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Is there any way of controlling suicidal thoughts stemming from sexual abuse?

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Practicing since : 2000
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Is there any way of controlling suicidal thoughts stemming from major sexual abuse at the age of 15? And because there was a lot of violence is there any way of seeing what else went on behind the violence because this is blocking a lot at the moment?
Posted Fri, 3 Aug 2012 in Mental Health
Answered by Dr. Abhijeet Deshmukh 7 hours later

First of all, thank you for choosing XXXXXXX for finding out answers.

Suicidal thoughts ('wanting' to die) are usually a result of a chain of other thoughts triggered by thinking about what happened in the past. Sexual abuse at the age of 15 is a significant trauma.

Some of the thoughts that might be coming to you may sound like - I am no good, people hate me, life is not fair, there's no use staying alive, etc. These are just my assumptions. If you wish, you can reply with more details about the thoughts.

It is not just the negative or self-defeating thoughts that are causing the suicidal ideas, but the strong beliefs that are there at the root. Such thoughts are probably experienced by other individuals as well. But not all of them are driven to think about suicide. What is the difference, then? The difference is the strength of the underlying beliefs. To know what beliefs might be affecting your response to all these thoughts, you will have to first see what all thoughts are there.

If you have been in therapy, you may have experienced the process of finding out the chain of thoughts and reaching the underlying strong (often irrational) beliefs. 'Irrational belief' is a belief that is not helping you reduce the disturbances and live happily. But if you haven't been in therapy, you might think about getting into it. The process of psychotherapy will certainly be of help.

Meanwhile, you can certainly make use of our discussion here to try to find out what lies beneath the thoughts of suicide. Please write back with some thoughts about that incidence in the past. And we can try to find out how we can 'modify' or 'moderate' the strong beliefs that might be causing the trouble.

In short, memories of the incidence that happened in the past are probably acting as triggers for thoughts. These memories, per se, are not responsible directly for creating suicidal thoughts. But these memories are acting as triggers for negative 'self-defeating' thoughts, which are stemming from some strong underlying beliefs about self/others/life. Some of these beliefs are probably strong and irrational, and thus, not helping you overcome.

I would say a similar process is happening with the memories of violence as a trigger. I invite you to have a dialogue to see if we can find some significant inroads. We can try that over a few exchanges here.

I hope this reply helps you a bit.
Take care.

Abhijeet Deshmukh, MD

Above answer was peer-reviewed by
Follow-up: Is there any way of controlling suicidal thoughts stemming from sexual abuse? 34 hours later
Dear Dr. Thank you so much for answering my question like that. Since you wrote it is like I am absorbing your information. I never thought of beliefs below the surface of the thoughts. To be honest I'm not really sure what my beliefs are. Sometimes they change a lot and sometimes when you understand something they change significantly. Maybe you have found that too.
I am indeed in therapy and I have just started a new type of therapy directed very much towards the rapes. There were five of them in total although I haven't told my latest therapist yet. It was the day of the therapy that I fell apart and it had all to do with time. He's asking me to go to therapy the exact same day (Wednesday) and the exact same time. Whatever it was I became highly suspicious that day and I was sure that the whole mental health system had some conspiracy going on. You see that was the day I was with two of them. One - I was meeting on a regualar basis for three years and the other was a doctor who was extrememly violent towards me that day. My therapist says that I have lost trust in doctors now and I knew that was true all along because I had such an awful fear of going to them and I always took my kids with me when I had to attend someone. It is extraordinary though how I feel I can trust the doctor I have in the clinic I go too and also a mental health community nurse who I have chats with a lot. Both of them are male and so is my new therapist and I find I can't function with women on this subject. Women tend to sympathise and I can't bear that but men can look at it without this and I find this much better. I think I am always picking men because I am looking for the protection that I know is in many men and I had four brothers who protected me very well when I was young. However I had no relationship with my father especially when he told me one day that he wished that I was a boy and so I cut off all ties with him and ran towards my mother.
The thoughts that come up when I am suicidal is that "I am not intelliegent enough" and I feel that I have lost the talents I thought I had when I was in school. I did exceptionally well there and was top of the class many times. But I left school earlier than I had hoped because my mother was very poor and needed money and so I took the job where I ended up getting raped very badly. And so I have tried so hard to bring back these talents and I have tried loads of things but I'm just not getting up there. I have seven children and I run my own business and all those areas are going very well so I should feel successful but I don't. All I can see is a girl that was so stupid to leave this happen. I've only put down one of the thoughts here so far but I wanted to stress this one because it really is the most prominent one.
Answered by Dr. Abhijeet Deshmukh 2 hours later
Hello again.

