Interesting thread about psychiatrist's negative feelings towards dealing with suicidal people

[KuriGohan&Kamehameha]

What caught my eye in this post is that the psychiatrist in question believes in the concept of rational suicide, even when it makes their peers and higher ups uncomfortable. Yet, they say they would never tell a patient about their beliefs.

It certainly puts things into perspective for me, that maybe a lot of staff I interacted with in the mental health system before might have agreed with me about my assessment of my own situation, but are bound by regulations and laws to keep their mouths shut and not have honest conversations about these difficult topics.

I think this post also highlights another glaring flaw in the fundamental framework of the mental health system, the fact that there is so much smoke and mirrors. Safety plans and contracts, verbal promises to not attempt, no real way to determine a person's mental capacity for long-term decision making. There is no good way to deem if a person is imminently suicidal or not, it's all guessing games.

When the consequences of being honest are losing one's freedoms and bodily autonomy, facing an involuntary hospitalisation/sectioning, it is no wonder that many people choose to put on a performance, that we memorize lines like actors in a play in order to dodge outcomes that have the potential to throw an already painful life into further chaos and disarray. If there were truly an effective and caring method of helping acutely suicidal people, there would not be such universal fear regarding it.

This whole system of "dealing with" us feels more akin to a theatre full of subtle stage cues and role rehearsals than actual healthcare. However, this is just my experience with interacting with the mental health system, for over a decade across multiple countries.

 

[cosmic_traveler]

This whole system of "dealing with" us feels more akin to a theatre full of subtle stage cues and role rehearsals than actual healthcare. However, this is just my experience with interacting with the mental health system, for over a decade across multiple countries.

That's a great way to describe it, it's the same in America. Some are very good actors and they convince you that this will help/work/solve your problems. After things don't work out, they blame you, because you couldn't keep up the charade. You're the one that broke character. Big hugs. Be well on your journey.

 

[SexyIncél]

That's a common problem with professional/managerials. They're paternalistic, treating you like a child. Rather than another intelligent person who they're assisting

They often know better, but intentionally lie when the truth isn't "proper"

 

[KuriGohan&Kamehameha]

That's a great way to describe it, it's the same in America. Some are very good actors and they convince you that this will help/work/solve your problems. After things don't work out, they blame you, because you couldn't keep up the charade. You're the one that broke character. Big hugs. Be well on your journey.

Sorry to hear that you've experienced this as well, once you start getting blamed for feeling so deeply hurt by life, it is utterly soul crushing because it feels like an unwinnable situation. Especially when you are and have been trying your best, and have always been compliant with whatever they suggested.

It truly does feel like playing a character. There are certain things you can't and can't say, you have to deliver things in a certain way to be heard, there's a script that must be followed at all times and deviations from that script lead to blank eyed stares at best, and austere judgement at worst. There is very much a typecast role of the model patient that one is expected to follow at all times. And when you are honest about something not working for you, they don't take very kindly to that. Much love to you as well.

That's a common problem with professional/managerials. They're paternalistic, treating you like a child. Rather than another intelligent person who they're assisting

They often know better, but intentionally lie when the truth isn't "proper"

I 100% agree with this. Like I said above, there's a very faux dynamic in these interactions, where one must behave like a doe-eyed, ignorant model patient who has no questions, concerns, or input in their medical decision making due to the perceived authority of the professional.

I believe a lot of people in the mental health field feel threatened when anyone has any sort of knowledge about their methods, and dares to question them. Even if you are educated in the field or a similar discipline, they will act as if you are a complete simpleton who knows nothing and needs to stay in your lane.

If I had not used my knowledge from research papers and my pharmacology lectures, there was a time where psychiatrists would have prescribed me a pretty dangerous drug combination, that even has the interaction warning listed on the label when dispensed at the pharmacy. Yet they still tried to argue that I knew nothing, and should have no say in the matter, because I am the patient.

One day I am hoping the archaic medical system goes to the ruins where it belongs and is replaced with something far less paternalistic that gives people more autonomy and decision making power, and stops enabling doctors to lie and play games. The core issue here I think is, there's 0 emphasis on quality of life, and only on preservation of life at all costs, so doctors are unwilling to be honest about prognosis unless they absolutely have to, and are unwilling to take risks that could potentially benefit someone greatly due to the sole-fact it may costs them their career if they dabble too much in risk taking, comfort care, letting patients make their own decisions, off label prescribing, etc.

 

[SexyIncél]

If I had not used my knowledge from research papers and my pharmacology lectures, there was a time where psychiatrists would have prescribed me a pretty dangerous drug combination, that even has the interaction warning listed on the label when dispensed at the pharmacy. Yet they still tried to argue that I knew nothing, and should have no say in the matter, because I am the patient.

One day I am hoping the archaic medical system goes to the ruins where it belongs and is replaced with something far less paternalistic that gives people more autonomy and decision making power, and stops enabling doctors to lie and play games. The core issue here I think is, there's 0 emphasis on quality of life, and only on preservation of life at all costs, so doctors are unwilling to be honest about prognosis unless they absolutely have to, and are unwilling to take risks that could potentially benefit someone greatly due to the sole-fact it may costs them their career if they dabble too much in risk taking, comfort care, letting patients make their own decisions, off label prescribing, etc.

