There isn’t much if anything as hopeless as contemplating, planning, or actively trying to die. And there isn’t much if anything more helpless than a loved one trying to keep someone alive who wants to die. There are a multitude of client personalities, known or hidden lifestyles, family histories, traumatic events, and chronic stresses that could propel someone to the end of their rope. They walk among us, those who want to die. They are us. People of all ages, races, public and socioeconomic status, genders and sexual orientations, levels of physical ability and mental stability, sometimes want to die, and as you know, many do by their own hand.
"Suicidality" ranges from passively thinking one can’t handle life in general to precisely planning or attempting self-murder. Wanting to die is a reactive and tragic expression of a painfully enraged or apathetic sense that the world -- which includes a multitude of factors like our own bodies and minds, our friends and lovers, our parents or bosses, our finances -- will often not cooperate with us. For logical reasons to be patiently explored in a therapeutic treatment environment, the suicidal person feels unable, unworthy, unsupported, and unreachable -- especially when life stresses become unwieldy.
What starts as a conversation with self, replete with extreme assumptions related to chronic discouragement or rejection -- nothing is ok, no one understands, everything and everyone is always against me -- can escalate to someone giving in to that inherently false but compelling storyline and manifesting as his or her own worst enemy. It is therefore crucial, after ensuring a suicidal person’s safety, that suicidality be approached with unconditional regard for and respectful curiosity around the events that shaped it, as a way in to the clients' tragic sense, where the real building of resilience begins.
Through trust and rapport with a nonjudgmental clinician, the development of supplemental supports, and practice of self-regulation and paradoxical inquiry, suicidal clients determined to rewrite their life stories eventually experience moments of peace and self-regard, then discover the workability of triggering situations, then recognize the real possibilities for joy and confidence in even the hardest of times. Family and friends are an important part of the story and can be enlisted for support as changing conditions in a formerly suicidal client's views and preferences emerge and require acceptance. As such, significant others are often included in sessions, and other treatment providers can also be excellent encouragement.