Tag Archives: WorldSuicidePreventionDay

Talking to someone who is suicidal

Talking about suicide is never easy. 

While you might want to help, it is important to first ensure that you are comfortable talking about it; if you’re not, it is bound to reflect in the conversation. If talking about suicide makes you feel uneasy, then it’s a good time for you to reflect and ask yourself why. Is the fear of saying the “wrong thing” stopping you? Then hopefully this document can serve as a comprehensive starting point. Beyond this, it is also suggested to read testimonials of survivors, to truly understand what it means to feel suicidal.

What pushes someone over the edge?

The thought of suicide is a consequence of feeling like there is no other option – that there is no other way out other than ending one’s life. It may sometimes come from a place of loneliness, a place of punishment, guilt and even pain.

Know that talking about suicidal thoughts rather than keeping it inside is a positive sign, because it means that the person is reaching out for help. They are reaching out for someone who can understand their pain. And reaching out always means that there is hope.

Hence when someone mentions that they feel suicidal, do not go into panic mode. Although it is completely natural for us to have this “default reaction”, understand that staying calm will help you think more clearly and to be actively present. If we equip ourselves with proper awareness and knowledge to deal with the situation, then we can trust ourselves to be better at providing support. Remember, all we need to do is to be there for the person on the other side. Because, that is all THEY need. But what does “being there” mean? It means to actively, whole-heartedly and truthfully pay attention to the person and to take them seriously.

Let us remember that contrary to the popular notion that talking about suicide can increase its risk, if the topic is addressed in a sensitive manner, it can encourage an individual to share their experiences and feelings.

Here are some myths and facts about suicide –

https://www.samaritans.org/how-we-can-help/if-youre-worried-about-someone-else/myths-about-suicide/

 

Assessing the level of risk

Assess the immediacy of acting on a suicidal thought. Does the person have a weapon nearby and can they end their life immediately (extreme risk)? Or are they calm and just talking about their suicidal thoughts as a way to share and reflect (mild risk)?

In the case of the former, understand that this extreme risk is driven by an intense feeling that “everything is too much to handle”. So try to lower the intensity of this feeling. Some de-escalation phrases are discussed below (re: Pt. 8 of “What should you say”). Engage the person in conversation, even if it is about the suicidal thought itself (given they want to speak about it; refer pt. 4 of “What should you say” below). Just keep the conversation going. And, when appropriate, calmly insert a suicide helpline.

In the latter case of mild risk, while the person shares these thoughts, please refrain from trying to “solve” or “fix” the problems causing those thoughts or an immediate attempt to “lighten” the mood. These efforts, although well-intentioned, may stagnate conversation. Pay attention to what the person needs through actively listening to them.

What does it mean to actively listen? It 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.

In some situations, it is helpful to plan a buffer – a “safety plan”, in case the person contemplates attempting suicide again. This is essentially a plan of action which consists of identifying one’s triggers (for increased awareness) and devising a set of internal and external coping strategies that can be used when needed. This plan enables them to have more control of the situation.

Please read more into this so that you can learn and maybe coordinate making such a plan with the person. 

Here are some links to read up more on what a “Safety Plan” is:

https://www.suicideinfo.ca/resource/safety-plans/

http://suicidesafetyplan.com/uploads/SAFETY_PLAN_form_8.21.12.pdf

https://www.nasmhpd.org/sites/default/files/SAMHSA%20SPI%20SMI%20PPT%20final_2.pdf

 

Safety plan template : https://www.getselfhelp.co.uk/docs/SafetyPlan.pdf 

What should you not say?

These are not meant to be a strict set of rules but rather guidelines that should be kept in mind while conversing with a person who is at risk.

 

  • “Suicide is selfish/Think about what your family and friends will go through” – This just adds on to the guilt that the person is feeling because they already think they’re a burden. And in their distressed condition, they may feel that they would be freeing their friends/ family of this burden. How to use empathy here? Understand that it is normal for anyone in excruciating pain to just want to escape. Haven’t we all experienced being in pain and just wanting it to go away? Think about those times and try to grasp the pain the person is going through.

 

  • “Suicide is cowardly”– This statement does nothing but add shame. It does not help the situation but instead can make the person feel judged and cornered.

