SUICIDE

I used to answer two suicide hotlines in both a volunteer and paid capacity.  Because of this experience, I often get many people in various social circles asking me questions about suicide.  Usually it is about "a friend" but I have sometimes found that third party queries can be personal.  In those cases, I would quickly turn the question around and ask the person questioning me if they have ever thought about suicide themselves, then, take their question from there as it pertains to the "friend." 

When I first began my training, I was asked if I knew anyone who attempted suicide and I didn't.  After the training, I realized that I had indeed known over 15 people who attempted suicide or completed the act.  How quickly the living can forget.  That is something the people contemplating suicide are rarely aware of.  One of them was a priest friend whom I had lunch with every Sunday for 25 years as I went in to do volunteer work at the VA Hospital.  He had written some not very flattering anonymous letters about the sexual proclivities of our Bishop, who then found out who wrote them and called my friend, Fr. Minkler, in from his vacation to sign documents stating that he didn't write the aforementioned letters.  As I met with Fr. John that Sunday afternoon, I was running late and we skipped lunch.  He told me that he was having problems and he asked me to pray for him.  I told him that I would and then went on my oblivious and preoccupied way.  He completed suicide that night and I was most likely that last person to speak with him.

There are many reasons people think about suicide.  Here are just a few.
A teen who identifies as homosexual and has homophobic parents; or he discovers that his religious faith forbids and condemns it or him; he may witness or is the recipient of bullying and persecution at school.  Ironically, our mainstream society is indeed very tolerant and unflinching about the topic.  It is the intolerant religious groups, media, politicians, parents worried about their child's future happiness and people who protest too much who are the real problems.

There have also been parents who lost their job and they see no hope of obtaining employment in the future and they think that the only way to provide for their children is to kill themselves for the insurance money.  Some people think they are a burden and their family would be better off without them.

Someone who was hurt and betrayed by someone they love and thinks that completing suicide will "show them" or get even.  Teens think this way quite often.  Sometimes a call for help can go unheard one too many times.

There are many people who are intolerably lonely and may feel friendless, lost or ostracized.   Each long day is a struggle to get through.  Sleep is their only relief from the pain of loneliness.

Another caller may be someone who was arrested.  It isn't the remorse for the crime which can make them think about suicide.  Restorative justice can easily resolve any wrongs they've committed and they know this and would gladly put things right given the opportunity.  It is the shame of getting arrested.  Then, maybe losing their job because of it, losing friends, the feeling that they've shamed their family and are facing an uncertain future with expensive courts, lawyers, prison and legal proceedings.  This is our punitive and unforgiving society at its best.

There are many people who suffer from biological, prescription or event  created depression.  I've had many people who witnessed something horrific such as military personnel, who then don't know how to deal with their experience.

Some people are in tremendous physical pain and see no relief or hope in their future.  Many of these people are trapped in a downward spiral of addiction to prescription drugs where either the drugs have no effect anymore or weaning off of them is intolerable. Doctors are quick to try other drugs or mix and match a cocktail of them.  This doesn't always resolve the dependency. 

The one thing to remember is when someone calls, they are not looking for somebody to fix their problems or give them a solution or tell them what to do.  They are looking for someone to be there and to listen.  To help them get through the moment.  To be a friend.

During my first few days of answering the phone, every time it rang I was terrified.  The key though, was in remembering that the caller was looking to get through the moment.  To live another day.  And, I was there to only listen.  To steer them into their pain of the now.

I had a caller who had a gun and was intent upon shooting himself.  I asked him to put the gun down so that we could talk.  He did.  Later in the conversation I asked him to take the bullets out.  He did.  I then asked him to place the bullets in another room and put the gun away in a separate room, which he did.  We then had a very long conversation.   At the end of the call, I invited him to call back tomorrow to let me know how he was doing and he said he would think about it.  He did call back the next day but got a different suicide specialist.  He wanted to thank me for saving his life and told the other suicide specialist that after he hung up with me, he was going to follow through with killing himself.  What saved him was his promise to call me back the next day.  His word and promise was more important to him than all the problems he was going through.  Making dinner, getting a full nights sleep and getting up the next morning was enough for him to be glad he was still alive.  I didn't fix his problems, but I did get him through the moment and gave him something to look forward to.

