Bob Edelstein L.M.F.T., M.F.T

Authentic Engagement

On Suicide

One therapist's perspective.

Posted Nov 01, 2017

In 1973, at 24, I attempted to kill myself by taking an overdose of pills. Thankfully, I didn’t succeed. As I offer my reflections on suicide, I will share some of my journey.

I've been an existential-humanistic psychotherapist for over 40 years. I've worked with adolescents, adults, and seniors who have had suicidal thoughts and feelings (suicidal ideation), from a minor to a major extent. Given both my personal and professional experiences, I feel that suicide is an important issue to explore as part of the human condition.

These are some of my reflections:

1. Suicide brings up the question, "Do I want to be here at all?" or as Shakespeare said in Hamlet, “To be or not to be, that is the question”. This is vital, because if I decide to live, then the question changes to, "How do I want to live?"

2. For some people, I believe there is a conscious choice not to live and it doesn’t have to do with psychological conditions, such as depression. The population that best exemplifies this is people with terminal diseases who don’t want to put themselves, or their family members and friends, through the amount of pain and suffering they are going through. In Oregon, where I live, we have an assisted suicide law that supports death with dignity. I had a friend who used this law to terminate his life after having struggled for years with ALS that was progressively getting worse. For him, it was a positive decision. Even as they mourned his loss, his family and friends understood and appreciated his decision.

3. There are many people with suicidal thoughts and feelings who need hope. They feel hopeless about whatever they are dealing with in their life, whether it be a relationship, a career, or that a sense of self-loathing towards oneself and one’s actions will never change. Suicidal thoughts and feelings often come from an existential crisis, where one realizes they are not the person they thought they were or will never be the person they wanted to become. One's sense of self becomes shattered. Most of us go through some form of existential crisis at different times in our life. The value of an existential crisis is that it can lead to a revitalized way of being and an authentic sense of self.

4. At 24, I was experiencing suicidal ideation. I was obtaining a Master’s degree in Education. I felt I was terrible at student teaching. I believed I wouldn’t succeed at being a teacher, and if I couldn’t do that, then I wouldn’t be able to find any career in which I could contribute to the world. I wondered, ‘why bother being here anymore?’ When I was in that frame of mind, this all felt very true to me.

5. What is tragic about suicide is that a person has convinced themselves that they need to kill their body. Something does need to be released, but it’s not the body. What needs to be released is a way of thinking about oneself or the world. Once this occurs, whether it be through any combination of psychotherapy, spirituality, medication, community, or an encounter with nature, a new way of being can emerge. Releasing an old way of thinking is a death. However, it is followed by the birth of something else. One’s life is changed for the better, and can still be challenging at times. It is important that one or more ways of being die, so there is space for healthier ways of being to be integrated.

6. A goal of mine, as an existential-humanistic psychotherapist, is to listen deeply to what the client’s internal experience is, so the client feels heard, seen, and understood. It is important that they know that they are not crazy or bad for having suicidal thoughts and feelings. They are not alone. A second goal is to help them discover hope and to hold hope for them. This can be done through deep listening, acceptance, and through pointing out possibilities that they are not aware of. A third goal is to let them know through your words and actions, that they are important to you. A fourth goal is to let them know that they can come through the other side to a fulfilling life, as others have done. This may include sharing your own past experience of suicidal ideation if that feels appropriate. 

7. My own therapist's belief was crucial in helping me move through my suicidal thoughts and feelings. After my suicide attempt, I discovered I wanted to be a therapist. While I realized I needed to put less of my worth in my career, I also knew I wanted a career I’d feel good about. My therapist, in a very pragmatic way, shared how to best go about this. I thought that after my suicide attempt, he’d tell me that being a therapist wasn't a good idea. He did just the opposite. It moves me to remember this. That was a turning point. The other turning point was when I got rejected from the Ph.D. psychology schools I had applied to. I was disappointed, but not devastated. I knew I was still worthwhile. My way of being, my attitude towards myself, and my self-worth had changed. My sense of worthlessness had died. In its place, an appreciation of my inherent value was born. Through my life, I’ve still had times when I have felt vulnerable and experienced a sense of worthlessness. However, what is different is my sense of worthlessness is a transitory experience that moves through me, not an identity that feels permanent.

I hope these reflections can be part of a dialogue with other professionals about suicide and suicidal ideation. I hope these reflections can offer meaning for anyone who has gone through suicidal ideation. I hope, for anyone currently suffering from suicidal ideation, that these reflections can offer them faith that a positive way of being can emerge.

About the Author

Bob Edelstein, L.M.F.T., M.F.T., is an existential humanistic psychotherapist based in Portland, Oregon.

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