Venting The Hypocrisy of therapy when it comes to suicide

[OhWellDerp321]

Therapy is:

Problem-solving: A place where you discuss your situation and the therapist helps you find solutions.
Except when you solution is to ctb. Then the therapist has to stop that as a solution.

Open and Honest Communication:
Speak openly and honestly about your thoughts and feelings, knowing your conversations are confidential.
Except when you say you want to ctb and have plans. Then the therapist has to share that information and send you to the hospital.

Incremental Progress:
An ongoing process, and each session is a step towards your progress.
Except when your progress is to ctb. Then each session is step away.

Taking Control of Your Life:
Take control of your life and make positive changes.
Except when you want to ctb. Then you shouldn't have control over your life anymore.
Then we should control your life and decide whether you are mentally stable or have to be admitted to the psych ward.
Also, "suicide is selfish". Instead of controlling your own life and making your own decision, you should think about all the others you're are affecting.

This is why I have found therapy to be useless for getting better. It promotes all these values, but the second suicide is involved, it goes against all those values.

Feel free to list any other points in the comments.

 

[WhatCouldHaveBeen32]

Therapy is useless because it assumes people are something more than animals. Life itself is make belief , if you simply choose to not believe in all the BS , you will get suicidal and depressed at one point or another, there can't be anything done outside of death.

 

[Jdieiejdjaow]

That's why it's important to get a competent therapist. Ask upfront: how do you work with clients who are suicidal (have a plan and are actively pursuing it)?

There are professionals out there (like Bessel van der Kolk) who see suicide as an option but would prompt in trying something before committing. Of course, it is done in a therapeutic setting where you're the sole beneficiary (and that you pay which is what the therapist is gaining).

Please note that A LOT¹ of therapists are incompetent so it's worth booking a free 15 minute call before committing to therapy with a therapist.

1: 70 to 80%

 

[escape_from_hell]

They are also human and you damn well cannot be vulnerable around them.
You can guarantee they will be judging you from the minute they see you just like any other rand on the streets: assessing your looks, intelligence, opinions, etc. And they are guaranteed making fun of you in their social circles even if 'anonymized' and are assuredly letting their bias affect their treatment of you. Don't share the same opinion on pets, flavors of food, politics, whatever it is? They are human too and are not some kind of hyper self-aware and disciplined creature that is not going to hold it against you.

That's why it's absolutely insane to me that many of the pushes for legalization of psychedelics are under the conditions that they are supervised by judgy therapists. At your most vulnerable around people that hate you. Clearly they hate you for being suicidal from the start.

 

[Blueberry Panic]

They want to stay alive so they can get more sessions out of you , they don't want you to ctb because that means they don't get paid .

 

[gothbird]

I think this post speaks to a lot of very real feelings—especially for those of us who are actively making plans. It's hard not to feel a sense of frustration, even hypocrisy, when therapy claims to be about openness, autonomy, and non-judgement, but suddenly draws strict boundaries the moment suicide is brought into the room.
From the inside, it feels like: "Be honest… but not too honest." There's a line you're not supposed to cross, and once you do, your pain becomes something unsafe. Something they need to control. That shift can be jarring—and for me, at least, it's felt like betrayal more than once.

But I also think it's worth understanding why it happens, even if it doesn't make it feel any less awful.
Therapists have legal and ethical duties—particularly around risk and safety. The moment you say you've got a plan or a clear intent to end your life, their role changes. It stops being about support and starts being about protection. Not necessarily because they want to take away your autonomy, but because they're required to. By law. By professional standards. Their job, at that point, is to keep you alive—whether you want that or not.
That doesn't always feel kind. Most of the time, it doesn't feel like care at all. It feels clinical, cold, even punishing. I don't think it's usually done out of cruelty. It's a system designed to prevent permanent choices and protect the therapist/institution. Whether or not that system works… well, that's another matter. (eyeroll)

Therapy doesn't always get it right. Some therapists are heavy-handed. Some panic. Some don't know how to sit with suicidal thoughts without immediately trying to fix or silence them. I'd be lying if I said I haven't felt more harmed than helped by therapy. It's not a flawless system. Far from it.
But I don't think it needs to be perfect to offer something. What I do think is that therapy should be more honest—about its limits, about the way it responds to suicidal people, and about the uncomfortable line it walks between care and control.