Thank you for reverting with more details. First of all, I would like to mention here that we are not attempting to do all the work that the process of therapy does, but we can try to find some inroads into what's creating the disturbances. You can then carry it forward with the therapy.

There are a few important thoughts I would like to mention.

1) The thought that "I am not intelligent enough" may not actually be directly related to the incidence that happened when you were 15 years old. My hypothesis suggests that the feeling of being lesser than othersor thinking that you are not intelligent enough can be a separate thought, stemming from a lifelong predisposition to thinking you are not good enough. This predisposition may have been there even before you experienced the trauma. Studying well and staying a class topper an be one of the ways you can prove to yourself and to significant others that you are good enough. While this is not a bad tendency, there's something underneath it, that can create disturbances, as follows -

We all as humans tend to have certain expectations from the self / other / life. Quite often, these ecpectations are so strong that in the event of them not getting fulfilled, we tend to fall back in a self-blame mode. For example, if one has a lot of talents and skills, he/she can develop certain strong expectations from self. But if those expecations are not fulfilled, they may think that their skills and talents stand for nothing. And that they are failures and do not deserve to live. And then the suicidal thoughts can pop up.

Since I have not had the opportunity to talk with you, I can make a hypothesis which suggests that the current suicidal thoughts in your mind may not be stemming from the traumatic event, but may be a result of this predisposition to think self-defeating thoughts, which lead to non-fulfilment of your dreams nad goals, in spite of the talents you have had.

I would like you to recheck this hypothesis from your point of view. Perhaps, you can try to recall any more incidences/events in your life after which you felt 'defeated' or thought that you are not good enough. Those events could be anything in day to day life such as exams, tasks, relationships, jobs, etc.

Through this, I have no intention of denying the role of the traumatic event altogether. However, if you can find any such connections in your thoughts and life events, you may be able to avoid what has always been happening - expectation not getting fulfilled --> self-downing thougths --> emotional disturbance --> reduced proactivity about talents --> letting go of oppoetunities --> further disturbance and self-downing --> thinking 'I am not good enough' or intelligent enough --> reduced motivation to live a happy life --> suicidal thoughts.

2) There is certainly the role of the memories of the traumatic event. And these memories and the disturbances attached to it are carried for a long period of time now. It seems that you have had to struggle with episodes of relatively severe emotional disturbance occurring periodically. However, you may not have had the opportunity to reflect upon the thought that the abuse trauma may not be directly responsible for you feeling inadequate in the present. May be you can write more thoughts about this.

The fact remains that you had to leave school early to support family. And then the sexual abuse certainly disturbed your planning for work and further goals. It is a bit easy to confuse the abuse as a cause for the entire disturbance. But I invite you to think again if the current suicidal thoguhts may be stemming from some natural tendency to think self-defeating thoughts after a set-back.

You may please reply with more thoughts. I will be glad to carry the discussion forward so that you can get the maximum benefit from our interaction here.

Take care.

