What I'm doing isn't working out so well. That much is clear to me.

[stolencrumbs]

Mod note: This thread is a continuation of the following thread: https://bpdfamily.com/message_board/index.php?topic=333139.0

Yeah, what I'm doing isn't working out so well. That much is clear to me.

It is tough. I think she would say that she is asking for help. She wants help changing the circumstances (house, place, etc.) because she sees those things as the primary problems. I see those things as real issues, but ones that are imminently solvable in a relationship with two reasonably emotionally healthy people. The primary problem, in my view, is that we have dealt with these issues in terrible, destructive ways. She thinks if we fix the other stuff, the destructive patterns will stop. I think we need to fix the destructive patterns in order to address the other things.

So we have a pretty fundamental disagreement about what the main problem is. I don't think it's my job to decide for other adults what is really most important to them, or what their real problems are. We might do that with children. But my wife isn't a child and I don't want to treat her like one. So these things are important to her. I feel like I should be supportive and do what I can to make those things happen. Part of what I'm hearing you say is that I should think differently about what it means to be supportive. I should be more supportive of her doing things to make those things happen. I agree with that, at least in the abstract. I don't know what it means in real life. She's not doing anything. She's spiraling downhill. And the only out she sees is moving. I don't think that's the only out, and I don't think that magically makes everything better. But it is what she wants and what she is fixated on, and I can either get on board and try to make it happen, or not. I don't know what the supportive, encouraging, positive, other option is. It feels like the option is to not do the things she says are necessary to establish the baseline she needs to work on anything else. And maybe that is the option, and she can decide if she wants to be with someone who isn't doing those things.

I'm not sure what my point is anymore, or if I have one. Pretty sure I'm just rambling, but I appreciate the opportunity to ramble.

[Cat Familiar]

Would you say anything has gotten better since when you first began posting here a few months ago?

In the past when you've made big life changes hoping that she would get better, how did that work out?

Is moving something that you'd like to do, or would you be doing it only to appease her?

Is she still seeing a therapist? Are you? Has that been helpful for you? For her?

[stolencrumbs]

So again today I did not hear from her until after 10:00 pm. I went over there after vague suicide talk. Got screamed at for a while. You just left me here for four days. You just send your little email and pat yourself on the back and leave me here to die. I wouldn't do that to my worst enemy. You want me to die. You're trying to kill me. Why would you do that? Who does that? You're a monster. You don't do anything. You're a coward. And so on... .

I don't have any idea what to do. My T's advice is ignore the emails/texts, don't go over there when they start, and call the police if she threatens suicide. Okay, then what? She spends 3-14 days in a not-very-good mental hospital and comes home and... .something is somehow better? I'm not seeing that.

 

[stolencrumbs]

Would you say anything has gotten better since when you first began posting here a few months ago?

In the past when you've made big life changes hoping that she would get better, how did that work out?

Is moving something that you'd like to do, or would you be doing it only to appease her?

Is she still seeing a therapist? Are you? Has that been helpful for you? For her?

I wouldn't say things have gotten better. I think I'm maybe better at not making things worse, but that hasn't resulted in things not actually getting worse. There are fewer broken dishes, pots, appliances, and such, though we have had some dishes, a window, and lots of dents in walls/doors. There are fewer endless, circular conversations, though those conversations have mainly been replaced with screaming and crying. Not sure that's an improvement.

We moved about ten years ago. She was not doing well at all. At the time we called it depression. Anyway, the move helped. It worked out for me, too, though it was not an opportunity I would have looked if she had been mentally okay. The more recent move obviously didn't work out that way.

I don't really know how to sort out what I think about moving now. In a world where we are a functioning couple, I would be okay with moving. I don't have any particular love or attachment to where we are, other than my job. If I found a comparable job in a different place, I'd be up for moving, and would probably get excited about it. But given all that is going on, it feels like doing it to appease her, and I don't like that.