So yeah. I get the disillusionment. I feel it in my bones. But I also believe therapy can still be a space for certain people to find a bit of breathing room—even if it isn't the answer, even if it's just a place to stall a bit longer.
Some days, that's all I can ask of it.

 

[OhWellDerp321]

That's why it's important to get a competent therapist. Ask upfront: how do you work with clients who are suicidal (have a plan and are actively pursuing it)?

There are professionals out there (like Bessel van der Kolk) who see suicide as an option but would prompt in trying something before committing. Of course, it is done in a therapeutic setting where you're the sole beneficiary (and that you pay which is what the therapist is gaining).

Please note that A LOT¹ of therapists are incompetent so it's worth booking a free 15 minute call before committing to therapy with a therapist.

1: 70 to 80%

It depends on the country that you are in.

In Western countries therapists are legally required to report it if you tell them you have a plan. You don't ask upfront. Even asking them upfront could get them to report it.

They are also human and you damn well cannot be vulnerable around them.
You can guarantee they will be judging you from the minute they see you just like any other rand on the streets: assessing your looks, intelligence, opinions, etc. And they are guaranteed making fun of you in their social circles even if 'anonymized' and are assuredly letting their bias affect their treatment of you. Don't share the same opinion on pets, flavors of food, politics, whatever it is? They are human too and are not some kind of hyper self-aware and disciplined creature that is not going to hold it against you.

That's why it's absolutely insane to me that many of the pushes for legalization of psychedelics are under the conditions that they are supervised by judgy therapists. At your most vulnerable around people that hate you. Clearly they hate you for being suicidal from the start.

Exactly. They will judge no matter what. They get paid to resist talking back. But that doesn't mean they don't judge you.
Also, again. If you mention suicide, they will for sure judge you and say your viewpoints are wrong. So much for no judgement.

 

[Jdieiejdjaow]

It depends on the country that you are in.

In Western countries therapists are legally required to report it if you tell them you have a plan. You don't ask upfront. Even asking them upfront could get them to report it.

Never happened to me, except one time. And I didn't even say I had a plan. But that's more like an outlier. Therapists are incompetent. Asking is fine. They are not legally bound to report if you just ask.

 

[divinemistress36]

Theres a lot of shitty therapists. There are some that are good but they are hard to get into often they are booked up or expensive. A good one has went through real shit in their life and worked a lot on their own healing and is open to try different healing methods as everyone is different. You can only be somewhat honest with them. You can say you have passive thoughts of suicide but not a plan. I like my therapists but I still want to die

 

[Jdieiejdjaow]

Theres a lot of shitty therapists. There are some that are good but they are hard to get into often they are booked up or expensive. A good one has went through real shit in their life and worked a lot on their own healing and is open to try different healing methods as everyone is different. You can only be somewhat honest with them. You can say you have passive thoughts of suicide but not a plan. I like my therapists but I still want to die

You do realize that without fully committing and being honest you're trapped in a vicious cycle which will end up with you transitioning?

I don't get people who have basic needs covered, can afford a good therapist, but still want to transition.

 

[OhWellDerp321]

I think this post speaks to a lot of very real feelings—especially for those of us who are actively making plans. It's hard not to feel a sense of frustration, even hypocrisy, when therapy claims to be about openness, autonomy, and non-judgement, but suddenly draws strict boundaries the moment suicide is brought into the room.
From the inside, it feels like: "Be honest… but not too honest." There's a line you're not supposed to cross, and once you do, your pain becomes something unsafe. Something they need to control. That shift can be jarring—and for me, at least, it's felt like betrayal more than once.