Abhijeet Deshmukh, MD
Above answer was peer-reviewed by
Follow-up: Is there any way of controlling suicidal thoughts stemming from sexual abuse? 1 hour later
That was a highly interesting post Dr. Abhijeet and it was a bit easier for me to answer rather than going away thinking about it. However, if more come up throughout the day I will let you know later. For now, I can answer several thoughts you have brought up.
When I was in school and doing so well - rather than thinking I may be better than others (which happens with some people) I had an incredible urge to bring others on with me and so I used to teach those who were being left behind. My own teachers were very grateful for that and it was as if we were a team together. Being brought up in a lot of poverty I think stopped me from feeling superior to others. Even today now that I am fairly well off - I never forget how life was not really tough but so precious when you live in a type of survival mode. Everything then was a huge bonus eg. growing and selling lettuce to survive, picking perries all throughout the summer, joining libararies for free, my mother knitting clothes ect. I don't know if these seem relavant to you or not but they meant the world to me. Now that I can afford things quite easily - I don't get the same pleasure or satisfaction from them. However, where my education was concerned I was almost a perfectionist. The more I learned - the happier I was and to gain even more insight I often went back and refreshed very easy books in case I missed something. This is all I have time to write for right now because I must do the bar now but I will be back later with more if that is okey?
Answered by Dr. Abhijeet Deshmukh 26 minutes later

Thanks for your reply.

The idea of me providing you with a hypothesis is for you to check if you can see a logical connection between the current suicidal thoughts and the abuse in the past. The hypothesis itself can be wrong, but the exercise will be a success if you can see from where the suicidal thoughts are coming, so you can proactively deal with them in your therapy.

You can take your time and reply with more thoughts.

Take care.

Above answer was peer-reviewed by
Follow-up: Is there any way of controlling suicidal thoughts stemming from sexual abuse? 4 hours later
I had more written earlier on Dr. but I erased it all. Maybe I shouldn't have but it just seemed so irrelevant. I really think that I had great beliefs before I left school. I had an amazingly strong connection with my creator and used to visit our church at least three times a day but there could have been a bit of an obsession here but this is what made me feel very safe and several things happened that made me believe that someone was watching out for me. However when I went to secondary school at the age of 13 I lost that connection very badly even though I still did very well there. But all the visits to the church went and I rarely called on God to help me. When I was 14 the sister I always wanted came and I was so happy and then the year later another one came but I didn't seem to want her at all. My mother was finding it very difficult financially because my father was drinking most of the money and so I decided to leave when the opportunity of a job came along. Of course it wasn't the job that I wanted but it would do for the time being. All I was doing was serving tea and sandwiches in an extremely busy organisation that had about 1000 men in it.
I worked very long hours here and only had a half-day off on a Thursday. I worked from 8 - 2 and from 4-11 most days. One night when I was leaving to get the last boat home my boss blocked me at the doorway and pulled me towards him. I tried really hard to get away from him but he was so strong Dr. - he really was and before I knew it he had me on the ground and broke my virginity. I missed the boat that night and tried to sleep under a tree but I was awake most of the night. I went back to work and the boss acted as if nothing happened and all I could think of was my mother and if I left this job now she would miss the money so much. From then on the boss would whisper to me every Tuesday night not to forget to XXXXXXX him on the Wednesday night in a different place and I was just so terrified to say no. And so I met him and without going into the details - I stayed with him for three long years. Anytime I got into his car all he would say is to lie down in case we would be seen and hardly anything was said when sex went on and all through the week at work we barely spoke as he would send instructions to me through his wife. I felt so bewildered by all this and didn't actually realise that I was having an affair. It was like I didn't know this at all and that is why I feel stupid. This man was about 30 years older than me. Then one night when I was going for the boat again - another younger man came up behind me with a penknife. He stuck it up against my throat and told me that he wanted sex. What could I do Dr.? All I could do is what he told me. It was either that or be killed. Of course I missed the boat again and had to try and sleep by a tree. I really want to tell you about the others as well but how far can I go in this conversation? Do you want me to close the discussion and give you a review first and then come back to you? What happens if I can't find you anymore?
Answered by Dr. Abhijeet Deshmukh 5 hours later

It was unfortunate that you had to go through all of that. But it is important that you do not let what happened in the past affect your present. I guess there will be some limitation to this conversation, and after you close the discussion, you may have to put in a fresh query. Also, though relevant, it may not help us (here on this platform) to discuss the details of the abuse and violence. But in therapy sessions with a therapist, the details can bring up the emotions and the associated thoughts, which can be helpful for reaching the core beliefs.

