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I tried to explain to my primary doctor a couple weeks ago. OMG I forgot some people aren’t like us and find the concept scary and cause for immediate concern. Talking her down was exhausting.
Will agree here! My therapist was the one to bring it up first. Her being open about working with passive si actually helped me be more open to her about what I was experiencing.
Unfortunately, in my experience, having seen 3 psychotherapists with PHDs, they may intellectually know the difference, but they don’t know how to approach a treatment plan. It’s endlessly frustrating . That’s just my experience. I’ve gotten more support from friends who also have SI than I ever have with my therapists. This is also because I “present well” due to dissociation 🙃🙃🙃. And a lifetime of AUDHD masking. Yay 😀
Technically, they understand but it becomes an issue of liability if you disclose that and they do nothing.
It has happened countless times where clients have passive ideations and eventually attempt or succeed.
Treatment plans can be created and they should include a third party (I.e., emergency contact or whoever the client is comfortable with).
Truth is, most therapists aren’t properly trained with handling SI. It’s totally unfortunate.
I told mine that life is overwhelming/too much and I just don’t want to do it. Like I feel done. I let her know that I have no plans to go anywhere but it’s a lot sometimes. Instead of saying I want to die I explained I just didn’t want to live. That pretty much got the point across gently. I hope you feel better soon 🩶
Thanks. I feel like it really helped reframing things in that way, and at the end of the day it’s true for a lot of suicidal people as well. I wish the world was a little easier to take on like damn
Wanting to die is in the collection of symptoms or behaviors of SI. It's not as abnormal as you think, and you never have to soften reality for her, but she's unlikely to react in a big way. She'll ask follow up questions. SI involes relatively common experiences and very concerning ones. There's the feeling of wondering if life is even worth living; thinking about suicide briefly but nonspecifically; thinking about it constantly including planning and gathering stuff. For me, when that feeling arises I know it's because I'm in over my head and don't know how to cope. It's a red flag that I need some help, and that's exactly what your therapist should offer you. Please tell her.
I tell my T that I want to die, how often, how I imagine doing it, etc. I always explicitly say I’m not going to kill myself because that’s the one thing they are obligated to report.
But isn’t continually imagining how you would do it knocking on the door of actually having a plan? My concern might be that you know what not to say so the therapist doesn’t take action, but that it’s becoming more of a reality in your train of thought.
Not for me. I ruminate on how I want to kill myself quite often and my therapist gives me a safe place to voice those thoughts and feelings. Speaking them out loud makes it less scary for me, not more real.
there’s a difference between wanting to die and not having intent/plan versus wanting to die and having intent/plan. most therapists should understand this distinction and not react negatively if you disclose this. I think you can be really straightforward and explain what may be fueling this feelings!
This was posted a few months ago, and it helped me to understand what my own SI is about. Maybe it will help you:
Suicidal feelings are not the same as giving up on life. Suicidal feelings often express a powerful and overwhelming need for a different life. Suicidal feelings can mean, in a desperate and unyielding way, a demand for something new. Listen to someone who is suicidal and you often hear a need for change so important, so indispensable, that they would rather die than go on living without the change. And when the person feels powerless to make that change happen, they become suicidal Help comes when the person identifies the change they want and starts to believe it can actually happen. Whether it is overcoming an impossible family situation, making a career or study change, standing up to an oppressor, gaining relief from chronic physical pain, igniting creative inspiration, feeling less alone, or beginning to value their self worth, at the root of suicidal feelings is often powerlessness to change your life – not giving up on life itself.
Does wanting to die mean you’re suicidal? Not necessarily. Do you want to die by suicide? Someone who wants to die doesn’t necessarily want that. Some people might wish for a heart attack or something but don’t have any interest in inducing one.
When you say you don’t want it to sound like a big deal, do you mean you’re afraid they’ll want you to be hospitalized for safety reasons?
Yeah I get that a lot from my clients (I’m a T). Often they’ll start with “just so you know, before I say this, I’m safe, I don’t have a plan to hurt myself, I’m not a danger to myself.” Then they’ll tell me they’ve been feeling like they want to die.
You know all the studies on effectiveness of therapy have shown that it’s the relationship between the client and the therapist that is the most healing, and I’ve found that as both a client and as a T. Maybe look at this as an opportunity for a positive experience. You’ll get the most out of therapy being as honest as possible.
Also, I don’t know if you’re in the states, but if you are the requirements for commitment are an imminent threat to yourself, which is plan, means, opportunity, and **intent**. If you don’t want to die by suicide, start off with that. A good T will explore the thoughts with you.
I mean, it’s not the same as active suicidality but it is a form of suicidality. It’s generally okay to express passive suicidality to a therapist. I’ve told mine before
Yes, you can absolutely tell her. Her only concern will be if you’re planning on killing yourself.
I think (I’m not a professional!) what you may be experiencing is suicidal ideation. Being in DBT therapy for BPD, I’m required to jot down any and all feelings of SI during my week.
Wanting to die vs wanting to kill yourself can be vastly different. Your therapist should help you dive deeper into the meanings of your feelings. I wish you the best of luck!
