How suicidal do you need to be before you talk to someone about it?

I wrote this post on Friday afternoon but got distracted before I finished it. A lot has happened since I wrote it but I'll post this first and hope for some blog time again before too long.

Friday 23rd December
It's hard to believe it's Christmas! I mean that because I have been dissociating a lot over the last weeks... in the way where the world and I seem unreal and unconnected. Derealisation? You'd think by now I'd have the hang of the different types of dissociation and what they mean but it's still unclear. I kinda have my own words for things. I can see the tree and the presents and hear the music but I can't connect with it somehow. I normally love Christmas and get so excited but this year I feel like I am just going through the motions.

I have had a lot on my plate I suppose, what with work stress and T's imminent departure and the prospect of the new year and what it will bring: a new job, a new psychologist and probably a new schedule of hospital appointments for my blood disorder :( I'm not looking forward to any of these things. I'm not relishing the thought of being another year older either. When I first started psychology I felt like I was only just an adult. I felt young. Now I feel old. I'm not old, but I'm aware how quickly time has passed me by over the last ten years and I worry that before I know it I will be old and I will feel like all I've managed to do is struggle through life and with what goal? What actually is my purpose for going to work? It's to pay the mortgage and bills and be able to eat. But why? If my life is taken over by work, what's the point in prolonging it? The only point really is the hope that change will come. Maybe one day I won't be in a job that leaves me with no capacity for a life. There are times when I envy the people who are on DLA (Disability Living Allowance). God knows I'm sure I could qualify for it if I decided to try. Sometimes I think the only thing that stops me is that I have a mortgage to pay so I must go to work. Sometimes I'm not sure what keeps me going but I feel sure that whatever the reason is, it isn't going to keep me going forever.

I'm eventually going to have to face the fact that I don't know what I believe about God and Jesus anymore. I'm going to have to try to come to some sort of agreement within myself about what mybeliefs are in terms of if there is a heaven and hell and what I need to do in order to make sure I don't go to hell if so. It sounds like a stupid concern for people who don't believe, I'm sure. For me it is so huge that I avoid thinking about it because I know I am not going to find definite answers and if I do, the answers are not likely to be the ones I want. This is all very vague, I know. I guess I don't really want to get into it just now. But going through life avoiding it isn't doing me any favours because it's still going on inside. There is still that voice reminding me that I am going to burn in Hell for eternity if I don't get myself sorted out.

I mentioned before that T and I talked about suicide last week. It seemed to be the theme again this week. I find it hard to talk about. T was surprised because I mentioned that last year I had written a suicide letter and she wanted to know a lot about it: why I wrote it, what was in it, had I intended to use it, what stopped me from ending my life etc. Hard questions. I had mentioned it because my thoughts had been centred a lot around suicide recently and I said I was concerned that after she goes things might get a lot worse. She was trying to assess the risk. She wants me to promise that I would ask for help if I felt I needed protected from myself. My problem with that is that I don't know at what stage I should ask for help. If I tell someone when the thoughts are in my head and I'm planning out what way I would do it, without actually having decided for sure that I am going to, I'm just going to cause unneeded stress and upheaval and interventions that might not be necessary if the feelings pass. But if I wait until I have made the decision, I'm not likely to want to tell anyone am I? If you decided suicide was the right choice, why would you then want to tell someone when you know they would just stop you? I felt T didn't really get what I was saying. She kept telling me that I would know when things had got to a stage where I needed to tell someone. I hope she is right.

She also said something which hadn't occured to me before: she said that when people tell her things like I did (ie that they wrote a suicide note last year because things were so bad) she is concerned that they didn't share that at the time, despite coming along to sessions. She said it puts pressure on the therapist because they can't trust that the client will inform them if things are really bad in future. She said it can become an issue that is always hanging over the sessions and affects the therapist's confidence in whether the patient is going to be able to cope with things that may be covered in the sessions. They may then be wondering if delving into certain issues is going to put too much pressure on the client or if it is the right time because they wouldn't know what the client is feeling at that time.

I felt guilty and sad when she said this. I don't want to hold my therapy back in any way and I don't want people to worry about me. I'm desperate to feel progress. So I think I will need to agree the suggested contract that while in therapy I am to tell someone if I feel this way. But something holds me back. I don't like to break my word and if I agree a contract, I need to know I can stick to it and in all honesty, how can I promise that? And how can I speak on behalf of others? And we are never going to get agreement from all of the parts.

T ended the session quite abruptly then and I found myself struggling. It may be normal for her to talk about these things with people every day but for me, it had stirred up a lot of pain and I was feeling myself dissociating in a physical way (my head feels weird, my vision goes weird, my hearing and all my senses go weird... not a great explanation but hard to explain). I felt sure she just wanted to get away promptly, it being her last day at work before Christmas. I didn't feel OK to leave, I felt really bad. I was struggling but I got myself out the door and to my car where I sat with my head buried in my scarf in my hands for probably a long time before I felt present enough to drive home. By the time I left the car park T's car was gone so she must have come out while I was sitting there. I wondered if she saw me and just decided not to see if I was OK because she wanted to get home. I felt hurt when I thought that could be the case. That was Thursday evening.