If you joined me for Part 1, you heard some of my story while also learning that our brains can heal despite any traumas we’ve suffered. I love that hope is real and healing is possible. Today I’m giving you specific ways to lead someone you love through the maze of suicidal distress with tools to guide your conversations and next steps.
Big hugs, Dr. Michelle Watson
Now let’s make this practical and personal.
What do you do if you have a friend or daughter you suspect may be suicidal?
I’ll tell you some truths that have guided my responses to this question. When I started grad school in 1995, I wasn’t sure what to do or say if a counseling client admitted to being suicidal. But I can tell you that I was greatly comforted to learn key insights about navigating this complex topic, insights that still guide me as a clinician 21 years later:
- It’s good to initiate the topic of suicide if you have even the slightest concern about someone, which will help that person know that it’s safe to talk openly with you. (Asking about suicide won’t plant the idea in their minds about it, but instead gives them permission to talk because “the cat’s out of the bag,” and they weren’t the one to initiate the conversation.)
- It’s good to disclose that you would be devastated if that person ever took their own life, including why it would matter to you. (I’ve teared up many times when disclosing my heart to suicidal clients, and typically this helps them release their tears while feeling that someone genuinely cares. Experts say that sometimes the individual will stay alive more for someone else than for themselves, and because I want to do everything possible to communicate compassionate care, I always remember this fact.)
- It’s good to ask whether they feel like they want to die or if they have a suicide plan—because those are two different things. If there is a plan in place, you must take immediate action to contract regarding their safety, call their support network, or discuss hospitalization. (By asking the straight-forward question, “are you suicidal?” you are encouraging honesty. You also want to watch their body language because it also will significantly reveal what’s going on inside. Remember that it’s worth risking their anger at you for intervening in order to get them the help they truly need.)
There’s one more important aspect to this topic that merits addressing.
If we read the accounts from friends and family after they’ve lost a loved one, rarely, if ever, did any of them know the situation was dire prior to the catastrophic event. This has been repeatedly confirmed by those who interacted with Kate Spade and Anthony Bourdain, as well as with those who knew Robin Williams four years ago and 28-year old Avicii recently. The pattern with all of them appears to be consistent: the pain is easy to hide and “putting on a good face” is an act, not their reality. This tells me that it’s wisdom to know what to look for so there is greater symptom awareness to reveal if someone may be sinking into despair.
Here are signs that could signal a deeper intensity than meets the eye (be sure to look and listen for these things in groupings, not individually):
- Withdrawal/more isolation (when someone feels desperate and alone, it’s easy to push people away because they don’t have the energy or capacity to engage and talk)
- Changes in sleeping patterns (a lot more or a lot less)
- Lack of enjoyment in activities that used to bring joy
- Depression (especially when the chronic sadness has lasted for more than two months)
- Feelings of hopelessness (listen for anything that sounds like they’re giving up or saying that life isn’t worth living anymore)
- Self-injurious behaviors (which, in and of themselves, aren’t always a cry for help, but when paired with other symptoms, are worth noting—whether cutting, reckless sexual activity, excessive spending, or anything where caution is thrown to the wind)
- Increases in substance use/addictive behaviors (use of drugs, alcohol, gaming, or eating disorders, to name a few, can be used to numb pain, particularly if other coping strategies aren’t working well or haven’t yet been learned)
- Cancelling appointments/not keeping commitments (this could be a sign of disconnection from people or from causes that used to have value)
- Lack of motivation (particularly in areas that once brought a sense of purpose and meaning)
- Friends or public figures recently committing suicide (when someone is battling with suicidal thoughts, there is power in suggestion so I encourage you to be aware of this reality, even if there was no personal relationship between them and the person who died.)
Take a big deep breath. (I’m serious).
I realize that this topic is heavy and intense. And I know this is a lot to take in. I acknowledge that it may be something you don’t want to talk about or look at. But you have to meet your friend or daughter where she is at because the world she lives in is impacted all too often by suicide. Out of love for your friend or daughter, you need to delve into these depths with her so she’s not left to tread these waters alone.
Please believe me when I say that talking with her about what she’s feeling and fearing will go a long way to helping her release questions and emotions inside herself while being able to gain perspective from you in the process.
If you want to initiate a conversation with your friend or daughter about the topic of suicide, here are some suggestions to get you started:
- Let her read this blog and ask if anything resonates with her, whether experiences or thoughts she’s having now or has had in the past.
- Gently, yet boldly, ask, “Are you suicidal or have you ever been suicidal?” If she’s not struggling in this area, she most likely won’t be reactive. If she has a strong negative reaction, it could suggest that she’s hiding something from you…and even from herself.
- Watch together Anderson Cooper’s town hall on suicide that recently aired (6.24.18) here.
- Let her know your story if you or someone you know has ever struggled with being suicidal or had suicidal thoughts. Though you may think you’re protecting her by not sharing about your past, the reality is that you are modeling that pain can be worked through and there is life on the other side. Let her know what you did to cope and what you wish you’d done differently. I assure you that your story will give her hope and she’ll entrust you with more of hers because she’ll trust that you won’t judge her since you’ve been through it yourself.
- Never get angry with her for disclosing that she’s feeling suicidal or struggling in this area. Never let your fear or sadness be expressed as frustration or anger. Never tell her she’s being stupid or foolish to want to end her life. Only show compassion and empathy. Listen hard and listen well.
- Put your money where your heart [treasure] is. Offer to pay for counseling (or help pay for it). Tell her that you will do everything possible to find her a good counselor (by calling her insurance company for her, asking for referrals from friends, offering to drive her to appointments or to pay for Uber or Lyft to transport her if she’s unable to drive herself.)
- Assure her that if she ever has suicidal thoughts, urges, or a plan that you want her to call you 24/7. Let her know you will find a way to connect with her or get her help at any time, day or night, if she is at that point of intensity, feeling hopeless and all alone.
Though this was a lot to take in, the truth is that there’s still a lot more that I could say! But at the same time it feels like there’s just not enough words to truly capture all that I want to say. So I’ll close with one my favorite acronyms for HOPE: Hold On, Pain Ends.
Wait, I do have one more thing to add.
The truest truth I can leave you with is this: Jesus and Abba Father God will hold the one you love when you can’t hold onto her yourself. And they promise to take the pain and sadness away bit by bit, exchanging beauty for ashes…and that is ultimately how pain ends.
The National Suicide Prevention Lifeline 1-800-273-TALK (1-800-273-8255) is available 24/7 across the United States.
Dr. Michelle Watson, PhD, LPC is a national speaker, author, professional counselor of 21 years, and founder of The Abba Project, a ministry to dads with daughters in their teens and 20’s. She holds her Doctorate in Health Psychology. She writes guest articles regularly for journals and magazines (online and print), as well as her own bi-monthly Dad-Daughter Friday blog. In 2014 she released her first book titled, Dad, Here’s What I Really Need From You: A Guide for Connecting With Your Daughter’s Heart (which will be available on Audible and inTunes in Dr. Michelle’s own voice on 9.1.18) and hosts a weekly radio program in her hometown of Portland, Oregon called The Dad Whisperer.