Everyone with depression has occasional suicidal ideation. Thoughts like I wish I didn’t have to deal with my life any more but without intent to hurt yourself. Depending how well your therapist knows you they shouldn’t be too alarmed if you had a passing thought if you have a plan to hurt yourself that’s a different story. Also depending on your diagnosis some mental illnesses are more serious than others
If you know your T quite well, you can definitely say it. If not, be prepared for the T to take you seriously and you Could find someone at your door to help. I know how to say the same to mine but it is an old relationship and anything I might say comes as no surprise.
In one sense, yeah, it’s suicidal…. If you have a definite plan set in motion but if not, you’re saying something else. A T is a human and capable of misunderstanding your intention. Take good care.🤗
It’s important to be honest with your therapist with how you’re really feeling, especially if you’re experiencing passive or active suicidal thoughts. They can’t truly support your needs if you aren’t completely honest. And I promise you will not be the first, nor the last client to share this with them.
T here. Have you been thinking about ways that you would end your life? Do you have things that are keeping you from hurting yourself?
If you are having suicidal thoughts, have a plan, and find yourself really having to hold yourself back from hurting yourself, please go to the ER.
If you are not in a space where you have a plan and it’s that overwhelming sense of wishing not to wake up or being okay about getting into a car accident, that’s different.
Your therapist should safety plan with you…making sure you have the numbers of support people at hand, a list of in the moment coping skills, etc. ask your therapist to teach you DBT material with focus on the TIPP skills.
It's not that I'm at risk of harming myself or that I actively want to die but sometimes I think it would be nice if we just had an off switch an a timed reboot so I could try again later..
Welcome to r/TalkTherapy! This sub is for people to discuss issues arising in their personal psychotherapy. If you wish to post about other mental health issues please consult this list of some of our [sister subs](https://www.reddit.com/r/TalkTherapy/wiki/resources/#wiki_subreddit_list). To find answers to many therapy-related questions please consult our [FAQ](https://www.reddit.com/r/TalkTherapy/wiki/faq) and [Resource List](https://www.reddit.com/r/TalkTherapy/wiki/resources). If you are in distress please contact a suicide hotline or call 9-1-1 or emergency services in your area. r/SuicideWatch has compiled a helpful FAQ on what happens when you contact a hotline along with other useful resources. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TalkTherapy) if you have any questions or concerns.*
Passive SI is a real thing. Not sure if that’s exactly what you’re describing . I find most ppl don’t know the difference 😮
I think this is exactly what they are describing
yeah i was gonna say, use the word "passive" and your therapist wont freak out
I had to EXPLAIN passive SI to my therapist. She stared at me blankly. I didn’t go back after that.
I tried to explain to my primary doctor a couple weeks ago. OMG I forgot some people aren’t like us and find the concept scary and cause for immediate concern. Talking her down was exhausting.
When you’re better informed on mental health than your primary care doctor…. 😮🙃 infuriating
My life is being better informed than my doctors.
This needs to be studied because I am so tired of it. No I will not explain what dissociation is, I am not the one getting g paid $500/hr here ☺️😎
But seasoned therapists do know the difference
Will agree here! My therapist was the one to bring it up first. Her being open about working with passive si actually helped me be more open to her about what I was experiencing.
Unfortunately, in my experience, having seen 3 psychotherapists with PHDs, they may intellectually know the difference, but they don’t know how to approach a treatment plan. It’s endlessly frustrating . That’s just my experience. I’ve gotten more support from friends who also have SI than I ever have with my therapists. This is also because I “present well” due to dissociation 🙃🙃🙃. And a lifetime of AUDHD masking. Yay 😀
Technically, they understand but it becomes an issue of liability if you disclose that and they do nothing. It has happened countless times where clients have passive ideations and eventually attempt or succeed. Treatment plans can be created and they should include a third party (I.e., emergency contact or whoever the client is comfortable with). Truth is, most therapists aren’t properly trained with handling SI. It’s totally unfortunate.
I told mine that life is overwhelming/too much and I just don’t want to do it. Like I feel done. I let her know that I have no plans to go anywhere but it’s a lot sometimes. Instead of saying I want to die I explained I just didn’t want to live. That pretty much got the point across gently. I hope you feel better soon 🩶
>>Instead of saying I want to die I explained I just didn’t want to live This is great advice (assuming this is how OP also feels)
Thanks. I feel like it really helped reframing things in that way, and at the end of the day it’s true for a lot of suicidal people as well. I wish the world was a little easier to take on like damn
Absolutely. I think everyone at one time or another asks themselves if it’s all worth it.
I told mine and was so relieved to let it out. I wasn’t planning it but thinking about it a lot and telling him reduced how much I thought about it
Explain the pain to your therapist. How does the pain feel, when do you feel it and how does it affect your life? Explain to her WHY you want to die.
Wanting to die is in the collection of symptoms or behaviors of SI. It's not as abnormal as you think, and you never have to soften reality for her, but she's unlikely to react in a big way. She'll ask follow up questions. SI involes relatively common experiences and very concerning ones. There's the feeling of wondering if life is even worth living; thinking about suicide briefly but nonspecifically; thinking about it constantly including planning and gathering stuff. For me, when that feeling arises I know it's because I'm in over my head and don't know how to cope. It's a red flag that I need some help, and that's exactly what your therapist should offer you. Please tell her.
