Question about therapy

[Una Nancy]

Hi everyone, hope you're doing well.

So tomorrow, I have my first ever meeting with a therapist.
Since I have no one else to talk to (except you all) about this kind of topic, I was wondering if I should tell my therapist that it's not unusual for me to have suicidal gestures, or if it's something that is guaranteed to make me kept under surveillance.
For context, I still live with my parents, and they don't know I have such dark thoughts (except one time I tried to take too much medicine, which is why I'm going to therapy). I want to be honest with my therapist, but I'm afraid she will feel obliged to tell my parents to keep an eye on me.
I think there's something called "medical confidentiality" for this, but I'm still unsure. What should I do?

 

[k75]

I'm not sure about confidentiality laws in places other than the US, but here your therapist couldn't discuss your sessions with your parents or anyone else unless you give written consent.

The exception to that is they are also mandated reporters so if they feel you are an imminent danger to yourself or others, they are required to report that and you'll be put on a psychiatric hold.

But you can tell your therapist you have those thoughts and want to work on them. They just need to know you are not going to walk out of their office and hurt yourself. If you say you often feel suicidal, that is generally ok. You're not in danger of being hospitalized just for having thoughts.

She'll ask you if you have a plan. If you intend to act on it. If you have access to guns or anything dangerous. If you have tried killing yourself recently. Saying yes to those things will most likely lead to you being sectioned.

A lot of people will insist you should never say you're struggling with suicide, but I believe it's important to be as honest as you can, so you get the help you need. Your therapist can only treat things she knows about. If she has no idea you feel that way, she can't help. You just have to be careful how you present it.

I've been to a lot of therapists. At this point, I just go ahead and tell them up front that I feel suicidal but I don't have a plan and won't do it. I just met with a new one last week. She didn't even bat an eye at the admission, just verified that I wasn't in danger and moved on.

I've never been held or hospitalized for saying I have constant suicidal ideation. They always ask the standard follow-up questions, which I lie about and say no, and from then on I never worry about bringing it up.

What's Said In Therapy Is Confidential, Except In These Specific Cases

Here’s when mental health professionals need to report what a client does or says during a therapy session.

www.huffpost.com

 

[Una Nancy]

A lot of people will insist you should never say you're struggling with suicide, but I believe it's important to be as honest as you can, so you get the help you need

Yes, actually that's what has been bothering me, because I've heard so much people say that kind of thing, that I didn't know what to do.
Like, you know, with that sort of memes

Thank you for all of your pieces of advice, it's something that will really help me for tomorrow

 

[PhilosOfDoom]

If I could say a peace of advice, is to go into the appointment with as positive mind as possible. Otherwise, you may feel like mentally rolling your eyes, feeling lectured, and not taking in, nor wanting the therapy. Eat some junk food, play video games, whatever it takes to give a positive mindset prior to leaving. I really hope it goes well for you, good luck!

 

[k75]

If I could say a peace of advice, is to go into the appointment with as positive mind as possible. Otherwise, you may feel like mentally rolling your eyes, feeling lectured, and not taking in, nor wanting the therapy. Eat some junk food, play video games, whatever it takes to give a positive mindset prior to leaving. I really hope it goes well for you, good luck!

I second this!

You basically get out of therapy what you put into it. It won't fix everything, but it can be a great tool. I really hope your therapist is nice and you have a positive experience.

 

[timf]

If you are a minor, your parents may have more access to information than they would if you were an adult. There are many different approaches to therapy and many different practitioners. You may want to be somewhat guarded until you have a better idea of the character and approach this particular therapist.

 

[I_love_to_bake]

You seem to want a straightforward response. There's always the chance of being involuntarily committed. I've heard of that happening with disastrous results. Missing weeks from school/work could make it difficult if not impossible to make up for the lost work. These are just things to consider and keep in mind.

I find therapy still very effective even if you don't being up suicide at all. Bring up what's making your life so awful and talk about that, no need to necessarily talk about the methods you've been ruminating over. Like other posters before me have said, you get out what you put into it.

My therapist is no dummy. I'm 99% sure she knows I'm very suicidal even though I've always lied through the mandatory safety questions. I'm not a good liar.

Ultimately, you should know that therapists are generally good people working very hard to help you out. They will do what they need to do to protect you, if they think it's necessary. Even if it feels awful at the time.

Keep moving forward. You've got this

 

[WhiteDespair]

I pretty much told my therapist all of this stuff. I usually give it a week or two so he could see I was stable.

Being honest is a part of therapy and it does no good to hide things.

