That seemed to quell the suicidal episodes for a while, as she entered a day treatment program. But months later, she paged Shrand to cancel her next day appointment -- and all of her therapy sessions.
"I don't remember a lot of it," Jan told ABCNews.com.
In therapy, Jan had promised she would call Shrand if she ever felt the urge to use the razors again. But now, on the phone, she told him she had a gun.
"You can't live with a gun, Jan," he responded. "It's too quick, too permanent. You changed the rules. I can't live with that either."
Shrand struggled with whether to call the police or 911. But he remembered they had a trust, and the fact that she had called "meant something."
"A promise is a nebulous agreement between two people," writes Shrand, telling the story. "But in therapy, it represents trust: A patient who trusts their therapist is one thing, but when a therapist has trust in a patient, it lets them know of that bond, that attachment, remarkable things can happen."
Shrand told Jan she could not be his patient if she had a gun and he expected to see her (and the gun) at therapy the next morning. No shots went off and she showed up the next day.
It was a turning point, according to Jan.
"He chose not to call the cops," she said. "He said, 'I trust you and see you in the morning.' It made me feel like I am OK, that I matter to someone. He didn't flip out and call 911."
The next day, all the secrets poured out -- her military officer father had sexually abused her and so had her brother. Jan was even able to confront her mother -- and her estranged brother -- and tell the truth.
The healing, over a decade of therapy, began and today, Shrand counts Jan as one of his biggest success stories.
Humans are social creatures, according to Shrand, and they need to trust each other for survival.
"In our heart of hearts, we just want to feel valued by another human being and if you think about the evolutionary perspective, it makes enormous sense," he told ABCNews.com. "If I don't feel any value to the world, I might as well not exist."
Listening to the person with suicidal thoughts and acknowledging their emotions, rather than telling them to "pull themselves up by the bootstraps," is also important, Shrand said. "It doesn't mean we condone it or like it, but we have to respect it."
When a person trusts another, the hormone oxytocin, which promotes bonding and attachment, is released, he said. "You feel that pleasure again."
And so did Jan. She moved to Kentucky in 2002 where she now has a large support group of friends and co-workers to keep an eye on her.
"I am in great shape and people love me," she said.
She has forgiven her brother.
"He's my only living relative," said Jan. "Why hold grudges over things in the past. I know a lot of people couldn't understand that, but I could relive the horror. I realized I had to stop the wheel [of anger] to go on."
Jan still has a "rocky" relationship with her daughter, who is now 24 and back living in Boston. But she knows now she loves her unconditionally.
She finds joy in caring for her five dogs -- at one point she had 11. She attends a "big old" Christian church she laughingly calls, "Six Flags Over Jesus," and says she loves her work as a parts manager for a tractor company: "I put 200 percent into my job."
"I have learned a lot about myself," she said. "I am a good person. I am working. I can do good and I can help people."
A co-worker was recently injured and has been depressed.
"I am blunt with him -- I say what is in my heart," Jan said. "I learned I need to be honest and blunt about my feelings. ... They were stuffed so way down deep, I didn't know what a feeling was."
Twice, close to the holidays, she slipped into a depression and checked herself into the hospital.
"I survived hell," Jan said. "My brother and father put me through hell, and I am still alive. And yeah, I'm glad to be alive."
For help or to report a suicide, contact the National Suicide Prevention Center Lifeline at 1-800-273-TALK (8255).
The following are signs that might indicate the risk of a suicide attempt:
Talking about wanting to die or to kill themselves;
Looking for a way to kill themselves, such as searching online or buying a gun;
Talking about feeling hopeless or having no reason to live;
Talking about feeling trapped or in unbearable pain;
Talking about being a burden to others;
Increasing their use of alcohol or drugs;
Acting anxious or agitated; behaving recklessly;
Sleeping too little or too much;
Withdrawing or isolating themselves.
Showing rage or talking about seeking revenge.
Displaying extreme mood swings.