Discussion Impact to therapist after I CTB?

[standingfast]

I am wondering how to lessen or mitigate or even eliminate the potential impacts to my psychologist as a result of my suicide?

She is the only person who I trust but she cannot reach me - I am too far gone. And she is not where I can ever find what I need. I feel safety and care from her, but she is "just" a safehouse in the war that rages around me and in me. I don't belong in the world and even if she does feel safe and caring, in the end she is my doctor and the reason to see her is so that I get to a place where I don't need her.

The only reason I haven't gone yet is because I fear how it will impact her professionally. Emotionally there will be unavoidable impacts, but I can't stay anymore.

Are there any ways to shelter her from any professional or legal fallout? She is very methodical and careful to document everything and has great boundaries. She has not committed me - partly because part of my CPTSD is from that kind of thing in the past (and there is literature to support it is sometimes not indicated to commit a person for those reasons) and partly because I have told her odds are if she commits me I probably would not work with her again. Pretty harsh of me but it has happened in the past with others and I am just going on my past reactions. I'm pretty open with her on 99% of everything so also to share that. It took a lot for me to try therapy again in the first place given my previous therapist betrayed me and out of blue dropped me and refused to even give me an explanation or any closure. So the odds of me going to another therapist if I stopped with my current one would be very low. I have thought of just ending therapy and taking that relationship out of the equation. But that is very hard for me.

So are there any ways to shelter her from any professional or legal fallout?

 

[athiestjoe]

Very thoughtful of you to be thinking about others like that!

I'm not entirely clear on whether you mentioned anything specific that would trigger a mandatory reporting obligation. If you didn't, then no worry at all on that. If you did, it might be possible, but it would require the professional licensing agency and/or law enforcement to demonstrate that she knew and that her mandatory reporting requirements were at play (expresses an immediate and serious intent to harm themselves or has a specific plan and means to do so). That could still be challenging to prove, as even with thorough documentation, they would need a solid reason to believe she was aware to compel those records (so even if she is methodically documents things as you mentioned). You do not (and maybe in this instance less might be more) need to respond on the post and take this feedback for what it is. Feel free to PM me if you'd like to discuss it further. I just wanted to respond here for anyone else who might have this similar question.

I hope you find everything you are looking for!

 

[DOHARDTHINGS24]

I only have the quickest of moments but wanted to jump on & share quickly.
One is that I haven't decided whether to leave a note or not, but even without a real note - I will leave at least a single line saying that there was nothing my shrink could have done, it was always going to happen.
And two, its depressing to read but may be reassuring to you - there's an article in the psychiatric times called "How to Write a Suicide Note: Practical Tips for Documenting the Evaluation of a Suicidal Patient" - I can't link, sorry.
Your therapist may well have been trained to write notes this way to avoid being sued. Again, it can be confronting to know this is how they write, but it (eventually…) brought me great comfort for when my bus finally gets here.
Best of luck with your bus or your recovery.

 

[standingfast]

I am
This life is no-win for me.
I don't know how to break free of her.
And that is the problem all the time. Always alone. Since age 4...alone. Always searching and when I find someone who treats me like I have worth I cannot be with them how I need or I destroy it. And if things changed and enabled me to be with then people I can't be with, I would destroy it anyway.. That is who I am. My foundation is made of no worth and hate.

 

[attheend13]

I only have the quickest of moments but wanted to jump on & share quickly.
One is that I haven't decided whether to leave a note or not, but even without a real note - I will leave at least a single line saying that there was nothing my shrink could have done, it was always going to happen.
And two, its depressing to read but may be reassuring to you - there's an article in the psychiatric times called "How to Write a Suicide Note: Practical Tips for Documenting the Evaluation of a Suicidal Patient" - I can't link, sorry.
Your therapist may well have been trained to write notes this way to avoid being sued. Again, it can be confronting to know this is how they write, but it (eventually…) brought me great comfort for when my bus finally gets here.
Best of luck with your bus or your recovery.

