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Difficulty Finding the Right Treatment for Suicidal Thoughts

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In April I was hospitalized for suicidal ideation, it was a very stressful time, and I found the experience more stigmatizing than helpful. I still have nightmares where I wake up sweating thinking I am back in the locked ward. I was not a good patient and was diagnosed with borderline personality disorder (I discussed this with my therapist, both past and present and they do not agree with this as a diagnosis.) My issue is I still have strong suicidal thoughts where I want to die, but I don’t want my family and friends to experience the pain suicide would bring them. It has gotten to the point where I focus on ways I could die, like getting some disease or something. This is making it difficult to move on with my life, I have dreams, and I know that they are possible, but I don’t know if I have the energy to accomplish them in my current state. What I would like to know is how best to bring this up with my therapist, without risking the hospital. Also, I am in the process of transferring to a new therapist because my current therapist is leaving. After only a few months and I was beginning to get to the point where I was about to bring this up with her, but I am afraid, this will be seen as a way of avoiding abandonment. I don’t know if I should wait to bring this up when I find a new therapist or I should share this with my current one as it takes a while to get comfortable with someone new, and the pain is serious at the moment. Thank you for your help.

Difficulty Finding the Right Treatment for Suicidal Thoughts

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A.

The time to discuss your suicidal ideation is now. Metaphorically speaking, it’s a mistake to ignore the “elephant in the room.” Not discussing it would be akin to delaying treatment. I would advise against doing that.

You should be honest with your therapist about how you feel. If true, stress the fact that you do not have a plan to end your life. The decision regarding inpatient hospitalization often hinges on whether or not an individual has a specific plan to end their life. Simply tell the truth to your therapist. Never try to manipulate the therapist. Thinking about suicide is very different than having specific plans to carry it out. You should also openly discuss your concerns about being re-hospitalized.

Consider consulting a therapist who is trained in dialectical behavioral therapy (DBT). DBT is a highly-specialized and effective intervention for individuals who engage in suicidal thinking and behavior. DBT is specifically geared towards teaching clients how to regulate their emotions. I would encourage you to read more about DBT and perhaps acquire a DBT workbook. The workbook may be helpful but I recommend that you complete it in tandem with a DBT-trained therapist. Ask for a referral or check the Psychology Today website to locate a DBT therapist in your community. Please take care.

Dr. Kristina Randle

Difficulty Finding the Right Treatment for Suicidal Thoughts

Kristina Randle, Ph.D., LCSW

Kristina Randle, Ph.D., LCSW is a licensed psychotherapist and Assistant Professor of Social Work and Forensics with extensive experience in the field of mental health. She works in private practice with adults, adolescents and families. Kristina has worked in a large array of settings including community mental health, college counseling and university research centers.

APA Reference
Randle, K. (2018). Difficulty Finding the Right Treatment for Suicidal Thoughts. Psych Central. Retrieved on May 24, 2019, from https://psychcentral.com/ask-the-therapist/2014/12/12/difficulty-finding-the-right-treatment-for-suicidal-thoughts/
Scientifically Reviewed
Last updated: 8 May 2018
Last reviewed: By a member of our scientific advisory board on 8 May 2018
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