Therapy while having method ready

[stilhavinightmares]

I have my method 100% ready and it is foolproof. However, I think the freedom of knowing I can go whenever I need to makes me want to try again to choose life. I want to see if I can figure something out to avoid hurting my loved ones.

My issue is that I am afraid to disclose how severe my suicidality is to my therapist. I work full time and am the breadwinner so I cannot be hospitalized or we will lose everything (also an issue keeping me alive currently). I know I can't get better if I'm not honest and actually trying so I want to try one last time, but how do I do that without being sent to the hospital?

 

[hiddenbpd]

I'm really proud of you for trying to choose life, that's not an easy choice to make when you have everything planned out for the alternative.
I can't guarantee that you won't be hospitalized as I'm not your therapist, but I can give you some pointers that will hopefully help.
First, emphasize that you don't have current intentions of hurting yourself, that you don't want to die, and that you're choosing to try to get better. If you don't have intentions to carry out a plan in the near future, they don't have much grounds. Having a slight bit of hope is a good sign to therapists. Have a list of reasons why you want to stay alive.
Also, I wouldn't disclose that you have access to your method. You could say what it is and that you're contemplating, but having easy access to a lethal method would put you at significant risk.
I just recently had this experience. I too am trying to give my therapist the full opportunity to help me. I disclosed much of everything to my therapist, but my date isn't for another month and I don't have current access to my plan so he let me leave. I'm also being followed by a psychiatrist which gives some protection too.
I wish the best for you and I applaud you for trying to give yourself another chance.

 

[stilhavinightmares]

I'm really proud of you for trying to choose life, that's not an easy choice to make when you have everything planned out for the alternative.
I can't guarantee that you won't be hospitalized as I'm not your therapist, but I can give you some pointers that will hopefully help.
First, emphasize that you don't have current intentions of hurting yourself, that you don't want to die, and that you're choosing to try to get better. If you don't have intentions to carry out a plan in the near future, they don't have much grounds. Having a slight bit of hope is a good sign to therapists. Have a list of reasons why you want to stay alive.
Also, I wouldn't disclose that you have access to your method. You could say what it is and that you're contemplating, but having easy access to a lethal method would put you at significant risk.
I just recently had this experience. I too am trying to give my therapist the full opportunity to help me. I disclosed much of everything to my therapist, but my date isn't for another month and I don't have current access to my plan so he let me leave. I'm also being followed by a psychiatrist which gives some protection too.
I wish the best for you and I applaud you for trying to give yourself another chance.

I actually saw your posts in another thread about being in a very similar place and I am proud of you, too! It's so painful and hard, words can't even come close. I am definitely not going to tell her I have access to the method. I hope I can muster up the same bravery you have and disclose almost everything. I want to feel better.

 

[Rounded Apathy]

I'm exhausted so hopefully this comes out right. I think knowing what precise powers they have over you in your situation is very useful - hopefully you're comfortable and can ask them flat out "in what circumstance would you have to break our confidentiality?". That should get the point across without asking something too on the nose like "how close to suicide do I have to be for you to rat on me?".

As @hiddenbpd says, I think it's also really important (if this is your case) to emphasize your not wanting to die. I've just started with a new therapist who I asked from the get-go about her inclination to work "with suicidality", and was very clear that not only do I not want to die, I want even less to kill myself - what I want is an end to the agony that my life has become. I think they feel better when you're aware of and express that. I'm also in a funny spot where I kinda derided the whole "safety-plan" thing because I explained how I don't and won't have a crisis attempt ever, because the way I want to go isn't possible to achieve spontaneously (what I didn't explain is that would be flying to the states, buying a gun and offing myself in the middle of nowhere - the only way I can achieve all that).

I'm too terrified to fuck around and if it gets to the point where I make an attempt, it's almost certainly beyond salvation. I have sn as a backup but I really don't want to use it. This is only really useful if it extends to you, but I just wanted her to understand the end-stage of all the issues I deal with is wanting to be dead (not end my life; that's just a means) so she knows how much and in what way I fucking struggle with everything else.

I think I rambled. I better take a nap. I wish you well on the road to recovery...

