Should I give up on therapy?
February 17, 2010 2:57 PM Subscribe
Should I give up on therapy?
When I was 19, I went to a therapist via friend for the first time. I knew nothing about therapy and was told that you go, you talk about your problems, you meet once a week. Easy. So it sounded like a good deal. I was living at home with very mentally/verbally abusive parents and I was tired of everything. I wasn't necessarily suicidal as in downing pills, etc. I just wanted the fighting and abuse to end.
I got there at night via my boyfriend at the time and the therapist and I talked. She asked me if I ever thought of harming myself. I said no but everyone thinks of it. I would 'act out' threats of suicide but never, ever had any wishes to fufill it. It was only to make my parents stop fighting. That's it.
I was asked if I had insurance. I did under my parents plan but didn't know the group number, etc and I couldn't tell my parents I was there getting therapy. The counselor told me to outright lie--say I was there for a job interview and they needed it. So I did. I honestly didn't know any better (I was reallllyy naive at 19).
She leaves and comes back telling me that I have 5 minutes to admit myself as inpatient OR be taken away to state via the security guards and an ambulance. I asked to speak to my parents. They refused. They said they will call them to tell them where I was. They did and refused my parents to speak with me. They said come in person in the morning.
I was terrified of the choice and didn't think I had rights. Security was blocking the door and my boyfriend left me to go home so I was alone.
So for 3 days they admitted me for in patient suicidal threats. I didn't have threats. I wasn't suicidal.
Fast forward almost 20 years. This incident never leaves me. I don't have a lot of trust in the mental health system because I'm afraid of saying the wrong things. But I did tell my former therapist and she was trustworthy and never used it against me. But I felt our therapy was going nowhere so I switched to a new therapist recently.
I told my current therapist about the incident only because it plays into part of my husband's threats of "if we divorce I'll use that incident against you for custody." That was the only reason why I told her--to aid in my individual/relationship/marriage therapy.
The next appointment she comes back to the topic of "well remember you mentioning that incident....are you going to hurt yourself or others (meaning our toddler!).
I was so angry. 1) I wasn't suicidal then. I was duped because I was stupid into admitting myself inpatient. 2) why is this a CONSTANT topic of concern when I'm here for individual/relationship therapy. Isn't a threat by my husband more important? Isn't me going into therapy to improve myself more important? 3) every time I talk about our son I light up. I told her I'm there to improve on being a better parent, stop the effects of abuse so I know how to communicate better, etc. I never, ever was depressed during or after my therapy. My son is my whole life.
So is this the way it's going to be with every therapist? This one incident makes me totally mistrust the system and I feel violated. Are they constantly going to gasp and go "oh well are you going to harm yourself or others?" when I'm there to improve on codependent tendencies and individual improvement? I'm not depressed, suicidal, or a cutter but I'm pissed to no end that I'm being judged for this incident.
I have another appointment next week but after this, I feel I can't get past it nor is she a good listener. If she was a good listener, she would have heard "not suicidal then or now. I was stupid but the past is being used against me." And with our son--she didn't see me beam and say he's the most important person in my life and I love him to death?
Will every therapist think I'm some pill downing, ready to jump patient? Because if it is, forget it and you know, that really sucks when I'm there for individual improvement.
When I was 19, I went to a therapist via friend for the first time. I knew nothing about therapy and was told that you go, you talk about your problems, you meet once a week. Easy. So it sounded like a good deal. I was living at home with very mentally/verbally abusive parents and I was tired of everything. I wasn't necessarily suicidal as in downing pills, etc. I just wanted the fighting and abuse to end.
I got there at night via my boyfriend at the time and the therapist and I talked. She asked me if I ever thought of harming myself. I said no but everyone thinks of it. I would 'act out' threats of suicide but never, ever had any wishes to fufill it. It was only to make my parents stop fighting. That's it.
I was asked if I had insurance. I did under my parents plan but didn't know the group number, etc and I couldn't tell my parents I was there getting therapy. The counselor told me to outright lie--say I was there for a job interview and they needed it. So I did. I honestly didn't know any better (I was reallllyy naive at 19).
