(Note: This post contains mentions of suicide and suicidal thoughts. Please read with caution if this content may be triggering.)
Scheduling an appointment and coming into the therapy room for the first time is super daunting. Sitting down in the chair and opening up to a stranger you met only five minutes ago also takes a lot of courage. While you’re in therapy, there may come a moment where you wonder, “How open can I be with my therapist? What am I allowed to tell them?”
It is best for both you and your therapist if you are as open and honest as possible with what you are sharing. But some things may be more difficult to share than others.
Your therapist may ask you questions such as:
“How has your sleep been?”
“Have you noticed any changes in your appetite?”
“How would you describe your mood from day to day?”
But once your therapist asks you: “Have you ever wished you were dead or wished you could go to sleep and not wake up?” You freeze.
Your mind may be full of worry and thoughts such as:
- What will they think of me?
- Should I tell them? Or should I just say no?
- Will they call the police? What if they send me to the hospital?
- What will they ask me next if I say yes?
These thoughts are normal. And pausing and not responding immediately to this question is also normal. It is normal to feel worried about how honest you can be with your therapist. You just met them not too long ago after all.
What will they think of me?
Your therapist is not there to judge you, but rather, to work together with you to figure out what type of support you need. Your therapist is there to listen and be on your side as you heal, grow, and work through your problems. If you share that you have had suicidal thoughts, your therapist will probably just think, “How can I help this person heal and be safe?”
It might feel shameful or embarrassing to tell someone that you’ve had thoughts about suicide. What if they think I am weak? What if they think I’m being dramatic? It is best to be honest with your therapist and being honest about suicidal thoughts takes a lot of courage. One of the common myths about suicide is that talking about suicidal thoughts will lead to more thoughts and encourage suicide. Talking about suicidal thoughts not only helps you and your therapist understand your experiences, but also helps eliminate stigmas and to find resources to best support you.
Should I tell them? Or should I just say no?
It may also be scary to admit to ourselves and to say out loud that we have had suicidal thoughts. We might think we’re weird or strange for having these thoughts, but actually, suicidal thoughts are more common than we think. In 2019, 12 million adults in the US have had serious thoughts about suicide.
During this initial conversation about suicidal thoughts, most likely, your therapist will ask you a yes or no question like, “Have you ever wished you were dead?” Answering with just ‘yes’ may take a lot of effort and bravery, but that one-word answer can help you take the first step to get the help and support you need from your therapist.
Will they call the police? What if they send me to the hospital?
You might also worry about your therapist’s response to you sharing. Suicide is the 10th leading cause of death in the US and it is something that you would expect people, especially your therapist, to take seriously. However, instead of immediately calling the police and admitting you into a hospital, your therapist will first ask you more questions to understand your suicidal thoughts more. Your therapist is on your side and wants to work together with you to figure out the best way to support you.
What will they ask me next if I say yes?
After you respond and say that yes, you have had suicidal thoughts, your therapist will ask you more questions to understand your experience. How frequently do you have these thoughts? How intense are these thoughts? Do you have a plan about how you would hurt yourself? Did you ever think about acting on these thoughts? What usually happens before you have these thoughts? Your therapist will not be judging your answers, but will be curious and compassionate to try to understand what types of difficulties you’re facing.
What you share with your therapist won’t scare them away but will help them better understand your difficulties to form a safety plan together. What will you do the next time you have these suicidal thoughts? What will you do when you feel the urge to act on those thoughts? What can we do to make you feel safe? It’s scary to have these thoughts and you may feel helpless and lost. Sharing these thoughts with your therapist and exploring them together will help you heal, recover, and live a meaningful life.
Talking to your therapist about suicide is hard. But taking the first step and saying ‘yes’ to that first question can create a big difference in how you and your therapist can work together to keep you safe and help your healing. No one should have to suffer alone, and working together with your therapist means you aren’t alone and are supported in your struggles.
- National Suicide Prevention Hotline: 1-800-273-8255
- Lifeline Online Chat: https://suicidepreventionlifeline.org/chat/
- Disaster Distress Helpline: https://www.samhsa.gov/find-help/disaster-distress-helpline
- Spanish speaking: 888-628-9454
- Black, Indigenous and People of Color (BIPOC) (emphasis on reducing traumatic interactions with police): https://www.callblackline.com; 800-604-5841
- Asian LifeNet Hotline (Cantonese, Mandarin, Japanese, Korean, Fujianese): 877-990-8585
- The TREVOR Project (LGBTQ hotline/online chat): 866-488-7386
- Trans Lifeline: 877-565-8860
- Veterans crisis line: http://www.veteranscrisisline.net; 800-273-8255
- StrongHearts Native Helpline: 844-762-8483
- ActiveMinds: https://www.activeminds.org/about-mental-health/be-there/coronavirus/chapter-student-remote-resources/