 

[stilhavinightmares]

I'm exhausted so hopefully this comes out right. I think knowing what precise powers they have over you in your situation is very useful - hopefully you're comfortable and can ask them flat out "in what circumstance would you have to break our confidentiality?". That should get the point across without asking something too on the nose like "how close to suicide do I have to be for you to rat on me?".

As @hiddenbpd says, I think it's also really important (if this is your case) to emphasize your not wanting to die. I've just started with a new therapist who I asked from the get-go about her inclination to work "with suicidality", and was very clear that not only do I not want to die, I want even less to kill myself - what I want is an end to the agony that my life has become. I think they feel better when you're aware of and express that. I'm also in a funny spot where I kinda derided the whole "safety-plan" thing because I explained how I don't and won't have a crisis attempt ever, because the way I want to go isn't possible to achieve spontaneously (what I didn't explain is that would be flying to the states, buying a gun and offing myself in the middle of nowhere - the only way I can achieve all that).

I'm too terrified to fuck around and if it gets to the point where I make an attempt, it's almost certainly beyond salvation. I have sn as a backup but I really don't want to use it. This is only really useful if it extends to you, but I just wanted her to understand the end-stage of all the issues I deal with is wanting to be dead (not end my life; that's just a means) so she knows how much and in what way I fucking struggle with everything else.

I think I rambled. I better take a nap. I wish you well on the road to recovery...

Oh I love this response. I thank you for spending the time and energy to write all that. It makes perfect sense. I may utilize what you said to gauge where her comfort level is at this particular time with the extent of my suicidality. I will also remind her I don't want to die, I want the agony to end. I want it to end so badly. It's just so constant.

I definitely resonate with your "wanting to be dead" vs "wanting to kill myself".

Curious - your therapist doesn't know you have SN, I assume?

 

[Rounded Apathy]

Oh I love this response. I thank you for spending the time and energy to write all that. It makes perfect sense. I may utilize what you said to gauge where her comfort level is at this particular time with the extent of my suicidality. I will also remind her I don't want to die, I want the agony to end. I want it to end so badly. It's just so constant.

I definitely resonate with your "wanting to be dead" vs "wanting to kill myself".

Curious - your therapist doesn't know you have SN, I assume?

Aaaabsolutely not, haha. Again, I don't feel it's necessary for them to know given my circumstance and other reasons; I don't have all the other meds yet, there are plenty of other things in the world that I could try to off myself with, etc. You're not a terribly new member and maybe you read more than you post, but before spending HOURS AND HOURS on this forum I basically thought most suicidal people were more or less like me: this awful slow burning thing, noticing this evil little seed sprout and insidiously grow in tandem with the degradation of the circumstances and quality of your life, into this diabolical bloom that eclipses just enough of the light of hope that you can still see scant rays, but feel like an absolute fool for continuing to try and find anything by its light.

F'ing wrong. An apparently significant number of people seem able to go from 0-100 in a few seconds and this is what 99% of the therapeutic and prevention efforts have zeroed in on as being representative of suicide and suicidality as a whole. Which sucks for everyone, but especially those of us on this side who don't experience it like that. We want the suffering to end, or lessen, or just be fucking manageable for christ's sake. But the only ones in positions purported to be helpful are convinced we're gonna shove a knife in our arm if they look the other way, so instead of focusing from the get-go on helping us do the unfortunately small amount of slow and gruelling work that MAY make it possible to not have such a hard time, their default stance if you mention suicide is red alert. They've also been indoctrinated to see suicidal ideation as inextricable from mental illness to the point of impairment (especially if you are young/they perceive you as a picture of health for whatever reason), which is out and out false.

All of this to say I always start by explaining my nuanced reality as well as the multitude of interlocking factors that have led me here. I've had more than one professional tell me how insightful/articulate/well-spoken/etc. I am, which I don't really grasp the full implications of but I think it's demonstrative of something wrong with the institution. I just have a personal and professional background that makes for effective communication skills so having been able to watch my life slowly go to shit over the course of the last several years, yeah, I've kind of had time to notice what's happened and can tell you in detail...

Sorry, that was even longer than the last one. TL;DR: make yourself seem smart and rational. I think they'll be less likely to try and violate your autonomy, and probably more likely to be able to actually help you (granted, again, I have no clue what it is you struggle with).