I found the article if anyone is interested.

How to Write a Suicide Note: Practical Tips for Documenting the Evaluation of a Suicidal Patient

Proper suicide assessment is probably the most important part of a clinician's job; appropriately, heavy emphasis is placed on this in our education. Unfortunately, psychiatrists receive comparatively little practical guidance in documenting the history and physical examination (H&P) of a...

www.psychiatrictimes.com

 

[standingfast]

I found the article if anyone is interested.

I read through the entire article. Thank you for sharing. It shows me she has avenues, but still A LOT of stressful steps for her (and confirms to my own mind why everyone is worse for knowing me, that in the end I am a curse in everyone's life and a mistake).

Yet too the article adds weight to my feelings it may be beneficial for my psychologist to just stop seeing her, to protect her. I think she would strongly fight me on it and if I did try to stop she might involuntarily commit me. So it is a tricky line to walk. I can't lie to her and pretend I am better and I don't know if I have the energy to do any "acting".

Overall I have put her in a tricky spot. Last time I had session I basically said "I can't believe my life has come to this." And she held back tears and fear as best as she could and said, "Do you need to voluntarily check in to the hospital?". I said no, it would make things worse and darker.

She keeps making suggestions for how to make even small dent all the time. Yet I refuse them all, saying I don't have the energy to try even if I wanted to and I don't want to try because there is nothing I want in life that is available to me.

 

[DOHARDTHINGS24]

I found the article if anyone is interested.

How to Write a Suicide Note: Practical Tips for Documenting the Evaluation of a Suicidal Patient

Proper suicide assessment is probably the most important part of a clinician's job; appropriately, heavy emphasis is placed on this in our education. Unfortunately, psychiatrists receive comparatively little practical guidance in documenting the history and physical examination (H&P) of a...

www.psychiatrictimes.com

Thank you so much for linking.
I found this article so very depressing but also so comforting. I think I may have vomited the first time I read it. Not kidding. But it kept sneaking into my brain. I thought back on ways my appointments could have been documented- from my perception of events to their notes (with an assumed reality somewhere in between, the whole 3 sides to every story, yours, mine & the truth…). I felt physically ill to think people I trust so implicitly would describe me that way, that they could turn my laughter into a weapon. It really fucked with my head. But I couldn't stop thinking about it. I have 2 doctors - one who couldn't really give a shit but hasn't done anything technically wrong, just maybe taken the impartial part too far into indifferent. And the other. Well. If I asked for a goddamn kidney, they probs would've given me one of their own. A terrific doctor, a terrific person. It makes me sick, out of all the people in the world, that they could be implicated in any way. I have watched another shrink be implicated in a suicide & they were so disgustingly "insurance company puppets" that it kept me up, wondering how they could be so separate. But now I see the need for it. They need to keep working. And save those that can be saved. As in, not me. So even though it's revolting, I hope my beautiful doctor wrote clinical, dead hearted notes. There was nothing they could do for me. It was written long before. All they did was delay the inevitable - something I guess we could both be mad at each other about. But I don't doubt that their empathy, insight & medical knowledge can save others. And maybe lots of them. And I have no desire to take that away from the doctor or their current or future patients. They "accidentally" saved my life once (medical related, not CTB related) so imagine what they do when they try.
I think that CTB'ing is our right. And it's my path.
But we are obligated to think how it will impact others - not in general, but specifically those we implicate (who we get meds from, who we source SN from, not to jump in front of trains if we can, not to leave our bodies for a month if we can, not to have witnesses if we can etc etc). Most of us are relatively desperate & that can impair our thinking & I understand that - but if we can avoid being selfish assholes, that'd be nice.
We do what we can with the hand we're dealt.
If we are able to make it less selfish, let's try. And if we can't, then we can't. I'm doing my best.

