What would you say to a person on the roof? That is, if you were called out to a crisis scene, where a young woman sat on the roof of a tall building weeping and shouting that she would jump at any moment, what would you say to her?
This provocative question – What would you say to a person on the roof? – was the title of an article that appeared in the academic journal, Suicide and Life-Threatening Behavior. The authors presented what they called a suicide prevention text. The 36-paragraph text provides a script with statements intended to convey empathy and understanding of the suicidal person’s unbearable pain, while also challenging the person to consider other options.
As you read the following statements in the script, keep in mind that the helper is presumed to never have talked (or listened) to the person before:
First of all, let me say that I understand that you are now at the very limit of the human capacity for endurance…In your mind, the present suffering may be just the first step on the way to far greater suffering.
What I am trying to tell you is that I understand something about your despair. You didn’t get there out of laziness or neglect of possible solutions. I am sure that if you could only see any other way out, a glimmer of a solution, you would not want to die.
The experience you are going through shakes you to your very foundations. For many people, this was the turning-point in their lives. After such experience, most troubles may seem small in comparison. I am not saying that you will feel like this immediately. These things take time. However, I think that the worst is already behind you.
How Would You Listen to a Suicidal Person?
Shortly after this article, along came another, titled, “How Would You Listen to a Person on the Roof?” by the late suicidologist Israel Orbach. This title captures beautifully the essence of helping suicidal people – listening, really listening.
Active listening involves:
Not trying to talk the person out of their thoughts or feelings.
Not professing to understand a story that is not yet known.
Not offering superficial reassurance.
Not problem-solving.
Not giving advice.
The author Orbach argued that having a preconceived agenda, relying on presumptions of how the suicidal person feels, can exacerbate an already dangerous situation. The suicidal person may feel further alienated and misunderstood.
Years ago, when I first started working in the field of suicide intervention, I had to observe calls at a suicide hotline before I could work the phones myself. I listened as a man called and told the counselor that he wanted to die because he was worthless, a bad person.
Having talked with the man for fewer than five minutes, the counselor said, “No you’re not, you’re a good person.”
Certainly she had good intentions, but such a statement does not usually bring about a good result. It is likely that the caller felt misunderstood, unseen, lonely – shut down, even. The counselor’s lack of connection with the caller could have reinforced the caller’s conviction that he was alone in the world, that nobody cared to understand him, and that he should die.
Orbach recommends asking the person questions that invite him or her to discuss her unique pain – poignant, yet pithy, questions such as:
How did things get so hopeless?
What pain are you feeling from now?
What is your unbearable pain?
It makes sense, and it sounds deceptively simple: Listen. Ask questions that invite the person to say more. Hear the person’s story. Listen so well that when you repeat back to the person your understanding of why they want to die, they say something along the lines of, “Yes, yes, that’s it.”
If, even after the person has shared their story, you cannot say to yourself, “I can really understand why you want to die, even if I don’t agree or approve,” then you need to listen more.
Other Ways to Help a Suicidal Person
Of course, listening alone is not enough.
If you are a friend or family member of a suicidal person, you also need to help the person get help.
If you are a professional, there is also the need to assess the person’s level of risk for suicide along the way. And, after you have truly heard and joined with the person, then comes the need to explore their ambivalence, to examine their reasons for living and dying, to tap into their hope, to challenge distorted thoughts, to engage in problem solving, to develop a safety plan, and to provide other aspects of psychotherapy.
Those are topics for other posts, some not yet written. Stay tuned!
© Copyright 2013 Stacey Freedenthal, PhD, LCSW, All rights Reserved. Written For: Speaking of Suicide. Photo purchased from Fotolia.com.
I came across the first paper mentioned in your post (“What would you say to a person on the roof?”) in a somewhat surprising context: it was referenced in the beginning of a 2017 article[1] published in an Israeli newspaper. The topic of the article was the tragic life story of an Israeli woman; it touched on many disturbing themes, including sexual abuse, incest, depression, attempted suicide, disability, chronic pain and other difficult topics. The woman in question ends up receiving physician-assisted suicide at Dignitas in Switzerland, though her reasons for pursuing it are physical (severe disability and chronic pain) rather than mental (and Dignitas doesn’t provide help in cases of purely mental anguish anyway, to my knowledge). It is certainly relevant to the topic of this blog post; thus I think you and your readers will find it to be an interesting read. Of course, the article was written in Hebrew; however, I have translated the article to English and posted the translation on Reddit (see [2]). Well, actually Google did the translation and I just fixed the few places here and there where the translation was erroneous or vague.
