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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by judy1 on February 2, 2003, at 16:26:16
we probably have discussed this before, but it's been on my mind since Shar mentioned it on PB2000, so I wanted to open it up for general discussion. for those of you who have a contract in place or one in the past with a therapist (or pdoc), do you feel it helped? any opinions would help me, because my therapist (who I recently started seeing again) wants to put one in place. take care, judy
Posted by Dinah on February 2, 2003, at 20:22:35
In reply to suicide contracts, posted by judy1 on February 2, 2003, at 16:26:16
My therapist brought up the idea tentatively a few times to see how I would react. I told him that a contract forced on me under duress would just cause me to lie to him. He never pushed it.
On the other hand, much later I offered to him my promise never to commit suicide without contacting him and giving him the opportunity to help first. I offered that to him as a gift, freely and of my own volition. He reminds me of it from time to time, and it does help in a way, because it gives me a step I must take if I feel genuinely suicidal. And that step gives me time to think. I've never had to call him for that reason.
But I also promised to call him if I felt the urge to self injure. That promise was given in a fit of remorse, not as freely, but I've tried to keep to it. So I have called him about that.
That's my only experience with contracts.
Posted by justyourlaugh on February 2, 2003, at 21:04:25
In reply to Re: suicide contracts » judy1, posted by Dinah on February 2, 2003, at 20:22:35
wow,
for me its different.
si is so personal,
death is so selfish.....when the thought is there,the world goes away.
no remorse no guilt no nothing...
i would never promise anyone,....my inner thoughts.
j
Posted by agencypanic on February 2, 2003, at 21:11:01
In reply to Re: suicide contracts, posted by justyourlaugh on February 2, 2003, at 21:04:25
> wow,
> for me its different.
> si is so personal,
> death is so selfish.....when the thought is there,the world goes away.
> no remorse no guilt no nothing...
> i would never promise anyone,....my inner thoughts.
> jI don't really have an opinion one way or the other about contracts, but can confirm the above from my own experience.
It played no role in preventing a previous attempt I made.
Posted by shar on February 2, 2003, at 23:16:12
In reply to Re: suicide contracts, posted by agencypanic on February 2, 2003, at 21:11:01
I had an agreement with my T for a year. We both knew--and said out loud--that it would not stop me if I decided to do it. After all, it's only words. And, the whole time we had the contract I still talked about feeling suicidal, and even about the day that the contract was up, and wanting to have that freedom again. But, it brought more of an ease to our sessions, because neither of us felt impending disaster, and we got a little more beyond talking about ending things, and more into the territory of living.
I can't predict what would have happened in its absence, but I imagine it helped. It was the longest and most intense period of SI I had experienced ever.
I've had other suicide contracts also, have been in therapy for almost 30 years! I guess if they are taken seriously, they can't hurt.
Shar
Posted by ShelliR on February 2, 2003, at 23:17:49
In reply to suicide contracts, posted by judy1 on February 2, 2003, at 16:26:16
Hi Judy,
I think you should make a promise, commitment, to your children and write your contract to them. (Although they need not see it). Then you need to do whatever you have to, to uphold that promise.
You created the foundation for that commitment when you chose to bring them into this world. Children need a mother to protect them from their own form of mental illness, which would be inevitable if you committed suicide.
Take care,
Shelli
Posted by Alii on February 3, 2003, at 0:45:35
In reply to suicide contracts, posted by judy1 on February 2, 2003, at 16:26:16
> we probably have discussed this before, but it's been on my mind since Shar mentioned it on PB2000, so I wanted to open it up for general discussion. for those of you who have a contract in place or one in the past with a therapist (or pdoc), do you feel it helped? any opinions would help me, because my therapist (who I recently started seeing again) wants to put one in place. take care, judy
I resent that my pdoc and therapists (over the years there have been several) have at one time or another asked/required of me to commit to a suicide contract. In clearer days I see the necessity of it due to how distorted the depression can make my thought process. But mainly I hate them and think they are a drag. (can you tell I'm not in one of dem clearer dayz?)I have many opinions on these contracts and how different therapists have worded them or approached the entire subject but am to exhausted and tonight came home to an empty house now that the partner has moved out. Wish I could put thoughts together but I can't even keep the food or pills down so mental clarity will be a goal for later on this week.
Thank you for raising an interesting subject that affects many of us.
--Alii
Posted by noa on February 3, 2003, at 4:26:34
In reply to suicide contracts, posted by judy1 on February 2, 2003, at 16:26:16
It absolutely helped me!
Posted by noa on February 3, 2003, at 4:28:14
In reply to Re: suicide contracts » judy1, posted by ShelliR on February 2, 2003, at 23:17:49
I like this idea, Shelli.
Posted by likelife on February 3, 2003, at 23:21:08
In reply to suicide contracts, posted by judy1 on February 2, 2003, at 16:26:16
Contracts have and haven't helped me. When I first entered therapy with a new therapist, she had me sign a contract the first day, and I mostly did so so that she would agree to work with me. My depression proved a little too vicious though, and I made an attempt shortly after.
Once I had started seeing the same therapist more regularly, she didn't force me to have an ongoing contract, but has twice asked me when she was quite concerned whether I could contract for safety. Not wanting to lie, I told her no (there have also been other times when I've said yes), and was subsequently hospitalized. Something I was angry about at the time, but do not regret now. Building a relationship with my therapist first was important for me to be able to take somthing like a contract seriously.
