What you've described is really normal. And I think your therapist isn't handling it quite right, which is her fault, not yours.
The reason you're telling her you'll try is probably, at least in part, that you want to be a good patient, which is really common. It's so common in fact, that it was one of the first things we talked about in my clinical psych class this term. You may really want to try to hurt yourself less, and that just disappears in the moment, or you may not want to at all - I can't tell you what you're thinking - but either one is perfectly normal.
Now, the part about you being "not ill enough" to get treatment is making me angry at the health care system that's supposed to be helping you... Asking for help rather than hurting yourself is a good behavior, and it should be rewarded. From the treatment provider side of things, I've heard about it particularly in the context of DBT for Borderline PD (which is the best supported treatment for BPD) because a lot of people with BPD hurt themselves essentially as a way of asking for help, and because it works that behavior is reinforced. In order to help someone overcome that, the therapist needs to provide reinforcement for asking for help in healthier ways, which means always being there for them when they ask for help (even at odd hours of the night, which puts a lot of people off from doing that kind of work, which is why we were talking about it in the first place). And a lot of times, treatment will even include things like having the client call a crisis line when they're not even feeling suicidal at the moment, to see that it will be there to help them when they need it, and similar things with various other support resources. So making you feel like you'd need to actually attempt suicide before you could get the level of support you clearly need is such complete and utter crap, and it's totally iatrogenic, and it's setting you up to have problems that you don't even have yet that are going to be harder to treat than if they'd just get their act together now.
I think that you should try to explain to your therapist as best you can both what you said about trying to be careful, and also your experiences with the additional support services she's tried to get for you. And if given that, she still just sends you back to these same services you're not actually getting, then I don't know what to tell you other than that you should recommend she read up on DBT, particularly in relation to self harm and suicidal ideation and behavior, and also on the potential for psychological treatments to cause harm.
|