What Happens When You Tell a Therapist You’re Having Suicidal Thoughts?

By M.B.S. Whole Health | September 22, 2026 | Comments 0 Comment

Content note: This article and the accompanying episode discuss suicidal thoughts and self-harm without graphic descriptions. Please care for yourself as you read. If you need immediate emotional support in the United States, call or text 988 or visit 988lifeline.org. If you or someone else is in immediate danger, call 911 or go to the nearest emergency room.

There are some words people are afraid to say out loud.

“I don’t want to be here.”

“I’m having suicidal thoughts.”

“I need help.”

Sometimes the fear is not only about admitting how much pain they are in. It is also fear of what will happen after they tell someone. Will their therapist panic? Will the police be called? Will they automatically be sent to a hospital? Will people see them differently?

Those fears can create silence at the exact moment honest support is needed.

In this episode of This Therapist Has Problems, I sat down with Amy Campi, LPC, LCDC for a candid conversation about suicidal thoughts, safety planning, therapy, and survival. Amy brings both lived experience and the perspective of a trauma-focused clinician. Her honesty gives us room to talk about something many people experience but still feel ashamed or afraid to name.

Suicidal thoughts do not always tell the whole story

One of the most important ideas in our conversation is that a suicidal thought may reflect a wish for overwhelming pain, fear, or pressure to stop. That does not make the thought unimportant. It means we need to slow down and understand what the person is actually experiencing instead of responding only to the most alarming word.

Amy described recognizing that she was in trouble and telling someone because she sensed that things could get worse if she stayed silent. That moment of reaching out mattered.

People may experience suicidal thoughts differently. Some thoughts may be brief or passive, such as feeling that they do not want to wake up or do not want to keep living this way. Other situations may involve greater immediacy, intent, planning, access, or preparation. These distinctions matter because support should match the person’s actual level of risk and need.

No article or podcast can assess an individual person’s safety. If the thoughts feel immediate, if there is an intention to act, or if a person cannot stay safe, call or text 988, call 911, or go to the nearest emergency room.

What happens when you tell a therapist?

Many people believe that mentioning suicide in therapy automatically leads to hospitalization. That fear may keep them from being honest.

A thoughtful clinician should ask more questions. They may explore how often the thoughts occur, whether they are happening right now, whether there is a plan or intent, whether the person has access to a way to harm themselves, what has helped them stay safe, and who can offer support. The clinician should also consider the person’s history, current stressors, protective factors, willingness to engage in care, and ability to follow a safety plan.

The goal is not to punish honesty. The goal is to understand the full picture and identify the safest, most appropriate level of support.

For some people, that may mean more frequent outpatient therapy, involving a trusted support person with permission, medication evaluation, an intensive outpatient program, or a partial hospitalization program. When the danger is immediate or the person cannot safely remain in the community, inpatient or emergency care may be necessary.

The right response is not one-size-fits-all.

A safety plan is more than a sheet of paper

As we discussed in the episode, a safety plan is not a guarantee that a crisis will disappear. It is a practical resource created before or during a difficult period so a person does not have to identify every next step while overwhelmed.

A safety plan may help someone identify:

Personal warning signs that a crisis is building
Coping strategies that can create a pause
People or places that provide distraction and connection
Trusted people who can offer direct support
Therapists, medical providers, crisis lines, and local emergency resources
Ways to reduce access to things that could be used for harm

The plan should be specific to the individual and created with a qualified professional whenever possible. Its purpose is to make support visible and easier to reach when the person’s thinking has narrowed around pain.

Asking directly does not plant the idea

Friends and family may notice that something is wrong but hesitate to ask about suicide because they fear introducing the idea. Research summarized by the National Institute of Mental Health shows that asking directly does not increase suicidal thoughts or behavior.

You can ask calmly and clearly: “Are you thinking about suicide?”

Then listen. Do not debate, shame, lecture, or rush to make the person reassure you. Ask what they need. Help them connect with support. If they are in immediate danger, do not leave them alone while you contact 988, 911, or emergency services.

NIMH offers five practical action steps: ask, be there, help keep the person safe, help them connect, and follow up. Read the complete guidance at NIMH.

The right therapist matters

Amy also spoke honestly about not connecting with her first therapist. That does not mean therapy cannot help. It means the relationship matters.

You deserve a therapist with whom you can say the difficult thing. You deserve someone who can remain present, ask thoughtful questions, and respond without shaming you or making their own fear the center of the room.