I do still see my T. I don't know how helpful it is at this point. She has been helpful for me, though I'm not sure how much I am getting out of it now. I don't know if she is seeing her T or not. I can't tell that there has been any improvement or change in the time I know that she was going.

[Enabler]

I had a bunch of other questions I thought about asking, about whether or not any move would be a long term solution (in your mind) to her inner sadness... .but actually, and I only ask this because I think you're very capable of philosophical deep thinking... .

Why do you care whether or not she kills herself?

If she actually killed herself how would you feel?

If she actually made a determined attempt to kill herself could you actually do anything to prevented it?

Enabler

[formflier]

  But my wife isn't a child and I don't want to treat her like one. 

Correct!   

Now... .thing about times when she has dysregulated.  What was she acting like in those times?

How do you think she feels about those actions when the dysregulation is over? 

FF

[formflier]

So again today I did not hear from her until after 10:00 pm. I went over there after vague suicide talk. Got screamed at for a while. You just left me here for four days. You just send your little email and pat yourself on the back and leave me here to die. I wouldn't do that to my worst enemy. You want me to die. You're trying to kill me. Why would you do that? Who does that? You're a monster. You don't do anything. You're a coward. And so on... .

I don't have any idea what to do. My T's advice is ignore the emails/texts, don't go over there when they start, and call the police if she threatens suicide. Okay, then what? She spends 3-14 days in a not-very-good mental hospital and comes home and... .something is somehow better? I'm not seeing that.

Has you T explained the reasoning or "theory" behind the advice?  (OBTW... .I think your T is giving good advice.  Very important you understand it)

I'd like to understand your decision making about staying to listen to that "speech" she gave you? 

Did things improve because you stayed to listen?

What did your wife learn from this experience?

FF

[stolencrumbs]

I had a bunch of other questions I thought about asking, about whether or not any move would be a long term solution (in your mind) to her inner sadness... .but actually, and I only ask this because I think you're very capable of philosophical deep thinking... .

Why do you care whether or not she kills herself?

If she actually killed herself how would you feel?

If she actually made a determined attempt to kill herself could you actually do anything to prevented it?

Enabler

No, I don't think I can prevent her from killing herself if she is determined to do that.

I've tried to imagine it and what I would feel. Some anger, some guilt. Sadness. Probably some relief, which scares me that I think that. I think I'd feel a bit lost for a while.

That first question is a doozy. Aside from selfish or self-interested reasons, I think there is beauty and wonder and joy and passion in the world that she will experience, and that she'll create. I think the world is better with her in it. Even now, there is a web of people who love and care about her, and who she loves and cares about. Those relationships have value. She often tells me she is like a rose, and I think there's a lot of truth in that. They are persnickety plants. They need lots of care and need to be in the right conditions. But when they are, they are wondrous. I believe there is some combination of things, some way of fitting the puzzle together, that creates the right conditions for her to bloom, and I think the world is better with those blooms in it, and she is better when she has some flowers on the canes instead of just thorns. Her life has value.

Of course, that's true of almost every one--that their lives have value. So why do I care about hers? I guess I think that's what it means to love someone, and I don't love everybody.

 

[stolencrumbs]

ff,
She feels humiliated. She can actually articulate that.

No, I don't think things improved. Things also didn't get worse, at least not in the moment. I think the message, and this is what my T says, is that the way to get my attention and get me to come over is to escalate, threaten suicide, etc. So I reinforce that when I show up.

Why do I keep doing it? I don't know. Because I don't have an alternative plan that I have any confidence in, either in it helping or in my ability to stick to it.

[formflier]

ff,
She feels humiliated. She can actually articulate that.

No, I don't think things improved.

Things also didn't get worse, at least not in the moment. I think the message, and this is what my T says, is that the way to get my attention and get me to come over is to escalate, threaten suicide, etc. So I reinforce that when I show up.

  Because I don't have an alternative plan 

There is lots to work with here.

What are the conversations like when she articulates humiliation?  I'm especially interested in your responses.

You love her and obviously want to help.  There is understanding that your actions reinforce her bad behavior.