 

  • “You don’t mean that. You don’t really want to die.” – Often out of panic, we might say this to the person, but it can be really dismissive and invalidating of the person’s experience. At ANY circumstance, it’s always better to believe someone is suicidal rather than dismiss it, because even if there is a morsel of truth to it, taking the person seriously can avoid the danger.

 

  • “You have so much to live for”– Although in some cases, this might convey a sense of hope, it is important to remember that the top reason someone resorts to suicide is because they DON’T think they have anything to live for. In such cases, this can communicate a lack of understanding of their feelings and situation.

 

  • “Things could be worse”– Yes, things can be worse but pain cannot be compared. Pain is a SUBJECTIVE experience. Someone’s whole world can be crashing even if they are relatively “well-off’.

 

  • “Other people have problems worse than you and they don’t want to die”– True, but don’t you think the person has already considered this? Compared themselves and felt more shame and guilt that they couldn’t handle it while others could? In fact, this can make them feel like they’re broken or defective. Reality will then just seem like a sick joke.

 

  • “Your problems can be solved/Your problems are temporary”– Although some problems may be temporary, there also exists problems that can be long lasting and all we can do is learn to cope with them in a better way. This statement just shows a blatant assumption which again may push the person further away, making them feel like you don’t understand their situation.

 

Here’s a link to read more – https://purplepersuasion.wordpress.com/2014/04/09/ten-things-not-to-say-to-a-suicidal-person/

If you feel you have already said something referring to those listed above, don’t panic. It’s okay. Just go back to the person and convey that you did not respond helpfully and apologise for it. Let them know that you want to understand better and that you will henceforth try your best to be a better listening ear, an ally, a buddy who will be there for them.

What should you say?

Please do not take this as a “script” to be followed word-by-word but try to grab the essence of what needs to be said. Also try to refrain from over-using the phrase “I understand” and instead use statements/ phrases that SHOW you understand. Ask yourself, “What can I say right now that will show the person that I understand what/how they feel and that I care about them?” The following statements are some examples for the same.

 

  • “I appreciate that you told me about your suicidal thoughts. This must’ve been so hard for you”– Acknowledge and appreciate the person for opening up. This will reinforce them to talk about it more and to also reach out more in the future.

 

  • “I’m sorry for all the pain and hurt that you are feeling. It must be eating you up inside to feel this way” – Use empathetic statements that show you understand how tiresome and burdening it can be to continue living with suicidal thoughts.

 

  • “I know you feel scared, but I’m right here and we can talk about this” – Reassure the person that you’re here with them- real time. That you will be there to virtually “hold their hand” through the whole process.

 

  • “If you’re comfortable talking about this, would you like to tell me what makes you want to die?” – Sometimes, talking about what makes one feel suicidal can serve to vent the frustration, increase engagement and help understand one’s triggers. Also keep in mind to use phrases such as “Are you okay with this?”, “Can we do this?”, “Are you comfortable with this?” to ensure that you are not pushing the person too much.

 

  • “What can I do to help/ make you feel safe?”– It is always better to ASK someone about their needs first, instead of assuming. If they reply with a “I don’t know”, reassure them that it’s okay and you both can figure this out together.

 

  • “It takes a lot of strength to decide to wake up and fight these painful thoughts everyday”– Acknowledge how difficult it is for someone who is suicidal to DECIDE (by using this word, you reinforce that they have a choice, that they can choose to live and work towards a better life) to continue living despite the difficulties they face.

 

  • “Sometimes we can feel trapped by our thoughts- like there’s no way out. But you are not your thoughts. It can seem hard but don’t let them limit you from reaching out and seeking more options” – Again, try reinforcing the idea that there are still options out there.

 

  • Some de-escalation phrases when they are threatening an attempt on chat- “I’m right here, although not physically, I’m listening and I’m here for you. We can take this one step at a time”. Ask them if they have anything that will cause them harm near them. If they respond with a yes, gently ask them if they can trust you and if they can listen to a small request. *Note: Emphasize on words/ phrases such as “small step”, “tiny request”, “just this one thing” because this makes what you ask sound achievable and is met with little resistance* Wait for their response and then ask them to put the instrument far away in a drawer or even under the mattress. Then gently try to calm them (if they are feeling overwhelmed) through grounding. 

Grounding is a technique that can be used to calm someone by increasing awareness of their senses – what they see, hear, smell and feel. This is also a great way to keep them engaged in conversation and to distract from the immediacy of a suicidal thought.

