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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Peter S on November 1, 2000, at 23:16:14
Yes after 39 years on this planet I've finally been thinking about suicide. I've mentioned this to my therapist on and off since we started a couple of months ago. I brought it up again and he said at some point later in the conversation "I don't think you are going to kill yourself". I was too shocked to say anything but at our next session he said that he meant that I wasn't going to kill myself "before next week".He has said and done a number of other things that indicate that he doesn't take my depression that seriously- he admits that he has never been very depressed himself. I have since terminated with him and I have sent him a letter outlining my concerns about how harmful his actions were to me. I also mentioned sending a letter to the ethics board about my concerns. First I plan on talking to him about it.
I realize it is hard for me to be objective under the circumstances. What do people think of this kind of behavior? Any ideas about appropriate action?
Thanks in advance!
Peter
Posted by Racer on November 2, 2000, at 1:02:55
In reply to Therapist lack of ethics or just incompetence?, posted by Peter S on November 1, 2000, at 23:16:14
It's a tough one, because we can't see your behavior in his office, but he doesn't sound overly great. That said, let me play devil's advocate:
It's hard to be a good therapist, and there aren't many out there. Isn't it sad that he's not very good at what he does, even after so many years of training?
Now that that's out of the way, good for you for leaving! And an extra two points for discussing it with him! That's the strength that'll see you through this.
Posted by Buffet on November 2, 2000, at 1:54:33
In reply to Therapist lack of ethics or just incompetence?, posted by Peter S on November 1, 2000, at 23:16:14
>
> Yes after 39 years on this planet I've finally been thinking about suicide. I've mentioned this to my therapist on and off since we started a couple of months ago. I brought it up again and he said at some point later in the conversation "I don't think you are going to kill yourself". I was too shocked to say anything but at our next session he said that he meant that I wasn't going to kill myself "before next week".
>
> He has said and done a number of other things that indicate that he doesn't take my depression that seriously- he admits that he has never been very depressed himself. I have since terminated with him and I have sent him a letter outlining my concerns about how harmful his actions were to me. I also mentioned sending a letter to the ethics board about my concerns. First I plan on talking to him about it.
>
> I realize it is hard for me to be objective under the circumstances. What do people think of this kind of behavior? Any ideas about appropriate action?
>
> Thanks in advance!
>
> PeterAs Racer said, its hard to tell if his behavior was inappropriate. What was it that provoked him to tell you this? He could have said it for a variety of reasons, and it was probably a misunderstanding. He may have not understood the seriousness of your intent. But, then again, he may be an idiot.
Has he helped you at all in the past? Is it time for a change in therapy or therapist? You definitely need to get some type of help, and if he doesn't provide it or makes things worse go elsewhere. I'd definitely talk to him about it but just make sure you are OK at the same time.
Good luck,
Buffet
Posted by R.Anne on November 2, 2000, at 11:55:22
In reply to Therapist lack of ethics or just incompetence?, posted by Peter S on November 1, 2000, at 23:16:14
From what you said I think you did the right thing in finding another therapist. In my opinion, suicide should NEVER be taken lightly! I'm sorry you had that experience and applaud you for the steps you took. I hope you will continue writing here and over at the Psychosocialbabble, too. There are people who care around.
*******
>
> Yes after 39 years on this planet I've finally been thinking about suicide. I've mentioned this to my therapist on and off since we started a couple of months ago. I brought it up again and he said at some point later in the conversation "I don't think you are going to kill yourself". I was too shocked to say anything but at our next session he said that he meant that I wasn't going to kill myself "before next week".
>
> He has said and done a number of other things that indicate that he doesn't take my depression that seriously- he admits that he has never been very depressed himself. I have since terminated with him and I have sent him a letter outlining my concerns about how harmful his actions were to me. I also mentioned sending a letter to the ethics board about my concerns. First I plan on talking to him about it.
>
> I realize it is hard for me to be objective under the circumstances. What do people think of this kind of behavior? Any ideas about appropriate action?
>
> Thanks in advance!
