Three Things I’ve Learned in Suicide Prevention Therapy

*This is not meant to be advice; it is simply something I’m learning as our family navigates having a family member with suicidal ideation. If you are thinking about suicide or have a loved one who is struggling with thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255 (In the United States. In other countries, please reach out to a similar service in your country).

Image by Mabel Amber from Pixabay

The hubby and I began participating in therapy with a specialist from a suicide prevention center just a few weeks ago. Our son, Blake, had been sharing a good deal of suicidal thoughts with us and, since he was not interested in any ongoing treatment, we recognized we needed support ourselves. So far, we’ve done an intake meeting and two sessions. Although I’m a psychologist who specializes in treating anxiety and OCD, it’s a completely different story being a patient. I am learning, for sure, so I thought I’d share three nuggets I’ve gotten so far:

1. It’s not necessarily a bad thing that someone is talking about suicide.

Emphasis here is on “talking.” It was terrifying to me when Blake shared the thoughts that go through his mind, how much he suffers, how much he thinks of dying. I became alarmed at the very presence of these thoughts. However, our therapist (and others) have told me that it is actually a positive thing that Blake is talking about his thoughts. Talking and sharing are attempts to reach out and connect with others. This is a better thing than keeping these thoughts all to oneself – and not connecting with others.

2. It’s important to listen, not try to problem solve.

Many times when Blake has shared his pain with us, the hubby and I have worked to problem solve with him about ways to cope. We’ve also tried to shine a light on the bright side of things that he may be overlooking. What I’ve learned is that the most important thing I can do when my son shares his thoughts and feelings – even though they contain very dark and frightening content – is to listen and accept them as his. It is not my job to problem solve. That’s not where he’s at; he’s in sharing mode and he simply wants to be heard. As far as pointing out the bright side, our therapist noted that, for someone who is not ready for that, it’s kind of like shining a light in the eyes of someone who has been sitting in the dark. It’s going to be jarring and unappreciated. So, I’ve been working on listening and simply hearing.

3. An increasing number of conversations about suicidal ideation does not necessarily mean the person is about to act.

In our last session, I noted to our therapist that the freqency of conversations seemed to be going up. Our son was having more conversations with us about his pain and his thoughts of death. He wasn’t sharing intent to act, he was just sharing more often. It was emotionally exhausting, at times, and I was concerned what it meant. The therapist reminded me that we’ve shifted our conversations from problem-solving and pointing out the bright side to actually just listening and accepting. She noted that the increased frequency may simply mean it’s become more safe to share and that, when a person feels like they will be heard, they’ll take the opportunity to talk more often about what may be going on in their head. So, although it feels scary to me to be hearing my son’s thoughts more, it may just be that he feels more accepted in voicing them now than he did in the past.

We still have a way to go on this journey, and we have to listen to our son to ensure we are not missing signs of intent to harm himself. On the way, I am learning, and I hope our experience can help others.

10 thoughts on “Three Things I’ve Learned in Suicide Prevention Therapy

  1. Hi Angie,
    I just wanted to check in as it has been forever since I have left a comment. I am the (now) 58-year-old (where did the years go?) guy who has been in treatment for OCD for 30 years as of last March. I am saddened to hear that Blake continues to struggle. I wanted to share that during various low periods in my long journey that I have had occasional thoughts about suicide. I just get so worn down fighting the obsessions and compulsions that sometimes I think: “What’s the point?“ Over the years I’ve had a couple of doctors (psychiatrists or psychologists, I honestly can’t remember which) who have said to me: “It’s not unusual to think about suicide. If you start thinking about taking ACTION, that’s when it’s time to get seriously concerned.” That seems to be basically in line with what you are sharing in this post. Thankfully, I have never crossed the line into the “take action“ state of thinking.
    ———
    I also wanted to share something that Blake may face down the road (I pray he does not). However this is what has been gradually happening to me and I think it’s worthy of note.

    As I get older, my family support system (which sadly I have had to lean very heavily on) is diminishing. My ex-wife helped me a lot from 1990 to 2000 (despite the fact that when we divorced she finally admitted to me that she does not believe in mental health problems at all. She thinks I am just weak minded and should be able to “get over it“ by being tougher mentally. My jaw just about hit the floor when I heard that. But there were signs that I did not notice early on. The biggest was that she would not participate in my therapy sessions. Anyway, I digress.

