This is a collection of observations based on times when I or a friend was suicidal. Do not freak out. I am not suicidal now. My thinking is, I admit, a bit disordered because of my toothache, but I’m quite safe.
Many of us, in the course of a lifetime will either talk TO a suicidal person, or talk AS a suicidal person. And I think we all wonder what to say or do…as usual with these posts, there is no one answer that is always right. And sometimes, an answer I list here as a wrong answer might be the right answer in a particular situation. You see, humans are capable of infinite diversity.
As always, I advise you to take suicidal persons seriously. If you have no idea what to do call this number. If the suicidal person is unable or unwilling to talk on the phone, they will talk to you and tell you what to do. Don’t get alarmed or frustrated if the suicidal person will not talk on the phone. It’s not just me, many suicidal people get weird about the phone.
Remember, when you are talking to a suicidal person, you are talking more to an illness than a person. Their illness has already shot down any positive thoughts they might try to cling to. It rarely helps a suicidal person if you approach them with the ‘Think of all you have to live for’ line. That illness, that depression, that bi-polar, that schizophrenia has already undermined all the good bright things in life. The ‘Think of all you have to live for’ attitude may only increase their sense of guilt, shame, and depression.
Another thing well-intentioned people do is try to play John Wayne playing a good-hearted Army sergeant. They grab you and say ‘Talk to me!’ This approach can scare or intimidate the suicidal person badly. A better tactic is saying “May I listen?” Remember that a suicidal person is living in a realm of rapidly diminishing choices. Their tunnel vision is tapering down to a single point. Inviting them to talk adds a new option, and it sometimes can change how they view the world.
Sometimes suicidal people engage in self-harm. Most cutters, burners, and scratchers only engage in these behaviors privately. But when people are very suicidal, they can become disinhibited, so you might see these behaviors. And they are not pretty things to see. Everyone who sees self-harm wants to say “Stop that!” and that is a reasonable impulse. But curb that impulse. Ask them, instead, “Are you doing that so you don’t do something worse?” Now, that might seem like I’m giving you poor advice, and it is poor advice, but it is also sound advice. Weigh the consequences. You would prefer to have your friend as a live cutter than as a dead friend who will never cut again.
Suicidal people often quit sleeping or eating. And that isn’t good. Try tempting them to eat with hyper-palatable foods…try ice cream, milkshakes, twinkies, doritos, whatever you think they might eat. Don’t worry that you are offering them unhealthy choices, just try to get some food in them (and if it’s me, offer pork rinds!) If they aren’t sleeping, try to get them to take a nap. They will be resistant. Build them a blanket fort to nap in, let them put their head in your lap to sleep, promise to stay while they sleep…again, do whatever you can to get them to sleep.
When you are dealing with a suicidal person, realize that they are still ‘in there’ they are just very small, very scared, and nearly voiceless. Their illness has grown large. It occupies all the space where the person normally lives. The person you know has been crowded into a very tiny corner. So speak slowly and clearly. Be prepared to repeat yourself. Your voice is a tiny whisper, the illness is roaring.
Remember, too, that the illness is the enemy. This sick, suffering person is not the enemy. You are not trying to outwit the person to get them to a safe place, you are trying to outwit the illness. The struggle is real, but you will make a mess of things if you do not know what you are struggling with. Also remember that getting the person to agree to go to the hospital can be very difficult. It is even more difficult if the person has been checked in before.
The hospital will take the person’s complaint very seriously. The hospital will go to heroic lengths to keep the person safe. But the hospital is, first and foremost, a hospital. The scared, sick, suicidal person will be subjected to indignities, they will wait a long time in an ER bay (waits of 2 days to be admitted to psych are not uncommon) The hospital is good at what it is good at, warmth and comfort are not areas where the hospital excels.
But getting the suicidal person to get help, getting them to go to the hospital should be a major goal. BUT do not lie to them to get them to go. Find another way to get them to agree. Understand that they might very well know exactly what the hospital will be like. Understand that they are scared to go to the hospital. Understand that they do not want to put up with the indignities of the hospital. Just keep truthfully bringing it up as the best option. (and, sadly, it is the best option, in fact, it is the only option.) Try to offer to take them to a ‘better’ hospital. Because we all know that some hospitals are better than others. We all know that the better hospital might transfer them to a hospital that is not so good, but going to the better hospital greatly increases the odds that they will be admitted there.
Finally. A suicidal person is generally not seeking attention. If they reached out to you, it was the last desperate act. Reaching out to you took tremendous effort, probably it took all their energy to do it. They are being suffocated under the weight and volume of their illness. Do your level best to get them help. There is something about you that the suicidal person believed and trusted in with the last of their will. If a suicidal person asks for your help they are telling you how highly they think of you.
In very rare cases, some types of illness use suicidal threats and behaviors as a way to manipulate others. These illnesses are more rare. And being used like that makes YOU feel terrible. You can feel angry or betrayed. Try to put that confusion and those negative feelings aside. Remember that this person has gotten so sick that they are threatening themselves to be heard. Get them to a hospital, get them help. They are really sick, and they are a very real danger to themselves.
Basically, helping a suicidal person is the same as being a good friend at any other time. Have empathy. Listen intelligently. Use your head and your heart. Put yourself in their shoes. And act decisively to get them the help they need. The world is a hard and scary place sometimes. We need all of our friends healthy and alive as long as normal mortality permits.