In the first place, the purpose of this conversation is not to replace the in-person therapy you are doing. I suggest you focus on using some cues from this discussion for an effective discussion with your therapist. Here are some points you can keep as reference points for discussions -

1) Are the suicidal thoughts really stemming from the abuse? Or are those independent set of thoughts, separate from the sexual abuse incidence?

2) How can you identify the chain of thoughts that lead to thinking "I am not intelligent enough" and suicidal thoughts? In this process, you can identify certain strong, often irrational, beliefs which may not be helping you.

You can continue the discussion here as long as is allowed by the website policies. After that, you may contact the site administrators or put in another query. Out purpose of this discussion needs to be specific, so we can achieve it in this limited conversation.

Regarding the suicidal thoughts, can you identify any specific triggers in your mind in the present? The triggers could be some events, things, or even memories of what happened.

Take care.
Above answer was peer-reviewed by
Follow-up: Is there any way of controlling suicidal thoughts stemming from sexual abuse? 21 hours later
Dr, Abhijeet, I have studied your post and today I did notice another few thoughts because I was feeling a bit low and tired. I did think that no-body cares about me and that no-body takes me seriously. Yet, I know that my husband and kids care about me and all the customers in my bar. This produces XXXXXXX lonely feelings and makes me think that only God loves me and so that is where I want to go. I find loneliness a very hard feeling to deal with and find anger much easier but the thing is - it is incredibly hard to make me angry. I find in the mental health service that I get sort of dismissed and I am too eager to take that dismissal. I just can't seem to get out what I want to say (mainly for fear of sounding foolish) and I feel really frustrated a lot of the times. Sometimes I write down what I am feeling and give them the letter but I don't know if they actually read it or not because it's never said in the next meeting. What can I do to make this better?
Answered by Dr. Abhijeet Deshmukh 12 hours later

The thoughts you have expressed in this message are important. You have narrowed down on the core thoughts that lead you to suicidal thinking.

The feeling of loneliness is there at the base of it. However, when we say 'feeling of loneliness', it is usually a 'thought that I am lonely'! Which means, even if you know people around you care for you and are there for you, you are still somewhere thinking in your mind that you are alone. Through therapy, you can learn how to go further with this thought and examine it for your benefit. Also, there may be some disturbing and strong beliefs attached to that thought, which need to be explored.

When you think only God loves you and that is where you want to go, you do have an option of thinking that "I don't need to think suicidal ideas to reach God. XXXXXXX

What this means is the notion of God exiting somewhere outside this life may be a subjective opinion. Without venturing into the realm of spirituality, I may add that the existence of God can be found into the things we do or people we love and care for.

As I mentioned earlier, we will not attempt therapy here on this platform, as it won't be appropriate and fitting for the seriousness of the matter. You might look for a therapist who is trained in CBT or REBT. The mental health care system may not have enough trained therapists, and the professionals you have shared you thoughts with may not be adequately trained to handle this information or matters of emotional disturbances. That's the reason you got the feeling that your thoughts are not understood.

Can you find out if your current therapist has a training in CBT or REBT? You might want to look for one, if needed.

