Loving Someone with Suicidal Thoughts

The thought of someone you love dying is terrifying.  The thought of them dying by suicide is even more so.  Too many people suffer and consider suicide.  Too many people who love them are tortured by their inability to stop the person they love from considering or attempting suicide.  The heart of Loving Someone with Suicidal Thoughts is learning to live in these terrible circumstances.

The Worry

Friends of ours, whose son died, admitted guilt about their feelings.  There were the unfathomable feelings of loss.  The feelings of disorientation existed, too.  They had the feelings that you expect with any death of someone you love.  It was doubled by the fact that parents aren’t “supposed” to outlive their children.  But what they were troubled by was the sense of relief.  They’d lived for years terrified that there would be a middle of the night phone call or a knock on the door at 3AM.  They were troubled by the sense of relief they felt, because their fears were finally over.  They would pick the worry every day over the actual loss, but they couldn’t help but admit that the relief was a part of what they were feeling.

I won’t pretend to fully understand.  I understand that sometimes the waiting is the hardest part.  While a rejection is infinitesimally small compared to the loss of a child, sometimes the rejection is better than the waiting for someone to decide.  The fear of what may happen is worse than what does happen.  When it comes to suicide, this isn’t true.  The hardest part is the finality of the loss of someone you love.

I do not share this to encourage people to die by suicide.  I share it so that we can recognize that those who love someone with suicidal thoughts are in their own torture.  Healing for the suicidal loved one is healing for everyone.

Am I Not Enough?

Widows of husbands who have died by suicide are prone to ask, “Wasn’t I enough?”  In the frame of the present, loving someone with suicidal thoughts leads to natural self-doubt.  If I were better, then they wouldn’t have suicidal thoughts.  Love is supposed to conquer all, just like in the movies – so if it doesn’t, then I must be doing something wrong.  Brené Brown explains in I Thought It Was Just Me (But It Isn’t) how we all question our value and how we need to accept our inherent value and know that we are enough.

That leads to a painful realization that there may be times when we don’t have enough control or influence to prevent the results that we don’t want.  We love the illusion of control.  (See Compelled to Control.)  However, the truth is that we have much less control than we would like to believe.

The Impostor

“Nobody would like me if they really knew me.”  Impostor syndrome is the sense that you don’t really belong where you are.  You don’t think you know enough.  You don’t think you’re good enough.  You wonder how you’ve managed to fool everyone for so long and, more importantly, when they’ll figure out that you’ve been pulling the wool over their eyes.  (See The Years that Matter Most for more.)

The fundamental premise is that there’s a gap between the way that someone is appearing and the way they really are.  It starts small.  We hide a part of ourselves, because we don’t expect that others will appreciate it.  (See No Bad Parts for more about different parts of our psyche.)  Over time, we’re reinforced that people like the person we’re showing them, and we begin to progressively believe that they only like the image we’re projecting – not the real person.  This leads, ultimately, to people believing that the parts they’ve hidden must stay hidden, and that people wouldn’t love them if they knew the real them.

In most cases, the people who love you already know what it is that you want to hide and are just allowing you to hold it back in respect for your choices.  We hear this all the time as parents have a child come out as homosexual.  Friends sometimes comment that they’ve known for years but respected them enough to wait until they were ready to discuss it.

While this isn’t a universal reaction, it happens often enough that it calls into question the idea that people don’t really know you.  Sometimes, they can know more about you than you do – and they love you still.

Always a Choice

Once suicidal thoughts have come to someone, particularly if they’ve ever made a plan, it’s always on the menu.  When they stub their toe, waiting on it to stop hurting, taking medication, or dying are the options.  It’s not that suicide isn’t a very bad option – it’s that because it’s been recognized, it remains a recognized option.  It takes some conscious effort to remind oneself how bad an option it is – and that it might be good to take that option off the table for now.

One of the problems with suicide screeners is that they can’t distinguish between people who have had a plan and know better than to use it and those who have newly formulated a plan.  It’s hard to discern the difference between someone who has their world well under control and those who are barely hanging on.

