Caring for the person with suicidal thoughts
What you want vs What they want.
By Yole Guzman, April 2021
Hearing them disclose that they are having suicidal thoughts can be a very traumatizing and confusing experience. We may experience various emotions like anger and panic, as well as feel lost as to what to do next. In addition, our experiences will differ depending on our capacities and relationships to the individual e.g. as a parent or a clinician. As such, there is no one size fits all approach. However, in this article, we would like to highlight some common challenges and possible solutions when caring for a person having suicidal thoughts.
When a person shares with us that they are having suicidal thoughts, more often than not, a bunch of questions floods our minds. Questions like “ why would you do that?” or “why would you hurt me this way?” We may feel overwhelmed, panic stricken, angry even, and have a sense of looming uncertainty. In an effort to prevent the person from acting on their thoughts, we tend to want to clear all our doubts and queries, and to ensure that they are always safe. Sometimes, we may get a little over protective, such as prohibiting them to go out or constantly asking for their whereabouts.
However, if the roles were reversed, do you really want to answer a truckload of questions about suicide and what were your thoughts? Do you want to be constantly monitored and literally man-handled? Probably not. Our methods of allaying our worries may actually cause them to feel even more overwhelmed and stressed out instead.
So, what should we do? How do we prevent our loved ones from actualising their thoughts?
There are several ways we can prevent this.
Using the narrative approach. This is asking questions that allow you to gain a better understanding of their feelings and thoughts, allowing you to have a better grasp of the situation. More importantly, it gives them the space and permission to talk about themselves, in a way that they are most comfortable. It allows them to feel better connected to you, and to feel heard and understood. The approach uses questions that are open-ended, giving them the flexibility to give different answers, as well as the signal to elaborate. “What were the events leading up to your suicidal thoughts?”, “What are some things or people that make you feel better?”
Using validity techniques to better phrase our questions. One technique is normalization where we remove the stigma and judgement from our questions. An example is “ You know people who face similar situations do feel this way sometimes”. It signals to them that we have heard this before, and we do not judge and we will be able to handle it, together. This invites them to feel comfortable to share more now and in the future.
Working collaboratively to create a safety plan. A safety plan is a personalized, practical plan that can help them avoid dangerous situations and know the best way to react when they’re in danger. You can find one below. Engage them in conversation and pay attention to what they are saying. Offer your perspectives and thoughts as necessary.
Avoid coercion and “guilt-tripping”. Studies have shown that tools like suicide contracts or saying things like “I’ll leave you if you attempt suicide again” have the potential to do more harm than good. They create a disincentive for them to tell you about their future thoughts, potentially because they fear your rebuke and fear feeling guilty.
About the writer
Yole Guzman believes in the power of relationships. A name concocted from a stupid mistake, it has now become a name in which their friends find solace in. yole guzman hopes that every individual will be able to find the same support from friends and family around. yole guzman hopes you won’t give up. Keep fighting!
Edwards, S. J., & Sachmann, M. D. (2010). No-suicide contracts, no-suicide agreements, and no-suicide assurances: a study of their nature, utilization, perceived effectiveness, and potential to cause harm. Crisis, 31(6), 290–302. https://doi.org/10.1027/0227-5910/a000048
O’Neill, M., and Stockell, G. (2011). Reconstructing identities and inviting preferred stories of self: Narrative practice in mental health settings and prisons. Friday Afternoons at Dulwich Centre.
Shea, S. C. (1999). The practical art of suicide assessment: A guide for mental health professionals and substance abuse counselors. John Wiley & Sons Inc. pp. 136-137.
Suicide – CHAT – Community Health Assessment Team. (n.d.). Retrieved September 08, 2020, from https://www.chat.mentalhealth.sg/mobile/get-the-facts/suicide/