I firmly believe that suicide prevention starts with a conversation. A conversation that can stop suicide can be initiated by the person feeling suicidal or someone around them; regardless, a conversation is the starting point. But it can be very intimidating to talk about suicide. There are all kinds of “rules” when you talk about suicide, and political correctness affects the language you are “allowed” to use. I say forget all that. Suicide prevention starts with a conversation that makes sense to you, not the PC police.
World Suicide Prevention Day 2020 Starts Suicide Prevention Conversations (Hopefully)
World Suicide Prevention Day 2020 is September 10th. World Suicide Prevention Day is a day to take a careful look at suicide, suicide attempts and what we can all do to prevent them. Of course, as a person with bipolar disorder, I’m acutely aware that about 11 percent of people with bipolar disorder die of suicide and up to half of all people with bipolar disorder attempt suicide (more on talking bipolar and suicide here). However, while this is the case, it certainly doesn’t mean that people have to have bipolar disorder to be suicidal. Suicidality attacks so many for so many reasons; that’s why it’s up to all of us to work to prevent suicide and attempts.
But the thing is, this is hard. Having even a conversation around suicide and suicide prevention is hard. Just saying the word “suicide” to a loved one you think may be in distress, or saying the word “suicide” to a loved one when you are suicidal is a huge challenge. That’s why I think we shouldn’t put additional rules around that conversation. Yes, there are ways to speak about suicide and suicide attempts that are more recommended than others (and I’ll talk about some of that below) but what matters is that we start talking. What matters is that we start having suicide conversations — whether we get the technical details wrong or not.
Why Are Conversations that Could Prevent Suicide Hard?
Conversations can literally prevent suicide and suicide attempts and if we know this, then why are they so hard? Why do we avoid them so much?
Well, from the perspective of a person who suspects their loved one may be suicidal, it’s scary because of the threat of death. No one wants to believe their loved one is in so much pain as to consider suicide — so we deny that it’s even a possibility. If we don’t say it out loud then it simply doesn’t exist. Suicide is so scary so as to force that logical fallacy, denial, on people. I get it. Loved ones are also afraid that talking about suicide might make it worse or they’re worried about what might happen if they’re wrong.
From the perspective of a person who actually is suicidal there seems to be innumerable reasons to avoid suicide-related conversations. In no particular order:
- The person doesn’t want to admit to feeling suicidal — which may be viewed as a weakness or character flaw either by them or their loved one.
- The person doesn’t want to die and doesn’t want to think about their death in spite of the fact that something is drawing them to suicide.
- They are scared that talking about suicide might actually make things worse.
- They don’t want to upset/disappoint/worry/etc. their loved ones.
- They are scared of what their loved ones might do with the information.
- They are scared that other people will find out.
And that’s just off the top of my head. When it comes to admitting to suicidality, fear reins.
The Truth About Conversations Around Suicide
I understand all of the above points. I have been in the shoes of someone who was suicidal and I know how hard it is to talk about it. I know how many times I didn’t talk about it. But I also know that conversations can prevent suicide and suicide attempts so we absolutely must get over our own fears and have them.
What you need to know about suicide-related conversations is this:
- A conversation about suicide doesn’t create suicidality in a person nor does it encourage people to act on their suicidal feelings/thoughts.
- While a conversation about suicide is hard, it’s worth it. Imagine if something terrible happened after you chose to say nothing. Preventing a bad outcome is worth the discomfort of the conversation.
- While there are “best” ways to talk about suicide, in the end, they don’t matter nearly as much as just being open, honest and vulnerable.
Suicide Prevention Conversations Started by a Loved One
If you’re the loved one of a person who may be suicidal, consider these tips when starting a conversation:
- Find a time and space where you and your loved one are calm and in private.
- Use straight talk. Don’t dance around what you’re trying to say. Don’t use euphemisms. Say the word “suicide.” You’re concerned this person might die or harm themselves gravely. Say it.
- State why you are concerned about the person’s safety. Make sure this is accompanied by information about how much you care about the loved one and that suicidality does not change the way you view your loved one.
- As I said, be open, honest and vulnerable. Speak from your heart. This will be hard. That’s okay.
- If you’re not sure exactly what to say or how to say it then say that. Don’t let this stand in the way of opening up such an important conversation.
- Listen without judgment. This is critical. If the person feels judged, they are unlikely to open up and be honest with you. Judging a person or denying what a person is feeling is a good way to alienate and further distress a person. Remember, even though this is hard, you want this person to come to you with their needs. You need to respect their needs in order for that to happen, though.
- Make sure you know the next step to take if your loved one is suicidal. If you’re not sure, you can always call the suicide hotline for your region with your loved one and if you fear for the immediate safety of your loved one, then call 9-1-1. Their life is worth it.
Suicide Prevention Conversations Started by the Person Who Is Suicidal
My advice is similar to anyone who might be suicidal.