I read through the entire article. Thank you for sharing. It shows me she has avenues, but still A LOT of stressful steps for her (and confirms to my own mind why everyone is worse for knowing me, that in the end I am a curse in everyone's life and a mistake).

Yet too the article adds weight to my feelings it may be beneficial for my psychologist to just stop seeing her, to protect her. I think she would strongly fight me on it and if I did try to stop she might involuntarily commit me. So it is a tricky line to walk. I can't lie to her and pretend I am better and I don't know if I have the energy to do any "acting".

Overall I have put her in a tricky spot. Last time I had session I basically said "I can't believe my life has come to this." And she held back tears and fear as best as she could and said, "Do you need to voluntarily check in to the hospital?". I said no, it would make things worse and darker.

She keeps making suggestions for how to make even small dent all the time. Yet I refuse them all, saying I don't have the energy to try even if I wanted to and I don't want to try because there is nothing I want in life that is available to me.

I posted about the story, just not the link (sorry…) & have responded above as well. I think a lot of it comes down to whether or not you think you can be "saved". If you are sure you want to CTB, lying to shrink is not a good option for them. If you are not planning to CTB soon, cutting contact with them may be bad for you - either a lack of support or a big red flag to them. I guess your actions depend on how serious you are to CTB, how serious you are to protect them, & what real life will actually allow. Best of luck.

 

[attheend13]

I am
This life is no-win for me.
I don't know how to break free of her.
And that is the problem all the time. Always alone. Since age 4...alone. Always searching and when I find someone who treats me like I have worth I cannot be with them how I need or I destroy it. And if things changed and enabled me to be with then people I can't be with, I would destroy it anyway.. That is who I am. My foundation is made of no worth and hate.

I don't have any words of comfort but I wanted you to know I really hear your post it resonates with me deeply

 

[nomoredolor]

I am wondering how to lessen or mitigate or even eliminate the potential impacts to my psychologist as a result of my suicide?

She is the only person who I trust but she cannot reach me - I am too far gone. And she is not where I can ever find what I need. I feel safety and care from her, but she is "just" a safehouse in the war that rages around me and in me. I don't belong in the world and even if she does feel safe and caring, in the end she is my doctor and the reason to see her is so that I get to a place where I don't need her.

The only reason I haven't gone yet is because I fear how it will impact her professionally. Emotionally there will be unavoidable impacts, but I can't stay anymore.

Are there any ways to shelter her from any professional or legal fallout? She is very methodical and careful to document everything and has great boundaries. She has not committed me - partly because part of my CPTSD is from that kind of thing in the past (and there is literature to support it is sometimes not indicated to commit a person for those reasons) and partly because I have told her odds are if she commits me I probably would not work with her again. Pretty harsh of me but it has happened in the past with others and I am just going on my past reactions. I'm pretty open with her on 99% of everything so also to share that. It took a lot for me to try therapy again in the first place given my previous therapist betrayed me and out of blue dropped me and refused to even give me an explanation or any closure. So the odds of me going to another therapist if I stopped with my current one would be very low. I have thought of just ending therapy and taking that relationship out of the equation. But that is very hard for me.

So are there any ways to shelter her from any professional or legal fallout?

I feel the same way. I'm leaving a note that says I systematically lied or omitted information to avoid hospitalization. That this decision is completely my responsibility and that no legal repercussions should be taken against my mental health providers.

 

[alltoomuch2]

This is something that bothers me a lot. More on the emotional/mental wellbeing side for them. Ever since one of the crisis team who's been on the team for years, told me she'd lost 6 patients over that time and she remembered their name, date of birth and their face to this day. That's a heavy heavy burden for her. I feel so guilty knowing that I will probably do that to my mental health workers. There's no legal repercussions I don't think, here in the UK. But they are called to the inquest if they've seen the person, even if it was 20 or more years before the ctb. I didn't believe that but asked another MH worker and they said it was true.