The first therapist may not be your therapist. It is okay to ask about a clinician’s experience with trauma, suicidal ideation, self-harm, and crisis assessment. It is okay to tell a therapist that the fit does not feel right. A caring provider can help you transition instead of leaving you unsupported while you search.

This moment is not the whole story

There may not be one dramatic moment when everything changes. Recovery can look like finding the right therapist, learning what triggers a spiral, involving supportive people, creating a safety plan, and remembering that an intense moment can pass.

Amy described how the thoughts became less frequent and less consuming over time with the right therapy and support. That is not a promise that every journey will look the same. It is a reminder that pain can change, support can help, and a person’s story is bigger than one difficult moment.

If you are struggling, please tell someone. A friend, family member, therapist, medical provider, spiritual leader, or 988 counselor can help you take the next step. You do not need perfect words. You can begin with: “I am not feeling safe, and I need support.”

This is not the end of your story.

Please watch the full conversation, then share it with someone who needs permission to say the words out loud.
Episode link: Say It Out Loud

About Amy Campi, LPC, LCDC

Amy has worked in the mental health and substance use fields since 2004. Before completing her advanced degree, she worked in a locked psychiatric unit for high-risk adolescents and as an adult probation officer with a high-risk caseload. Her postgraduate experience includes substance use evaluations, nonprofit organizations, intensive outpatient programs, private practice, and facilitating psychoeducational groups in jails. In private practice, Amy specializes in working with women who have experienced complex trauma and/or are struggling with substance use.

Amy is currently accepting new clients in Texas. She offers virtual sessions throughout the state and in-person sessions in Plano. She accepts UnitedHealthcare, Cigna, and Aetna, as well as private pay and clients using out-of-network benefits. Insurance participation can change, so prospective clients should confirm current coverage directly with the practice.

Learn more at Pirouette Counseling or connect with Amy Campi LPC, LCDC on Facebook.

Crisis and treatment resources

988 Suicide & Crisis Lifeline: Call or text 988, or chat at 988lifeline.org. Available 24/7 in the United States.
Find mental health and substance use treatment: FindTreatment.gov
How to help someone who may be having suicidal thoughts: NIMH’s 5 Action Steps
If you or someone else is in immediate danger, call 911 or go to the nearest emergency room.

Educational disclaimer: This article and podcast are for education and general information. They are not therapy, medical advice, diagnosis, crisis assessment, or a substitute for care from a qualified professional who understands your individual situation.

Dusting Off the Microphone: What the Silence Held 🎙️

By M.B.S. Whole Health | July 17, 2026 | Comments 0 Comment

The Truth About Silent Grief After Pregnancy Loss

It has been forever since I posted an episode of This Therapist Has Problems Podcast.

For months, I thought about how I would come back. Do I just press record and move forward like nothing happened? Do I jump into the next topic? Do I avoid the personal update and keep it professional?

But if you have been here before, you already know this podcast was not created for surface-level conversations. This space was created for honesty, transparency, and real conversations about the things we often carry in silence. 🤍

So as I launch Season 2, I am dusting off the microphone and sharing what the silence held.

The vulnerability hangover is real 🫣

I will be honest. This episode felt vulnerable in a way I did not fully expect.

There is a difference between sharing from a healed place and sharing while still feeling the tenderness of what happened. I had to sit with whether I was ready to say certain things out loud. I had to ask myself if sharing this story was necessary, helpful, or simply too much.

What I came back to is this: some stories are hard to tell because they are connected to the parts of us that are still healing.

And sometimes, even when it feels scary, telling the truth gives somebody else permission to stop carrying their pain alone.

What happened behind the silence 🌿

In this episode, I share a personal life update about an unexpected pregnancy after having my tubes tied, the concern for a possible ectopic pregnancy, repeated blood work, physical pain, fear, and ultimately the emotional weight of miscarriage.

This was not something I planned for. It was not something I expected. And it was not something I knew how to quickly process.

There was a lot happening at once. Medically, I was being told that the loss may have been the best-case scenario because of the risk connected to a possible ectopic pregnancy. Emotionally, there was nothing about it that felt simple, easy, or like good news.

That is the part I wanted to give language to.

Sometimes grief is complicated. Sometimes grief shows up even when the situation was not something you asked for, planned for, or thought you wanted. Sometimes your mind understands one thing while your heart, body, and spirit are trying to catch up.

Grief does not always come with condolences 🕊️

One of the thoughts that stayed with me is that sometimes grief does not come with condolences.