Think of your CtB ideation as a symptom of a disease. You may get improper or downright wrong treatment by skipping symptoms.

 

[Una Nancy]

Thanks everyone, I don't know if anyone really cares, but it was super!
I didn't hesitate to be honest with my therapist, as you all said. And she said that she was worried, but I assured her that even if the two recent weeks were bad for me, I couldn't bring myself to end it all.
So, as a response, she said that we will see each other quite regularly: my second appointment is actually next Saturday.

I eventually came to realise that it's not normal for everyone to have dark thoughts like that thanks to this first appointment.
Things seem to be on the right way. I hope I'll be happy soon.
I felt like I could tell my therapist everything, it was wonderful, but it was a bit hard at first because I have so many problems in my life I just didn't know how to tell it all without messing it up haha

I really can't thank you all enough for your comments, it gave me a lot of strength!
Thanks, I don't know any one of you, but you're the people who helped me the most recently. I know it's dumb but yeah thank you so much

 

[PhilosOfDoom]

Thanks everyone, I don't know if anyone really cares, but it was super!
I didn't hesitate to be honest with my therapist, as you all said. And she said that she was worried, but I assured her that even if the two recent weeks were bad for me, I couldn't bring myself to end it all.
So, as a response, she said that we will see each other quite regularly: my second appointment is actually next Saturday.

I eventually came to realise that it's not normal for everyone to have dark thoughts like that thanks to this first appointment.
Things seem to be on the right way. I hope I'll be happy soon.
I felt like I could tell my therapist everything, it was wonderful, but it was a bit hard at first because I have so many problems in my life I just didn't know how to tell it all without messing it up haha

I really can't thank you all enough for your comments, it gave me a lot of strength!
Thanks, I don't know any one of you, but you're the people who helped me the most recently. I know it's dumb but yeah thank you so much

We are always here! I'm glad you could sympathize and connect with your therapist, it is a great tool towards recovery. Best of luck!

 

[BlackPoppet]

Thanks everyone, I don't know if anyone really cares, but it was super!
I didn't hesitate to be honest with my therapist, as you all said. And she said that she was worried, but I assured her that even if the two recent weeks were bad for me, I couldn't bring myself to end it all.
So, as a response, she said that we will see each other quite regularly: my second appointment is actually next Saturday.

I eventually came to realise that it's not normal for everyone to have dark thoughts like that thanks to this first appointment.
Things seem to be on the right way. I hope I'll be happy soon.
I felt like I could tell my therapist everything, it was wonderful, but it was a bit hard at first because I have so many problems in my life I just didn't know how to tell it all without messing it up haha

I really can't thank you all enough for your comments, it gave me a lot of strength!
Thanks, I don't know any one of you, but you're the people who helped me the most recently. I know it's dumb but yeah thank you so much

 

[Genetics]

Hi everyone, hope you're doing well.

So tomorrow, I have my first ever meeting with a therapist.
Since I have no one else to talk to (except you all) about this kind of topic, I was wondering if I should tell my therapist that it's not unusual for me to have suicidal gestures, or if it's something that is guaranteed to make me kept under surveillance.
For context, I still live with my parents, and they don't know I have such dark thoughts (except one time I tried to take too much medicine, which is why I'm going to therapy). I want to be honest with my therapist, but I'm afraid she will feel obliged to tell my parents to keep an eye on me.
I think there's something called "medical confidentiality" for this, but I'm still unsure. What should I do?

HIPAA (I assume your in the states) protects your medical/mental confidentiality no matter your age or what you tell the doctor/counselor. Your therapist would be unethical to tell your parents anything if you're 18 or over. If you're under 18 your state might have mandatory reporting but not for thoughts.

Therapy can't help you unless YOU participate and are painfully honest and open in your sessions.

 

[emohamster]

Hi Una Nancy,

Your therapist/counselor is mandated by law to report suicidal intent, but to what degree depends on your state. Almost all therapist will ask these questions if you ever bring up suicide.

• Thoughts of wanting to die or thinking one would be better off dead (called "passive suicidal ideation")?
• Thoughts of actually harming or killing oneself?
• A desire to kill oneself?
• A plan for killing oneself?
• Steps a person has taken to prepare for suicide (e.g., giving away belongings)?
• Ready access to the means of suicide (e.g., owning a gun)?

I think for most therapist they only raise the alarm bells if you have thoughts of suicide, a plan, and access to implement. If you meet those three I would caution you from saying anything until you know they won't report. From personal experience, you do not want to end up in psych.