Take care.
Above answer was peer-reviewed by
Follow-up: Is there any way of controlling suicidal thoughts stemming from sexual abuse? 1 hour later
That was a brilliant post you wrote Dr. I certainly will ask if there is someone trained in this. The news came on yesterday talking about suicide and they said that many of those who committed suicide had attended a mental health clinic. They also said like you did that there needs to be a review done and much more training for therapists in this area. But I think patients need training too Dr. in being able to express Precisely what way they think and feel. We're going in there and we don't even know ourselves. And we need more than anything to be able to say it in such a way that it won't sound foolish. I have often spoken with patients down there and many a time they have said to me something like - "Oh, I couldn't tell him that XXXXXXX Their biggest fear and mine of course is that we will get locked up and as much as I hate to say it there is huge embarrassment in going into what is still termed "The mad house XXXXXXX And the fear is not really being inside there but what others might think after coming out. So there is a huge amount of information being held back in this area and if this continues there will be very little progress and many people will continue to go on and commit suicide.
Answered by Dr. Abhijeet Deshmukh 1 hour later
You are quite right here. This can be a cause for concern for the mental health profession. The part of the world I practice in is a bit more free as far as expression in therapy is concerned. And I presume there's a slight dichotomy out there. On the one hand, the laws are strict as far as monitoring mental health issues is concerned, as is evident from the fear expressed by individuals regarding getting locked up. But on the other hand, there is still a lot of stigma attached to therapy and the system is not prepared to handle these issues in a more humane way.

The process of therapy involves (or should involve) a therapist who is unbiased and neutral. And thus, whatever thoughts are expressed by the client need not be judged. But the fact that clients still are not able to say all they want to say for the fear of sounding foolish, says a lot about the services.

In my opinion, one should still try to find a way out of this. A lot of work can be done at the individual level. A proper understanding of the therapy technique before the work begins gives you a freedom of choice. A choice to express; also a choice to not feel too disturbed if you are not able to express certain things. And the therapist is the person who needs to help you with this.

If you are comfortable with it, can you let me know how you might proceed if you had to successfully deal with your suicidal thoughts at present? The purpose of this question is for me to be sure you take at least something out of our conversation here and are able to prevent yourself from acting on your thoughts in any way.

Take care.

Above answer was peer-reviewed by
Follow-up: Is there any way of controlling suicidal thoughts stemming from sexual abuse? 5 hours later
Oh, don't worry Dr. I am taking plenty out of this conversation. Much more than you realise. I know that I have gone down very deeply this week and I know that I am not fully up there yet. I didn't have a great session below in the clinic today really. A lot of the times I came away very uplifted but today I didn't. I felt afraid again in the corridor waiting for the doctor and when I went in I did tell him how I felt but when he asked me certain questions I did try to answer them but I was watching my words very carefully. However he does know that I have contemplated suicide and I think I did pretty well in conveying the message to him. I stayed very serious throughout it all because really Dr. this time above any other time I felt more unsure of my thoughts and actions. Then I went to see another man who I usually ends up making me laugh but today I couldn't. I didn't come away feeling worse - I just came away feeling serious and when I got into the car I could feel myself becoming emotional and upset. On the way home I just felt that life was pointless and that I was too tired from all this and I was so tempted not to go home. But I did and somehow I got through the day and now I am writing to you. Now tomorrow I have the meeting with my new therapist about the abuse but I will go and I don't want to put this off just because I feel bad. Maybe this will pass - maybe it won't for a while. All I am doing now at the moment is sitting with it but that awful loneliness is still there. The clinic below worked a lot for me before but in the last few months I have been looking other places and I have found the internet invaluable at the moment. I think the best thing about here is that I can sit and type what I really feel like and know that the computer can't lock me up. And it seems so private to me as well and so far the people I have met on here (which is very little because I am aware that others can read this) are extremely helpful, understanding and non-judgemental. Yet, there is an amount of valuable tools given that I can use for my benefit. So this works for me now at the moment and I think many people could be helped in this way too. I would love to see it become a big part for the mentally ill.
Answered by Dr. Abhijeet Deshmukh 9 hours later

I wish you good luck with your session for today. The more connected thoughts you are able to explore and express, the better the outcome is likely to be.

This particular conversation is not open to public, and so it is pretty confidential. You are right in saying that sitting at home and typing your thoughts helps. You can chose the most appropriate words and write, and edit, which is not an option in a face to face session.

I hope this has been helpful to you. You may close the query if you think this is adequate for the time.

Take care.

Abhijeet Deshmukh, MD
Above answer was peer-reviewed by
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