what to say and what not to say to a therapist

[amandaelmo]

So I finally got up the guts or maybe just got so tired of how i've been feeling over the years, i actually called my insurance to get a referral for, no offense a "head shrinker". well i called and left a message and was able to get out this one sentence:my name is amanda my number is this thankyou, then i hung up. haha, better than nothing i suppose. but now that im waiting for a call back im thinking, what can i say and what not?

Do I think about suicide? yep, there is not a single day that goes by that i don't.  do I cut myself? yep, for over 10 years, but the thing is I am not going to get locked up in a mental hospital. I won't do it, I'd rather stay this way than that. So what can I actually say? Im afraid if I say what really goes on in my head, they will lock me up.

What's really sad is I have been obsessing over this for years, so I can't even remember if I askd this before? Anyways what would cause say a therapist or whatever to try to have you locked up? what is out of bounds? and if my thoughts would get me locked up how do you ever really get help? i don't even understand why this has happened to me, but what do say and what do you have to keep hidden?

I know it's kind of messed up to ask this on an ask a doctor forum, but i really need to know before i go.

thanks

[KCupp]

I know what your going through. But, they can not just lock you up for your thoughts. the best thing for you to do is tell them the truth and tell them you know what is going on and your not "out of your mind" let them know exactly what you have said here. they cant just carry you to the hospital for talking. Now if you threaten them or say that you "are going to hurt them or yourself again: its different but tell them that you want help and don't want to think these things anymore and you don't want to hurt yourself. Tell them you want it all kept confidential. and sign the paperwork. I have told my psch. everything and if anyone could get locked in a hospital for talking to a shrink i wouldn't be on this computer right now.

[Jaquta]

Sorry for not responding sooner (I'm in another country and don't have great internet access).

Perhaps following your appointment up with a phone call could have been helpful.  From either of you I guess.  I think the therapist should have taken the initiative and made the phone call though.  Is hard to know what was going through the therpist's mind.  Maybe they thought they were sparing you more distress by not following up??  I had one T who wanted to cut my therapy session short because I was so anxious.  I think that sets a dangerous precedent.  I don't expect that avoiding anxiety will ever make it go away or help us in the long-term.

That's not a great way to conduct business.  Theoretically though if you needed to run away that could signify significant issues and that could represent a lot of business.

Sometimes you just have to laugh at things.
During a crisis once I ask for more intensive support and I was discharged.  Discharging me did nothing to help my mental state.  At the time it really hurt but the irony of the situation has helped me to deal with it (on a superficial level anyway).

Living with anxiety is also very draining.  I understand your need for more time.  I would suggest that you don't wait too long though.  I always use to find talking, whether it was on the phone or face to face, extremely stressful.  I have found that therapy has helped.  Feeling fed up with health professionals has helped too because it has given me the confidence to say what I think and feel.

I think writing about your experiences here or elsewhere can be helpful too.  I personally wouldn't recommend on-line therapy, not exclusively anyway.  I think that avoiding relationshipscould make things worse.

I hope things are currently going better for you, and others here in a similar situation.

[lindahand]

One thing you may want to try is online counselling. Not as good as in person but may be a bridge to helping yourself. I've only ever seen the advertisements myself.

Tanya

[ShandraB]

It looks like I sent my last post to the wrong person... sorry about that.  This is new to me, so it may take a little while to figure it all out.

Panic attacks are pretty scary.  Like I said in my previous post, I have felt like running out of my therapist's office before and managed to stay there, physically, that is.  Which for me is going out of my mind.  Whether bolting physically, or emotionally, it still makes us feel bad.  I have an idea though.  If you can, imagine sitting in that therapists chair enough times to not be scared of it.  It will not be so easy to do at first, but gets easier with time.  Once you can see yourself there, without panicking, do the same outside a mental health clinic until it is not so scary.  Making an appointment, and actually staying, might be easier that way.  

Psychotherapy is a wonderful thing, which has changed by life.  It is not always easy, though.  For the most part, the hardest sessions are the ones that have helped me learn the most.  Finding a good fit is the key.  If you try again, maybe you could talk to the person over the phone and tell them what happened, which could also help. I imagine each time you tell the story it will get a little easier to say.  See what their reaction is, which may be a good start in telling if that person is a good fit for you.  Talk to a few professionals before you make a choice.  Find someone that you feel, at least somewhat, comfortable talking with before you make a choice.  Keep in mind, just because you talk with someone does not mean you have to make an appointment with that person.

I hope you do decide to try again, sometime soon, instead of down the road... it will be worth it.

