Perhaps because it’s the biggest killer of men under 50 talking about suicide has become less taboo but there’s still a lot of stigma and fear when it comes to actually talking about suicidal feelings. People fear that talking about these feelings will result in panic and chaos, that a counsellor will call the police or prevent them from leaving the room until an ambulance arrives with a mental health team and a straight jacket. Some suicidal people want something like that to happen, for someone to relieve them of all responsibility, to take control and let them rest but anxiety about how that may happen prevents them from taking a first step.
My contract has four clauses that limit confidentiality and one of them is if the client is seriously suicidal, but what does ‘seriously’ actually mean?
If a client tells me that within the last few hours they’ve taken an overdose then I’ll call an ambulance whether the client says they want me to or not – the fact that they’ve told me at all suggests that some part of them wants my intervention. So far that’s never happened to me. What has happened is that a client has told me enough to make me concerned that they may actively try to kill themselves within the next few days. I’ve asked their permission to contact their GP to get them involved. I’ve done this twice, both times with the client and me in the same room and with the speakerphone on. It’s important for the client to know precisely what is happening. Both times the client saw the GP within 4 hours. They weren’t sectioned or coerced into anything and continued to come to therapy.
Huge numbers of people feel more or less suicidal every day. When things seem too overwhelming, when you’re too tired and worn down, when there are too many demands and nowhere near enough resources suicide can seem to be a rational choice. The vast majority of people who feel this way don’t want to die, they dearly want to live, but to live differently from the life that they are trapped in. Poverty, pain, violence, shame, discrimination, fear, exhaustion and a long list of other circumstances can make life anguished and hopeless, compounded by the wretched fashion of positivity that boils down to ‘You are always failing.’
Suicidal feelings can be comforting, they offer a semblance of control when everything else seems frighteningly out of control. If the pain or other struggles become too much then suicide simplifies everything. It’s why prisoners are kept on suicide watch: to stop them having any control whatsoever over their own life. To remove that final aspect of control from a person who sees suicide as their last resort is a form of torture.
Feelings of despair and suicidality are more than worthy of being heard, they are the heart of the matter. Sometimes they are a howl from the past when events took over and swept you away. Sometimes the present is unbearable. You know that no one ever gets over the death of a child or another dearly loved person and the idea of living with this pain seems impossible at the same time as beginning to come to terms with it can seem like a betrayal. Moving into the liminal space between life and death can be caused by cumulative smaller events: being subjected to ‘regeneration’ or being made redundant; the end of another relationship or many long years of a violent one; workplace insults and misery can wear a person down to nothing. Living with suicidal feelings can become habitual, the neurological pathways between anxiety, a sad thought, a difficult event and the solution of death become well worn and more swiftly travelled without us even realising it.
Whatever the case examining these feelings and thoughts is the work of therapy. Bringing a light into these places can make them less mysterious, less alarming. Looking at them squarely can diminish their power and witnessing them honours what may have been longing to be seen for many years.
No counsellor can stop a person who is determined to kill themselves. For some people life is genuinely too complex and painful to endure and no amount of care, trust, relationship, medication, voluntary or involuntary hospitalisation or anything else will ultimately prevent it. Yes, suicide often bequeathes more pain and misery, no one denies that, and there are often ways out of present agony other than death.
If you can choose to die at any time, take the time to share your truth with someone who can bear it.
Maytree - 020 7263 7070
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