When Dark Thoughts Need Acknowledgment

“In the still of that late winter night, 1979, for the first time I laid in bed, cold and numb except for a thin, hot streak coursing through my head, and fantasized about killing my father.”

These words hung conspicuously at the end of one of the essays I wrote for my MFA thesis last year. My collection of childhood stories included this account of the time when I was 14 years old and my dad had just roughed up my 17-year-old brother. Violence and alcohol-fueled degradation were like the stained wallpaper that covered the interior of our small ranch home, only much louder. I’d never written these words before. Indeed, I’d never uttered these words before. My father died several years ago and although this event occurred more than 40 years earlier, writing these words still felt taboo, almost wrong to acknowledge. And yet, through that time and for several years hence, they were truer than true.

Talking about suicidal and homicidal thoughts

In my 30-plus years of being a witness to my clients’ stories, the tracts of suicidal and homicidal thoughts have felt siloed. It’s as if a threshold has to be crossed for these experiences to be acknowledged. A person has to have substantially horrific experiences of abuse (highly subjective designation) or significant clinical depression/anxiety for there to be a social endorsement of giving voice to these thoughts.

Most of my clients are the walking, functioning wounded. In other words, they are seeking to manage and adjust to the slings and arrows that being human in this modern, first-world age bring. They don’t necessarily have major diagnoses. In this arena, thoughts of suicide and homicide remain taboo. To acknowledge these would trigger a range of inhibitory social responses, from public withdrawal and shunning up to a potential overreaction resulting in a call to a crisis and assessment clinic.

As a clinician, I know well the assessment protocol for threat of harm to self or others: the character of the ideation; the existence and lethality of a plan; past harm behaviors/attempts; and risk and protective factors. There is a continuous stream of research that gauges the prevalence of suicidal and homicidal ideation. In a 2023 data brief with the CDC, Strashny, Cairns, and Ashman note that the lifetime prevalence of suicidal ideation in the United States sits at 15.6%. This data was derived from emergency department visits. I have been unable to find a more comprehensive accounting for suicidal and homicidal ideation that would include unambiguous thoughts with no intent for action. I imagine this number to be much higher. These thoughts occasionally reach the ears of therapists in private practices and clinics. I must assume that many more never reach the ears of anyone.

I’ve had numerous conversations with clients who hesitantly give voice to the mildest degrees of suicidal or homicidal thoughts. After giving due diligence to vetting the character and degree of their disquieting thoughts, and determining no significant threat, I pivot to helping my clients understand the function of these images and ideation, lest they be more distressed for having these thoughts in the first place.

In their mildest form, these thoughts are unbidden pressure-release valves in fantasy form. Distress would be gone. There would be no more pain. Powerlessness becomes agency. While these conclusions may mirror the ones that align with more serious harm ideation, the distinct difference is the surplus of protective factors and motivations for not entertaining more substantial actions.

Giving light and voice to our darkest corners

So, how do we approach naming these thoughts in a society that reinforces avoidance and silence?

As I delve more into the marriage of psychic work and therapeutic writing, the art and practice that occurs both in and outside of formal clinical settings, I want to encourage others to explore via expressive writing these corners of their own psychic experiences. Those that are cobwebbed and dusty with age as well as those that may be new residents in their minds. Seeking to acknowledge, understand, and integrate these thoughts are important parts of our ongoing path to emotional health. In working through these untenable ideas, healthier paths to healing and agency can evolve.

Of course, this process should not be approached casually. In a 2024 meta-analysis of 31 studies of creative writing therapies, Porras-Segovia et al., determined that therapeutic writing may help with depression but evidence for reducing suicidal ideation is still insufficient. Other studies point to the prospect of increased stress after writing about upsetting events. If at any point in writing and revisiting psychologically taxing events a person feels overwhelmed by this process, professional support should be sought.

The greater the integration of our experiences, our past and current assaults and losses, the healthier we will be.

If you live in the U.S. and are having suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-8255 for free and confidential support. It's open 24 hours a day, seven days a week. For crisis support in Spanish, call 888-628-9454.

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To find a therapist, please visit the Psychology Today Therapy Directory.