Not because people do not care, but because they may not know what to say. They may not understand why something hurts as deeply as it does. They may be focused on the medical outcome, the practical details, or the fact that things could have been worse.

But grief does not need permission to be real.

You do not have to justify why something hurt you. You do not have to prove your loss was big enough. You do not have to explain why you are grieving something that was unexpected.

If it mattered to you, it matters. 🤍

Why this conversation matters right now ✨

This episode is also being released during National Minority Mental Health Awareness Month and in recognition of Black Maternal Mental Health Week, observed July 19 through July 25.

That timing matters.

So many Black women and women of color are carrying reproductive grief, pregnancy loss, medical trauma, fear, confusion, and silent pain while still being expected to function, work, care for others, and keep going.

We are often praised for being strong, but strength does not mean we are not hurting.

Strength does not mean we do not need support.

Strength does not mean we should have to process grief in silence.

This conversation is not just about my story. It is also about creating space for the stories that often go untold.

Listening to your body matters 💛

One of the biggest reminders from this experience was the importance of listening to my body.

I knew something was off before I had answers. I could feel that something was not right. And because I listened, I was able to get medical attention before things became more dangerous.

I want to be clear that this episode is not medical advice. But it is a reminder to pay attention to your body, ask questions, advocate for yourself, and keep pushing when something does not feel right.

Your body matters.

Your concerns matter.

Your questions matter.

Healing does not mean pretending it did not happen 🌱

Healing did not mean I stopped feeling anything. Healing did not mean I was suddenly okay. Healing did not mean I could check grief off a list and move on.

Healing looked like resting when I wanted to keep pushing.

It looked like crying when I needed to cry.

It looked like allowing myself to be human, even as a therapist.

It looked like giving myself permission to not have all the answers.

And slowly, the grief did not feel the same way it felt in the beginning. It was still real, but it was not as heavy every single day.

That is what healing can do. It may not erase what happened, but it can teach you how to carry it with more gentleness.

A reminder for anyone holding silent pain 🤎

If you have been carrying something quietly, I hope this episode reminds you that you are not alone.

Your story matters.

Your body matters.

Your grief deserves space.

Even if it happened years ago.

Even if other people did not understand.

Even if you minimized it because you thought you had to be strong.

Even if you never gave yourself permission to call it grief.

It is not too late to acknowledge what happened, honor what you lost, and make room for your own healing.

Watch the full episode 🎧

Season 2 of This Therapist Has Problems Podcast begins with honesty, vulnerability, and a reminder that therapists are human too.

Thank you for stepping back into my office.

Watch the full episode on YouTube: Dusting Off the Microphone: What the Silence Held

Resources and support 🤍

If this episode brings something up for you, please know that you do not have to process it alone. Whether your experience is recent or something you have carried quietly for years, support is available.

Pregnancy loss and grief support:
Share Pregnancy & Infant Loss Support offers support for those impacted by pregnancy loss, stillbirth, or infant loss, including help finding support by state.

Miscarriage, loss, and grief education:
March of Dimes has resources for miscarriage, pregnancy loss, grief, and finding comfort after loss.

Maternal mental health support:
The National Maternal Mental Health Hotline provides free, confidential, 24/7 support for pregnant and postpartum individuals and their families. Call or text 1-833-TLC-MAMA.

Perinatal mental health and support groups:
Postpartum Support International offers a HelpLine, online support groups, and resources for pregnancy, postpartum, pregnancy loss, and pregnancy after loss.

Black maternal mental health support:
The Shades of Blue Project focuses on maternal mental health support for women of color and minority communities, including Black Maternal Mental Health awareness and resources.

Black maternal health advocacy and education:
Black Mamas Matter Alliance centers Black mamas and birthing people through advocacy, research, education, and Black maternal health resources.

Immediate emotional crisis support:
If you are in emotional distress, experiencing thoughts of suicide, or feel unsafe, call or text 988 to reach the Suicide & Crisis Lifeline. If you are in immediate danger, call 911 or go to the nearest emergency room.

Please use the resources that feel most supportive for where you are right now. You deserve care, support, and space to heal.

Disclaimer

This blog and podcast episode are intended for informational and educational purposes only. The content provided is not a substitute for professional mental health care, therapy, or medical advice and does not establish a therapeutic relationship. If you are experiencing a mental health emergency, please call 911 or go to the nearest emergency room. Please reach out to a licensed mental health or medical professional in your area for personalized support and guidance.

Tag: MBS Whole Health