It’s always a challenge for any therapist to realize that the client sitting across from them is suicidal. How do you walk the fine line between acknowledging the depth of their despair and the need to keep them alive so that they can work through the despair, or at least survive until the conditions at the root of the despair attenuate or pass?
In the following excerpt from my new book, “The Challenge to Heal“, I outline one technique I used while working with suicidal clients. As mentioned in the excerpt, it is a strategy one can also use for oneself if suicidal ideation is a problem.
“When I have clients that present as suicidal, I explain to them that it is pointless to do the hard work of therapy if they are only going to turn around and kill themselves. Why put themselves through the angst? I tell the client, “If, we are going to invest ourselves in the hard work of therapy, I will only do so if we agree to a ‘time-limited contract’ that you will make no attempt to terminate your life during the work.”
The client then decides on the duration of the ‘contract’, with the majority of them agreeing to make no attempts for anywhere from a month to six months. Clients surprisingly step up to the challenge of a time-limited no suicide contract. (This always pleases me, for I invariably expect the client to reluctantly say they will only agree for a week or two. But they co-operate with the suggestion for a no-suicide contract – which has me convinced that there is always a part of the self that wants to hold on to life.) We agree that at the end of the contract we will see where things stand and, if necessary, renegotiate another no suicide contract. By the end of the first contract, clients have gained a fresh point of view, new coping skills, and frequently during the postponement, their personal circumstances change, enough to make suicide irrelevant and unthinkable.
You could challenge yourself with this same time-limited, no-suicide contract. Consider making a contract with yourself to postpone ending your life for two or three months (whatever time period you choose) and see if you still feel the same then. You are still entirely in control and retain all your options. But, for now, you stay alive by contracting with yourself to delay your demise.
Why not contract with yourself that you will delay acting on the impulse to suicide until you have completed reading this book (The Challenge to Heal) and used some of the techniques offered to help you manage difficult emotional states? With the time gained, seek professional help and/or engage in serious self-care and self-help work on your own.” (The Challenge to Heal, page 84)
If you would like to read more tips on how cope with suicidal thoughts and how to manage difficult feelings such as grief, anger, fear, guilt, shame, etc., check out my book, “The Challenge to Heal” here on Amazon.com.