I’m having existential issues. I have very good affect regulation and impulse control. I am on medication and have been in about 2 years of psychotherapy. I’ve struggled with suicidal ideation, not as a function of seeking attention or because I don’t feel loved or valued (I very much am) – I am also accomplished and motivated and have a life full of things to do – I’m physically healthy. My primary psychological issues are PTSD from extreme childhood abuse and neglect and I have almost no ability to attach to people. I’ve found suicide to be a rational expression of what I feel is a pointless life that I don’t care for anymore. I need to talk to someone about this in a philosophical sense and my therapist is on the side of life and it is dangerous to her professionally to help me with this issue. I also cannot get the personal (though still detached) reflections due to boundary issues. I really REALLY want to explore what I feel about death the way I may explore the issue of abortion (I’m pro-choice but anti-abortion for myself). With suicide I feel I am pro-choice there too but I’m wondering if it’s the right option for me. I need someone to consult with who isn’t professionally obligated to “save me” and can be impartial? Like a spiritual advisor? Or are there therapists you can sign a pre-release to make sure they do not get bothered for malpractice if I choose to die?

A. You are essentially asking for assisted suicide. Assisted suicide is almost universally illegal. I am aware of no cases in which a mental health professional has or would knowingly agree to assist a client in ending their life.

In virtually all cases of assisted suicide, the individual who is considering suicide is experiencing agonizing physical circumstances. Their distress and pain are typically the result of an incurable medical illness, the prolonging of which could be characterized by some as tortuous or inhumane.

With regard to psychological problems, under no circumstance is suicide an appropriate choice or action. Research supports this assertion. Case after case, study after study, has shown that suicide ideation is temporary and fleeting. The feelings eventually dissipate. Studies of individuals who have survived their suicide attempts report that survivors strongly regret their actions and were grateful to have lived. Many of those individuals feel so strongly about their mistakes that they have dedicated their lives to suicide prevention.

You stated that you are loved but that you believe you’re not. That is evidence of an inability to see reality as it is. Nothing is more important than one’s ability to see reality clearly. Simply believing in the truth could prevent you making the biggest mistake of your life.

The inability to see reality clearly might also be a sign of depression. Individuals who are depressed are more likely to consider suicide than individuals who are not depressed. Those around you do love you but you do not believe them. It could be that you do not feel worthy of their love so you deny that it exists. Feeling unworthy of love is a signature characteristic of depression.

I would highly recommend that you strongly reconsider your plans. Take suicide “off the table.” Do not allow it to be an option. Realize that psychological pain can be eliminated from your life. It is often a matter of finding the right therapist or the right medication, or a combination of both. Explore your existential questions through meeting with a variety of mental health professionals. Become familiar with the work of Abraham Maslow, Viktor Frankl, and M. Scott Peck, all of whom wrote extensively about existential and psychological problems.

Finally, consider how suicide would forever alter the lives of those who love you. You may not believe that they love you but the reality is, as you have stated, they do. That is reality. In all probability, your loss would be devastating and their suffering would be immense.

I sincerely hope that you get the help that you desire. Please take care.

Dr. Kristina Randle
@DrKRandle

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Last reviewed: By John M. Grohol, Psy.D. on 23 Oct 2011

APA Reference
Randle, K. (2011). Considering Suicide: Need Help Finding a “Detached” Therapist. Psych Central. Retrieved on November 26, 2014, from http://psychcentral.com/ask-the-therapist/2011/10/23/considering-suicide-need-help-finding-a-detached-therapist/