If a suicidal patient, or a patient with suicidal thoughts without (immediate) plans, are a therapist’s most difficult patient, then why even take them in, in the first place? If the stats are correct – that being one-quarter of all patients have some sort of suicidal traits, then why mention it? That alone makes people who may want to end their life to think that ‘suicide might as well be my choice since ‘I’ could be so-and-so therapist’s worst/most difficult patient, so I’m probably not worth going back there etc etc’ It makes the (somewhat) suicidal patient feel burdened by this fact – ‘suicidal patient(s) are a therapist’s most difficult patient’.

Nice wording. Really, it is. But guess what?

IT’S NOT.

I feel insulted by this. If suicide is already a taboo, then saying that to a suicidal person is like ‘here, I’ll give you a push over that favourite, high cliff of yours’.

I’ve had experience with suicidal thoughts before, however I did lie to a former therapist regarding suicide. It was like suicide was my hope – that going to therapy was like trying to win a battle which ended in death, whose efforts of that person were given before s/he died in vain. Something along the lines like ROYGBIV – Richard of York gave battle in vain. Colours of the rainbow? Someone ought to be familiar with the in vain thing.

My therapist and I have different political views. I wish I didn’t know my therapist’s political views, but we happened to discuss a world event a few years ago, and my therapist went off on a short but fierce tirade. I wish that hadn’t happened. My therapist is excellent, compassionate, wise about people, and has done me a world of good — probably saved my life.

I feel terrible about the lie, but I was afraid of being judged or losing the good relationship we have. It doesn’t directly bear on why I’m in therapy (depression), but it feels like a crack in the relationship nonetheless.

Not sure what I should do now.

An example: I have terrific trouble with clutter. Two bedrooms of my 3 are unusable at the moment due to clutter storage. There have been times when mail covered my ceramic-top stove for months at a time. My garage is packed with stuff. I have brought it up several times to my psychiatrist, but he downplays my concerns. He does not know how bad the clutter is, but he has the general perception that I am too hard on myself and self-criticize too much. Hence when I bring up my disordered state he tells me that I seem organized and efficient and then he makes excuses for me and describes places that are a lot worse and tries to “put it into perspective” for me, so I never really get the full unpleasant truth described to him because he seems to thwart me. In truth, he might know best because I’ve been making improvements to my organizational level and cleanliness as my mental health has been improving (the kitchen’s been clean now for about 6 months). But still, I would feel horribly embarrassed if he ever saw my house and can’t describe it in detail to him. His negative comments about the “worse” houses actually make it harder for me, also, because I worry how much less cluttered my place is than his described worse places.

The same thing goes on when I tell him how exhausted I am and how non-productive. He tells me it’s OK to have non-productive days and that I have accomplished enough in the last year and can be non-productive for a week of vacation or a weekend (for example). I slept (and was physically ill) most of Christmas break and while I castigated myself, he said it was fine. I could not get myself out of bed, had a hard time showering, spent hours reading or on the computer, etc while dishes sat in sink and bills needed paying etc. I do keep trying to tell him.

Another issue is that a salesman who knows him mentioned him to me (because the salesman knew I knew him but thought we are friends, not patient-doctor) and in the same breath mentioned a man. Then he continued to talk about them in the same breath such as “John&Bill both really love jazz. John&Bill have such a lovely home”. So for over a year I have been sitting on the possibility that my male psychiatrist has a male significant other, and yet he has hidden it from me, mentioning only his deceased wife and not mentioning ever the sex of his current mate. I have desperately wanted to ask and yet feel it’s his personal life and not my business and yet feel somehow it is my business because I stumbled upon this and it bothers me because I was at the time I heard about the significant other feeling a crush on my psychiatrist.

I also did not reveal the full extent of my crush on my psychiatrist, though I did tell him and told him that it was distressing me to feel that way. Once again he told me that it was “OK” and to not feel distressed. Still, I felt I was still withholding because he did not hear all my thoughts on the topic. I could only choke out a few lines, though he did “get it”.

I walked out of this particular session and walked out of the relationship