A 61-year-old man, E.H., survived suicide attempts, received care for depression in psychiatric hospitals, and battled alcoholism for many years. His father died by suicide. E.H. was convinced that one day he, too, would kill himself. In 1961, he fatally shot himself in the head. Was his suicide inevitable? Ernest Hemingway, the famous author and the […]
The loss of a client to suicide is devastating. If as a therapist you experience this tragic loss, you may go through the familiar questions that beleaguer all suicide survivors. Could I have done something differently? Why couldn’t I prevent their suicide? There is another question for mental health professionals that is not talked about […]
Just about every list of “suicide myths” mentions this one: “If a person is serious about killing themselves then there is nothing you can do.” But is it always a myth? In important ways, yes, it is a myth. There are many things that loved ones of a suicidal individual can do to help – things like […]
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 […]
In just four sessions, the Attempted Suicide Short Intervention Program aims to stop somebody who recently attempted suicide from making another attempt. This is quite an important goal, because a previous suicide attempt is the largest predictor of eventual suicide. Is it really possible to prevent another suicide attempt with just four sessions of therapy? […]
There are many characteristics that place a person at higher risk for suicide – depression, substance use, a prior suicide attempt, as examples. It is important for clinicians to know that an especially dangerous characteristic, one that exponentially increases the chances of suicide, is recent discharge from a psychiatric hospital. I am at the Aeschi West […]
“Client denied suicidal ideation.” “Client reports suicidal ideation but lacks plan or intent.” “Client reported only mild suicidal thoughts.” Many clinicians use these phrases in their clinical notes – and then say nothing else about suicide risk. Such minimalism is not good practice, for either the clinician or the client. Good documentation enables the […]
You are listening to a client describe very specific plans to attempt suicide by overdosing. She has 94 pills of a potentially lethal medication at home. She knows the number because she has counted, again and again, in a sort of ritual to prepare herself for the act. A familiar unease settles in you. You ask […]
“If someone’s life is so awful that they want to die by suicide, why stop them?” I am frequently asked some variation of this question, even by mental health professionals. Once, a therapist told me about a client of hers with schizophrenia. “He is miserable, and he will always have schizophrenia. I think letting him […]
To help a person deal with suicidal thoughts, you first need to know they have them. The challenge here is that many people who seriously consider suicide do not tell their therapist, at least not fully. What To Do? First: Ask the question. Don’t shy away from asking if the person is having suicidal thoughts. […]
People who die in tornadoes are so selfish. They have people who love them, people who will be hurt terribly if they die. Yet they die anyway. People who die in tornadoes are thinking only of themselves. They take the easy way out when they refuse to overcome the storm. They don’t care that their […]
When you come to me for help, I want to help you. I hope you will let me. I cannot know your secrets without your words. I hope you will tell me. Tell me, please, your thoughts of suicide. You might feel scared to tell me When I ask you if you are thinking of suicide. I […]
The grief, loss, and bewilderment following the suicide of a loved one can be overwhelming. Many reactions are common, ranging from everything from shock to anger to self blame to considering suicide for yourself. There are questions, so many questions. “Why?” “What if…?” “What could I have done?” And there are few, if any answers. […]
You are walking with your best friend and she steps into the street without looking, forcing a car to swerve around her. You say, “Oh my God, you almost got killed,” and she says, “It wouldn’t matter anyway if I were dead.” Your son is home from college for spring break and has barely left his room. […]