Louisa Collectively, we are beginning to do better at facing up to the reality of suicide and suicidal states, thanks to myth busting campaigns, to Mental Health First Aid and Suicide Prevention courses. Yet, it seems that it is often limited to those experiences of suicidality that are acute, reach a discernible peak, and – if responded to effectively – can be ‘nipped in the bud’.
We need to acknowledge those individuals who regularly feel suicidal and may need more than safety-planning alone can offer. What if when someone tells us they are suicidal, we could listen differently, in a way that would allow us to attend to them more fully?
The first-aid part of suicide prevention can be lifesaving in and of itself, but how do we best attend to a person when the suicidal states are repeat visitors?
To be truly in touch with the idea of suicide is to be taken to our very limits. The person who feels suicidal is coming up against their own capacity and/or desire for survival, and those close to them may find their own sense of powerlessness and panic unbearable.
A suicidal person may find a sense of sanctuary in knowing there is a way out, such that thinking about dying can be a sort of momentary haven. Those on the outside of the experience might find sanctuary in convincing themselves that the suicidal person “doesn’t really mean it”.
While the person contemplating suicide is unique in their reasons for feeling suicidal, what many people struggling to stay alive have in common is a profound ambivalence.
Ambivalence is not about ‘mixed feelings’ in the diluting sense. Ambivalence in this context is wanting both to end one’s life and, also, to be able to live.This can be disorienting and make a person feel as if they are going mad.
Maybe you do not have to imagine this tension, but if you do, consider how it might be to host a civil war inside yourself. Not only is there conflict about the very fact of existence, but the different factions are not wearing uniforms or name tags. It can be hard to figure out which parts of the self to take on trust and which parts to question.
All this and no one can see it happening.
Suicidal states are lonely, terrorizing places for some people, this is why meaningful, validating connection matters.
Here are some approaches that have been useful in my work supporting people who are suicidal:
- Resist thinking in the singular. There is often not one unified self at this point. We think in aspects or parts of self, and we aim to create a space within which these can be better understood.
- When we have a good relationship with the person, we sit side by side, not attempting to fix. Instead, together we survey the landscape the person is telling us about. “That place you point to that is bombed out, a wasteland nothing can grow from, I want to know about it, if you can bear to tell me?”
- We pledge to bear-with the person the feelings inside that may be in contradiction, that may feel like they make no sense, and we ask questions to better understand. We do not refute; we dare to know these places of devastation, so they are no longer alone there.
- If we have the right kind of relationship with the person, we might ask, if we think of you feeling in bits, are you able to tell us about what different fragments inside you might be communicating? Who wants to die? Does some part of you want to destroy you? Why? Whose voice is missing? Do you know why? How do we give them space to be heard?
- We need to bear in mind the complexity of these internal dynamics. While we might help the person identify the small part(s) of them still holding on, still in touch with a flicker of hope, we should know, too, that the very act of hoping might inflame the part of them who wants to kill their body, particularly if it is in relation to shame and self-hatred.
- No one is the enemy, not even the parts who want to kill their body off. Consider these murderous aspects to be deserving of understanding, perhaps they are lost in translation and death seems the only response to their circumstances/experiences in relation to the rest of the self. What might they need that feels impossible to access in this life?
- Notice when you want to collapse into hopelessness. It is tempting when bearing states of tension that are in the realms of life-and-death, to decide the person either isn’t really at risk, or is so at risk that there is nothing we can do. Sometimes aspects of the suicidal person need us to feel this so we can side with the part of them that is also tired and desperate to fall on one side of a resolution, for example to choose suicide once and for all. The person is not in a singular state.
- When the tension feels painful, it is a sign to also increase your own emotional scaffolding with others who are apt to support you.
- Together with the person who experiences suicidal states, we also get creative. We treasure-hunt for the parts of the self that glimmer in certain conditions. That might be in contact with animals, with nature, with music, or art, or certain people, or sensations. They will not save the person alone, but they make moments endurable while we build conditions for healing.
- Acknowledge that coming back to life, or choosing to stay, might feel quite treacherous. There is often a mourning process in reckoning with suicidal states because they have come about for complicated and painful reasons. This is not a linear event and not a one-time thing. Not killing oneself is different to making life feel livable and meaningful.
- Also, we must respect that some people will need to keep the option of suicide on the table, an alive question to be revisited, because it is a serious and worthy one that we can show up for.
This post is by no means meant to encompass and accommodate the full range of possible experiences of suicidality in us humans. It is merely to point to an under-acknowledged aspect of some peoples’ experiences. If this resonates with you and you would like help to work through what takes you to these places of despair or hopelessness, you can find details here about how to make contact with me. Please also read through this page of support services available to you, many of which are 24/7.
I will always return to the creative work of survivors when it comes to testimony and expertise on these kinds of issues. Whomever you are, I wholeheartedly recommend stocking up on zines like this one by Rachel Rowan Olive, listening to Andrea Gibson, especially The Nutritionist and Every Time I Ever Said I wanted to Die, and finding the tiny things that make the aching at least feel less lonely.
Lastly, do not underestimate the momentary power of a sweary song.