- Find a time and space where you and your loved one are calm and in private.
- Use straight talk. Don’t dance around what you’re trying to say. Don’t use euphemisms. Say the word “suicide.” You’re concerned about your very life. Say it.
- State why you are concerned about your safety. This is very hard but it’s the way to get help.
- Be open, honest and vulnerable. Speak from your heart. This will be hard. That’s okay.
- If you’re not sure exactly what to say or how to say it then say that. Don’t let this stand in the way of opening up such an important conversation.
- Make sure you know the next step you want to take. If you’re not sure, you can always call the suicide hotline for your region with your loved one and if you fear for your immediate, then call 9-1-1. Your life is worth it.
Recommended Ways to Talk About Suicide
As I said, there are some generally agreed-upon ways to talk about suicide and suicide attempts. The big thing to remember is not to put any judgment around suicide. Don’t make suicide sound like a goal or an answer. Also, do not paint it as a moral failing or sin. Suicide is an act that is usually a symptom of an illness. Remember that.
In general:
- Don’t say someone “committed suicide.” Instead, say someone “died by suicide.”
- Don’t say a suicide attempt was “failed” or “successful.” Instead, just keep to saying a person “attempted suicide” or “died by suicide.”
- Don’t inadvertently glamorize suicide by talking about famous people who have died by suicide.
But, like I said, conversations can prevent suicide so it’s much more important that we have them rather than focusing on us having them “right.” If your loved one is suicidal, focus on how much you love that person and how much you want to help them. What matters is that they get help, not the, perhaps, winding way they got there. If you are suicidal, focus on how you honestly feel. You are not alone in feeling that way. Only by being open and honest can you get the help you need to get out of the pain that is driving you to a place of suicide.
So this World Suicide Prevention Day 2020, let’s focus on the conversations we can all have to save people’s lives. The discomfort of those conversations absolutely pales in comparison to what we have to gain.
See more suicide posts, here.
So far this year about 1,600 Japanese have died of Covid-19 — compared to more than 13,000 by suicide… The Aokigahara forest, aka suicide forest also called the Sea of Trees, sits right along the edge of Mount Fuji, roughly a two-hour drive west of Tokyo. At the entrance of the forest, a sign reminds visitors that “life is a precious gift” from their parents. “Quietly think once more about your parents, siblings or children,” the sign says in Japanese. “Please don’t suffer alone, and first reach out.”
https://www.google.ca/amp/s/amp.cnn.com/cnn/2018/01/03/health/japan-suicide-forest-intl/index.html
Dr Jordan Peterson Canadian clinical psychologist and professor of psychology at the University of Toronto’s echos a similar message https://m.youtube.com/watch?v=QT2KNvzovHM. I was recently watching different video of his where he mentioned his own family history of depression. His daughter says her father’s health has suffered greatly this year due to catching the Covid19 virus and enduring 2 bouts of pneumonia. He’s also been struggling through the brutal effects of benzodiazepine withdrawal…
I’ve personally known 2 people who went through benzo withdrawal (it took up to a year) and were very suicidal as a result
Never Give Up
Never Surrender
You Are Not Alone
I believe conversations with a suicidal person very often have the effect of moving the person a step back, away from suicide. Mind you, not a cure or solution, but a strong persuasive effect in the moment. Suicidal people usually feel completely isolated, nowhere left to turn, disconnected. They tend to believe some variation of not deserving other people, not being able to reach out to others or that others do not care about them. If you can have a conversation and connect, if the suicidal person feels like they have a connection, it can be a very strong feeling, and strong deterrent. Suicide is frightening even for the determined, especially the closer to the precipice one comes. A suicidal person might instinctively choose, psychologically/emotionally to move towards the feeling of connection and away from the very frightening final moment.
Not always. People can reach a very resolved decided state, not to be deterred. But many people will have a whole host of conflicting feelings and desires.
Some things that generate connection are lots of eye contact, using the person’s name frequently, within reason. smiling. brief light touch, such as people do, placing/patting fingers on a forearm or shoulder. It communicates trust, solidarity and care. Close physical proximity can generate connection(it can also cause anxiety, so be aware). Obviously both touch and proximity may or may not be appropriate depending on how the person normally is about boundaries, cultural boundary sensibilities, the relationship between the two people, potentially (same or opposite)gender might influence in favour or against too. Mirroring (an empathy reflex) is helpful–we subconsciously pick up on it. Keep an eye on whether they mirror, it is a positive sign.
Making someone laugh, or sharing laughter simultaneously strongly generates connection and a sense of group or team identification. The next suggestion is very situationally dependent: sharing any tears–if the suicidal person becomes teary, and then your response is an emotional tear, this can generate a strong feeling of connection and being cared about. You tearing up in the absence of the suicidal person tearing can backfire, making them feel guilt or shame, that they are a burden or causing you pain. But as a response to their own tears, it can be very powerful.