 

[stilhavinightmares]

Aaaabsolutely not, haha. Again, I don't feel it's necessary for them to know given my circumstance and other reasons; I don't have all the other meds yet, there are plenty of other things in the world that I could try to off myself with, etc. You're not a terribly new member and maybe you read more than you post, but before spending HOURS AND HOURS on this forum I basically thought most suicidal people were more or less like me: this awful slow burning thing, noticing this evil little seed sprout and insidiously grow in tandem with the degradation of the circumstances and quality of your life, into this diabolical bloom that eclipses just enough of the light of hope that you can still see scant rays, but feel like an absolute fool for continuing to try and find anything by its light.

F'ing wrong. An apparently significant number of people seem able to go from 0-100 in a few seconds and this is what 99% of the therapeutic and prevention efforts have zeroed in on as being representative of suicide and suicidality as a whole. Which sucks for everyone, but especially those of us on this side who don't experience it like that. We want the suffering to end, or lessen, or just be fucking manageable for christ's sake. But the only ones in positions purported to be helpful are convinced we're gonna shove a knife in our arm if they look the other way, so instead of focusing from the get-go on helping us do the unfortunately small amount of slow and gruelling work that MAY make it possible to not have such a hard time, their default stance if you mention suicide is red alert. They've also been indoctrinated to see suicidal ideation as inextricable from mental illness to the point of impairment (especially if you are young/they perceive you as a picture of health for whatever reason), which is out and out false.

All of this to say I always start by explaining my nuanced reality as well as the multitude of interlocking factors that have led me here. I've had more than one professional tell me how insightful/articulate/well-spoken/etc. I am, which I don't really grasp the full implications of but I think it's demonstrative of something wrong with the institution. I just have a personal and professional background that makes for effective communication skills so having been able to watch my life slowly go to shit over the course of the last several years, yeah, I've kind of had time to notice what's happened and can tell you in detail...

Sorry, that was even longer than the last one. TL;DR: make yourself seem smart and rational. I think they'll be less likely to try and violate your autonomy, and probably more likely to be able to actually help you (granted, again, I have no clue what it is you struggle with).

You are fantastic. I had to think about this all morning because I read it at 6am when I woke up and couldn't form words.

I definitely think the mental health system sees MUCH more of the impulsive type of suicidal, which makes sense as to why providers are so quick to raise that red flag. I also think the system is unfairly focused on keeping people alive so they'll do anything just to do that, even when they have no idea the quality of the life they're trying to keep here. I am also a slow-burner, and we aren't recognized as much because we aren't "imminent risk" and require a lot more than a quick suicide assessment and ambulance ride to sustain. Plus we are usually quiet about it all.

My therapist knows me well. She also knows my past history and what led to my attempts, so I'm definitely going to tread lightly and carefully. I'm also working with someone new doing trauma therapy so she is really a wild card to me.

I wish I could bold and quote and shout everything you wrote in this reply. You get it and you express it so well. I thank you for this. It's nice to see someone whose ideology is much like mine.

 

[Rounded Apathy]

You are fantastic. I had to think about this all morning because I read it at 6am when I woke up and couldn't form words.

I definitely think the mental health system sees MUCH more of the impulsive type of suicidal, which makes sense as to why providers are so quick to raise that red flag. I also think the system is unfairly focused on keeping people alive so they'll do anything just to do that, even when they have no idea the quality of the life they're trying to keep here. I am also a slow-burner, and we aren't recognized as much because we aren't "imminent risk" and require a lot more than a quick suicide assessment and ambulance ride to sustain. Plus we are usually quiet about it all.

My therapist knows me well. She also knows my past history and what led to my attempts, so I'm definitely going to tread lightly and carefully. I'm also working with someone new doing trauma therapy so she is really a wild card to me.

I wish I could bold and quote and shout everything you wrote in this reply. You get it and you express it so well. I thank you for this. It's nice to see someone whose ideology is much like mine.

You're sweet. It's nice that my writings are having a positive effect on people. Using this site has reminded me of how much I enjoy writing when it's totally on my own terms.

