Dr X. said, "What would you like me to do with this information to keep you safe and to help you? I just sat there thinking..."Duh, what do I want him to do and why did I tell him all that"?
I explained to him I told him all this because I feel intensely guilty about being disingenuous in terms of planning and successfully obtaining all the serious medications I did from the pharmascist. I feel guilty for planning my suicide and taking all those steps towards achieving that plan.
He said: "If you carry out your plan it will really impact our ability to continue therapy". Ha, ha!! I really laughed when he said that...because it was such an absurd, but true comment. It was risky for him to say that, because I am really sensitive and could have felt like I was not being taken seriously, but he seems to know me well enough to know when a bit of humour can lighten a really dark situation. I like that he knows me that well.
I found it harder to tell him what I wanted him to do with the information than what I did not want him to do with it. I did not want him to tell my husband. (There is some talk at the university about setting a policy to notify one's parents (or next of kin) when a person is suicidal or expresses suicidal thoughts or plans) Dr. X. and I both disagree with that policy. I would simply never speak up and express my suicidality if I knew that was going to happen.
I did not want him to put me in the hospital, for a few reasons:
- I am completely freaked out and grossed out about sleeping in a bed where someone else has slept.
- I have major contamination fears about lice, bedbugs, just yucky things in general.
- I am worried about losing my freedom.
- I am worried I will be treated poorly or misunderstood, because that has been much of my experience with mental health care people. (Although overall last time I was in the hospital most of them treated me very well).
- I don't want to sleep in the same room with someone else. I had such a great roomate last time I was in the hospital, but it could really be a nightmare if you did not get along with someone.
- I do not think I need to be in the hospital. I feel better today and yesterday.
Dr. X let me know it was an option. I explained I have been considering ECT again. He told me I could go into the hospital without having ECT. I appreciate he was providing options for me.
I told him about my dreams and that I thought they were telling me it was okay to commit suicide. He explained that I may have been projecting suicidal meaning on the dreams, when perhaps they were dreams telling me I needed a transformation in my life, but not neccessarily transformation via suicide. That makes sense to me. When I am depressed and feeling suicidal it seems like everything is telling me to kill myself. I read that meaning into what I read, into music I hear, videos I see etc.
In the end he expressed that he was concerned about me, and did not want me to think he did not take my actions and thoughts very seriously, but that it was important that we made the decision about what I should do to take care of myself together. He would not send me to the hospital if that was not what I wanted. I appreciate his trust in me. Times like this strengthen our therapeutic alliance.
In the end we decided to increase my Prozac, and increase my Valium to offset the Prozac induced teeth tapping and the repetitive music playing over and over in my head. At first I felt like an idiot for telling him all I thought and did over the past few weeks, especially when he asked me what I wanted him to do about it, but in the end I am really glad I was open and honest, and I feel like I can get through another week because I trusted him enough to talk and because he trusted me enough to let me make choices for myself.