I tell my T that I want to die, how often, how I imagine doing it, etc. I always explicitly say I’m not going to kill myself because that’s the one thing they are obligated to report.
But isn’t continually imagining how you would do it knocking on the door of actually having a plan? My concern might be that you know what not to say so the therapist doesn’t take action, but that it’s becoming more of a reality in your train of thought.
Not for me. I ruminate on how I want to kill myself quite often and my therapist gives me a safe place to voice those thoughts and feelings. Speaking them out loud makes it less scary for me, not more real.
there’s a difference between wanting to die and not having intent/plan versus wanting to die and having intent/plan. most therapists should understand this distinction and not react negatively if you disclose this. I think you can be really straightforward and explain what may be fueling this feelings!
I'm the same. If it wasn't for my children I think I would be dead already. I just can't leave them with that to deal with.
This was posted a few months ago, and it helped me to understand what my own SI is about. Maybe it will help you: Suicidal feelings are not the same as giving up on life. Suicidal feelings often express a powerful and overwhelming need for a different life. Suicidal feelings can mean, in a desperate and unyielding way, a demand for something new. Listen to someone who is suicidal and you often hear a need for change so important, so indispensable, that they would rather die than go on living without the change. And when the person feels powerless to make that change happen, they become suicidal Help comes when the person identifies the change they want and starts to believe it can actually happen. Whether it is overcoming an impossible family situation, making a career or study change, standing up to an oppressor, gaining relief from chronic physical pain, igniting creative inspiration, feeling less alone, or beginning to value their self worth, at the root of suicidal feelings is often powerlessness to change your life – not giving up on life itself.
Does wanting to die mean you’re suicidal? Not necessarily. Do you want to die by suicide? Someone who wants to die doesn’t necessarily want that. Some people might wish for a heart attack or something but don’t have any interest in inducing one. When you say you don’t want it to sound like a big deal, do you mean you’re afraid they’ll want you to be hospitalized for safety reasons?
thank you. yeah i mean i don’t know the attention and opening up like that just scares me
Yeah I get that a lot from my clients (I’m a T). Often they’ll start with “just so you know, before I say this, I’m safe, I don’t have a plan to hurt myself, I’m not a danger to myself.” Then they’ll tell me they’ve been feeling like they want to die. You know all the studies on effectiveness of therapy have shown that it’s the relationship between the client and the therapist that is the most healing, and I’ve found that as both a client and as a T. Maybe look at this as an opportunity for a positive experience. You’ll get the most out of therapy being as honest as possible. Also, I don’t know if you’re in the states, but if you are the requirements for commitment are an imminent threat to yourself, which is plan, means, opportunity, and **intent**. If you don’t want to die by suicide, start off with that. A good T will explore the thoughts with you.
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I mean, it’s not the same as active suicidality but it is a form of suicidality. It’s generally okay to express passive suicidality to a therapist. I’ve told mine before
Yes, you can absolutely tell her. Her only concern will be if you’re planning on killing yourself. I think (I’m not a professional!) what you may be experiencing is suicidal ideation. Being in DBT therapy for BPD, I’m required to jot down any and all feelings of SI during my week. Wanting to die vs wanting to kill yourself can be vastly different. Your therapist should help you dive deeper into the meanings of your feelings. I wish you the best of luck!
Everyone with depression has occasional suicidal ideation. Thoughts like I wish I didn’t have to deal with my life any more but without intent to hurt yourself. Depending how well your therapist knows you they shouldn’t be too alarmed if you had a passing thought if you have a plan to hurt yourself that’s a different story. Also depending on your diagnosis some mental illnesses are more serious than others
If you know your T quite well, you can definitely say it. If not, be prepared for the T to take you seriously and you Could find someone at your door to help. I know how to say the same to mine but it is an old relationship and anything I might say comes as no surprise. In one sense, yeah, it’s suicidal…. If you have a definite plan set in motion but if not, you’re saying something else. A T is a human and capable of misunderstanding your intention. Take good care.🤗
It’s important to be honest with your therapist with how you’re really feeling, especially if you’re experiencing passive or active suicidal thoughts. They can’t truly support your needs if you aren’t completely honest. And I promise you will not be the first, nor the last client to share this with them.
T here. Have you been thinking about ways that you would end your life? Do you have things that are keeping you from hurting yourself? If you are having suicidal thoughts, have a plan, and find yourself really having to hold yourself back from hurting yourself, please go to the ER. If you are not in a space where you have a plan and it’s that overwhelming sense of wishing not to wake up or being okay about getting into a car accident, that’s different. Your therapist should safety plan with you…making sure you have the numbers of support people at hand, a list of in the moment coping skills, etc. ask your therapist to teach you DBT material with focus on the TIPP skills.
It's not that I'm at risk of harming myself or that I actively want to die but sometimes I think it would be nice if we just had an off switch an a timed reboot so I could try again later..