpd and the suicidal thoughts under control.

I just don't know how to approach the topic. I have mentioned feeling like everything is pointless but I can't just rightout say I'm suicidal. Thinking I might just mention having a bad day on n.y.e. And hoping we'll approach the topic when I tell him about my husband wanting to have me sectioned. It's like I can only give hints and then need my therapist to ask me questions. I seem to be unable to flat out say it.

 

[Dot]

Thank u for your reply. I understood your typing just fine.
I'm not too worried about mandatory reporting. I'm from the medical field, so I know the laws. They would have to report if they think I'm an immediate danger to myself. Which I'm not. Usually. But with bpd I can be quite unpredictable. Also, I wouldn't mind a trip to the psych ward if they think it really would benefit me. I do trust their opinion very much. As I said, I really do want to get better. Bpd sucks. I have a bunch of long term health issues caused by my eating disorder, so I very much would like to get my bpd and the suicidal thoughts under control.

I just don't know how to approach the topic. I have mentioned feeling like everything is pointless but I can't just rightout say I'm suicidal. Thinking I might just mention having a bad day on n.y.e. And hoping we'll approach the topic when I tell him about my husband wanting to have me sectioned. It's like I can only give hints and then need my therapist to ask me questions. I seem to be unable to flat out say it.

Ok

Wht abt thngs lke 'wsh tht slf dd nt wke up'
Or
'Smetmes fl = easr t/ nt b arnd n.e mre'

Wld tht stll b 2 dirct

Also am nt sre wht knd of thrrpy u hve bt Schema Therpy & Internl Famly Systms Thrpy hve apprntly bn gttng gd rsults fr EDs & persnlty dsordrs - thre = info abt thm in Therpy Typs thred

 

[siouxsie]

Ok

Wht abt thngs lke 'wsh tht slf dd nt wke up'
Or
'Smetmes fl = easr t/ nt b arnd n.e mre'

Wld tht stll b 2 dirct

Also am nt sre wht knd of thrrpy u hve bt Schema Therpy & Internl Famly Systms Thrpy hve apprntly bn gttng gd rsults fr EDs & persnlty dsordrs - thre = info abt thm in Therpy Typs thred

The past two sessions I've been talking about not really knowing why I get up every morning besides having to in order to take care of my kids. Paired with having told him that life feels pretty pointless I assume he knows what I'm getting at. It's just the previous halfhearted attempts that I left out in my intake session a year ago and I feel like I can't go back to that now. I wish I could just straight out tell him how I "sometimes go a little crazier than usual" and think about taking the "300+ pills of a substance that will kill me that I casually keep in my nightstand just in case."

As for therapy, we're doing a mix of Cognitive behavioral therapy and dialectical behavioral therapy. As for bpd it's working pretty well. For the eating disorder not so much but that is due to the fact that I'm not really ready to give it up just yet after being stuck in this cycle for most of my life and not knowing what will be left of me if my eating disorder is gone. It's like that's all I am really. I have also been offered group therapy for both but declined. Group for eating disorders would worsen it cause I would compare myself to others. And I never fit in anywhere and get anxious in groups so it would be pretty pointless cause id just never say a word.
He also keeps mentioning how I really should be in inpatient treatment cause that's the level of care I need but seeing how I have kids and university it seems impossible to actually do that. That's why I trust him with not reporting me for opening up. He once told me that I should not get below a certain weight cause i would be crossing some magical line. I assumed that's when he would have me hospitalized. So I gambled, dropped 7 pounds below said weight and here I am, still not hospitalized even though I'm not exactly stable in physical terms. So I guess I really can trust him.

 

[Redacted24]

Seems to my that using the proposed icebreaker lines are a good way to help develop the discussion into the way you want.
Yeah, there's all the life things you have on your plate. Completely get that- I have kids, job, all that too and being interrupted would kind of mess those up, right?
But since the really important thing here is to continue giving yourself the opportunities for the future, taking the big first step of honesty, with courage and awareness, is a bold way to seize control back.
After all, things might not get better or worse, but they'll be different... and that's what you're looking for.
Sending strength and support to you. I believe you can do this!
I've considered using the phrase that I'm planning to transition my life to another phase when talking with others about my big life ending moment and leaving it to them to come their own decision about what that actually means.

 

[Kit1]

I do take overdoses and find myself in compromising situations surrounding suicidal ideation. And whenever I am struggling to tell my clinical psychologist, I email her and I find that easier. As long as I don't have a solid plan or a time, I wouldn't be sectioned - especially because the NHS do not have any bed anyway.., Sometimes writting might help.

 

[siouxsie]

I do take overdoses and find myself in compromising situations surrounding suicidal ideation. And whenever I am struggling to tell my clinical psychologist, I email her and I find that easier. As long as I don't have a solid plan or a time, I wouldn't be sectioned - especially because the NHS do not have any bed anyway.., Sometimes writting might help.

I thought about writing it. I'll give it some more thought I think. Got 6 days until my next appointment

 

[marina]

please do the uncomfortable thing and tell him. I found success writing it down, if just to organize my thoughts. Please be honest to him, its the only avenue on which progress gets done. If you are posting here, I am 100% sure any therapist would rather you just be honest. I deeply encourage you to be honest with your therapist.

Sessions started getting "stuck", but I saw success after a few months of being honest about my suicidality. Discussing suicidal ideation did not remotely feel like the same thing, the process works alright, and can work for nearly all individuals. I hope you feel an improvement

 

[siouxsie]

I thought I should update this post.
Last session I really wanted to tell him but had a panic attack whilst in the waiting room and then couldn't do it.
Today I had it all planned out like what I'd say. But he picked up on it before I could start really. We were talkin about why my skills aren't working sometimes and I mentioned how my husband follows me when I tell him I need to be alone and then I said that I told him to check on me every 20 minutes if he doesn't see or hear me. So he asked me why I have him check on me and I just said so I don't end up doing something stupid. We talked about it for a while. Wasn't as bad as I imagined. He asked me if I ever imagined how I'd do it. I said yes. He asked how. I tried not to give specifics, obviously didn't work out but worth a try told him I'd use SN, but added that I do not have any or anything else that could kill me for that matter. Besides the tools I use to self harm but I did say I want a painless death so slitting my wrist obviously isn't an option. I'm now on weekly instead of bi-weekly appointments and a higher dose of meds.

Thank you all for your help and kind words, I really appreciate it