>
> Peter
Posted by pullmarine on November 2, 2000, at 20:03:32
In reply to Therapist lack of ethics or just incompetence?, posted by Peter S on November 1, 2000, at 23:16:14
>
"I don't think you are going to kill yourself".Is one of the big "DON'Ts of suicide prevention.what he said was dangerous and inconsiderate.
What do people think of this kind of behavior?I wouldn't forgive someone who's not trained in suicide prevention, let alone a trained professional!
Any ideas about appropriate action?
GET ANOTHER THERAPIST ASAP!!!!!!
JOHN >
> Thanks in advance!
>
> Peter
Posted by judy1 on November 2, 2000, at 20:05:58
In reply to Re: Therapist lack of ethics or just incompetence?, posted by Buffet on November 2, 2000, at 1:54:33
Dear Peter,
I'm sorry you had to go through that, I think what makes it really difficult is that you probably had developed some trust and must have felt completely let down. I was terminated by my psychiatrist (a very traumatic thing) 2 years ago and while going to a psychologist after a suicide attempt, he suggested I do the very thing you did- write a letter and discuss it with him. I think you are very strong to do what you did and you will be helping not just yourself but him in discussing your feelings. I wish you the best of luck with this, I truly understand how you feel. Take care, Judy
Posted by S. Howard on November 3, 2000, at 20:43:09
In reply to Re: Therapist lack of ethics or just incompetence?, posted by R.Anne on November 2, 2000, at 11:55:22
What a jerk! Tell your therapist that he's fired.
Posted by Hannah on November 10, 2000, at 19:12:22
In reply to Get thee to a psychiatrist, posted by S. Howard on November 3, 2000, at 20:43:09
I found an article about verbal and emotional abuse in psychotherapy (by therapists). It might be of interest to some of you.
http://www.home.aone.net.au/psychotherapy/what_is_abuse.htm
I think it's sometimes too tempting for people to think if something is wrong in the therapy it must be their fault. At any rate it was something to think about!
> What a jerk! Tell your therapist that he's fired.
Posted by Cindy W on November 10, 2000, at 20:34:36
In reply to Therapist lack of ethics or just incompetence?, posted by Peter S on November 1, 2000, at 23:16:14
>
> Yes after 39 years on this planet I've finally been thinking about suicide. I've mentioned this to my therapist on and off since we started a couple of months ago. I brought it up again and he said at some point later in the conversation "I don't think you are going to kill yourself". I was too shocked to say anything but at our next session he said that he meant that I wasn't going to kill myself "before next week".
>
> He has said and done a number of other things that indicate that he doesn't take my depression that seriously- he admits that he has never been very depressed himself. I have since terminated with him and I have sent him a letter outlining my concerns about how harmful his actions were to me. I also mentioned sending a letter to the ethics board about my concerns. First I plan on talking to him about it.
>
> I realize it is hard for me to be objective under the circumstances. What do people think of this kind of behavior? Any ideas about appropriate action?
>
> Thanks in advance!
>
> PeterPeter, I'm so sorry to hear of your bad experience with your therapist. Look for a new therapist, ASAP! In the past, I went to a social worker for a few weeks who kept calling me "abrasive" and treating me very negatively; I just stopped going. Now I feel fortunate that I have a truly wonderful pdoc who is loving, caring, and nonjudgmental, as well as extremely skilled in psychopharm. Hope you can find a new therapist who is more helpful for youj!--Cindy W
Posted by coral on November 11, 2000, at 12:22:21
In reply to Therapist lack of ethics or just incompetence?, posted by Peter S on November 1, 2000, at 23:16:14
Dear Peter,
Please forgive me if this post seems insensitive to you.
Unquestionably, a trusting relationship between you and your therapist is crucial to recovery. If that relationship does not exist, and the difficulties are not due to the inherent process of therapy, find another therapist immediately. It seems most considerate and responsible for you to let the therapist know your concerns.
Now, to the potentially insensitive part... the fact is you didn't commit suicide, so the therapist was right on that point. (This is NOT to minimize suicidal risks.) On the other hand, had your therapist considered you to be at risk for suicide, he would have been required to take immediate steps, which probably would've included involuntary hospitalization.