[amandaelmo]

No he never did ring me back. Apparently, he must not have been all that great, if he didn't even care enough to give me a call. But if I were in his shoes, i probably would have done the same, after all, it is a business of sorts, and its was pretty odd what i did. I don't blame you for finding my recounting of events humorous, to be honest it is pretty funny, and also pretty sad at the same time. thanks to you and everyone for the advice, but I don't think I'll be trying to do this again anytime soon. hopefully, i can get the courage back up to try again sometime down the road, but i dont think that time is now or anywhere in the foreseeable feature, its all just very draining.

[ShandraB]

I have bee through this before, too many times.  I finally got the courage up to say something about my fears.  In a phone message, of course, because I was too afraid to say it in person.  although I have certainly felt like it, I never did the bolt out of the office before, though.  In order for any doctor, police officer, or whoever has the authority to place a phschiatric hold on a person, they need to feel there is probable intent.  In other words, they need to feel you will carry out your thoughts, feelings.  I found that once I got past the fear (well, not always, but getting there) I have been able to get things out of my mind, instead of going out of my mind.  It is so helpful to feel safe enough to talk about it all.  Every doctor is different though.  I called several doctors, and did my own interview, before I made an appointment with one, which helped.  It helped because I was able to go through the list I had until I found someone I felt would work well with me.

[Peter Forster]

You did a good job getting as far as you did and you should see this as a step forward after such a long time of avoiding getting help. You called the access line, got an appointment and made it to the office. These are big steps and, honestly, big accomplishments.
Now if you want to make another step forward perhaps you could print out your post and send it to the therapist with a note saying that you are working your way forward, step by step. His response would give you some idea of whether or not he was a good choice for you.

[Jaquta]

I found your recounting of the event quite humorous.  I expect it was anything but.  Probably any number of us have thought about doing that.  I use to do that when planes would fly overhead or when people would come up our driveway.
Running is a normal, although not very socially acceptable, way of coping with anxiety.

Did this person ring you back?

Hopefully the doctor will be able to advise you.  It's good to see him posting again.

[amandaelmo]

I did end up calling and going to the psychologist, unfortunately it did not go as planned. It's really ridiculous but this is what happened. I was nervous and in a way dreading the whole thing for the whole week leading up to my appointment and i guess i was kinda trying to talk myself outta even doin it. it's just something about putting out there what's going on with me that is quite frankly a little scary. but i forced myself to go anyways. i made it to the office, met the psychologist and he told me to have a seat, and i was completely overcome with panic. I looked around for an escape, So i told him can you wait one second? he said okay i went around the corner in the office(room is shaped really weird) to where he couldnt see me and without another word, i bolteed. i literally ran out the office and down 10 flights of stairs(office on 10th floor of a building) and ran to my car and sped away like i was a bank robber or something. It is totally ridiculous and i guess childish, but i just couldnt deal with it. i can't explain it other than to say if there was no door and it was just a window with a fire escape, i would have at that moment gone out the window and down the escape. its like i was trapped in a burning building and if i didnt get out right that second i was gonna die. thats what it felt like. it would be funny if it wasnt so pathetic/sad. i honestly don't know if i can put myself through that again.

[Peter Forster]

I am sorry that I was offline due to technical problems for a couple of weeks. I hope you have called and gotten help. If not please post again.

[Jaquta]

Making that phone call was a good first step.

Let the therapist guide you.
As an introduction you might like to disclose why you are interested in therapy, i.e., to work through and resolve the suicidal thoughts and feelings and your urges to cut.

A good therapist will allow you to disclose any thought or feeling.  Thoughts and feelings give the therapist material with which to work with.

I think each therapist has a different limit or boundary in what they will tolerate.
To be sectioned or committed usually requires you to be considered either a danger to yourself or others or to be mentally disordered.

For me personally I disclose very little to those in the mhs.  I may say I have safety issues but I don't elaborate.  My reluctance comes after being misunderstood and mistreated by those in the mhs.  It was a constant thing for me and I got fed up with it and health professionals making it worse.
I was in good therapy for a while before my therapist left and only had one episode of suicidal ideation and urges (which happened during a particularly stressful period for me) compared to almost constantly.

I think you talk to a psychiatrist/ therapist and express your concerns.  Tell them that you are afraid of disclosing information as you fear they may lock you up.  Be open and honest.  This may also help them trust you and respect your need to not be hospitalized.

I think it's good to ask especially if it helps you to access the care and support you need.  Getting your concerns out in the open can be beneficial.

Good luck for your phone call (and hopefully appointment).