Can you see a pathway to use your love for her to STOP reinforcing bad behavior.  I get it that you aren't clear on what to do.  Perhaps we can focus on that as a separate.

FF 

[stolencrumbs]

I don't know that there have been actual conversations about that. She will occasionally scream it out. She feels humiliated when I don't respond or don't come over because she is screaming out in pain to someone who isn't doing anything. She feels humiliated when I do come over because it's humiliating to have me see her disintegrating. And she's humiliated that she's in a position (from her point of view) that she needs me. So there's lots of humiliation to go around.

I don't recall any specific responses to that. I suspect I've mostly ignored it, or not directly responded to it in any meaningful way.

I can see the broad outline of a pathway, but yeah, I don't know what the details of that path are. I do love and care about her, and I do want to help. What I am currently doing and have been doing for years is not helping. It's not caring, or at least not effective caring, to keep doing things that are at best not helping, and likely making or contributing to things getting worse. So if I love her and want to help, that means figuring out some different way of going about things.

My T likes to tell me that it is very unlikely that I will come out of this looking like the good guy in my wife's eyes. I think I'm okay with that. But I do want to feel confident that what I'm doing is actually the right thing, and I'm not really anywhere close to that.

[Enabler]

A friend at church once told me a story after I had told him about my compulsion to ‘stick around’ so my W wouldn’t self harm in the early parts of our relationship and marriage. He lived with a woman who threatened and attempted suicide regularly. He said he got to the point where he had to accept that he may come home to find her dead, and that that wasn’t his fault and there was nothing he could do about it. If she chose to kill herself then there was almost nothing to do to prevent it in the long run.

I understand your rationale for wanting her to live, maybe you don’t have romantic feelings to her anymore, maybe that has been killed over the years, but I hear you. Is it fair to say that you think it would be a tragic waste of a life, you see so much potential for thriving if she could just get herself together? If you could just split the two people and allow the BPD bit to kill herself leaving the non inside to flourish.

I also see how you feel compelled to come to the rescue, feel compelled to ‘be around’... .‘just in case’. The risk of not is too much, the risk of seeing what happens might be catastrophic? Do you feel like you’d be cruel leaving her when she cries? Like a baby crying when you put them down (a babies cry is excrutiating for its parents, it almost has the perfect pitch and tone to hurt your insides and rattle your brain... .weirdly it might not sound too bad for other people)? 10 minutes can seem like an eternity watching a baby monitor flash to red. I guess your anxiety goes through the roof, only compounded by your W’s text, email, phone pleas for help during and berating afterwards as to why you didn’t come.

Then comes the shame. “You came but now I’m ashamed of what I did”. I don’t have easy access at the moment but there are some great diagrams on a PDF presentation if you google ‘Emotional cascade model’. It shows how emotional dysregulation (maybe due to fear of abandonment) feeds rumination which feeds maladaptive behaviours (suicide threats, self harm, drinking, casual sex, spending), which then leads back to further emotional dysregualtion due to feelings of guilt and shame post maladaptive behaviours which then leads to further maladaptive coping mechanism... .self feed self feed self feed.

As FF has pointed out, the suicide threats work, you come. Now how do you stop feeding those threats without he feeling the need to escalate or take the burden of responsibility of guilt for not acting. The question that maybe needs examining is, does she want you to come or does she want ‘someone’ to come? If she wants someone to come then the ambulance will do, if she wants you to come then sending an ambulance may stop the behaviour as it will be ineffective.

Sorry for my ramblings, I find advising on suicide threats so difficult because it’s literally life and death.

Enabler

[Red5]

... .I think there is beauty and wonder and joy and passion in the world that she will experience, and that she'll create. I think the world is better with her in it.

Wow, that's wonderful : )

... .I really needed to hear that today.

I am going to take this and keep it, if its alright Stolencrumbs,

Thank you in advance,

Red5

[formflier]

  But I do want to feel confident that what I'm doing is actually the right thing, and I'm not really anywhere close to that.

