What will my therapist do if I tell the truth?

[incrediblytired]

My mental health has been at an all time low. Between my mental illness, and just life circumstances I'm thinking about suicide every night. I'm exhausted because I can't sleep. When I do sleep I sleep all day because I don't see the reason to get out of bed. I catch myself planning out in meticulous detail how I would do things to inconvenience the least amount of people possible. Honestly? If it were not for one very specific thing I would already be dead.

My family lost my aunt to suicide last year. It tore us to pieces. My mother is never going go recover from this, I know it. And because of this, I know if I were to follow in my aunt's footsteps, it would destroy her. And there is nobody in this life I love more than my mother.

So I feel stuck in an untennable situation. Living is excruciating, but I can't die because I can't do that to my mother. But I'm not sure how long I can go on the way things are.

I have a therapist, but we're relatively new together. We've only had three sessions. I think I need to tell her how bad things are for me right now, because how is else can she help if she doesn't know? But I'm terrified of what might happen.

If I tell her the truth - that I'm thinking of suicide every day, but will not go through with it for my mother's sake - is she obligated to do anything? Report me anywhere??? I don't want the situation to be taken out of my hands, if that makes sense. I want to talk to her in confidence on a professional level for help, not lose my autonomy.

[Sophie_M]

Hi incrediblytired,

Welcome back and thank you for reaching out. We are so sorry to hear that things have been so hard for you and that you are feeling exhausted and hopeless. It sounds like a lot has happened over a year including losing your aunt which has had a devastating impact on your family. We can hear that you love your mother very much and would not want to put her through any pain. Please know that you are in a safe, supportive place where you can freely talk about whatever you are going through. We are so glad you've posted here tonight.

It is great that you are working with a therapist. You said you haven't fully told her about how bad things are for you as it has been only three sessions together so far. Your instinct to tell her everything is spot on. As you said, she can only truly help you if you tell her everything, including that you are experiencing suicidal thoughts. You can also share your concerns about losing your autonomy. Suicidal thoughts and feelings are not rare amongst people experiencing life challenges and mental health challenges. It is very likely that the priority and preference would be to get you the help and support you need without resorting to reporting it. Hospitalization is usually the final resort and occurs when someone fully intends to go through with a plan. It doesn't sound like that's what's happening for you. It is scary to talk about and admit having suicidal thoughts but please know that many people suffer from these thoughts and it is perfectly okay to talk about them with your therapist. The sooner you can tell your therapist, the sooner you'll get the support you really need.
 
We also  recommend reaching out to our support line on 1300 22 4636 or on email and Webchat (1pm-12am AEST) through our website: www.beyondblue.org.au/getsupport to talk to a friendly, caring counselor about how you can bring up this topic with your therapist and the feelings and thoughts you are going through. You can also reach out to our friends at Lifeline on 13 11 14 if you feel like things are getting too much to handle at this moment.

We hope to hear more from you here, whenever you feel up to it.

[geoff]

Hello Incrediblytired, and a warm welcome to the site and feel the pain you are experiencing at the moment and it's not a good situation to be in.

If you have only had 3 sessions, it's difficult to know whether you have their absolute trust because the first 2 visits are to get to know each other and slowly introduce yourself to each other, so you're unsure how far to extend this 'friendship', whereas if you have known them for a long time, then you realise what you are able to say with a guarantee of what's will eventuate.

However, if you tell them how you are thinking each day, but won't follow through because of the love for your mum, that's very important as the sessions will be handled differently and talked about accordingly and won't be taken out of your hands.

They may want to see you a couple of times a week, that's a decision they will need to make.

We are here for you as Sophie_M has said.

Take care.

Geoff.

[bettertomorrows]

Hi incrediblytired,

Thank you for sharing tonight. I'm sorry to hear that things have been tiring and that you feel quite trapped and exhausted, and I'm really sorry for your loss.

