What to Say When a Life is at Stake

Because saying nothing is a mistake

Wednesday, May 22, 2024

There are many hard things we occasionally need to say to people. One of the most difficult has to be asking someone if they are thinking about suicide. I don’t imagine many of us feel equipped to venture down that path. Not only might it feel like an invasion of privacy or not the kind of thing you and this person talk about, but you may have serious concern that opening up the conversation will open the door and give them the idea.
 
When Dr. Pamela Morris Perez, a developmental psychologist and professor of applied psychology at New York University, lost her 17-year-old daughter to suicide, she focused her research skill on finding methods for tuning into someone’s deep suffering because her daughter, Frankie, had not given any indication she’d had suicide on her mind. And so in the aftermath of her grief, Dr. Perez founded Arcadia, a research center for bringing adolescent approaches to suicide prevention into the spaces where teens spend their time.
 
What follows are key takeaways from a conversation Dr. Perez had with Kate Bowler on the Everything Happens podcast.
 

• Talking about suicide does not increase the likelihood of it.  If you label something, you can manage it better, which is what we teach our children.  Teenagers especially struggle to label their difficult emotions, and often struggle to speak about troubling ideas like the thought of suicide.  
• Say “died by suicide” rather than committed suicide. The word “committed” comes from the legal system reflecting the ages and eras when dying by suicide was considered a crime. Language matters. It subtly and not so subtly shapes perception and feels infinitely better to those who have suffered a loss to suicide.
• People who have lost someone to suicide are “suicide loss survivors,” similar in language to how we talk about survivors of trauma. This language provides a very helpful label for those who have suffered the loss and need something with sensitivity to call their experience.
• Suicide is not about wanting to die which is what many of us assume. It’s about wanting to avoid severe emotional pain so unrelenting it feels like there’s no other way out. It’s really important, therefore, to give somebody a different way to relieve deep and unrelenting emotional pain.
• Suicide proof your living environment by keeping firearms and dangerous medications, both prescription and over the counter, in a lockbox. 
• It’s important to safeguard against suicide because timing is critical when impulsivity is a factor. If there is a means, then there can be immediate follow-through. Many people who attempted to take their lives but did not die are often relieved they didn’t and don’t go on to attempt again.
• Suicide proofing a living environment is like a seatbelt. There is a built-in strong will to live so if a pause button can be hit, if suicide can be delayed a little longer, then some lives will be saved. It’s why the Golden Gate Bridge’s safety nets actually work to prevent some deaths.
• Parents, peers and others close to a person of concern need to ask that person directly: “Are you thinking about suicide?” Then we need to stop and listen, following up with: “At all?”
  
  Do not say things that soften the question or take it back such as, “Of course you’re not” or “I’m sorry I asked.” The questions must be asked; asking them normalizes them.
• Ask the question directly. Don’t say things like, “Are you feeling really sad?” Though depression and suicidality can be paired, thoughts of suicide can exist without depression or anxiety.
• Once the question has been asked, then the ice is broken, and they can come to you six months down the road or whenever. This is now something that can be talked about.
  
  Further, asking the question has now been modeled for them so they, in turn, can ask their friends if they are concerned.
• If we don’t talk about suicidal thinking then there is no space to explore it, defang it, regulate it. In most cases, when you ask you will be hearing thoughts, not plans.  Often, talking openly about thoughts of suicide brings a measure of relief to the person having them.
• While the only person who can save a person is ultimately themselves (which is important for people who lose someone to suicide need to know), if you can sit with someone for a moment in their emotional pain and feel it with them, then for that moment they’re not alone and that moment may help them find their reasons for living.
• When someone discloses suicidal thoughts:
  • Let them know you are there with them, without judgement, and that you care about them.
  • Ask them to tell you more, how long have they been thinking about it, do they have a plan they have been thinking about.
  • Validate the emotional pain they are in by saying things like:
    • “I’m here with you, right now.”
    • “Thank you for talking with me.”
    • “Can you tell me more.”
    • “I can see how much pain you are in.”
  • Encourage them to call or text 988. Offer to start the call yourself and to sit with the person while they talk the crisis specialist.
  • If at any point you believe someone is at immediate risk of hurting themselves, call 911.
  • The most important thing to do when someone tells you they are suicidal is to alert the proper people. That could be this person’s parents, teachers, friends, even a work supervisor. Do NOT keep it a secret, even if you are asked too. Safety is always the number one priority.

The best way to normalize having direct conversations about someone’s state of mind is to have them. I am betting the people we ask will be relieved that we did. I have always been touched and grateful when someone has checked in with me on absolutely anything.
 
To tuning in,
 
E
 
 
Resources

1. Healthy Life EAP is a free, confidential and 24/7 benefit for all Northern Light employees and family members living under their roof. 1 – 800 – 769 – 9819.
2. 988 is a 3-digit number to call if you or someone you know is struggling. This Lifeline provides 24/7 free and confidential support for people in distress in addition to prevention and crisis resources for you or your loved ones. Think of it as a befriender line, someone actively listening and empathizing. Parents can also call the number if they are worried about their child.
3. Loving Someone with Suicidal Thoughts: What Family, Friends and Partners Can Say and Do is a helpful book.
4. The Magician’s Elephant by award winning author Kate DiCamillo is a book for 9 – 12-year-olds that explores themes of loneliness and sadness, hope and belonging, desire and compassion with a light and magical touch.