She leaves and comes back telling me that I have 5 minutes to admit myself as inpatient OR be taken away to state via the security guards and an ambulance. I asked to speak to my parents. They refused. They said they will call them to tell them where I was. They did and refused my parents to speak with me. They said come in person in the morning.
I was terrified of the choice and didn't think I had rights. Security was blocking the door and my boyfriend left me to go home so I was alone.
So for 3 days they admitted me for in patient suicidal threats. I didn't have threats. I wasn't suicidal.
Fast forward almost 20 years. This incident never leaves me. I don't have a lot of trust in the mental health system because I'm afraid of saying the wrong things. But I did tell my former therapist and she was trustworthy and never used it against me. But I felt our therapy was going nowhere so I switched to a new therapist recently.
I told my current therapist about the incident only because it plays into part of my husband's threats of "if we divorce I'll use that incident against you for custody." That was the only reason why I told her--to aid in my individual/relationship/marriage therapy.
The next appointment she comes back to the topic of "well remember you mentioning that incident....are you going to hurt yourself or others (meaning our toddler!).
I was so angry. 1) I wasn't suicidal then. I was duped because I was stupid into admitting myself inpatient. 2) why is this a CONSTANT topic of concern when I'm here for individual/relationship therapy. Isn't a threat by my husband more important? Isn't me going into therapy to improve myself more important? 3) every time I talk about our son I light up. I told her I'm there to improve on being a better parent, stop the effects of abuse so I know how to communicate better, etc. I never, ever was depressed during or after my therapy. My son is my whole life.
So is this the way it's going to be with every therapist? This one incident makes me totally mistrust the system and I feel violated. Are they constantly going to gasp and go "oh well are you going to harm yourself or others?" when I'm there to improve on codependent tendencies and individual improvement? I'm not depressed, suicidal, or a cutter but I'm pissed to no end that I'm being judged for this incident.
I have another appointment next week but after this, I feel I can't get past it nor is she a good listener. If she was a good listener, she would have heard "not suicidal then or now. I was stupid but the past is being used against me." And with our son--she didn't see me beam and say he's the most important person in my life and I love him to death?
Will every therapist think I'm some pill downing, ready to jump patient? Because if it is, forget it and you know, that really sucks when I'm there for individual improvement.
They don't think you're a pill-downing, ready to jump patient. They're asking you if you are. Many people who are seriously self-harming mention it in exactly that kind of off-the cuff way, and she's using her skills and training to figure out if you're in that category. Like if you go into the ER reporting chest pain and shortness of breath, they'll do an EKG. It doesn't mean they think you're having a heart attack; it means they want to rule out a heart attack.
I asked my primary care doctor about increasing my antidepressant dose around the fall equinox last year, because I was finding that the short days were making me feel all depressy again. She said sure, and then both emailed me and called me for a followup to ask me those same questions. Bear in mind I have _never_ been suicidal.
Your first therapist was unethical and a quack, and committed malpractice. But it is the job of any mental health professional to follow up on any _hint_ of self-harming thoughts, and from my experience, your current counselor is acting appropriately.
posted by KathrynT at 3:15 PM on February 17, 2010
I asked my primary care doctor about increasing my antidepressant dose around the fall equinox last year, because I was finding that the short days were making me feel all depressy again. She said sure, and then both emailed me and called me for a followup to ask me those same questions. Bear in mind I have _never_ been suicidal.
Your first therapist was unethical and a quack, and committed malpractice. But it is the job of any mental health professional to follow up on any _hint_ of self-harming thoughts, and from my experience, your current counselor is acting appropriately.
posted by KathrynT at 3:15 PM on February 17, 2010
You're allowed to ask her why she asked you that and explain that this line of questioning makes you uncomfortable in light of your past experiences. I tend to favor the explanation that it's part of their job and not a personal judgment on you, because I'm fairly sure therapists who pass personal judgment on their clients are on shaky ethical grounds.
I'm not a therapist. I've had my shoelaces taken away in the past, though, and it felt very invasive and upsetting to me.
posted by fairytale of los angeles at 3:25 PM on February 17, 2010
I'm not a therapist. I've had my shoelaces taken away in the past, though, and it felt very invasive and upsetting to me.
posted by fairytale of los angeles at 3:25 PM on February 17, 2010
Every therapist I've ever had has asked me if I thought of harming myself or others. I'm pretty sure it's a standard question. I'm so sorry your trust was violated by that first therapist. Something vaguely similar happened to me, and it took me a long time to trust again.