I'm a words guy and I totally identify with doing the "right" thing.  However... .I would suggest you think about the implications of that word... ."right"... .

It seems to suggest there is one "right" answer... .and more importantly that other answers are "wrong".

There is also the implication that if you find the "right" answer, she will be "Fixed" and all is well.  Sadly... .I wouldn't advise you to believe this.  I don't.  I used to...  

This BPD thing is so complex and irrational that I would encourage you to start thinking about

"helpful"

and

"healthy"

Then... .step 1

Have I done it before and has it been helpful or healthy.  That will take replicating prior actions off the table.

Then... .what is helpful for the suicide threat.  Well... .professionals are helpful.  They have specific training for this.  Calling them is helpful and healthy.

Note:   Your T again seems wise to me.  Please notice I don't put anything in my steps about your wife being happy or sad... .about your actions. 

If you have other ideas, we can help you think through if they could be helpful or healthy.

Hang in there... . 

FF

[stolencrumbs]

Red, use away!

Enabler,
This is much harder when suicide threats are involved. I so wish I had had more awareness and found the tools earlier in our relationship. It would be easier to test out different things if the consequence were that my wife will be mad at me or not talk to me or break a few things. None of that's good, but none of that is life or death.

I get where your friend is coming from. I prepare myself for that possibility any time I go out of town. I guess I don't quite believe that there is nothing I can do about it. I accept that if she really wants to do it, I can't prevent it. I can't make her want to live. But in the moment, it does seem like there are things I can do to make sure she doesn't die then. I agree there's not much I can do in the long run, but in any particular moment, shouldn't I do what I can, when I can?

Yes, I think that's fair to say. I do think it would be a tragic waste. I guess I don't quite think there are two people inside who should be split. I think there are benefits to her "emotional vibrancy," and it is part of who she is. I wish for her to be able to control or manage the negative and destructive aspects.

I do feel compelled to be around, and that is partly (largely) out of fear and the risk of not doing that. I am sure most of her threats have not been serious (meaning she was not at the moment actively thinking about killing herself), but what if I'm wrong about that? The cost of a mistake seems too great to take a chance.

I've been thinking a lot about whether I think it would be cruel to leave her to cry, and whether I feel anxious about it. I think that was true at some point in the past. At this point, I don't actually feel much anxiety or guilt about doing that. I mainly feel frustrated and angry and annoyed by it all, and it's mainly fear and obligation that seem to keep me doing the same things.

Does she want me to come over? Probably. I assume there is some payoff there in terms of her pain. Does she want just somebody there? Maybe, if they can do something that lessens her pain. Would sending the police over do that? I don't know. Maybe. And then what? I hate to keep saying that, but I do think about and mull over the effects that getting the police involved might have, and how that actually works.

Assuming the trip to the mental hospital doesn't magically make her not suicidal, what happens the next time she is? Does calling the police become the new way of dealing with those feelings? Or does she then feel like she can't possibly say to me that she is feeling suicidal because I will call the police, and so she says nothing. Neither of those outcomes seems positive.

[stolencrumbs]

ff,
I take your point about "right." I don't think there is one right answer, and I definitely don't think finding a right answer fixes everything. I guess I intend to the word to have moral implications, as I do think these are moral questions, and I think the moral dimension stretches beyond "helpful" and "healthy."

what is helpful for the suicide threat.  Well... .professionals are helpful.  They have specific training for this.  Calling them is helpful and healthy.

Are you sure about this? I'm not.

I don't have any other ideas, really. I have thought about whether I should talk to her family about it and let them in on the fact that she is suicidal. I don't really have a vision for how that is helpful, either, though. 

[formflier]

Are you sure about this? I'm not.

 

I'm positive.  100%.  I also really appreciate the nuance with which you are approaching these words and the issue.

Staying away from black and white is a very good approach.

Morality:  Human life is a precious thing.  If given the choice between protecting someones "feelings" versus protecting a human life... which is the moral choice?  

Does that calculus change if the human life belongs to the person whose feelings you are considering?  

