Treating Suicidal Clients
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- Jennyag
- Victor01
- Jennyag
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» Jennyag - The other side
Over the last 8 years having suffered with severe clinical depression with constant suicidal ideation and acute episodes, can I put some thoughts to you from the other side of the coin so to speak.Firstly it is not always attention seeking behaviour,it is pure desperation at the apparant lack of anything to live for, but with the very tiny idea that it is not the answer somewhere inside your head. I could even rationalise how much better my husband and son would be without me.
I can understand how a professional is paralysed by a client stating their intention, I know that immediately a professional has to do a risk assessment and I do understand the difficult position into which the client has placed their professional. From my personal experience I can tell you that there are very few people who can cope successfully with the situation BECAUSE OF their professional training. Because they are in "deep water" if a client carries out their intent they consequently act from that perspective. Many are not prepared to even discuss with the client why they feel like that, the "contracts" can be very one sided and very negative and often there is no empathy.
I was very fortunate with my therapist, he was prepared to understand and to talk about how I felt. I had a traumatic childhood and at 7 years old suicide became my escape, my way-out. I didn't know or understand any of this until I was in my mid-forties and half-way through psycho-therapy. He suggested that perhaps it wasn't actually death that I craved but peace from all that was going on in my head. By exploring this and working on it I realised that he was indeed quite correct. From that point suicide faded from my thoughts and indeed I came to realise that I did want to live, just not in the way that I had for the preceeding 40+ years. Even though it was early in terms of the therapy I was undergoing I did know that things were improving in some areas and therefore there was some hope of having a happy life eventually, if I could hang on.
The points I am trying to make though are that by letting me talk about suicide, even down to how I would do it and gently directing the way I was thinking, had very important implications for me. Firstly I came to trust him, he was not going to react and "throw" me into hospital because I had dared to suggest I couldn't go on any longer, instead he was going to be proactive and help me to face up to what and why I was feeling this way. He took me seriously, he may have thought I was attention seeking but he never gave me that impression, again reinforcing the idea that he knew how "ill" I really was and how badly I felt and at the same time telling me how much he respected me, that despite feeling as I did I was continuing to work and hold down a responsible full time job and look after a family etc., etc. There were occasions when I was admitted at these times, but it was done sensitively by talking and gentle persuasion with the control left firmly in my hands. On more than one occasion he would see me or speak to me on the telephone everyday, (a very positive contract as I felt that someone actually cared about me) until he had gently persuaded me that I needed respite. Even then I could not make the final decision for various reasons tied in with my childhood, but once I had got to the position that I could see that I needed care he would then make the decision but only with my permission, his phrase was "Would it make it easier for you if I told you that I want you to come in?"
Another bonus of the way in which he treated me was that I came to trust him even more. Never having trusted anyone before, not even my husband this was an enormous leap forward.
I have great admiration for the way in which this man cared for me. A new concept for mental health is coming soon to the UK called Recovery, which is very much along the lines in which therapy works, i.e. people with mental illness/distress can recover, a better quality of life not always a cure of course. Recovery talks about holders of hope, not just professionals but anyone knowing or caring for someone with mental health problems. It is about allowing the sufferer to hold their own hope for the future but when they are unable to hold that hope the friend or professional holding it for them. The difficult part about this is knowing when to give it back, because hope has to be returned. It is also about empowering people and allowing them to hold their own risk. In terms of suicide it is very much about the way in which my therapist handled me, he allowed me to hold my own risk, when his instincts for his own professional survival were saying that I should be in hospital. The fact that he was prepared to do that, even when the outcome was that I was admitted, detered me from taking the final step, it had a very positive effect on me and aided my eventual recovery.
My message is please, even when your instincts shout otherwise, listen to what your client is saying, try to understand but above all help them to hold their own risk. Not all clients are attention seeking children, many are adults who have come to a crossroads which appears to offer peace on one side and just more torment on the other, to know that someone care and will help them through the torment step by step does more for them than knowing each time they reach this point they cannot discuss it because they will be "policed", admitted or medication changed, even if all those things do have to happen, it can be done together as intelligent adults.
Jenny
-- posted by Jennyag
» Victor01 - Re: The other side
In response to message posted by Jennyag:Hello Jenny,
I wanted to thank you for writing this.
I believe you have/had a wonderful therapist and I am very grateful that you did.
I do not see suicide talk/threats or attempts as manipulation at all.
One thing as a survivor is, when as a young child, there was nothing we had control over. The only thing we did and really do have control over is whether we live or die. (most of the times unless an accident occurs. I think you know what I mean.)
Heck, I am just glad that you had a good therapist and that he helped you to see where your suicidal thoughts were coming from.
I wish you all the best in the world.
-- posted by Victor01
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