Yeah, someone close to me was ruined by doctors who pushed toxic cocktails for something relatively minor. The rest of her life will now be misery & tragedy, even though she can afford the world's best healthcare. Her family was complicit too, pressuring her hard to take it — despite her concerns. As well as other lying doctors she asked for second opinions

Only afterwards, when the symptoms were undeniable, did a doctor finally call it a "toxic cocktail" — his words

You might be glad to know that there's improved societies in the world that get rid of healthcare paternalism, with its monopolies on your body/mind. They exist, we can point to them & see how it works out. It's "revolutionary", in that they had to change some fundamental institutions. But it's certainly doable & needs to be experimented with more

 

[noname223]

What caught my eye in this post is that the psychiatrist in question believes in the concept of rational suicide, even when it makes their peers and higher ups uncomfortable. Yet, they say they would never tell a patient about their beliefs.

It certainly puts things into perspective for me, that maybe a lot of staff I interacted with in the mental health system before might have agreed with me about my assessment of my own situation, but are bound by regulations and laws to keep their mouths shut and not have honest conversations about these difficult topics.

I think this post also highlights another glaring flaw in the fundamental framework of the mental health system, the fact that there is so much smoke and mirrors. Safety plans and contracts, verbal promises to not attempt, no real way to determine a person's mental capacity for long-term decision making. There is no good way to deem if a person is imminently suicidal or not, it's all guessing games.

When the consequences of being honest are losing one's freedoms and bodily autonomy, facing an involuntary hospitalisation/sectioning, it is no wonder that many people choose to put on a performance, that we memorize lines like actors in a play in order to dodge outcomes that have the potential to throw an already painful life into further chaos and disarray. If there were truly an effective and caring method of helping acutely suicidal people, there would not be such universal fear regarding it.

This whole system of "dealing with" us feels more akin to a theatre full of subtle stage cues and role rehearsals than actual healthcare. However, this is just my experience with interacting with the mental health system, for over a decade across multiple countries.

This thread resonated very well with me. I more or less convinced some psychiatry staff that assisted suicide might be reasonable in my case.

Here is how I convinced some staff members of the psychiatry assisted suicide might be reasonable in my case

The story is extremely complicated. I will just state some facts and sum up main points of this story. I elaborated on them countless times if you want to know all the details read my old threads related to this issue. They did not openly say that to me. I think in Germany this might be...

sanctioned-suicide.net

Two staff members changed the workplace after being confronted with my severe longerterm suicidality. For one I have no proof that I really was the reason but I am pretty convinced the psychiatrist quit because of dealing with me and my family.
The clinical psychologist and a male nurse sort of alluded that they think it would be the right decision if they offered me assisted suicide. It is some years ago but he said something like no matter how my life ends hopefully it will involve at least pain as possible. I think he could get into a lot of trouble for alluding that. Of course I would never report that. I like him. And I highly respect him for saying that to me.
This was soon after the highest court ruling in Germany that ruled in favor of very liberal assisted suicide laws. Which the media elites and politicians try to block as good as possible with all their power. Fuck them.

 

[PromisedLand]

When the consequences of being honest are losing one's freedoms and bodily autonomy, facing an involuntary hospitalisation/sectioning, it is no wonder that many people choose to put on a performance, that we memorize lines like actors in a play in order to dodge outcomes that have the potential to throw an already painful life into further chaos and disarray. If there were truly an effective and caring method of helping acutely suicidal people, there would not be such universal fear regarding it.

This whole system of "dealing with" us feels more akin to a theatre full of subtle stage cues and role rehearsals than actual healthcare. However, this is just my experience with interacting with the mental health system, for over a decade across multiple countries.

Yeah, just one time of being locked in a seclusion room for 48 hours was enough to finally convince me once and for all that the health industry will never help me. I have delt with so much shit from them before that, such as being forced to take medications since I was 3 years old, for "ADHD". It fucked me up and gave me serious anxiety, and nobody gave a shit about that.

I have lost friends "because I refuse to seek professional help". I have like, no friends left. Society pushes a ridiculous and unreasonable romantic fairytale of help for SI, that most people who have never experienced it, are actually stupid enough to believe.

 

[LaVieEnRose]

Chief complaint of SI? Well SI is certainly the chief complaint here....just of a different sort. I wonder how many of their patients are actually "complaining" of their suicidal ideation.

I was expecting something more outrageous from the thread title because stigmatizing attitudes towards suicidal people on the part of mental health professionals abound. Plus psychiatric spaces on Reddit tend to be wanky. I doubt clinicians of any sort actually like working with suicidal people. For one thing, as soon as any mention of feeling suicidal is made, even in the most passive and vaguest of terms, their minds become occupied with calculating the risk to themselves and that is at the forefront during any conversation revolving around the topic.
I'm sure it is draining work but if they are a resident they must be working in some hospital environment. It's hard to have sympathy for having a bad time in that capacity.
The referenced post feels more icky than perhaps it deserves to be but I don't feel like trying to find the language to describe how and why.
In the end, I don't think current mental health frameworks are right at all for addressing suicidality specifically. I doubt this person has anything useful to offer people like us. Of course, part of the usual consequences of failing an attempt (or being too loose-lipped) is that we are brought into contact with and made to prostrate before people who have nothing positive to offer us. That's the scary part.

It certainly puts things into perspective for me, that maybe a lot of staff I interacted with in the mental health system before might have agreed with me about my assessment of my own situation, but are bound by regulations and laws to keep their mouths shut and not have honest conversations about these difficult topics.

Oh, I have no doubt some would have.

 

[Raindancer]

I didn't make it through all the responses so maybe I missed something, but what surprised me is the deep chasm between people wanting to CTB and those professionals. Granted a few had some good and positive things to say, but it left me feeling very bereft that they do not understand us at all. I know that is not a surprise to all who have gone through such therapy, but I would have hoped maybe one professional would have been able to speak from our point of view and not just speak from it but have some real understanding of it. Granted the question and answers were to help them deal with their side of things, but at least IMO, they desperately missed the target.