Keeping the suicidal person talking, letting them do most of the talking, if possible is advantageous. If you fill the time–with pleas, reasoning, pep talks, etc., this can all just irritate, feel patronizing, increase resistance, even galvanizing a person. Their own talking however is all investment in being present, in connecting, in doing things the way we do when they matter–talking and conversation are living people business (as opposed to suicidal mode, where talking wouldn’t have any point–think how once you decide to end a relationship with a person, often you no longer feel the need to be heard by them, or argue, or “be right”, because it no longer matters).
So, the more the other person talks, the more energy they are investing in an “it matters” position, like someone going to live. Additionally, the person may really have been isolated, spent a lot of time alone with their thoughts with no one to tell. The thoughts they verbalize can look very different to them than they did as internal thought. Thought distortions are more apparent when given voice. Bad feelings can lose powerful. Absolutes don’t feel so absolute. Black and white perceptions become more noticeable as exaggerations or catastrophizing. Negativities(Everyone hates me; I failed at everything) don’t feel as substantiated and are exposed as hyperbole and may sound just silly.
I have to say, I don’t care much for the phrase “died by suicide”. It is so passive. Suicidal people may feel powerless. It seems somehow cruel to take an act–an arduous act, by someone who had previously felt helpless, to take that final act and render it as without agency, like something that passively happened to them. It seems wrong. Bad enough someone had to make that terrible choice, but to then remove ownership, to misrepresent a person as a passive victim, just seems unnecessarily derogatory, and perhaps betraying a judgement. That is just how it strikes me. I have learned that my sensibilities are often very different than and often quite at odds with the usual, or normal sensibilities about anything. I just don’t process in the same way as a majority of people do.
I do feel suicide is awful, and often it might overlook hope and possibility. That said, people have limits to endurance for suffering, and I fiercely believe in people’s sovereign ownership of their life, including if need be, it’s duration. I do not believe it to be wrong. Sad, yes. Tragic, maybe. Frustrating, guilt-stirring, sure. A person’s suicide impacts people, but that isn’t an argument for it being wrong. Other people don’t own my life, they don’t get to demand that I live, and their feelings don’t trump my right to my life. I am very intolerant of people who call it selfish, or ask why did they not think of others. I’m intolerant too of people who feel thy have magic powers and know better than the person what their feelings were, and meant, and cost, or that they know better what choice should have been made. It reeks of arrogance and narcissism to me. If I stay alive, it is not because I have an obligation to. It is my choice. I have power and agency, I am not passively alive. Even if it feels like being trapped at times, ultimately, I am accountable, responsible for my being here. That can’t be taken from me, and it is wrong when people try with their moralizing on the matter, and it is offensive that hey feel they have the right to. I don’t think they would like me deciding I had rights over their status as alive.
What if you live with an isolating, controlling, abusive spouse or parent. Where do you go for help. A shelter, a foster home, the streets etc
How do you access proper support when you are homeless? You need an address to get welfare. Many shelters now have cut back services due to social distancing
What if you don’t have access to adequate healthcare? How do you even pay for medication without an income?
Many illegal immigrants/refugees do not have access to the services the rest of us citizens do. Language is also a major barrier for them
You usually need a computer to apply for a job. Some people don’t even have enough education to get a decent job to adequately support themselves. The use of food bank is on the rise.
Without a computer (or internet access) or phone how do ask for help during a pandemic. It’s getting harder and harder to access services in person as a result of the COVID19 pandemic
What if you don’t have the typical social supports of family and friends? Depression tends to make people isolate. People’s past behaviour may have also alienated them from others.
Wait lists are notoriously long and growing for mental health care and services as the pandemic continues to compound problems for everyone
The best we can do as non professionals I suppose is lend an empathetic ear. But is that truly enough? Platitudes and false hope are not really helpful in the long run
If we are seriously gonna talk about suicide we need to take a realistic look at the causes and from that standpoint work toward meaningful realistic solutions voicing our concerns as loudly as possible until we are truly heard
In my opinion talk is cheap, it’s highly overrated unless it leads to an effective solution for the suicidal person. Talking obviously didn’t help Ronnie McNutt (the guy who recently live-streamed his suicide after clearly hanging up from talking to someone on his phone.)
Overmedicating a suicidal person (effectively putting them in a chemical straight jacket) in hospital does NOT ultimately solve their precipitating problem either, especially an environmental one, like for instance losing a job, the love of your life, becoming homeless, etc. Rendering them a powerless zombie by overmedicating is apt to make them feel more hopeless not less and will likely make them more upset ultimately as what’s left of their self esteem crumbles under the stigma of mental illness. In my opinion that’s why the the suicide rate/risk is especially high after release.
Whether putting someone in a mental hospital or jail (same thing in my opinion especially in the case of involuntary hospitalization, where you take away their rights) without dealing with the issues that got them in there in the first place is pointless.