Suicidal Impulses - Violence

'Suicidal impulses are the mirror opposite of homocidal impulses' - Janina Fisher [Janina Fisher, Ph.D. is a licensed clinical psychologist and a former instructor, Harvard Medical School. An international expert on the treatment of trauma, she is an Advisory Board member of the Trauma Research Foundation and the author of three?books, Healing the Fragmented Selves of Trauma Survivors: Overcoming Self-Alienation (2017), Transforming the Living Legacy of Trauma: a Workbook for Survivors and Therapists (2021), and The Living Legacy Instructional?Flip Chart?(2022). She is best known for her work on integrating mindfulness-based interventions into trauma treatment, and she is also the creator of Trauma-Informed Stabilization Treatment (TIST) therapy.]

We are here talking about the impulse to violence, to achieve control over the other person or over one's own feelings

To the other and/or self-f/directed violence in the case of trauma and PTSD, are one response to the loss of control that follows the pain of trauma;

the violence serves a purpose. Always. The interesting question would be: what is behind ? what preceeds the violence ? what and where is the pain ? What and where are the resources? There are always resources; they may play hide and seek, too shy, too unsecure to show up in the front row of the dialogue or shall I say, the multilogue [my own neologism ;)]

After the suicide assessment, there is a fine balance between the therapeutic work and our legal frame. Taking into account where the patient is in relation with their suicidal ideation as well as their age

We are not focusing on the symptom, we open a wider space for the pain, the fear, the hopelessness to be recognized, seen, welcomed and reassured. Like we do for all symtoms. For this, we need to be trauma informed

We must see the person in their broad environments: time circle / line, history, generational history and listen to them. make no assumption, have that precious ability to be humble and listen. A person will express all that we both need to work with in the therapy relationship.

I know the importance of reminding myself to step back when I have my therapist cap.

I know the importance to show up as who I am as a person, mixed with my function of being a therapist

I know the importance of welcoming the person I am working with, the way they show up themselves on that day we are meeting

That allows the person to reconnect with who they are; a connected that has been damaged in the aftermath of trauma.

Let's welcome Vs diagnose