    So I lost my ex wife’s support in 2000. From 2000 until roughly 2015 my mother was my main support from family. Though she never fully understood OCD, she has always been very interested in health. Born in 1925, she became a doctor of chiropractic. Quite ahead of her time I am proud to say. Anyway in 2006 she was diagnosed with MCI (mild cognitive impairment) which meant her cognitive skills were worse than average for a person of her age (81). Sadly this evolved into Alzheimer’s so she had more and more difficulty being able to lend me a hand as the years went on. Regardless, she has been a gift “from the universe“ to both my father and myself. My father suffered from severe unipolar depression. One of his sisters had OCD. I am fairly certain that I inherited the predisposition for OCD from my father’s side of the family. I would say around 2016 my mothers Alzheimer’s became bad enough that she could not directly help me with OCD. So that support gradually faded. We had in-home care support for mom from 2016 through 2019, but in July 2019 we finally had to break down and put her into a (very nice) assisted living facility. She’s 95 now, and her Alzheimer’s is pretty severe. Despite that I can still ask her for general wisdom about life. Her physical health is still OK (though I see signs of recent decline). Even now, the quality of her life “in the present moment“ is worth living. She is quite special. She also has a very very strong faith which I am convinced has given her the strength support my father and myself in such an amazing way. (Dad passed away back in 1991… Lymphoma…)

    So now I am left with two brothers when I need a shoulder to cry on (and of course my doctor!). My brothers and I are quite close, but their lives are full. One of them is nearby eight months of the year, and the other is on the opposite coast of the country. My brother who is nearby is very generous about helping me with my needs if they are way out of my comfort zone, but I try to ask as little as possible from him. He deserves a life of his own.

    I have reached a place in my life where I do not expect a cure for OCD in my lifetime. My goal is to make the most of the 20 or 30 years that I have left by continuing to expand my “OCD toolbox”. I believe low stress and a simple life are key to making the most of life with OCD. Consequently I am studying mindfulness and meditation, and have just recently started learning about minimalism which I’m hoping will help simplify my day to day needs. Sadly, even though I wrote computer software for 23 years and was married for 18 years I feel like OCD has basically “ruined“ most of my life thus far. I’m trying really hard to squeeze out something positive that will make me feel like my life was not a complete waste during this final 1/3 of my time on this good Earth. Long story short, it is never too early to start thinking about the kind of support Blake may need down the road when you and your husband may not be available for support. Not an easy topic I know, but we all need to plan for the late chapters in our lives.

    My apologies for writing such a long comment. I’m quite proud of my mother and my two brothers and I guess I wanted to share that. Feel free to edit this comment to make it “short and sweet” as you see fit. (Or don’t even post it. I’m fine with that!)

    I hope your family and Blake are far more successful at overcoming OCD than I have been. Don’t get me wrong, I have much to be grateful for and I realize that. For example, I wasn’t born in Syria!

    Blessings and Best Wishes,
    Paul

    1. Hi Paul, So good to hear from you. You have been on my mind. I always appreciate your words and your thoughtfulness. Thank you for sharing your story and your insights. Sending all my best out to you! – Angie

  2. I didn’t read the comment above because it’s so long, so I apologize if this is along the same lines… how do you discern between suicidal thoughts and the intrusive thoughts that occur with OCD? Before I was properly medicated, I had intrusive thoughts about self-harm frequently. One time I was so certain that I was going to intentionally amputate my hand with a power saw that I chopped up the power cord into pieces. My therapist later indicated that intrusive thoughts co-occurring with OCD are unlikely to be actionable. Her ‘certainty’ surprised me and possibly she was using psychology to help get these ideas out of my head. It seems to me that a person with suicidal thoughts who has OCD has a high wall to clear. Even when the urge for suicide isn’t present, the suicidal thoughts still might be.

    1. Hi Jeff. Good question. Intrusive thoughts of suicide are different than suicidal ideation. Intrusive thoughts of suicide are unwanted thoughts in which a person fears they might self-harm. They engage in mental and/or physical rituals to try to prevent that self-harm. They may review their intentions to prove to themselves they won’t act. They may hide things they might harm themselves with. They may ask others to reassure them that they will not harm themselves. The key here is the fear – the person doesn’t want to harm themselves and the thought of it often terrifies them. Different from suicidal thoughts where self-harm feels like the way out of pain – those thoughts are not marked by fear of the thoughts, but by the desire to be out of pain and suffering. Here’s one article about the subject: https://www.madeofmillions.com/ocd/suicidal-ocd

      Best,
      Angie

      1. Good explanation and good article. The article suggests SSRIs for OCD which weren’t effective for me. Do the docs ever prescribe anti-psychotics? I started taking Risperidone for Tourette and found that it worked miracles on the OCD. Although my medication manager doesn’t seem to believe me.

      2. I’m going to qualify my answer by saying that it’s anecdotal and based only on what I’ve seen some psychiatrists do for some of my patients. I don’t know what the actual recommendations are. That said, the answer is, yes, I’ve seen psychiatrists prescribe anti-psychotics like the one you mention for patients with OCD. I don’t recall if I’ve seen it as a primary med, but for sure as an augmentation with something else.

  3. Carol

    It is a very scary time when a loved one talks about suicide. The hardest part for me is lack of control. I cannot control how they feel or if they choose to act. I have to keep praying and doing my best to be open to listening. I am also a problem solver and probably shine too much light on my loved one. Something I will work better at not doing. Thank you for sharing. You and your family are often in my thoughts and I wish you all the best. xo

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