But I also think it's worth understanding why it happens, even if it doesn't make it feel any less awful.
Therapists have legal and ethical duties—particularly around risk and safety. The moment you say you've got a plan or a clear intent to end your life, their role changes. It stops being about support and starts being about protection. Not necessarily because they want to take away your autonomy, but because they're required to. By law. By professional standards. Their job, at that point, is to keep you alive—whether you want that or not.
That doesn't always feel kind. Most of the time, it doesn't feel like care at all. It feels clinical, cold, even punishing. I don't think it's usually done out of cruelty. It's a system designed to prevent permanent choices and protect the therapist/institution. Whether or not that system works… well, that's another matter. (eyeroll)

Therapy doesn't always get it right. Some therapists are heavy-handed. Some panic. Some don't know how to sit with suicidal thoughts without immediately trying to fix or silence them. I'd be lying if I said I haven't felt more harmed than helped by therapy. It's not a flawless system. Far from it.
But I don't think it needs to be perfect to offer something. What I do think is that therapy should be more honest—about its limits, about the way it responds to suicidal people, and about the uncomfortable line it walks between care and control.

So yeah. I get the disillusionment. I feel it in my bones. But I also believe therapy can still be a space for certain people to find a bit of breathing room—even if it isn't the answer, even if it's just a place to stall a bit longer.
Some days, that's all I can ask of it.

"Be honest..... but not too honest". That pretty much sums it up.

I understand it is their job to keep you alive. I understand that they legally have to report you.
It's that restriction that does the exact opposite of "help me get better". Does it keep you alive? Yes.
But it makes things 10 times worse than before after they throw you in a psych ward for sharing your plans to ctb.

Again this is where the hypocrisy occurs again. I am supposed to openly share everything and feel safe. Yet if I tell you that I have a plan to ctb, all of the sudden I have to fear about my rights being taken away.

You should be able to tell them your plans to ctb without having to suffer consequences.

If you think about it logically, whats the difference between suicidal thoughts and having plans?
Aren't both just as dangerous? Just cause you don't have plans today to ctb doesn't mean you won't have plans when you leave the session or the next day.
So how come you are allowed to tell therapists that you have suicidal thoughts but not plans?
And even if I do have plans. Do you think I will openly tell you knowing that you would send me to the psych ward? Again, "be honest...not too honest".

It does more harm than good. If I would be able to tell my therapist that I have plans and just want to be honest and have an open discussion, then that would be good. But of course, you can't do that without them sending you to the hospital.
If you aren't harming anyone, and the therapist isn't convincing you to ctb, then whats wrong? Its only your own life that you are affecting.

That last point I agree with. Venting is about the only thing therapy is actually useful for.

Never happened to me, except one time. And I didn't even say I had a plan. But that's more like an outlier. Therapists are incompetent. Asking is fine. They are not legally bound to report if you just ask.

I mean, I don't know the laws in your country.... But if you did that in some western countries you'd definitely be put in a psych ward.

Also how would that conversation go if you called to ask?

"Hi, my name is ____, I was just wondering what would you do if I saw you and told you my plans to ctb. If I saw you and kept telling you in these plans in every session?".

What would you expect the answer to be? Even if they don't report you when you call, they still can't do a therapy session the way you imagined without risking their own job. That's in countries where they are actually required by law to report you.

Therapists are legally obligated to report the information you shared during therapy:
"When there is an immediate risk of physical or psychological harm to you or someone else,"

 

[gothbird]

"Be honest..... but not too honest". That pretty much sums it up.

I understand it is their job to keep you alive. I understand that they legally have to report you.
It's that restriction that does the exact opposite of "help me get better". Does it keep you alive? Yes.
But it makes things 10 times worse than before after they throw you in a psych ward for sharing your plans to ctb.

Again this is where the hypocrisy occurs again. I am supposed to openly share everything and feel safe. Yet if I tell you that I have a plan to ctb, all of the sudden I have to fear about my rights being taken away.

You should be able to tell them your plans to ctb without having to suffer consequences.