I usually encourage people to resist dichotomous choices, since life is generally more nuanced and complex that a "this or that" question.

However, on questions of life it's basically a dichotomous choice.  For purposes of this discussion it is a dichotomous choice.  (the technical hedge is there is an arguable stage of "life" called a vegetative state.  While true it exists I don't think it applies to this discussion)

I've had personal experience with putting people in "psych hold" because of suicide threats.  I'm a retired Naval Officer.  Many things in the military are extremely stressful and suicide ideations sometimes arise in your people.

On the one hand I likely have more training than the average person in "dealing with suicidal people" and a tenant of that training says if better trained people exist... .use them

What you don't want to do is NOT avail yourself of the resources and have someone die.  There are NO DO OVERS.  

100% of the people I have sent to psych hold were alive after the ideations passed.  100%

Sadly... .I'm aware of some in the Navy that were told to go to their room and relax and "get over it".  They hung themselves and were found in the morning.  I wasn't directly involved in the event, but was directly affected... .since I had flown many hours in an airplane with him.  He was a good man and I can't begin to imagine what the issue was that would bring such a solid man to do this... and leave a family behind.

If he had been sent to medical... . very very sad.

So... .ask the question.  Which person/entity is likely to be more qualified to handle a suicidal person.  The family you are considering telling or the people that will get involved through 911 and the emergency room?

Does that answer your question?  

FF

[stolencrumbs]

It answers it. That doesn't (yet) mean I'm convinced.

100% of the people I have sent to psych hold were alive after the ideations passed. 

I don't doubt the effectiveness of getting someone through a crisis. I think the chances of suicide ideation passing for my wife in a matter of days or weeks is approximately zero. I'm not convinced of their ability to deal with chronic suicidality, or that going that route doesn't make things worse. 

[formflier]

  I'm not convinced of their ability to deal with chronic suicidality, or that going that route doesn't make things worse. 

I would encourage you to not conflate the issues here.  Yes... they are related... .but distantly so.

How does it work out if you hold of taking immediate action  and find the perfect provider for chronic issues?  More specifically... .does it matter if you deal with the chronic issues, if she is successful in the crisis?

Let those adept at working the crisis... work it... .every time. 

Seriously... .would you hold off calling the fire department because they don't know how to install fireproof materials in the rebuild?

The chronic issue is important but... .it's chronic.  By definition you have lots of time to deal with is

A crisis is... .by definition an emergency.

You don't have to know how to solve everything... .to act and solve what you can. 

Tough stuff to think through.

FF

[stolencrumbs]

I guess they seem more connected to me. Or maybe the question is this: What counts as a crisis?

She has been suicidal for at least four years. She has expressed a wish to die in various ways over a very long period of time. If every suicidal thought or statement is a crisis, 911 would be the most frequent number I called.

Do you call the fire department to put out the fire that's been burning for years, when the Vestal Virgins are hanging around making sure that fire keeps going, even after the firefighters leave?

At some point if the fire threatens to grow, yeah, give 'em a call. I guess this has been going on for such a long time, and I am so far into it, that I can't tell what's a crisis and what's not.

[stolencrumbs]

Morality:  Human life is a precious thing.  If given the choice between protecting someones "feelings" versus protecting a human life... which is the moral choice? 

The choice to me seems to be about what is most protective of her life, not about protecting her feelings.

Here's the fear that drives some of this. I call 911. Police show up. She gets a trip to the ER in a police car. She stays there until a bed opens at the psych hospital. She is there for 3 to 14 days maximum. She probably gets medicated. There is no contact between us for that time period. She comes back to the same situation she was in, only now she is more angry and feels more betrayed by me. She becomes suicidal again. She can't unload on me, because I've taken that off the table and replaced that with calling the police. So she is completely alone, without even the fleeting relief or coping strategy she had before. Does that make it more or less likely that she'll kill herself?

There are obviously other scenarios that aren't so grim, and I can't know the future. But the above seems likely to me. Of course, the outcome of continuing on the path we're on also seems grim. 

