When a Loved One Threatens Suicide
What can you do?
Posted Jan 18, 2017
On March 14, 1932, U.S. inventor and philanthropist George Eastman, immediately after signing documents giving the final installment of his fortune to charity, wrote a note—“To my friends, My work is done. Why wait?”—then shot himself dead.
When someone you care about feels self-destructive, first, seek help; get professional advice. This is advisable, because thoughts of killing oneself may be associated with a treatable form of mental illness. People with depressive disorders feel hopeless, helpless, and worthless as part of the illness. Suicidal thoughts are symptoms that may respond to medication, cognitive behavior therapy, or other treatments.
Similarly, people with schizophrenia may hear persistent critical voices that tell them compellingly to commit suicide. Here, too, medication and appropriate social care can be a big help.
A comprehensive psychiatric assessment is required to detect such cases. In the UK, these can be arranged by a General Practitioner through the local Community Mental Health Team, and/or the Social Services. In urgent situations, the Police may need to be called, or the person taken to a hospital Accident and Emergency department for assessment.
There are many other cases, though, for which a medical explanation is unsatisfactory and psychological treatment of only limited value. I remember, years ago, seeing a couple (both about 30) in a psychiatric emergency clinic. Let’s call them Peter and Vickie. Vickie was highly distraught because Peter had been threatening to kill himself. "You’ve got to stop him," she insisted.
Once alone with me, Peter said that it was Vickie’s idea to come for advice, not his. He then spoke calmly about himself and the many things that had gone wrong with his life. He felt a burden to his girlfriend, and thought she would be better off with someone else. Although he often felt like suicide, he did not plan to carry out the self-destructive act immediately or in the near future. It was more of a back-up plan if things were to get a lot worse, particularly in terms of the relationship.
I decided that, like George Eastman, perhaps, although deeply unhappy, he was not suffering from a mental illness. He could make rational decisions for himself, and knew what he was about. Vickie’s desperation, while understandable, was not helping. With Peter waiting outside, having given me his permission, I then spoke to her.
"Have you got him to change his mind?" she asked immediately. I repeated that he was not mentally ill, and that I was not going to Section him (i.e. use the Mental Health Act) to force him into hospital or take treatment against his will. Although I much preferred that he live, I had realized that I could not decide for him whether his life was worth continuing with or not, and was therefore bound to respect his choice in the matter. Naturally, Vickie was upset. I wasn’t doing what she wanted.
"How am I going to stop him killing himself?" she asked, tearfully. "I can’t be with him all the time. I can’t do this on my own."
We then had quite a long conversation, during which she agreed that Peter was in control of himself, rather than mentally ill. She accepted that I could not guarantee his safety, even in hospital. People who are determined to kill themselves often find ways of doing it, even when the people around them are fully vigilant. Finally, Vickie agreed that she, too, was powerless to prevent Peter’s death, whenever it happened, and whether from suicide, illness, accident, or anything else.
As she sat there, crying—grieving—and ultimately acknowledging and accepting the hard truth of the situation, I could see that she was becoming less anxious, much less desperate, free from the idea that she would be responsible for what happened, rather than Peter himself. It was she who was healing; and maybe this needed to happen, because when Peter joined us again, the interaction between them was different: much less strained, much less toxic. The dynamic them had shifted. The love and affection that had brought them together in the first place was now able to re-surface. This, in turn, immediately improved Peter’s outlook—and reduced his risk of suicide.
Vickie had been able to step back and see Peter no longer as a distressed part of herself, a distressed part that she was unable to fix. Now she could relate to him in a new way; as a separate person with a mind of his own, with choices to make—not only about living or dying, but about everything, including the little things in their lives. Peter, in turn, could see that Vickie’s choice to stay with him was a genuine one, not forced on her by a misplaced sense of duty, or out of pity. She was giving him his freedom, and he valued her all the more for doing so. This all seemed to me to bode well for their future.
This is just one story out of many; some similar to it, many very different. If Peter had killed himself before coming to the clinic, Vickie would have felt failure and blamed herself, despite having tried everything she could. Peter, considering himself nothing more than a burden, might have thought he was doing the right thing, not realizing the lasting pain he would leave behind. It would have been a mistake. Children, especially, can experience damaging levels of self-blame when a parent commits suicide.
There are no easy answers, but it does seem advisable—as Vickie’s story reveals—to face the reality of loss when it threatens us, to allow ourselves to grieve and so eventually heal. Emotional healing like this is transformative, prompting personal growth. It results in the emergence of wisdom, of the kind of guidance from within that some might think of as spiritual. Somehow, with the wonderful mystery of guidance like that, we will always know what to do.
Copyright Larry Culliford.