I would print out this paragraph and show it to her, because it's concise and assertive:
posted by desjardins at 3:26 PM on February 17, 2010 [2 favorites]
I would print out this paragraph and show it to her, because it's concise and assertive:
I was so angry. 1) I wasn't suicidal then. I was duped because I was stupid into admitting myself inpatient. 2) why is this a CONSTANT topic of concern when I'm here for individual/relationship therapy. Isn't a threat by my husband more important? Isn't me going into therapy to improve myself more important? 3) every time I talk about our son I light up. I told her I'm there to improve on being a better parent, stop the effects of abuse so I know how to communicate better, etc. I never, ever was depressed during or after my therapy. My son is my whole life.If she doesn't let go of the subject, find someone new. It's fine for her to ask if you are having thoughts - it's not cool to fixate on them when you've repeatedly stated that you aren't.
posted by desjardins at 3:26 PM on February 17, 2010 [2 favorites]
Knowing that you were admitted once for suicidal ideation, any therapist SHOULD be asking if you have any of those thoughts now. (If there is any hint of a problem, they need to do an assessment to find out if there is a real concern or not. If they don't ask and they missed it, they could be sued for malpractice.) So don't take it personally that they ask. However, once you answer the question, they should hear you and refocus on your current problems.
Also, I'm wondering if your therapist might be an intern. It sounds like she might have thought that there wasn't anything serious going on at the time and then consulted with her supervisor who told her that she better ask you point blank and she should use the magic words "harm to self or others".
I would suggest telling your therapist how you feel. Therapy thrives on honesty. If she listens and hears you on this (even if she did or did not hear you last time) then you will feel better moving forward. If she doesn't get why you are upset, then the relationship is not working for you.
As for future therapy, I would expect to be asked but also expect that the therapist not make a big deal out of it unless there is something additional going on.
Also, in this day and age, hospitals do their own assessments and don't admit people to the psych ward unless they agree that there is an actual danger.
posted by metahawk at 3:30 PM on February 17, 2010
Also, I'm wondering if your therapist might be an intern. It sounds like she might have thought that there wasn't anything serious going on at the time and then consulted with her supervisor who told her that she better ask you point blank and she should use the magic words "harm to self or others".
I would suggest telling your therapist how you feel. Therapy thrives on honesty. If she listens and hears you on this (even if she did or did not hear you last time) then you will feel better moving forward. If she doesn't get why you are upset, then the relationship is not working for you.
As for future therapy, I would expect to be asked but also expect that the therapist not make a big deal out of it unless there is something additional going on.
Also, in this day and age, hospitals do their own assessments and don't admit people to the psych ward unless they agree that there is an actual danger.
posted by metahawk at 3:30 PM on February 17, 2010
Therapists have to ask you this question. Therapists ask me this question too - and everyone else they see. I can understand why it's awful for you given your history though.
It sounds like therapy overall might be helping you - and this particular issue is the part that is challenging. So it may be worth sticking through the discomfort for the benefits you receive.
I strongly advise you start the next appointment by explaining how you are feeling about this, asking the therapist to tell you more about their "mandatory reporter" status so you can understand better why they are asking this, and explain that you need to feel she hears how much you love your child. A skilled therapist should be able to help you figure out a workable plan for this issue, but only if you tell them how you're feeling about it.
posted by serazin at 3:40 PM on February 17, 2010 [1 favorite]
It sounds like therapy overall might be helping you - and this particular issue is the part that is challenging. So it may be worth sticking through the discomfort for the benefits you receive.
I strongly advise you start the next appointment by explaining how you are feeling about this, asking the therapist to tell you more about their "mandatory reporter" status so you can understand better why they are asking this, and explain that you need to feel she hears how much you love your child. A skilled therapist should be able to help you figure out a workable plan for this issue, but only if you tell them how you're feeling about it.
posted by serazin at 3:40 PM on February 17, 2010 [1 favorite]
Everyone in medical professions has drilled into their minds life threatening things to look for: Acute abdominal pain? They'll think ectopic pregnancy, appendicitis, etc, and work down the diagnostic tree from there. You might say "woah woah Doc, I had a bean burrito for lunch, I think it's gas" when they ask if you have an appendix or unprotected sex. They still need to ask. This makes sense when you're talking about things that could kill you in a matter of hours, obviously you need to rule those out first.