Once relatively de-escalated, you can ask them to lie down, drink some water or to eat something (mindfully pay attention to whether this is what they need) because the intensity of the emotions can make them feel tired and light-headed.

For more info on grounding and related exercises-

https://www.speakingofsuicide.com/2015/08/20/tips-to-calm-anxiety

 

  • Follow up: Persistence is the key here. Dropping a message or giving them a call, can go a long way in reaching out to the individual. Even if you don’t talk on a regular basis, let the person know that you are there for them.

Highly recommend reading this article- https://www.speakingofsuicide.com/2013/06/06/how-would-you-listen-to-a-person-on-the-roof/

If you’d like to read the original sources/ inspiration of the above article, kindly look at these links

What Would You Say to the Person on the Roof? A Suicide Prevention Text- https://guilfordjournals.com/doi/pdfplus/10.1521/suli.31.2.129.21509

How Would You Listen to the Person on the Roof? A Response to H. Omer and A. Elitzur- 

https://guilfordjournals.com/doi/pdf/10.1521/suli.31.2.140.21518

Hopefully, this helps you feel a bit more confident about responding to mentions of suicide! Please reach out at engage@lonepack.org if you’d like to share some feedback on this or if you’d like to suggest improvements!

For a Friend

What goes through people when they decide to take their own lives ? I would never know….. I have never been there. I would never want to either. But I know something else. Grief. Grief of losing someone you cared about. Grief of losing someone you wish you knew better. Grief of losing someone you wish you had spoken with one last time before there was no more time left. Grief of losing the joyful soul of a friend untimely to the perilous hands of death. Death by suicide.

Gourab was a jolly young man. I remember my initial impression of him as the guy on whom was attached the stigma of having an year back in school. However, I would want him to be remembered for anything but that now. He not only overturned his educational problems by working hard during the time I knew him, but also always did it with a smile. A smile which made me happy. Made probably everyone he knew happy. Little did we know the happiness was hiding something far more painful than anything we could even fathom. Gourab wasn’t the first friend I had lost in my school life. I had lost another friend named Soumyadeep to leukaemia. However, this was different. And far more painful. I do not know if any philosopher has made any analogy to link age with emotional distress and pain; however, I know it for a fact that an analogy is not too far off. Or it was just the fact that Gourab’s suicide was out of the blue. Shock has that lingering memory which claws at you, asking you how things could be different. Was I close to him ? I do not know about others, but from where I am from, you do not study in a class for two of the toughest of your adolescent years and not be close. From analysing our favorite club Manchester United together to the time spent playing football after school, from playing hand cricket all through boring Chemistry hours to meeting up and discussing movies at uninteresting tuitions, he had been a quintessential friend during those years. Moving to SRM did bring a heavy toll on my social life with my friends back in Kolkata, for in trying to settle in within a culture shock and catching upto engineering I had been guilty of ignoring the people I loved the most. And that included Gourab. Two years of studying engineering passed by in a breeze, I settled down in my new life and with new friends, till a friend called me up on that fateful day to tell me Gourab had committed suicide. I would be lying if I say I ever expected something remotely similar to happen. I didn’t really know what to do. I was not shocked, not sad…..I felt nothing. I attended class as usual. Went about my day….till it was lunch break and a friend expressed gratitude for me sharing my food with him. That is when it hit me. The abyss of having lost a friend. The feelings reverberated in me till I could hold it no more. I cried. Long and hard. I didn’t know why, or what even really brought this, I just did. Gourab’s death brought me sadness. Sadness which passed but for moments of passing grief on specific days of the year. His death brought me misery which accompanies the shocking misery associated with losing loved ones. Even that passed. What didn’t pass was regret. Suicide is not accidental or biological, it is the result of constant crippling psychological trauma. And I could have been a better friend, maybe even tried to find out if everything was okay. All those busy school fests, I could have taken an evening out to call a dear friend and ask him if he was doing fine. Catch up on our shared anger at Moyes’s mishandling of ManUtd. Tell him how engineering is sapping the life out of both of us. Tell him, “Chill, It’s a burden we both are sharing, and it’s a burden we can split between us”. Explain to him by telling that ” Don’t go friend, this world is tough, and one less friend is one less shoulder to cry on when the going gets tough.” Maybe even offer my shoulder for him to vent his grief out on. Like a brother. But why would I ? Gourab was always happy, and psychological stress is hardly a problem. Till this world’s refusal to see a problem for what it is was too late, my blindness to a friend’s misery was perpetrated to an extent where it didn’t see through a facade. And when the facade fell, so did a dear friend.