[formflier]

Do you call the fire department to put out the fire that's been burning for years

That would depend if you actually wanted the fire put out.

If you are ok with a fire continuing to burn... .the let people work with it that don't specialize in putting out fires.

If you want the best chance  to put out the fire... .call people that put out fires. 

How long a fire has been burning is not that relevant.  That you have a  fire that you want put out is.

FF

[formflier]

She becomes suicidal again. 

Professionals get called again.  Wash rinse repeat.

You are correct... the future is not knowable

Generally what is seen is the suicide threats stop getting them what they want... .so they try other tactics to act out.

Again... it's not knowable.  Don't make decisions based on fear of the future... make them on what is happening right now.

FF

[formflier]

I If every suicidal thought or statement is a crisis, 911 would be the most frequent number I called.
 

Yep... that could happen... .it is possible.  I don't think it is likely.

Use the dance analogy.  She is "dancing" with you and getting something out the dance.  She threatens... you give her attention.

If you change the dance... .she is FORCED to change.  She threatens... professionals come.  The dance changes.

We don't know exactly what dance she will do, yet we are positive she won't do the same dance, because YOU control NOT doing that dance.

You have a lot more power than you likely give yourself credit for having.

As one who has called 911 several times now... .the first call was the scariest.  Now that I've done it and can reflect.  I wish I had done it much... much sooner.  (my call was for DV... .not suicide, yet the fear of the call and the fallout of the call is the same)

Don't let fear of your wife feeling betrayed stop you.

They will feel betrayed.  They will deal with it.  That's not your circus.

FF

[stolencrumbs]

I don't think this is that relevant to your advice, which I appreciate, but just to give a fuller picture. She doesn't just threaten suicide when she is really upset, or late at night, or during a rage. She expresses it calmly. She expresses it when things aren't so bad. She has done so for years. This is what I mean when I say it is chronic. It is always there. You and I might think on any random night, I could eat Mexican or I could eat Chinese. She thinks I could eat Mexican, I could eat Chinese, or I could kill myself. It is always an option. It is an option that seems to bring her some comfort. It's like the terminal patient who goes through the process to get a prescription for assisted suicide, but never uses it. I assume they feel better having the option. I think that's how she sees it.

So, yes, I could stop my part of the "dance." But the dance is only one part of it all. 

And I'm not really scared of her feeling betrayed. She already feels betrayed. I'm scared of what the effects of her feeling betrayed (again) are, and of unnecessarily bringing that about.

[formflier]

 
So... .since you haven't "betrayed" her I'm assuming she is doing so much better... .right?

The benefit of not betraying is... ?

If there is reasoning that says... ."I know it's bad now... .but if I do x... .it's really going to be bad. "

Well... .why even use that reasoning at all.

FOG

Fear  Obligation  Guilt

IF you are using those to make decisions... .almost always... .almost always... .

You are hesitant to call because you (fill in the blank) her response?

Is fear the correct word to put there?

FF

[babyducks]

Hi stolencrumbs,

I have  been following along with your conversation and would like to add my thoughts.

Are you sure about this? I'm not.

I am also sure about this.   Getting professionals involved is helpful and healthy.  

Can I tell you it will go smoothly?   No, I am sure there will be moments of deep emotional pain for you.    Will there be immediately results for her?   Probably not.    It may be the opening of a new door, or it may not be.    What I am convinced of is it will be is a step in the right direction.    

Can I ask you a question?   Who do you think is the appropriate, helpful, healthy resource to assist your wife?   That's a real question and all possible answers are welcome.    All the way from 'No one will ever help my wife' to 'only I can help my wife'.    Who do you think is the best source of help for her?

Here's the fear that drives some of this. I call 911. Police show up. She gets a trip to the ER in a police car.

If I thought this is how things would play out I would be reluctant to make that 911 call too.    Can we look at this some more?    Typically suicide or psychotic behavior is considered a medical emergency, not a crime.  The police do show up, to escort the ambulance crew who will make a medical assessment.   Typically if transport is required it is in an ambulance under the care of the EMT, with police escort only if the person is combative or violent.    

