Tuesday, September 11, 2018
Challenging Conversations: After Asking if Someone is Thinking of Suicide
When survivors of suicide loss go to suicide prevention trainings, we fortify ourselves with information and strategies we wish we’d had when our loved one was in crisis. Often we're hoping to stumble on some stray piece of the puzzle that will unlock the mystery of their suicide. Sometimes we recognize our family member in the lists of risk factors and warning signs and the testimonials of suicide attempters; sometimes not. Sometimes we are triggered; sometimes numb. We’re spurred by the need to spread suicide awareness on the chance of saving a life, sparing another family our torment.
At a recent conference, I learned more about how to talk to people who are suicidal. I was reminded of the two times I managed to ask my son Noah if he was thinking of suicide when he was suffering from major depression and anxiety disorder. Somehow I knew then that it was important to ask; what I didn’t know was how to respond to the answer.
The first time I asked Noah about suicide, he scoffed and said he would never do such a thing. I was relieved, though I knew he could be bluffing. I assumed he meant that he valued life and knew how devastating it is to be left behind; he had felt bereft and betrayed after a close friend’s suicide at college.
The second time I asked was on the phone when he’d gone back to college with great difficulty a few weeks after a psychotic episode. He had already called twice to say he was coming home, then changed his mind. This time when I asked The Question, he paused and said, “not right now.”
To my great regret, instead of hearing him out, I went mama-bear ballistic on the phone. “That’s all the more reason you need to go back to the therapist and tell him what’s been happening!” I shouted. “Please promise me you’ll do that.” He never did, though he did call a previous therapist 3,000 miles away, who told Noah to see a psychiatrist immediately.
I know better now. I’ve learned that, rather than suddenly provoking thoughts of suicide, being asked if they’re thinking of suicide can be a relief to people who have not been able to express their thoughts. I’ve learned that a helper’s role in these horrifically challenging conversations is to listen calmly, without judgement or efforts to persuade. That’s almost impossible advice for parents—or for anyone who feels alarmed and protective with someone in crisis—which is why we have to practice these lines and make them our own, in readiness for when they might be needed. I’ve learned the difference between passive suicidal feelings (wanting to go to sleep and never wake up) versus active ones (intending to take one’s life), and the risk of having a general plan for the method of suicide versus a detailed plan (how, when, where). (You can read about a simple 6-step screening tool here.)
After the conference, I sat down with pen and paper for an awkward do-over of that second exchange with Noah. With what I know now, some things I wish I’d said:
I’m really, really sorry to hear that. Thank you for telling me. I appreciate your honesty.
I love you; I want to hear what you’ve been going through. I promise to stay calm and listen.
That sounds really hard.
When you said you thought about suicide recently, was it just thoughts or did you plan to act on those thoughts? Did you know how you would do it? Did you start preparing?
We know you’ve been suffering terribly and we want to help you get healthy. We’re here for you, every step of the way. Let's talk about some ways to keep you safe.
Noah might have shut me down with, “Forget it, Mom, you’re not my therapist.” Or he might have opened up, even a little.
Might words like this have helped lead Noah away from the brink? I’ll never know. It’s too late for my family, but it’s not too late to inform myself and others so we can try to make a difference when someone is suicidal.For Suicide Prevention Month and beyond, please: Know the signs. Find the words. Reach out .