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Wednesday, 8 May 2013

When someone you know is suicidal


I was recently training a group of people, who were gearing up to be effective counsellors, on the subject of suicide, and was numbed when I learnt that each and every person in the room that day, including me, had had someone in their life who had either already committed suicide, or was contemplating it.

Bangalore, unfortunately, has the distinction of being the suicide capital of the country – having the highest number of reported suicides. The daily newspapers carry several reports of suicide. And, I’m sure for each suicide that gets reported, there are several others that do not. And for each successful suicide, there are probably 10-20 attempts made that have not been successful. Given this, the chances that each one of us may know someone who is feeling suicidal are high, because the people who feel suicidal do not belong to some other remote world (much as we would like that to be the case). They belong to our world and our communities. They are one of us and they are among us – in our schools, colleges, offices and families. I learnt this the hard way having lost one of my clients, whom I had worked with for over six months. I was left with several questions, several regrets and several fears. That is what started me on this journey of trying to understand what happened.

So, if someone comes to us and lets us know that they are feeling suicidal, how do we support them in a positive way? While the best option is to get them to a mental health professional – may be even take them there yourself, that may not always be possible, or practical. In that case what do you do?
There are several things a lay person can do to help someone who is contemplating suicide. Probably the most important, but hardest, is being non-judgmental about the person who is feeling suicidal, and the situation. We must remember that the thought of suicide is a “cry for help”, not a “desire to die”. We commonly believe that someone who is contemplating suicide wants to die. On the contrary he or she is simply giving out a desperate cry for help. We can choose to ignore it, or we can choose to respond. The choice is ours. And often we choose to ignore it because it means confronting some tough questions for our self. We must remember that while there is a time for us to confront those questions, clearly this is not that time. This is the time to give the person non-judgmental support. This is the time to respond to their cry for help positively. This is the time to just be with the person.
Many dismiss this cry for help as an attention-seeking behavior that they don’t want to encourage or fall for. The question to ask our self is why the suicidal person has to resort to such measures to get the positive attention they want, and deserve. We tend to just look at the behaviors and try to fix those, without understanding the deep insecurities that result in that behavior, and address those insecurities.

No person is 100% suicidal. About 80% are sitting on the fence – ambivalent, confused and gasping for life, looking for a deterrent, and hoping someone will stop them. With their constricted thinking, they are contemplating a permanent solution to a temporary problem. It is a myth that contemplating and committing suicide is an impulsive, irrational act. On the contrary, it is often well thought out and the person who is feeling suicidal gives several warning signs along the way. It is also a myth that those who threaten it don’t do it; that children don’t commit suicide; that once a person is suicidal they will always remain suicidal; or, even that discussing suicide with the person will drive them closer to it.

So we must respond to their cry for help; we must be the deterrent they are looking for. But how?
Firstly, by being non-judgmental and staying calm. This is not the time to lecture, blame or preach; or to criticize their choices, analyze their behaviors, or confront them with your own interpretations. This is the time to “listen” and allow them to ventilate their feelings in a safe space and encourage self-disclosure.

By not keeping the suicidal risk a secret and not falling into the confidentiality trap. They need help, and must get it.

Don’t debate the pros and cons of suicide; or deny their suicidal ideas. Acknowledge it as a choice, but don’t normalize it. Don’t challenge them for shock effect; but find out what is being hoped to be accomplished and communicated by the suicide.

Don’t leave them isolated, unobserved or disconnected. Show them your personal concern. Show them some hope and be the temporary champion they so desperately need. Help them stay in the “here and now”.

Don’t be misled by their telling you that the crisis has past. Most people make a second attempt soon after. Don’t get sidetracked by extraneous, external issues and don’t forget to follow up and stay connected.

The risk is greatest when a person has the means, the opportunity, a specific plan, and, 
the lack of a deterrent. So be their deterrent. Be their temporary champion. Show them some hope. And most importantly, be there.

6 comments:

  1. Excellent article with good advice. Thank you for sharing, I'm sorry the newspaper wouldn't print it. I think it is an important subject every one needs to know about.

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  2. Thank you. Yes, it is a pity. Sometimes we don't like to address topics that are so vitally important, and like to pretend that they are not issues. Please circulate this for wider publicity.

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  3. Sometimes the closeness of your relationship will not allow you to stay away! Even if you want to, you will not be comfortable doing it - especially if it is a partner, child, sibling, parent, or close friend. You can choose to stay away only if the person is a mere acquaintance. Otherwise what do you do? Sometimes our biggest lessons and learnings in life come out of situations where we been able to pull someone up with us, rather than get pulled down by them. I guess which way you go depends to a large extent on your current state of mind as well. And, if you feel you will get pulled down by them, and therefore, also pull them further down, it is best to get someone else involved who will be able to pull the person up.

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