If you think about it logically, whats the difference between suicidal thoughts and having plans?
Aren't both just as dangerous? Just cause you don't have plans today to ctb doesn't mean you won't have plans when you leave the session or the next day.
So how come you are allowed to tell therapists that you have suicidal thoughts but not plans?
And even if I do have plans. Do you think I will openly tell you knowing that you would send me to the psych ward? Again, "be honest...not too honest".

It does more harm than good. If I would be able to tell my therapist that I have plans and just want to be honest and have an open discussion, then that would be good. But of course, you can't do that without them sending you to the hospital.
If you aren't harming anyone, and the therapist isn't convincing you to ctb, then whats wrong? Its only your own life that you are affecting.

That last point I agree with. Venting is about the only thing therapy is actually useful for.


I mean, I don't know the laws in your country.... But if you did that in some western countries you'd definitely be put in a psych ward.

Also how would that conversation go if you called to ask?

"Hi, my name is ____, I was just wondering what would you do if I saw you and told you my plans to ctb. If I saw you and kept telling you in these plans in every session?".

What would you expect the answer to be? Even if they don't report you when you call, they still can't do a therapy session the way you imagined without risking their own job. That's in countries where they are actually required by law to report you.

Therapists are legally obligated to report the information you shared during therapy:
"When there is an immediate risk of physical or psychological harm to you or someone else,"

Yeah, I hear you. You're told therapy is a safe space, somewhere to talk about everything, no matter how dark—but the moment you mention plans, everything changes.

I understand why that happens. Therapists have legal and ethical responsibilities, and when they hear you've got a plan, they're trained to see that as immediate risk. But that response—while maybe well-intentioned—often lacks any real nuance. It doesn't leave room for the fact that sometimes we're not looking for intervention, just understanding. Sometimes we're trying to talk ourselves through it, not act on it. But therapy doesn't always make space for that kind of complexity.

And you're right—there's not a clean line between having thoughts and having plans. That boundary can blur in a heartbeat. But therapy often treats those two things as if they exist in entirely different categories, with entirely different consequences. That inconsistency makes people shut down, or worse, lie. Not because they want to be deceptive, but because they're trying to protect themselves from a system that doesn't always respond with care.
It's not fair. It's not supportive. And unfortunately, it's how things are set up right now.
That's why I think, for some people, therapy might not be the most useful tool—at least not in its current form. Especially if you're someone who needs to talk openly about suicidal thoughts or plans without the fear of losing your autonomy. It's painful to say, but the system just isn't built to hold that kind of truth without reacting to it.

It doesn't mean therapy is useless across the board. But it does mean it isn't right for everyone, especially when what you need is someone who will sit in the dark with you, not rush to pull you out before you're ready.
You deserve to be heard fully, not just up to the point where the system gets uncomfortable.

 

[Jdieiejdjaow]

"Be honest..... but not too honest". That pretty much sums it up.

I understand it is their job to keep you alive. I understand that they legally have to report you.
It's that restriction that does the exact opposite of "help me get better". Does it keep you alive? Yes.
But it makes things 10 times worse than before after they throw you in a psych ward for sharing your plans to ctb.

Again this is where the hypocrisy occurs again. I am supposed to openly share everything and feel safe. Yet if I tell you that I have a plan to ctb, all of the sudden I have to fear about my rights being taken away.

You should be able to tell them your plans to ctb without having to suffer consequences.

If you think about it logically, whats the difference between suicidal thoughts and having plans?
Aren't both just as dangerous? Just cause you don't have plans today to ctb doesn't mean you won't have plans when you leave the session or the next day.
So how come you are allowed to tell therapists that you have suicidal thoughts but not plans?
And even if I do have plans. Do you think I will openly tell you knowing that you would send me to the psych ward? Again, "be honest...not too honest".

It does more harm than good. If I would be able to tell my therapist that I have plans and just want to be honest and have an open discussion, then that would be good. But of course, you can't do that without them sending you to the hospital.
If you aren't harming anyone, and the therapist isn't convincing you to ctb, then whats wrong? Its only your own life that you are affecting.