I imagine it's the same thing, suicide being a life threatening condition. She would be negligent to not mention it.
posted by fontophilic at 3:42 PM on February 17, 2010
I imagine it's the same thing, suicide being a life threatening condition. She would be negligent to not mention it.
posted by fontophilic at 3:42 PM on February 17, 2010
Oh, and btw, the "harming your self or others" question is becoming standard on regular physicals with teenagers, (along with "do you wear your seatbelt in cars?"). Doctors are big on the whole, preventing death thing.
I wouldn't take it personally.
posted by fontophilic at 3:46 PM on February 17, 2010
I wouldn't take it personally.
posted by fontophilic at 3:46 PM on February 17, 2010
Don't give up on therapy. There are lots of therapists out there who are good listeners and who, upon hearing something that they think indicates a possibility of self-harm, won't wait until the next session to bring it up.
In your case, I can't tell if she wasn't listening when you explained your situation or if you were giving off vibes of hopelessness and despair when she asked you about self-harm. I think you are entitled to ask her about it and try to see if the both of you can come to an understanding about what your hospitalization meant to you at the time and what it means to you now (in terms of trusting your therapist and/or husband) and how to move forward with that.
If you still don't feel you can trust her, then seek out another therapist. It's not worth it to you go to a therapist that you're going to hide important things from, and there are plenty of good therapists out there who may be a better fit for you.
posted by stefanie at 4:28 PM on February 17, 2010 [1 favorite]
In your case, I can't tell if she wasn't listening when you explained your situation or if you were giving off vibes of hopelessness and despair when she asked you about self-harm. I think you are entitled to ask her about it and try to see if the both of you can come to an understanding about what your hospitalization meant to you at the time and what it means to you now (in terms of trusting your therapist and/or husband) and how to move forward with that.
If you still don't feel you can trust her, then seek out another therapist. It's not worth it to you go to a therapist that you're going to hide important things from, and there are plenty of good therapists out there who may be a better fit for you.
posted by stefanie at 4:28 PM on February 17, 2010 [1 favorite]
Just a few (semi-knowledgable) thoughts, as I'm a first year clinical psychology PhD student. It sounds like your first therapist made a bad call in terms of committing you. However it is an ethical and legal responsibility to ask you about suicidal and homicidal ideation and to document your response in the clinical paperwork. I have to do it in every client intake and if there is any indication that it might be a possibility, hopeless and depressed client etc. Like if you told your therapist that you were not suicidal and you killed yourself then your therapist would have done her duty and had her butt covered from a legal standpoint. However if your therapist had not asked about suicidal ideation and you did something to yourself, she could be sued by your family, potentially lose her license or worse.
So the question itself about suicidal and homicidal ideation (SI/HI in clinical shorthand) is relatively standard procedure, and should not be taken personally. However that being said there are many next steps to take to assess the risk, and alternative interventions like a suicide contract where you promise to call the therapist if you find yourself thinking seriously about suicide. Commitment should be a last resort, only if self harm seems imminent, and usually it is a joint decision made with the client. It sound like the idea of suicide to your teenage self was symbolic, and a way to communicate with your parents, rather than an direct action that required commitment.
In terms of the future, I would bring all of these feelings up to your therapist next session, especially that you feel a sense of breached trust with her. Give her a chance to try to repair the relationship between you. If you can come to an understanding with her this experience may make your relationship stronger. Also I would try to talk more about the experience of being committed and the betrayal you felt in the past as well. It seems like it still cuts really deep, and may need to be explored more, especially since your husband is using this experience against you now to undermine you. But like everyone is saying, if after talking to her you are still unsatisfied with her responses, I would seek out someone else who you can trust. Good luck!
posted by amileighs at 8:06 PM on February 17, 2010
So the question itself about suicidal and homicidal ideation (SI/HI in clinical shorthand) is relatively standard procedure, and should not be taken personally. However that being said there are many next steps to take to assess the risk, and alternative interventions like a suicide contract where you promise to call the therapist if you find yourself thinking seriously about suicide. Commitment should be a last resort, only if self harm seems imminent, and usually it is a joint decision made with the client. It sound like the idea of suicide to your teenage self was symbolic, and a way to communicate with your parents, rather than an direct action that required commitment.