I had a frequent caller who kept a bottle of vodka and prescription pills under her bed.  That was how she was going to do it.  Her problems were many and she didn't want to complete suicide, but she did want to die.  Her life held no joy.  I once convinced her to pour the Vodka down the drain.  She continued to call to both check in and to make sure we were still here for her.  She would call sometimes just to say hi.  I would ask her if she was thinking about suicide today and she said yes, but wasn't going to do it.  Then, on cue, she would tell me what she was going to do for the rest of the day to get through it and we'd hang up.  One day she procured a new bottle of vodka and called us.  She got a new person on the phone who panicked at the fact that she had the means and the intent so, he called 911.  The police went to her home, broke down her door, put her in handcuffs, the neighbors all came out, the lights were flashing and they then transported her to a mental institution where she had to remain for three or four days of observation.  We never heard from her again.

There are many right and wrong things to say to a caller.  Trust me, some callers will let you know when you say the wrong thing.  They can either blow up at you, insult you, or hang up the phone.  The irony is that all the wrong things to say are very natural to us.  They include things like,
"I'm sorry."
"Let me tell you what happened to me."
"I know exactly how you feel." 
"The same thing happened to my sister." 
"This is what I would do." 

It is uncomfortable for many of us to not be able to help someone fix their problems.  It is our nature and desire to fix people but in reality, it drives us further from the person seeking help.  A caller calls because they want to talk.  The more talking we do, the less they get to.  The more we talk about ourselves, the less they get to talk about their problem.

Sometimes a caller is silent and that can be very uncomfortable for us because we feel like we have to say something to fill the void, when in reality, just being there is enough.  One caller told me that she didn't want to talk.  She just wanted to know that somebody was there.  Some of my callers had their greatest breakthroughs in the silence.  Silence was my greatest tool in my suicide toolbox.

Here are a few questions I would ask a caller to get the conversation started.  The next time someone shares a problem with you, and it doesn't have to be about suicide, resist the natural urge to wallow in their complaints or fix them and their problems.  The hard part is to just listen and steer them into their pain.  When they can talk about what is bothering them, they can begin to heal.  Try these and see where the conversation goes.  Notice that these questions, comments and concerns get the other person to talk more and you, less.  The key lies in truly listening and caring.  Only then can you hear the subtle cues as to what to ask next for, one answer can open up a dozen more questions and comments from you. The questions may be:
What would you like to talk about today?
How have you been dealing with that?
You said that this problem has been bothering you, what is most difficult?
Tell me what happened when . . .
Say more about . . .
What is it that you want from . . .
It sounds like that is very difficult to deal with.
How did they make our feel?
Tell me more about how feeling ___ is like for you.
It is not always comfortable talking to someone about these things but take your time.  I'm here to listen and support you (after a prolonged silence).
Have you told anyone how you're feeling?
What do you think you can do?
What may stand in your way of . . .
What support options do you have?
You sound like you are in a lot of pain (note, that's not a question).
Does anything trigger that?
Where do you direct your anger?
Have you been trying to stop?
How did you feel when . . .
What kind of coping techniques do you use?
What can you do right not to take your mind off of . . .

As you can see, those questions get the caller to talk about what is bothering them.  But, that is just the tip of the iceberg.  After establishing rapport, defining the problem, exploring their feelings, I would come right out and ask them if they were thinking about suicide today, if they haven't already told me.  I would also come right out and ask them if they have a plan, a time, the means, or if they ever tried it in the past.  At this point they are very comfortable admitting anything.   Even that they are standing at a river's edge or there is a gun in their lap.

When I feel that they are safe for the moment, I would get them to make plans for after we end the call.  These are called distracting activities.  At this point I know quite a bit about the caller and can make suggestions if they are at a loss at coming up with their own.  They may include: 
Calling or visiting someone
Exercise, going for a walk or ride a bike.
Go shopping.
Watch TV.
Cook or eat something they enjoy.
Play with a pet.
Create something with art or music, a letter or a journal, meditate or take a shower.
Go outside and take pictures.
Clean the house.
Etcetera. 

The fact that someone calls us in the first place and is willing to talk about suicide shows that they have ambivalence and that is a great way to start.

There are hundreds of suicide hotlines.  Many are funded and staffed through schools and colleges.  Unfortunately they may have limited hours, are open mostly during the day or not on the weekends.  The National Suicide Prevention Lifeline (NSPL) is seven days a week, twenty four hours a day.  Their toll free and anonymous number is 1-800-273-TALK (8255).

"Like" NSPL on FaceBook (FB is also a source of depression for many people, BTW).  Blog about NSPL.  Print out their cards and leave them around schools, the library, at work, in your church, on bulletin boards, on coffee tables, on store shelves, anywhere where people are.   Keep the toll free number on your cell phone so when you encounter someone with a problem, ask them if they would like to speak with someone about it then pass them your phone. Check out the NSPL website to learn more:  
https://www.suicidepreventionlifeline.org

Suicide should not be a secret.  Are you thinking about suicide today?

-Malcolm Kogut.