The Paradox Of Suicidality: How We Are Making Things Worse

Death is terrifying.  In fact, the concept of death has led many a person to an all-out existential crisis.  Death is so frightening that the idea that someone could take his or her own life willingly shakes us to our core.  So what do we do when someone that we know, love, or work with becomes suicidal?  I’ll tell you what we do, the same thing that a younger, more novice version of my therapist-self did early in my career.  We save the person and put all of our energy into engaging what made him or her suicidal.  We fear losing a friend, patient, client, or lover.  We fear it so much that we try to put the suicidal person in a bubble of sorts, doing our best to protect those that we love by filtering reality and doing one of two things.  We either focus on all of the good still left in a person’s life hoping that those tidbits of happiness will be enough to save a life or we place all of our efforts on ensuring that everyone knows that the person is struggling, throwing every resource that we have on engaging the thought of suicide head on, essentially branding someone as being ready and able to implode at any moment.  Somehow, someway, we lose our sense of balance when we are afraid or cannot control and ensure the outcome of a crisis.  We stay up at night paralyzed by a fear that the very same person that we spent so much time trying to save will backslide and die.  There is a sad truth to our loss of balance in the face of fear.  It is the ultimate paradox.  In trying to do our best, we sometimes inadvertently make things worse. 

Let’s face it, when we tag someone as being at-risk for suicide, we essentially follow one of two paths. Traveling down one path, we paint his or her forehead with a neon X so that all of those who see it know to walk on eggshells and use kid-gloves.  We ensure that we quickly escort every person that hints about thinking of suicide to the closest emergency room.  We try to bubble wrap the world putting a band-aid on issues such as financial strain, divorce, chronic pain, and mental illness.  In stark contrast, a trip down the second path usually translates into a silent cover-up.  We do our best to make sure that no one knows.  Stigma rears its ugly head and we are again seized by fear.  What if someone finds out? What if everyone thinks that the person is crazy? If I say anything, will a job be affected?  If everyone knows, will that make it all worse? 

On either path we pigeon hole a person into a tiny space the leaves no room for growth.  On the first path we focus on illness losing what is healthy somewhere along the way.  We throw resources, medication, and time at a problem.  These actions on their own are not bad, but when combined they leave little room for a person to focus on anything other than feeling suicidal.  A trip down the second path does just the opposite, in trying to insulate someone from stigma and hiding the problem away we fail to acknowledge that a problem exists.  Without acknowledgement, we trap that same person in his or her mind with no way out and no hope for assistance. 

So now to my most important point. What does all of this mean? What could we do differently and why should it matter? Suicide is not going away any time soon. Twenty-two veterans per day are reported to be dying by their own hands. Suicide is the second leading cause of death for adolescents in the United States. A day does not go by without the mention of an active shooter, a murder-suicide, or the tragic loss of life of some of our nation’s best and brightest. Suicide does not choose its victims based upon race, ethnicity, economic status, or age.  It is a part of the human condition. Suicide is often a last ditch effort to end pain, exert control, and leave this world on personal terms. If we want to make things better, we need to accept that suicide can show up anytime, anywhere, and next to anyone. We need to remind ourselves that crisis is an opportunity for growth. 

Why growth? The term post-traumatic growth has gained momentum in the last ten years. It is based upon the idea that we, as humans, can grow out of a crisis.  In facing our own mortality, our worst fears, we learn to re-frame life and find strength in the struggle.  If we are to effectively treat suicide, we need to understand two things. First, we cannot save everyone. We can do our best, but sometimes the grip of illness and pain will be too great. Second, we need to find balance in how we engage those who are or have been suicidal.  We need to both support and empower the growth of others. Recently, a wise person said it best as we spoke about how to handle the suicidal thoughts of a person that we both cared for and worked to assist. He said, “We will make sure that this is a healthy event.” At first glance, this seems counter-intuitive. How can anything regarding suicide be healthy?

The path forward is found in taking the above statement for exactly what it is, a didactic phrase that implies that growth is possible following pain. In supporting a person in asking for help and acknowledging that pain is present, we can validate that pain and start a framework in which growth can occur. We support and empower; we provide care while ensuring that a person still has the right to live, grow, and learn from each day.  We make the moments, days, and weeks following suicidal thinking a time for health and wellness during which a person can gain confidence, face demons, access mental health care, and move forward with life.  Essentially, we find the balance.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline . Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.