Discussion Should I continue with therapy?

[Kit1]

I am hoping that we can have a discussion about whether I should carry on with therapy and then I can make a decision.

I have complex PTSD, CFS, autism and a number of other health challenges - complex PTSD is due to a traumatic childhood. I dissociate a lot and would sometimes take an overdose or find myself on top of a cliff or mountain before actually realising what is happening. I am trying to keep myself alive - bit there is a suicidal part of me that I have very little control over and one day, there is a good chance that I will be dead without actually consciously planning it. I have been admitted to hospital for an antidote last year when I consumed more than what I should have and only came back to realise what was happening after I had consumed more than I should and my GP sent me to the hospital. I have a habit of purchasing paracetamol in a disassociated state (with absolutely no memory at all) and often end up with 100s of packs of paracetamol - there was a time when I had a caring GP and I would drop off the tablets once I realise. Since late summer 2023, I stopped using NHS services (GP and hospital services) due to a change in the way patients are allowed to reach out to the doctor and I had accessibility challenges. I also stopped taking my prescribed medications.

Anyway I still see a clinical psychologist (who is in contact with my psychiatrist) with the community mental health team - the only NHS servuce I have continued to use. I took an overdose in November or December last year and had taken more than the usual dose before realising that I had been taking them - totally dissociated when I was taking them. This had slipped out when I wrote an email to the clinical psychologist and at the time, she had asked me to see a doctor and I had refused. She also invited the psychiatrist for a three way meeting and they had both tried to persuade me to get a blood test and I had refused. Since that overdose, I haven't been 100% (mind you, I haven't been 100% for the past few years anyway, but I have gone down recently and this might be because it has been 4 1/2 months since I stopped taking all my prescribed meds).

My clinical psychologist is okay and when I went for therapy, she mentioned that if I took an overdose again and I refuse to have a blood test, then we cannot carry on with therapy. She wasn't angry and I could see that she spoke in a concerned way. On principle, I refuse to ever lie unless it is to protect someone's safety, confidentiality (for the greater good of another human being). The question now is;

1. Do I stop therapy and if I do, the suicide risk will increase substantially and I really need to stay alive for my loved ones that I look after?

2. Do I carry on with therapy and not tell her when I take an overdose next time (not telling is not lying)? However if she asks me directly, I cannot lie and if she then decides that I should perhaps be sectioned to get medical care, I will have no choice but to actually end my life again as I refuse to be sectioned or if I am ever sectioned, to definitely end my life at the first chance available..,

I have no control over taking an overdose. I would really like to know what you think I should do. Your advise will be considered and appreciated.

Thank you

 

[Forever Sleep]

This sounds terrifying- I'm so sorry. I guess I find it hard to wrap my head around. Are you in a dissociative state when you buy the pills, come home and put them away? Is there truly no control you have in that period? If you realise some days later that you have these pills- do you still hand them over to your doctor? I would imagine that prevention is better than cure type of thing- so- better not to have the pills there to take.

I know there's a limit to two boxes per purchase in the UK- unless I guess you are going to multiple stores? So- presumably, you shouldn't be able to build up a massive stash in a short period of time. Not that I suppose you need that many to overdose on.

I guess I'm just curious. Obviously- ignore me if this is too intrusive. What is your mindset do you think when you are buying them? Is it a suicide or self harm attempt? But then- you kind of logically know that attempts to suicide via OD are rarely successful. It's not to judge you by the way. I would say I suffered with borderline binge eating disorder in the past and I imagine it is the same terrible compulsion to just do it. I simply couldn't have binge inducing foods in the place. I don't know but I feel like trying to stop yourself purchasing them to begin with would be the best thing to do. Of course, it's harder when you do need them now and again. Do you have family, friends or neighbours that could keep them for you?

As to your therapist though. Obviously, the ideal is to not overdose again. Still- if you do and don't need hospitalisation, I mean- if it's doing you some good- it would be awful to lose it. Do you suppose your therapist is saying it to try and blackmail you into stopping?

 

[Kit1]

I think when it gets too much, I must be buying the paracetamol. I usually find them stacked up in the same place, in an orderly fashion (all facing the same way etc) and the receipts all in order as well. What is interesting is that the receipts indicate that I spend hours literally buying paracetamol in various shops and could spend one spending spree with purchasing between 30-50 boxes of paracetamol from various shops and it is all paid for in cash (which is also highly unusual as I don't normally pay for my shopping using cash).., I do have memory lapses with time - throughout my life, I have so many memory blanks (there are chunks of my childhood I have no memory of) and this is caused by extreme stress and a symptom of Dissociative Identity Disorder (DID) which I have spent yhe last few years in denial - though the clinical psychologist is aware of this as she got me working actively on a workbook to do with DID and then realised that it was probably too early to start the work and it has been put on hold. Even now, I can lose several hours every week - and usually I have taken the car and disappeared somewhere and I have a camera in the car now so that I can play back to where I have been etc.., There is a part to me that wants to desperately die and it feels like that is the person who comes out with the buying of paracetamol etc. I know that once I went into a shop and the Pharmacist asked if I needed any paracetamol and that she was happy to sell up to 10 boxes for me "as I did last time" - it is illegal to sell more than two boxes and I remember seeing 5 receipts for the 10 boxes and wondered how I had managed to do that and somehow I had and it wasn't the first time and clearly she recognised me and I didn't recognise her. There is also another shop that I noticed have been selling 6 boxes - clearly the pharmacies are not all following the law and I am also amazed at how many stores I seem to go into as I actually hate shopping normally!

In terms of the therapist, I don't think it is blackmail as she knows that I have no control. Though she has been asking me to drop off the paracetamol with her when I realise that I have stocked up - currently there are probably about 1600 paracetamol stocked up - I used to give it to my GP as ling as he promised to donate the meds as I don't want it wasted. Since I stopped engaging with my GP, there is nowhere I can drop it off. Apart from my GP, only the clinical psychologist and the psychiatrist know that I have these challenges - so I cannot ask anyone else to hold on to them..,