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Depression and Suicide If you or a loved one is feeling depressed or suicidal, you are not alone. Talk with other users about your feelings here.

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Chaotic_ Offline
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Name: Cass
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Counseling questions - July 22nd 2017, 04:55 AM

So for the first time in 11 years I finally have a counselor that gets me, and that I trust. He goes above and beyond to actually try to help me out, and created an appointment so I didn't have to go over a month without seeing him. I'm trying really hard to be honest with him. But getting better is hard and I feel like all of the words are just stuck in your head.

Today, there was a small miscommunication and I told him it upset me via email, which he kindly responded too, and apologized for. He basically said we would reset and continue on how I see fit. I'm not 100% sure what he means by that, and I feel like I'm pushing my luck asking him. He typically doesn't respond to emails.

Besides that, I really have been struggling with self-harm urges and "bad thoughts." I don't claim them as suicidal because I don't think I would act on them. My question is how do I tell my counselor this. I typically write an email a couple times a week updating him, but I don't know if I should mention this via email.

I'm also struggling with the time inbetween appointments.
Right now I feel like I could use weekly appointments but he's super Cush and I don't think he could manage. I also don't know how to ask him. Right now I have a 3 week wait, I'm on the cancellation list, so hopefully something opens before then, but I don't know if I can do the three weeks and I don't know if I should mention that in my next email as well.

Overall, this is just a very vulnerable time for me.
I'm ready to open up but I don't know how which is why I want to change tj frequency of appointments.
Plus, being in a bad place wants me to change it as well.
I guess I don't know what to tell him via email.
If I tell him about the "bad thoughts," what will he do?
I don't want to lose a great therapist because I fucked Up.
   
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Ambedo. Offline
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Re: Counseling questions - July 22nd 2017, 08:13 AM

Hey Cass,

It's great that you've found a therapist that you feel comfortable opening up to! It really does change the entire feeling of sessions when you genuinely want to express your thoughts and feelings to your counselor. That being said, I know how difficult it can be to figure out how to word things, especially when it isn't during a face-to-face session.

Was the miscommunication about an approach taken during therapy? To me, it sounds like your therapist recognizes that what he thought might be helpful didn't have the desired effect. It seems like he is saying that, going forward, he would like to work with you to find solutions that you both think will work, rather than simply coming up with suggestions on his own or taking therapy in a direction that you might not be comfortable with. I could be way off base since you didn't mention what the misunderstanding was, but that's my interpretation of what he said. There's nothing wrong with asking for clarification, though! You can always email your therapist back and say something along the lines of "I'm not quite sure what you meant when you said we would continue on how I see fit. Could you explain that a little bit more?". I'm sure he'd be happy to clear things up for you.

When I first started going to therapy, I had similar concerns when it came to mentioning self-harm to my therapist. Over the years, it has become clear to me that therapists tend to recognize that the urge to self-harm and having suicidal ideations are two different things. In my experience, my therapist has typically followed mentions of self-harm with questions that are meant to determine whether self-harm is a coping mechanism or something being used as part of a plan. If you do choose to talk to your therapist about it (especially if it's via email), you might want to let your therapist know why self-harm is something that you have been thinking about and why you use it as a coping mechanism. You can also be straightforward with him and let him know that you are not considering suicide, but simply struggling with these urges.

There's no harm in asking your therapist if you would be able to schedule sessions more frequently. It might mean changing your usual date and/or time in order to accommodate more regular sessions, but the two of you may be able to find something that works with both of your schedules by talking about it. If scheduling more sessions isn't a possibility, perhaps you could ask him to help you brainstorm things that you can do during the time in between sessions to help make it easier for you to deal with your struggles until you're able to have another session.

I hope this helped answer some of your questions. If you'd like to talk about this more, feel free to reply to this thread or shoot me a PM!