She stays there until a bed opens at the psych hospital. She is there for 3 to 14 days maximum. She probably gets medicated.

She might indeed get medicated.    If violent or hysterical it is more likely an injection would be given to diffuse the immediate reaction.     If lucid the medications would only after a diagnosis and with discussion.   Medication against someone's will is a serious consideration and there are many many safeguards to prevent this from happening.

There is no contact between us for that time period.

 I am curious how you reached this conclusion.   Did I miss something?    Are you under the impression she would bar you from the hospital?   That you would have no contact with her mental health care team?    Are you not her nearest next of kin or her health care proxy?

She comes back to the same situation she was in, only now she is more angry and feels more betrayed by me. She becomes suicidal again. She can't unload on me, because I've taken that off the table and replaced that with calling the police. So she is completely alone, without even the fleeting relief or coping strategy she had before. Does that make it more or less likely that she'll kill herself?

I completely believe she will feel angry and betrayed.     Have you ever heard of cognitive distortions?    They are interesting things.   We all have them and we all do them, and in a nutshell a cognitive distortion is inflated thoughts that distort reality in a negative way.    Simple example:   I shouldn't take that test I will just fail it.

No one, including you can predict the future and say if she will be more likely or less likely.     There are many possibilities.    No certainties.    

'ducks

[babyducks]

She doesn't just threaten suicide when she is really upset, or late at night, or during a rage. She expresses it calmly. She expresses it when things aren't so bad. She has done so for years. This is what I mean when I say it is chronic.

I can see your point about the chronic versus crisis.   I would like to say that neither chronic or crisis should impact if medical care is required.     It is.    The only impact is how fast you get there.   

Would you consider a less abrupt method of mental health intervention?    Let's say the next time she mentions suicide you say "I think you should call the 1-800 suicide hot line, here is the number".   I rather suspect you are going to tell me she will react badly to that, I am sure she will.    Put the number where she can find it and drop the topic.    The next time she mentions suicide or dying you say " I still think you should call the 1 -800 suicide hot line number".   and yes she will tell you that's a bad idea and lots of reasons why.   

The third time mentions suicide or dying you say "I am going to call the 1-800 suicide hot line number to get some help."     Then call.    Speak honestly with the people on the phone.    99 chances out of 100 they are going to suggest immediate medical intervention.    Discuss this.    With your wife and the people on the phone.   Ask if she will go to the Emergency Room via car.  (be careful of this because she might try to jump out of the car in route).   If need be call again.   If she won't go to the ER, ask if she will see her doctor.    Make the appointment.   

And I'm not really scared of her feeling betrayed. She already feels betrayed. I'm scared of what the effects of her feeling betrayed (again) are, and of unnecessarily bringing that about.

stolencrumbs,... .'unnecessarily bringing that about'.    oh my.    that's gut wenching.   my stomach twisted up for you.    I have to ask though,... .what would have to happen before it became necessary?   


'ducks

[stolencrumbs]

Thanks 'ducks. I wanted to quickly respond to some of this, and think about the rest.    

The information I have comes from my T. The police are the ones who respond here. They are "trained" to do this, generally err on the side of caution, and take the person to the hospital for evaluation. The mental hospital here is almost always full and she would likely spent a lot of time in the ED waiting for a spot to open. And again, per my T, yes. At least for the first 72 hours, the mental hospital does not allow the person to contact anyone.

[babyducks]

. At least for the first 72 hours, the mental hospital does not allow the person to contact anyone.

I understand SC.   can I suggest you may want to be cautious about how you fill in the blanks around some of the information you have?   If the person can not contact anyone,   that's different from you not having contact with her mental health team.    there is differences between voluntary and involuntary holds, there is nuance to all of this.    the picture may indeed be difficult,  the local facility may be always full.    I would hope this doesn't translate to impossible.

'ducks