As far as his never having been depressed, for me personally, that would not be a detriment if I felt trust and competence with him. I wouldn't expect an endocrinologist to have diabetes to effectively treat diabetes.
During therapy, I told my therapist that I was having suicidal thoughts and he said that he'd expect that, given the relapse of my depression. I've also told him that I'd given thought to killing my sister. Therapy requires a significant amount of judgment on the therapist's part and a significant amount of mutual trust between the client and therapist. In my case, he made a judgment that I would neither commit suicide nor kill my sister, and he was right. I trust him and feel free to say whatever's on my mind to him. If I felt that by indicating suicidal thoughts, I'd wind up involuntarily committed, I'd never open my mouth in therapy. My point is that if your therapist isn't helping you and you're certain that you're not resisting hearing difficult things in your therapy, fire him. Without trust, the therapy is doomed. I fired my first therapist after three sessions without a backward glance, so please don't hear me to be saying that therapists are gods and always right.
Good luck,
Coral
Posted by Peter S on November 11, 2000, at 21:03:19
In reply to Re: Uhh.....welll......., posted by coral on November 11, 2000, at 12:22:21
Dear Coral,
You may have misunderstood what I was getting at. I was not saying that his responsibility was to try and hospitalize me. If you have ever dealt with suicidal people, which I have (I worked in a crisis clinic for a year), you know that there are certain factors that make suicide more likely. These factors include: previous attempts, a plan, intent, means (for example access to a gun), family history of suicide, history of unremitting depression, and lack of social support.
If someone goes into a crisis clinic and says they are suicidal, they would probably not hospitalize them as a "danger to self" unless they demonstrate the first three: a plan, means, and serious intent. (Most public hospitals wouldn't accept the person unless these conditions were met anyway)
When I was suicidal I had intent, a plan, but not the means (a gun). So it seems very easy to say the therapist is absolved of legal responsibility for doing anything.
Ethicial issues are a little more subtle, however according the the ethical code (upon which one's license is based) one of the primary responsibilities is to "do no harm". I would contend that it is harmful to predict something as unknowable as suicidal action. There are many cases of people who kill themselves with absolutely no indication of any of the above factors. So noone (especially a therapist) should ever say something like "I don't think you're going to do it". After talking with him that day, I felt more at risk than before. And no I didn't do it- but if someone had given me a gun, who knows? It is incredibly arrogant and unethical to make statements based on statistics- I would call it gambling with people's lives. There is always the "see I told you so" vindication- but what about the next time, or the next client who may be a little more impulsive?
Ethically, a therapist must try and reduce the odds of someone's killing themselves as much as possible. This means fully exploring it and giving as much support as possible. If for whatever reason they have difficulty doing this, they should not have a license.
I hope this clarifies what I was trying to say. And no I am not going to write a letter to the Ethics Committee. After talking with him, I think he knows that it was inappropriate and I'm sure that he didn't mean overtly to cause any harm. But next time I think he will be more cautious and when it comes to suicide, being cautious is the best policy.
Peter
> Dear Peter,
>
> Please forgive me if this post seems insensitive to you.
>
> Unquestionably, a trusting relationship between you and your therapist is crucial to recovery. If that relationship does not exist, and the difficulties are not due to the inherent process of therapy, find another therapist immediately. It seems most considerate and responsible for you to let the therapist know your concerns.
>
> Now, to the potentially insensitive part... the fact is you didn't commit suicide, so the therapist was right on that point. (This is NOT to minimize suicidal risks.) On the other hand, had your therapist considered you to be at risk for suicide, he would have been required to take immediate steps, which probably would've included involuntary hospitalization.
> As far as his never having been depressed, for me personally, that would not be a detriment if I felt trust and competence with him. I wouldn't expect an endocrinologist to have diabetes to effectively treat diabetes.