I toss this around whenever I come across someone who seems to be of a similar bent to me; I recently finished a book by a suicidologst about a lot of what is wrong with the field and why. It's not perfect obviously, but still interesting. I made a thread featuring an interview article and highlights from it, which turned into a summary which turned into a full-on book report. In case it's up your alley, you can access it however deeply you wish here:

https://sanctioned-suicide.net/threads/we-have-to-reconceptualize-suicide-craig-bryan.102186/

 

[stilhavinightmares]

You're sweet. It's nice that my writings are having a positive effect on people. Using this site has reminded me of how much I enjoy writing when it's totally on my own terms.

I toss this around whenever I come across someone who seems to be of a similar bent to me; I recently finished a book by a suicidologst about a lot of what is wrong with the field and why. It's not perfect obviously, but still interesting. I made a thread featuring an interview article and highlights from it, which turned into a summary which turned into a full-on book report. In case it's up your alley, you can access it however deeply you wish here:

https://sanctioned-suicide.net/threads/we-have-to-reconceptualize-suicide-craig-bryan.102186/

Totally up my alley. If I wasn't so depressed I'd be interested in the book, but I did read what you wrote from the interview. It draws on a lot of what DBT aims to do which I appreciate, as well as being strengths-based. I think suicidality needs to be reconceptualized in clinical settings as a whole; this is a good continuation and expansion of the whole "keep this impulsive suicidal person alive" thing.

 

[Regen]

I don't find it contradictory at all to try therapy again, but at the same time to keep the way out open. I find that completely okay and very reassuring.

At the same time, I share your opinion that therapy can only help if you are as honest as possible.

It depends on your therapist how far you can go. There is no advice that is always valid. The way I have always done it is to approach the issue. Then I could see how far I could go. And I would just ask clearly where the line is that your therapist needs to hospitalize you. Most of the time, that line is where you can no longer credibly demonstrate that you will come back for the next therapy session. With some suicide methods, you always have your "tool" at the ready, rope or train for example. It helps me a lot to be able to talk about suicidal thoughts in therapy. If I can't do that, it doesn't do me any good. Then I would rather change therapists.

Ask him how he deals with the subject of suicide. And don't tell him that day that you're all set and about to make a decision. Approach him cautiously. You can ask, What if ...? Then you can row back if he reacts in alarm. You can say that you've been at this point in the past, but not today, and that you want to know how he's dealing with it. Explain why you don't want to go to the hospital and that you are very afraid of it.

Maybe a planned hospital would be something for you, because if you kill yourself, you also fall away as the breadwinner of the family. It's very hard when everything is hanging on you, I know. I would also like to go to a good clinic, but it is not possible because of the family.

I really hope your therapist can handle the issue well!

 

[stilhavinightmares]

I don't find it contradictory at all to try therapy again, but at the same time to keep the way out open. I find that completely okay and very reassuring.

At the same time, I share your opinion that therapy can only help if you are as honest as possible.

It depends on your therapist how far you can go. There is no advice that is always valid. The way I have always done it is to approach the issue. Then I could see how far I could go. And I would just ask clearly where the line is that your therapist needs to hospitalize you. Most of the time, that line is where you can no longer credibly demonstrate that you will come back for the next therapy session. With some suicide methods, you always have your "tool" at the ready, rope or train for example. It helps me a lot to be able to talk about suicidal thoughts in therapy. If I can't do that, it doesn't do me any good. Then I would rather change therapists.

Ask him how he deals with the subject of suicide. And don't tell him that day that you're all set and about to make a decision. Approach him cautiously. You can ask, What if ...? Then you can row back if he reacts in alarm. You can say that you've been at this point in the past, but not today, and that you want to know how he's dealing with it. Explain why you don't want to go to the hospital and that you are very afraid of it.

Maybe a planned hospital would be something for you, because if you kill yourself, you also fall away as the breadwinner of the family. It's very hard when everything is hanging on you, I know. I would also like to go to a good clinic, but it is not possible because of the family.

I really hope your therapist can handle the issue well!

This is what I think I'm going to do - it hurts so badly to keep it to myself so I'm going to approach the topic but not divulge anything too risky. Thank you for your thoughts and empathy, it means so much.