Gourab is no mere friend, brother, son lost to suicide. He is one of many martyrs, who have cleared the clout in our minds surrounding mental stress and psychological illness. I will never commit suicide, and I ensure I checkup on everyone I love, telling them that they are loved, ensuring that they know they have some place to go to in order to vent, not lose it all in inevitable death. Suicide is as real a threat as HIV or Zika, but my friend taught me it can be fought……together. I loved him like a brother, and wish his soul peace. More importantly, I wish him gratitude. He left me a life where I knew that nothing could be more important that people close to you, and they could have demons like you, but far more terrifying. I will be there for them. I am sorry I couldn’t be there once. That is my demon, and I am fighting it. This is not an eulogy, it is a letter acknowledging something I have never done. Dear friend, thank you for being there, thank you in life and in death, and thank you for leaving me with a wonderful touch of perspective. And know, I miss knowing that every night I go to sleep, you are safe in some part of the globe. Goodbye dear friend. I promise I will not let what you taught me in life and in death go to waste. I promise.

– Soumyajyoti Bhattacharya

Image Credits : Google Images

Recognizing the warning signs of Suicide in people & helping them

 

According to the WHO, on an average, one person commits suicide every 40 seconds.

Suicide is a complex phenomenon and not an illness in and of itself. Suicidal ideas and attempts are important to look for and evaluate. Unquestionably it is hard to predict who will attempt suicide but, it is possible to characterize the risk aspects keeping in mind that it is a risk and not an absolute prediction.

Some of the common predictors of suicide are persons undergoing extreme/ acute emotional distress of any cause. This could be symptoms of depression or other psychiatric disorders, there could be acute changes in interpersonal relational status, any acute loss/ change in financial status. This is the one characteristic that is most obvious to outside observers who could be friends, family or well wishers of the individual. This is a time when all those who care for the person suffering could express their support by “Just being there”.

Hopelessness as a thought characteristic is significantly associated with suicide. This is basically a sense of there being no future for the person. This could occur in the context of again life stresses such as a breakup, financial losses. Persons experiencing hopelessness may appear listless, not interested in looking towards the future – even towards the immediate future – not wanting to go out, dejected and saying as much.

Substance abuse whether alcohol or other drugs especially increases the risk of suicide in individuals. It has the ability to impair a persons world view and make things appear more bleak than they are.

There are other risk factors that are associated with suicide attempts including a prior history of suicide attempts or self injurious behaviors, family history of suicide, exposure to suicide in a family member or significant person, and exposure to physical or sexual abuse. These factors may increase the possibility that the person experiencing distress currently is at a higher risk of harming self.

So, what can any other person do to help their loved one?

Families and friends are scared of hearing the word suicidal in the context of their loved ones. Rather than jumping to conclusion that they need to be taken to a psychiatrist/ counsellor, the easiest thing that can be done is to be there for the person in distress. This would involve just being present, letting them know that you are there to help if they need and most importantly there is someone if they want to talk.

The sense of having someone nearby who cares for them has a significantly soothing effect on individuals.

A patient, non-judgmental hearing of the persons woes before asking the question “How can I help?” will also go a long way in helping persons put their current problems in perspective. This would enable them making better choices in the form of not harming themselves. Finally before closing, it would be helpful to finish with a sense of hope in the form of saying something like “If there are problems, then there must be solutions and we can find them together”.

-Dr. Shiva Prakash

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Note from the LonePack Team:

People who’re going through a tough time find it difficult to ask for help. It could be anyone from our silent classmate, to the girl we sit next to on the bus.

Can we help show our peers that the world is not devoid of hope anymore?

So reach out to them, and write them a message. LonePack will publish them all on their Facebook “Wall Of Positivity” on Sept. 10th, which marks World Suicide Prevention Day.
Send in your message and share to keep the chain of positivity going. Do join us in spreading some joy and showing some support to the people who need it.   

https://goo.gl/forms/UgJdu3q1wdf0ayhz1

So, tell me, did you spread some positivity today?

-The LonePack Team

Image Credits: flickr.com