Anyway, here are the links:
[1] Original article (Hebrew): https://www.haaretz.co.il/st/c/prod/global/moran/7/
[2] Reddit post with English translation of the article: https://www.reddit.com/r/MorbidReality/comments/ng379p/israeli_woman_was_sexually_abused_as_a_teenager/
Mark,
Thanks so much for correcting and sharing the translation of the Israeli article. That’s generous of you. I look forward to reading it soon.
If small children in the family or nearby utter loving, caring words to that person, makes her /him feel that he, she is needed by them, and that they love him /her, I have seen that there pure, divine and loving energy also melts the self hatred and desperation, I have experienced this many times, also you may suggest such people to spend more time in the company of children and watch, children cartoons. What we call grown up stuff has only helped us reach to this desperate state. In the name of maturity and Age most of us have only become serious, sick, egoist, stupid and hard hearted. As Osho, a great mystic says, “We grow old only because we stop being a child”. All I have to say is that Playfulness and Meditation and Yoga are the only things that can bring a person out of their unhappy state. Also frustration and sadness comes mostly when we expect others to listen to us, care for us or pay attention to us. In short, when our attention is on others(mainly on our family members or other near and dear ones, and when they do not fulfill our expectations sadness and desperation is born. If the attention can be brought back to our own selves and we engage ourselves in work or projects we have a passion for, this state of mind changes incredibly fast. Meditation and Yoga are such amazing things that helps you return back to your own Centre, to your Own self, where all we need the others are for giving and sharing our Love with and not to get from. (Osho, Brahmakumaris RajYoga, Art of Living(Sri Sri Ravishankar ji), Louis Hay, Deepak Chopra are some of the many Wonderful Organizations that are pouring Divine Love, Bliss and Joy in the lives of millions of people all around the world. With the help of any person who is in the good books of such a person you can help him /her to join a Meditation and Yoga course and find out things and ways that helps him /her to be playful. Much much love to You and many Good Wishes for your efforts. Please You also take care of yourself as All the time you are dealing with sad and stressful beings, Meditation and Yoga and more such related things can help you stay balanced and wash away the picked stress. God bless You and everyone. May every being find their Joy and Light within. Love and Light ❤️❤️❤️?
How do i tell my dad I want to die when he know I have depression and ignores it?
Maybe your dad is scared. He loves you, and sometimes it is hard for them to hear that someone they care about-someone they raised is suffering. I feel as if you just need to tell him: “Dad I’ve been contemplating suicide and I am hurting. It might be hard for you to comprehend, but I really am hurting.”
Tia,this is excellent advice. Thank you for warmly sharing your wisdom!
I am facing the same problem currently. I feel it is best for is to just tell our parents, and just get it over with so that we can get the help we need. Maybe try writing a letter to him.
My parents hit me when I told them. Be careful, be aware of your surroundings, go in with a gauge as to how they will react, you know your parents well though.
Thank you for this helpful website. I found just the information that I needed for support today. (I’m not contemplating suicide but a teen in my close circle of friends is)
I understand this posts starts with the situation of not knowing the person on the roof, and develops very well as to the how to listen to rather than assume the condition, which would likely enrage the person, consequentially pushing them to act under the effects of rage in suicidal manner.
If you do know that person however, something they would want to hear as a first reaction, something that doesn’t blow the subject out of proportion with accusations of them being an attention seeker, something that doesn’t imply artificial generic hopes in life and what to live up for, something that puts no further burden nor guilt about the effects of their suicide after they are gone, and finally, something that doesn’t compare them to others enduring misfortune, thus raising a matter of weakness.
It’s not magic but could likewise have the immediate desired reaction; it’s about re-making associations. It would be something that triggers affection and relation, that makes a first-hand bond, a sudden tie back to the earthly.
Something that makes them the center of attention for a second, something that keeps aspirations personal, something focusing on the time spent together alive, something that lets them know of their worth as they are and unchanged.
Something along the lines of, “Don’t do it, because I love you”.