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You are here: Home / All Posts / Counseling someone considering suicide: Know the myths, risks, and responses

Counseling someone considering suicide: Know the myths, risks, and responses

August 22, 2017 by Dr. Jeff Black

When he comes into your office, his hopelessness is clear. Jon doesn’t see a future for his life. The car accident, the pile of medical bills, and his marriage falling apart weigh heavily on him. He has met with a support group, but the pain seems only to intensify. He is looking for a way out and thinks taking his own life is the only option left.

How do you help him? What do you say that might actually help?

Avoid the myths

When you first are approached by someone who is suicidal, you may unknowingly turn toward common myths you’ve heard or thought in the past. Avoiding those myths can equip you to better help suicidal people.

MYTH: Asking people if they have a desire to harm themselves will somehow implant the idea. If people have suffered greatly, the thought of harming themselves has probably crossed their minds already, so making a reference to it will have little or nothing to do with their intentionality. So, ask the question and get a better understanding of what they are feeling.

MYTH: When people talk about taking their life or try to harm themselves, they are just seeking attention. There may be some who bluff about suicide, but that is generally not the case. When people are talking about it, they are talking about it because they are in significant distress. Talking about it, at least in that moment, can be helpful to them.

MYTH: When people talk about suicide, it eliminates their actual desire to take their life. When people talk about this, you should take it very seriously and always err on the side of caution.

MYTH: Once people decide they’re going to take their life, you can’t stop them. In fact, people intervene all the time with suicidal individuals. For instance, people who are hospitalized against their consent while suicidal can act exceedingly angry. After they’ve been in the hospital for a couple of days, though, they are usually extremely grateful that someone didn’t simply let them have their way and go through with it.

MYTH: People who have tried and failed to take their life once before won’t try again. After they have tried once, it’s actually easier for them to make a second attempt.

MYTH: People who are suicidal are weak in character. Christians tend to oversimplify what’s involved in suicidal people’s pain and their desire to end that pain. Instead of seeing them as weak, see them as individuals who lack hope.

MYTH: When people become suicidal, it’s a lifelong trait that you have to continuously watch. Suicide is not a virus that they have in them for the rest of their lives. Frequently, people are suicidal for a certain period of time, but then they change. As life changes, it’s simply not a part of who they are anymore.

Know the risks

A risk factor is an element in a person’s life that increases the likelihood of suicidal thoughts or actions. Knowing some of the risk factors can make you more aware and better prepared to address people at risk for suicide.

IS PATH WARM?

There are several different risk factors to keep in mind when working with potentially suicidal people, and not everyone will show the same signs. Using the acronym “IS PATH WARM?” can help you remember the most significant risk factors to look for. Of course, these are possible contributing factors, not a perfect formula to identify a person who is contemplating suicide.

    Ideation
    Substance Abuse

    Purposelessness
    Anxiety

    Trapped
    Hopelessness

    Withdrawal
    Anger
    Recklessness
    Moods

Generally speaking, people who are suicidal have an excessive and unbearable level of emotional pain. They are hopeless and feel that their emotional pain is unbearable. Additionally, they’ve come to believe that there isn’t any way for that pain to go away.1

Self-harm: An additional risk factor

Self-harm can also be included as a risk indicator for someone contemplating suicide, but it is not always a direct indicator. When people engage in certain kinds of self-harming behavior, like cutting, they use it for tension relief, but they are not trying to cut to end their life. This may be a type of “warm-up” exercise prior to suicide later on, but self-harm does not always lead to suicide attempts. When people are suicidal, they’re not looking to release tension. They’re looking to eliminate some perceived unbearable pain. That is a significant distinction between self-harm and suicide attempts.

Assessing the possibility

Ask these people to talk about their level of psychological pain. Are they hurt and in anguish? What kind of misery are they experiencing? This is not the same as physical pain or stress. A person can have a lot of pain but not necessarily feel stressed. Or he or she can feel stressed but not necessarily feel lots of emotional pain. It is when you take them together that it increases that person’s risk.

Find out about their level of agitation: if they sense they need to do something about their stress and their pain. Rate their sense of hopelessness and sense of self-contempt. Generally speaking, those who are considering taking their life have to have great pain, but there’s usually a heavy dose of self-loathing also involved.

Immediate response to threat of suicide

If you are on the phone with someone saying this is his last phone call before downing a bottle of pills or using a gun to end his life, you need to act quickly.

Continue talking to him, but find someone to call 911 to send the police to his location right away. While it’s easy to get into a heroic frame of mind and think you can go rescue the person, that’s a bad idea. The police always need to be called in a situation in which a person is expressing that he can’t deal with life anymore, and he has a lethal means of harming himself or someone else.

Once the person is no longer an imminent risk for suicide, you may continue counseling him in order to find out what caused that point of crisis. Your counseling occurs after he has been released from the hospital or cleared by a medical professional.

Most people who have suicidal thoughts do not have a single catastrophic event to deal with but, rather, are simply worn down by life.

They likely need to relearn how to manage the stresses of regular life more effectively. This is a process of transformation and healing that addresses the psychological or emotional pain they are experiencing and reinforces a belief that there’s hope for them.

Ensure that these people know they have a support system through the body of Christ. Let them know that even with a crisis, people are still there who recognize the grief or pain that they have. This is the struggle of their heart, and that heart struggle can continue for some time.

Point them toward God and His power. If they even attempted to harm themselves, then they crossed the threshold of hopelessness. It means they felt their pain was so strong that they had no other option. So, your primary concern is to reestablish their belief that God is more powerful than their pain.

A person who is a believer who is also hopeless is someone who hasn’t experienced God as someone who is present or near in his life. Focus on that person’s realization of God’s imminence. Some may acknowledge God’s providence but feel it is more of an ideal than a reality that touches their lives. They fail to recognize His nearness, which tends to foster a sense feeling alone. They then feel they are the only ones up against the obstacles before them instead of picturing God right beside them to help them.2

Call attention to the ways in which God is near in their life. Encourage them to turn toward God first, even when they don’t feel He is there. They might consider the pattern of the many “lament psalms” in the book of Psalms. Typically, the psalmist begins by describing his distress and ends the psalm by affirming his trust in the Lord: “Since I trust in you, I won’t be afraid.”3

Editor’s note:

Given the high correlation between suicide and depression, you should also see How Pastors Can Help the Depressed.

Dr. Jeffrey Black
Dr. Jeffrey Black

Dr. Jeffrey Black has served in the counseling profession for thirty-three years. A licensed psychologist, he has served as a counselor in private practice, as clinical director of Christ Home for Children, and, for twenty-one years, as associate pastor at Calvary Chapel of Philadelphia. In addition to teaching at Cairn University, he has also published in the Journal of Biblical Counseling and taught at seminaries and at the Christian Counseling and Education Foundation.

Footnotes:

  1. You will need to assess how the person’s perspective on trials differs from the biblical writers’ perspective on trials, which incorporates our hope in Christ. See Romans 4:18–21, 5:1–5; 1 Peter 1:3–9.
  2. Here are some possible passages to use with people when they don’t feel like God is there: Genesis 45:1–11, 50:19–21; Psalms 139:1–16; Proverbs 16:1, 9; Philippians 4:5; John 16:33.
  3. Here are some of the lament psalms that can help despairing people see that God’s people are not exempt from serious trials, but they are always assured of God’s provisions for weathering the trials: Psalms 13, 22, 31, 41, 102, 141.

Filed Under: All Posts, Emotional & mental health, Suicide & self-harm Tagged With: Biblical Counseling, counseling, Dr. Jeff Black, guest post, suicide

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