That last point I agree with. Venting is about the only thing therapy is actually useful for.


I mean, I don't know the laws in your country.... But if you did that in some western countries you'd definitely be put in a psych ward.

Also how would that conversation go if you called to ask?

"Hi, my name is ____, I was just wondering what would you do if I saw you and told you my plans to ctb. If I saw you and kept telling you in these plans in every session?".

What would you expect the answer to be? Even if they don't report you when you call, they still can't do a therapy session the way you imagined without risking their own job. That's in countries where they are actually required by law to report you.

Therapists are legally obligated to report the information you shared during therapy:
"When there is an immediate risk of physical or psychological harm to you or someone else,"

In a Western country. Last time I talked about my first attempt was with a doctor. Told her how to do it and all. She got visibly distressed. Didn't ask a thing if I plan again.

The one time the ambulance came was without even saying, the health professional just called it when I texted her after the session that I wasn't feeling good. I was referring to my pain, but she interpreted it as having taken an overdose most probably. Suffice to say I went to the hospital and got fed up with it, told them I was feeling better and I left. They even called a taxi for me.

It really depends on your country in the West. Here, people are laid back.

I hope nobody will call anyone when I'll transport my N2 tank from the homeless shelter to the hotel room.

 

[OhWellDerp321]

In a Western country. Last time I talked about my first attempt was with a doctor. Told her how to do it and all. She got visibly distressed. Didn't ask a thing if I plan again.

The one time the ambulance came was without even saying, the health professional just called it when I texted her after the session that I wasn't feeling good. I was referring to my pain, but she interpreted it as having taken an overdose most probably. Suffice to say I went to the hospital and got fed up with it, told them I was feeling better and I left. They even called a taxi for me.

It really depends on your country in the West. Here, people are laid back.

I hope nobody will call anyone when I'll transport my N2 tank from the homeless shelter to the hotel room.

Shouldn't that say something though? They called even without you saying you had a plan. Just that you weren't feeling good.

 

[Jdieiejdjaow]

Shouldn't that say something though? They called even without you saying you had a plan. Just that you weren't feeling good.

It says you've a chance of a professional calling the ambulance of 1 in 7

 

[spypilot896]

yeah fuck therapy
my first therapist didn't report me when I talked abt suicide and talked to me abt it and after enough sessions I got better for a while
then my uncle caught the bus and I went back down the spiral and my second therapist reported me and I spent a week in a shithole psych ward
I'm done with therapy and shit

 

[Jdieiejdjaow]

yeah fuck therapy
my first therapist didn't report me when I talked abt suicide and talked to me abt it and after enough sessions I got better for a while
then my uncle caught the bus and I went back down the spiral and my second therapist reported me and I spent a week in a shithole psych ward
I'm done with therapy and shit

For me, the problem is the quality of help. It needs to be holistic. And it's very rare to come across someone like Bessel van der Kolk, for example. Those who are good advance in positions of leadership that they train others and do less of clinical work themselves and then they retire. It's good that they train others, and, you may find someone else with whom you can connect, but it's also likely you may not. Especially given how hard access is, and, thus, if you can even afford it.

 

[spypilot896]

For me, the problem is the quality of help. It needs to be holistic. And it's very rare to come across someone like Bessel van der Kolk, for example. Those who are good advance in positions of leadership that they train others and do less of clinical work themselves and then they retire. It's good that they train others, and, you may find someone else with whom you can connect, but it's also likely you may not. Especially given how hard access is, and, thus, if you can even afford it.

I can afford it , I have money
will I try again , no
I'm not gonna ctb immediately but I'm not gonna try to save myself
eventually I'll either die of ctb or unintentional overdose

 

[OhWellDerp321]

It says you've a chance of a professional calling the ambulance of 1 in 7

? I don't quite understand. 1 in 7? How?

 

[Jdieiejdjaow]

? I don't quite understand. 1 in 7? How?

From 7 professionals I dealt with, only one called the ambulance.