Universal Warning Signals

There’s a persistent myth that everyone who dies by suicide has sent detectable warning signs.  (I prefer signals to signs because signs sound clearer than the average suicidal person is.)  The problem with the desire to find this is laid out in Rethinking Suicide and in Myths About Suicide.  Some people, possibly more than 50%, don’t consider suicide more than a few hours before their death.  If they don’t know themselves, what kind of signals are they sending?

Not only must the suicidal person send a signal about their intent it must be detectable.  Most of the warning signs list include a dozen or more things, and those things have a very low predictability for whether the person is or is not suicidal.  In fact, the American Association of Suicidology (AAS) once proposed an acronym, “IS PATH WARM?” as a set of warning signs for suicide – that is, until the research showed that it wasn’t effective.

For me, I focus on clear, loud signals like the following: directly indicating they’re planning to die by suicide, giving away all their possessions, or explaining that it doesn’t matter because they won’t be around.  Those are clear, detectable signals; things like changes in mood or behavior aren’t, because many people change their moods and behaviors without considering or attempting suicide.

Feelings, Beliefs, and Facts

How we feel, our emotions, are undeniably our experience.  We feel the way we feel – and no one outside of us can say we do or don’t feel a certain way.  However, that doesn’t mean that the feeling is congruent with reality.  We can feel unloved and be loved deeply.  We can feel lonely in a crowd.  We can be alone and not feel lonely at all.  (See Loneliness for more.)  Because we feel it, we think it’s truth when it may not be, as Lisa Feldman Barrett illustrates in How Emotions are Made.

Similarly, we trust our beliefs as facts when we shouldn’t.  In fact, research shows that we routinely fail to search for ways to disprove our hypotheses.  In the famous Wason selection task, less than 10% of participants could correctly identify how to properly ensure that the provided conditions and rules matched.  There’s plenty of other research to indicate that we’ll sometimes cling onto beliefs that we should know are wrong, but we’ve invested too much in them.  Going to Extremes walks how this can be used to create radical groups.

The natural bias to accept our feelings and beliefs as facts sometimes leads us to believe we’re unworthy or unloved when the truth is radically different – and we can cling to this even if we’re faced with irrefutable evidence that this isn’t true.

Detachment

One of the most important tenets of Buddhist philosophy is the idea of detachment.  The idea is that the more attached you are to your views and the outcomes, the more suffering you’ll feel.  (Suffering is another major tenet.)  (See Resolving Conflicts at Work for more on detachment.)

When loving someone who has suicidal thoughts, detachment may be more than you can muster – and you wouldn’t be alone.  The one step that you may be able to take is to listen without judgement or resistance.  Maybe you can listen without becoming attached to the words in a way that you feel you’re responsible or have any control of the outcomes.

Courage

Many people don’t understand that courage isn’t the absence of fear, it’s the presence of fear and proceeding anyway.  (See Find Your Courage for more.)  I can’t think of anything more courageous than loving someone with suicidal thoughts.  You are constantly afraid that they’ll decide to take their own life, and the best you can do is love and support them through it.  It’s an impossible situation in which too many are placed.

It’s courageous to say to your loved one that you want them to feel better, so they’ll stay, instead of trying to coerce or manipulate them into compliance.  (See Motivational Interviewing for more on non-coercive, effective strategies.)

911

There’s a temptation – even among therapists – to treat every mention of the word “suicide” as an emergency requiring a call to 911.  However, we know that many 911 calls end in tragedy – particularly with people who have mental illness or are suicidal.  (See People in Crisis for more about suicide by cop.)  While being present with someone who has suicidal thoughts is scary, it doesn’t mean that 911 is the right answer.  Calling 911 may be the right answer if they’re in imminent physical harm or they’ve made an attempt that you’re aborting.  If they’re pre-attempt and you need help, the national mental health hotline at 988 is an option to get tips and support for your loved one.

As the moments move to days, there’s another pull to have someone committed to inpatient treatment.  In the cases where it can be done, it may still not be the best answer.  It necessarily deprives the person of their freedom and sense of autonomy.  It often substantially damages relationships to the point they cannot be repaired.  To make the decision to have someone involuntarily committed to an inpatient program is very risky for the relationship and not particularly protective of the person, as the probability of suicide after exiting an inpatient program is roughly 300x.

Sometimes, the best you can do in the moment and in life is to keep Loving Someone with Suicidal Thoughts.