From my experience with my counsellor, therapists/psychologists are here to help and to keep someone safe. I understand that it can be scary thinking about whether or not you will have control and autonomy still, I felt that way too. When I told my counsellor, what happened for me was to work out a safety plan, we linked up with a mental health triage team. It was a relief to be able to talk to someone and share with them that I was at my lowest and thinking about suicide and it got me the help that I needed. It might be scary to talk about it but I felt safe with my counsellor and I think you are feeling that way too. There was shared decision making on her part and it didn't feel as intimidating as getting help is often portrayed in the media. If it is too hard to talk about it, perhaps you can show them this post where your words have been put together so nicely.

Take care incrediblytired. Feel free to pop by whenever like Sophie has mentioned.

[romantic_thi3f]

Hi incrediblytired,

Thank you for your post- I can see you've been offered so much support already here so I just wanted to pop in and share some thoughts.

You are right there in that your therapist is obligated to try and keep you safe, but what that looks like is different for every therapist. For the most part, therapists use safety plans (like bettertomorrows said), and risk assessments. These are ways to help determine how at risk you are to yourself, and things you can put in place to help keep you safe.

It sounds like your mum is in a way, your safety plan- because the thought of hurting her is keeping you here. So while hospitals (I know, scary) help some people, it really doesn't sound like it would make a difference in a sense to your own sense of safety.

I'd like to think that the therapist can help use your mum as a safe base in knowing that you are safe for now, and then working to include more and more things to improve your mental health. I know this is a really tough conversation (I've been there too), but it might help to start out with hypotheticals first- i.e. when do you break confidentiality? Even talking about suicide in general can be a really helpful way to see if this is a person you can trust.

I hope this helps

rt

[Guest_1643]

hey incredibly tired -

thank u for sharing ur post. i was very affected by it - so honest and so many of us have been there. so really from my heart a big thank u for opening up.

I wanted to reassure u that putting someone in any sort of MH "hold" eg hospitalising someone against their will etc... does happen, but i dont see this happening in ur situation. She can't "report" you anywhere for SI and i dont think she will. This is a rare thing that happens. You can also open the conversation by saying "I'm safe.... but..." If you are safe and not at risk of immediate harm she absolutely can't breach your trust. I've done this before and found that helpful.

She could in duty of care tell ur GP or another person etc if you say and identify as not safe but to disclose that u are strugglng with thoughts i personally don't think will put u at risk

That said, I would add, it's okay to form a trusting relationship over time before opening up....u dont need to necessarily "push" urself. Perhaps you can broach adjacent topics until u get comfortable. I say this related to suicidal ideation. If you are at risk immediately and in this moment in that case I would call the hospital in ur area to keep you safe. Again, they won't lock you up, they will speak to you and do an assessment.

This is has happened to me before, and I say this because I think it's okay and important in emergency to call the hosptial if you feel unsafe or also for repetetive suicidal ideation. If u aren't at risk they can assess and chat to u. U can also go directly to the hospital for this.

Ur life is too precious to worry about stigma etc , first take care of urself in emergency and give yourself support etc.
I do truly believe that if you disclose to any medical professional - gp, psycholigist, psychiatrist, that u have suicidal ideation, that they will not lock you up, take any imposing action etc... and this is a common misconception in the mental health system.

I say this as someone who has disclosed to my psychiatrist, doctor/gp etc and to the local triage that I have suciidal ideation and have never ever had any imposed hospitalisation or medical treatment. Speaking it out doesn't equal locked up.

x

[Doolhof]

Hi incrediblytired,

You have received some wonderful advice, suggestions and support from many caring people here.

One thing that helped me when I was having very dark thoughts is the following:

Maybe I think I am suicidal but maybe my thoughts are:

- I feel so overwhelmed

- what is making me feel so trapped?

- how can I find a healthy way out?

- how can I make things better, even in a small miniscule way?

-accept I am exhausted right now

- I am in emotional pain and turmoil

-my depressed mind has taken over.

When I looked at my suicidal thoughts in this manner, I realised my mind was taking me on a dark journey that told me suicidal thoughts were the only answer. There are other answers. When we are in that dark place they are hard to see.

Your mind is crying out telling you something needs to change and you need help. Please seek that help until your mind calms down again.

Regards to you from Dools