Take care,
Sammi


wanderlust consumed her;
foreign hearts & exotic minds compelled her.
she had a gypsy soul
and a vibrant heart for the unknown.
-d. marie
   
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Re: Counseling questions - July 22nd 2017, 09:21 AM

I've had a psychiatrist (which is a doctor) for many years and I've told her when thoughts of suicide come to mind and it's OK. Thoughts and feelings are OK. Actually it's the things I don't tell her that she ought to be worried about, which is why I tell her everything, so she knows I'm bad off, but I also have family and friends surrounding me so I'm OK, even though I'm not OK (if that makes any sense).

I can tell my doctor pretty much anything and they won't do anything unless I ask them to. Such as when I'm really beyond the point I can't stand it anymore (like it's been going on for a year, and I've finally reached the end of my rope), then I tell my doctor, "Look, put me back on the medicine that works, or give me ECT, or I'm going to die."

Same with my counselor, which I now have. (I don't see my psychiatrist doctor very often anymore. Maybe once every 2 or 3 months. Now I see a counselor.) I can tell her anything. She's not going to throw me in the hospital, unless I really want to go, (and even then, they might not take me, because they have to have room, and they have to evaluate me, and see if my insurance will cover me, etc. Actually I've never been. I've visited friends though.)

So pretty much all "Bad Thoughts" are OK to tell.

As for not being able to see your counselor as often as you'd like, perhaps there are other people you could talk to during the gaps, or support groups you could join. There may be a Depression and Bipolar support group in your area. Check http://www.dbsalliance.org/. Check https://www.nami.org/. Ask your counselor if he knows of any. Churches may have some. Church pastors love to talk. It's why they went into that profession. (It's also why counselors go into that profession.)

Self-harm urges to me always suggests the option to see a psychiatrist doctor and try some medication along with counseling, just based on my own experience. Once I found a medication that worked for me it changed everything and I'd say it even cured me and I'm fine now, which is quite remarkable, so now I suggest it to everyone.

Mindfulness Meditation is another option that has worked for me. Maybe there's a group in your area. Or "Therapeutic Yoga". (There are so many different types of Yoga. 9 formally different types. Yoga is almost too generic a term. But you may be able to ask around for a yoga that's very gentle and relaxing.) Training the mind to focus on the present moment may be helpful in the long run. There are some apps you can try on your cell phone. ("Headspace" is one. It at least has useful introductory videos explaining the concept at the beginning of lessons 3,5,7, and 9.)

Finding some supportive people, or at least one supportive person, or others who have suffered similar in the past so they also understand. I've been surprised at how many there actually are! Perhaps as many as 10%!

Mindfulness Meditation may give some insight into ways of getting better where instead of trying harder, we try less hard, and instead learn to relax and accept what we are experiencing, and just observe what we are feeling, and notice it, without judging or reacting to it, but instead just paying attention to it, which is often the opposite of what we want to do, we often want to run away from it and NOT pay attention to it, and instead escape it somehow, but the idea here is to do the opposite, and just relax and observe and notice it, and examine the feeling, how does the body feel, where does it feel, what does it feel like, and just notice these things, and focus on them.

(We're trying to activate the Parasympathetic Nervous System. Another way to try this is when we successfully activate the Parasympathetic Nervous System our blood flow to our extremities like our hands increases, which means the temperature of our hands increases, and this can be measured by a thermometer, so another way is to get a biofeedback thermometer that measures the temperature of our skin and then concentrate our mind and see if we can make the temperature go up by consciously relaxing. I think more on this technique can be found at http://hansmalab.physics.ucsb.edu/ where he talks about curing chronic pain, as it's a similar thing.)

OK sorry I wrote so much. Probably more than you wanted. Well some ideas at least. What really worked for me was being around people. Counselor, friend, anybody. I dislike being isolated. I found support groups I like. I've tried a lot of other groups too. Yoga groups. Walking groups. Meetup.com groups. Meditation helped me relax so I could better engage with strangers and make small talk with them.

Best wishes!
   
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