> During therapy, I told my therapist that I was having suicidal thoughts and he said that he'd expect that, given the relapse of my depression. I've also told him that I'd given thought to killing my sister. Therapy requires a significant amount of judgment on the therapist's part and a significant amount of mutual trust between the client and therapist. In my case, he made a judgment that I would neither commit suicide nor kill my sister, and he was right. I trust him and feel free to say whatever's on my mind to him. If I felt that by indicating suicidal thoughts, I'd wind up involuntarily committed, I'd never open my mouth in therapy. My point is that if your therapist isn't helping you and you're certain that you're not resisting hearing difficult things in your therapy, fire him. Without trust, the therapy is doomed. I fired my first therapist after three sessions without a backward glance, so please don't hear me to be saying that therapists are gods and always right.
> Good luck,
> Coral
>
>
>
Posted by Peter S on November 11, 2000, at 21:33:24
In reply to Re: Therapist lack of ethics or just incompetence?, posted by R.Anne on November 2, 2000, at 11:55:22
It has helped
Posted by coral on November 12, 2000, at 8:40:42
In reply to Re: Uhh.....welll......., posted by Peter S on November 11, 2000, at 21:03:19
Dear Peter,
I may well have misunderstood. On the issue of suicide, I'm not trying to absolve anyone of their professional responsibility, and wholeheartedly disagree with the concept that if someone in therapy does commit suicide, he/she failed therapy. On the other hand, if someone does commit suicide, is it anyone's fault? That's obviously a philosophical discussion for the ages.
I don't know what state you're in, but in Michigan, it's extremely easy to get someone committed for observation. A spouse can do it, and even an employer can do it.
If I may be so bold, it seems that the therapist's insensitive response to your statement of suicide was symptomatic of your relationship with him and he was not meeting your needs. That alone is sufficient reason to find another therapist. I admire your willingness to discuss it with him and hopefully he will improve with future clients.
Best of luck in your recovery and finding another therapist.
Coral
Posted by Peter S on November 12, 2000, at 13:48:51
In reply to Re: Uhh.....welll......., posted by coral on November 12, 2000, at 8:40:42
Dear Coral,
Thanks for your reply. No of course it doesn't make sense to pin the "blame" for someone's suicide on someone else. What I'm saying is that to obtain a license in California (where I live) to be a Marriage and Family Therapist you must abide by certain ethical principles. If you cannot uphold these principles then your license will be revoked. It is an ethical principle to not cause harm to a client. It is true that relationships are very complex, and that the definition of harm is subjective. However because the therapist role by nature involves influencing the client, it is their responsibility to monitor themselves and make sure what they are doing does not cause harm.
Of course there are degrees of harm (sex with a client, breach of confidentiality), some merit a slap on the wrist and others actual revoking of the license. I think what my therapist did is more on the slap on the wrist end, but if he continues to do things like that then more serious action should be taken.
Some therapists need to be reminded that the licensing process exists for a reason and that they are not really "alone" in the room with the client. Clients need to know that they have recourse if they feel that a therapist is acting unethically. This is not to encourage frivolousness about this kind of thing, and hopefully the first step is to work it out within the relationship.
****Regarding admission to a hospital for suicidality: I worked in a clinic where we saw a lot of people without insurance (besides SSI or SSDI) These were the people who had trouble getting into the hospital unless they could "prove" that they were really suicidal or homicidal.Thanks for the opportunity to discuss this- I think it is an important topic.
Peter
> Dear Peter,
>
> I may well have misunderstood. On the issue of suicide, I'm not trying to absolve anyone of their professional responsibility, and wholeheartedly disagree with the concept that if someone in therapy does commit suicide, he/she failed therapy. On the other hand, if someone does commit suicide, is it anyone's fault? That's obviously a philosophical discussion for the ages.
> I don't know what state you're in, but in Michigan, it's extremely easy to get someone committed for observation. A spouse can do it, and even an employer can do it.
> If I may be so bold, it seems that the therapist's insensitive response to your statement of suicide was symptomatic of your relationship with him and he was not meeting your needs. That alone is sufficient reason to find another therapist. I admire your willingness to discuss it with him and hopefully he will improve with future clients.
> Best of luck in your recovery and finding another therapist.
> Coral
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