In terms of the future, I would bring all of these feelings up to your therapist next session, especially that you feel a sense of breached trust with her. Give her a chance to try to repair the relationship between you. If you can come to an understanding with her this experience may make your relationship stronger. Also I would try to talk more about the experience of being committed and the betrayal you felt in the past as well. It seems like it still cuts really deep, and may need to be explored more, especially since your husband is using this experience against you now to undermine you. But like everyone is saying, if after talking to her you are still unsatisfied with her responses, I would seek out someone else who you can trust. Good luck!
posted by amileighs at 8:06 PM on February 17, 2010
I had a very negative experience with a therapist when I was a teenager and as an adult I am still extremely suspicious of all mental health professionals. Having said that, I did have a positive experience with one when I was in college, after my father died. I went in with specific concerns, worked through them, and was done. I also did marriage counselling with my ex-husband, which obviously failed but the therapist wasn't the problem there.
Not knowing much about therapy, I can't speak to whether the questions are normal; I accept that other people think they are. Having said that, if you don't feel comfortable with this therapist, move on and find one you are comfortable with. You have to trust a therapist or you won't get any good from the work. That some therapists don't have a style or approach (including their concerns about the incident when you were a teenager) that works for you, and that you have understandable trouble trusting because of that incident, doesn't mean you can't find a therapist whose approach does work for you. I did.
posted by immlass at 8:26 PM on February 17, 2010
Not knowing much about therapy, I can't speak to whether the questions are normal; I accept that other people think they are. Having said that, if you don't feel comfortable with this therapist, move on and find one you are comfortable with. You have to trust a therapist or you won't get any good from the work. That some therapists don't have a style or approach (including their concerns about the incident when you were a teenager) that works for you, and that you have understandable trouble trusting because of that incident, doesn't mean you can't find a therapist whose approach does work for you. I did.
posted by immlass at 8:26 PM on February 17, 2010
Anon, involuntary commitment when it wasn't necessary happened to me when I was 19 as well (I refused to sign a contract stating I wouldn't kill myself because I was pissed off at the therapist, and well, they committed me, probably to cover their asses).
I agree with the advice in this thread: therapists are going to ask the question because they need to cover all the bases.
You need to practice making it clear to the therapist that the commitment was unnecessary and invasive, and that you are not currently, nor have you ever been, seriously suicidal. Tell them [based on what you said] "I never had any kind of plan, it was just something I occasionally thought about when I was a teenager as kind of a revenge thing, I haven't had those thoughts for years and if I did, obviously I would seek help right away".
That should make them stop. If the therapist still brings it up over and over, sever the relationship and find a therapist who believes you.
As for the husband using your involuntary commitment against you in a custody case, the fact that you are stable and have been so for years (i.e. haven't been in the hospital since you were 19) is a big positive in that case. I would talk to a lawyer about that, though, because obviously this is extremely important to you.
posted by saveyoursanity at 9:44 PM on February 19, 2010
I agree with the advice in this thread: therapists are going to ask the question because they need to cover all the bases.
You need to practice making it clear to the therapist that the commitment was unnecessary and invasive, and that you are not currently, nor have you ever been, seriously suicidal. Tell them [based on what you said] "I never had any kind of plan, it was just something I occasionally thought about when I was a teenager as kind of a revenge thing, I haven't had those thoughts for years and if I did, obviously I would seek help right away".
That should make them stop. If the therapist still brings it up over and over, sever the relationship and find a therapist who believes you.
As for the husband using your involuntary commitment against you in a custody case, the fact that you are stable and have been so for years (i.e. haven't been in the hospital since you were 19) is a big positive in that case. I would talk to a lawyer about that, though, because obviously this is extremely important to you.
posted by saveyoursanity at 9:44 PM on February 19, 2010
This thread is closed to new comments.
posted by dfriedman at 3:05 PM on February 17, 2010