Handling Suicidal Tendency

The recently-bereaved often have suicidal tendencies. A deep sense of hopelessness, inescapable loneliness, intolerable emotional pain, a desire to join the lost loved one, a compulsion to “get-even” so that others will feel guilty over the suicide and many other factors can drive a person to contemplate self-destruction as the only best solution out.

Any threat to kill themselves or disclosure of such intent must be taken seriously. If the bereaved says something like he or she will not be missed if gone, even if jokingly or in an off-hand manner, we must respond with the question: “Are you thinking of hurting yourself?” The elderly and those living alone run a high risk in suicidal potential.

In our grief support services, we have come across many such people who contemplated suicide at the initial stage of the bereavement. With proper counselling and support, they recovered from such a threat and never again considered it. Below are some preventive measures that we can or should take:

1. Discuss the suicidal tendency with them. This will not drive them towards carrying out the suicide but provide them with a sense of relief and a desire to buy time to regain control of themselves.
2. Validate the emotional pain to move the suicidal behaviour off centre stage. Make statements such as, “You are having tremendous pain to make you think of suicide. Tell me what is troubling you. We have plenty of time.” We must identify the precipitating factor that surfaced the suicidal tendency.
3. Gently take them on a “trip of logic” such as their responsibility to the family or children, moral and spiritual objections as well as the social disapproval that will be faced by the survivors.
4. Find out if they have access to weapons or inhibiting substances such as lethal drugs. If this likely to be so, immediate action must be taken to minimize the risk of using them.
5. After normalizing the situation, show them that everything comes down to a matter of problem-solving our troubles. Teach them problem-solving skills and encourage them to look at the long-term benefits of doing things.
6. Help them make small, concrete plans that they can fulfil in the next few days. This builds in them more control over their own decisions and behaviours.
7. Do not lecture, blame, judge, criticize or preach. As crazy as it seems, their intended escape through suicide makes perfect sense to them at that time.
8. Get a verbal or written commitment from them not to harm themselves for a specified period. Get them to agree not to attempt to kill themselves without first talking to you.
9. Point them to God, the ultimate source of all hope.
10. Tell someone who can keep them safe. If they are living alone, reconnect them to live with their children or have someone move in. Do not leave them isolated and unobserved.

If “the less alarming symptoms of suicidal tendency last longer than two months,” (source: Barlow, David H and Durand, Mark H., (2005) in Abnormal Psychology) or there is any evidence that they have formulated a specific plan to carry out the suicide, or if you feel what that is going on is beyond the level that you can manage, then you must immediately refer them for professional help. Other major tell-tale signs which require urgent referral include the disposal of their valuable possessions, putting their personal affairs in order, frequent visits to the grave of the deceased and being highly preoccupied with the anniversary of the loss. Fortunately, suicide seldom happens without warning. People invariably give away many signs and hints of their suicidal intentions.