Posted by judy1 on February 4, 2003, at 12:50:03
In reply to Re: suicide contracts » judy1, posted by ShelliR on February 2, 2003, at 23:17:49
You are absolutely correct. As the daughter of a father who chose that method to die, I understand all too well the pain and anger that suicide brings to survivors (it has been 20+ years and I still deal with it). I appreciate you stating it so well and couldn't agree more. take care, judy
Posted by judy1 on February 4, 2003, at 12:52:56
In reply to Re: suicide contracts » judy1, posted by Dinah on February 2, 2003, at 20:22:35
I think any method that causes us to take an extra step and therefore makes us think more can only help. I have to agree with the self-injury though, that is often done spontaneously or in my case in a dissociative state and I don't see how a contract would help. thanks, judy
Posted by judy1 on February 4, 2003, at 13:05:06
In reply to Re: suicide contracts, posted by agencypanic on February 2, 2003, at 21:11:01
I agree about the selfishness of the act, and therefore it is really important to trust your therapist. best of luck-judy
Posted by judy1 on February 4, 2003, at 13:07:42
In reply to Re: suicide contracts, posted by shar on February 2, 2003, at 23:16:12
I guess it probably does help to feel like you can talk about it to your therapist- almost anything that I'm able to express out loud lessens the anxiety associated with it. thank you, judy
Posted by judy1 on February 4, 2003, at 13:09:33
In reply to Re: suicide contracts » judy1, posted by Alii on February 3, 2003, at 0:45:35
hope you start to feel better, for me just missing meals really messes up my thinking. take care of yourself, judy
Posted by judy1 on February 4, 2003, at 13:19:40
In reply to Re: suicide contracts, posted by likelife on February 3, 2003, at 23:21:08
I get upset by the fact that if I say I'm feeling suicidal I risk being hospitalized (which is repugnant for me because of some awful experiences). Interestingly, my pdoc gave me his home #, which I've used maybe 2-3 times in 3 years in the middle of the night- but my therapist has a recording that says if this is an emergency contact the hospital (like I ever would). I'm curious what people think of that? Thanks- judy
Posted by Dinah on February 4, 2003, at 13:44:30
In reply to Re: suicide contracts-lifelike and others, posted by judy1 on February 4, 2003, at 13:19:40
Yes, my therapist is always eager to offer the hospital, even if I just discuss ideation, not intent. I finally discussed how it made me feel like I needed to lie to him about it, and he told me that he didn't think the hospital was the best solution either, he was just using it to assess the strength of my intent. Hopefully, he'll choose better methods now.
If I remember correctly, doesn't your therapist work with a lot of high risk patients? Perhaps she feels like she needs to set limits to protect herself from burnout. If she works in group, it would seem like they could rotate on call, but if she works alone it might be overwhelming. My therapist gave me his cell phone number and told me to please call him day or night if I need him. Of course he knows I'm very unlikely to do so and generally only call during office hours. But I'd been his client for a long time at that point, and I don't think he does work with a lot of high risk clients. At first I was supposed to call the on call therapist or go to the emergency room, and I never did either. I think he realizes that the desire to keep from bothering him acts in a powerful way to control impulses.
Have you asked her about it?
Posted by judy1 on February 4, 2003, at 16:22:00
In reply to Re: suicide contracts-lifelike and others » judy1, posted by Dinah on February 4, 2003, at 13:44:30
If I remember correctly, doesn't your therapist work with a lot of high risk patients?
Yes, you're right, she does. I never thought about it from that perspective- thanks for reminding me.
Have you asked her about it?- no, that would be confrontational :-), I'm still working on issues that fall into that category. But I do think I'll bring it up since I'll just get resentful if I don't.Take care, judy
Posted by shar on February 4, 2003, at 23:37:53
In reply to Re: suicide contracts, posted by likelife on February 3, 2003, at 23:21:08
>>and was subsequently hospitalized.
Oh, yeah, this is something I was hugely pissed about at the time my T and I were fighting about this. I told her I didn't want to empower her to hospitalize me.
I had forgotten about that. We had several discussions about the issue, and after thorough exploration of the facts of commitment, I was less concerned about it.
Glad that was mentioned here.
Shar
Posted by shar on February 4, 2003, at 23:46:47
In reply to Re: suicide contracts-lifelike and others, posted by judy1 on February 4, 2003, at 13:19:40
I think the recording is a cop-out. It's true that T's need sleep, too, but giving out a number to someone having a particularly difficult time, only to get a machine....well, that's a mixed message. If the T gave the number to everyone, well, she'd be getting calls all the time and would need a machine to handle them all.
I'm of the opinion that being a T to clients with more than fine-tuning needs is sort of a 24-hour job. Again, I would limit my home number to people who really might need it, or even get a second line. My pdoc has a machine and I leave a message, and he gets back to me right away (within the hour). That would work, too.
Shar
> I get upset by the fact that if I say I'm feeling suicidal I risk being hospitalized (which is repugnant for me because of some awful experiences). Interestingly, my pdoc gave me his home #, which I've used maybe 2-3 times in 3 years in the middle of the night- but my therapist has a recording that says if this is an emergency contact the hospital (like I ever would). I'm curious what people think of that? Thanks- judy
Posted by likelife on February 5, 2003, at 1:36:23
In reply to Re: suicide contracts-lifelike and others, posted by judy1 on February 4, 2003, at 13:19:40
It does feel terrible to know that when you are truly in crisis, the interventions that are likely to be used will make things even worse.
I have also been told that in case of an emergency, I'm just to dial 911 and go from there--something I would never do. If I can barely discuss suicidal ideation with my therapist whom I've known for years, how would I possibly discuss it with a stranger?
I do wish my therapist would give me her number (of course I've never asked), though I understand that to do so could lead to a potentially draining situation for her. Though in the past, when my therapists have given me their numbers, I never actually called. Just knowing I had it was comforting.
This is the end of the thread.
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