Suicidal thoughts: Having the strength to stay

In his blog, UKCP psychotherapist Paul Salvage outlines how he works with clients experiencing suicidal thoughts.

In my practice as a psychotherapist working with adults and adolescents, I often work with people who are experiencing suicidal feelings. Some may have had a shock, a bereavement, a job loss and suddenly be having dark, inexplicable thoughts, that they have never experienced before and are understandably frightened by. They don’t want or have any intention to kill themselves but these unwanted intrusions are deeply troubling.

Other clients have more sustained depressions, and this can be more difficult. What I offer is attentive listening to what is going on for them. I do my best to really try and understand how they’re feeling and convey my understanding to them, challenging when I believe it may be helpful.

What both of my client groups tell me about their experience of disclosing suicidal feelings is that it tends to make other people panic.

I try to remain calm so that I can stay with their experience and try to bring a space where the pain and distress can be thought about, contained and maybe even transformed a bit. I keep the therapeutic space confidential, which allows feelings and thoughts to be talked about without fear.

Adam Phillips in his latest book, ‘A cure for psychoanalysis’, recounts a talk given in 1970 by the British psychotherapist and medical doctor Donald Winnicott to a group of doctors and nurses about the word cure:

‘If this word be allowed to talk it can be expected to tell a story… At a most superficial level the word “cure” points to a common denominator in religious and medical practice. I believe cure at its root means care. About 1700 it started to degenerate into a name for medical treatment.’

As well as working with clients experiencing suicidal feelings, I work with the friends and relatives of people who have committed suicide and this is always heartbreaking. The sentiment brings to my mind a chapter from a novel where the protagonist described losing his friend in the Vietnam war;

‘I know that my buddy Jorgeson was a real American hero. I wish that he had lived to be something else, if not a painter of pictures then even some kind of fuckup with a factory job and four divorces, bankruptcy petitions, in and out of jail. I wish he had been that. I wish he had been that. I wish he had been anything rather than a real American hero.’ The Pugilist at Rest. Thom Jones.

Suicide is a tragedy and part of the tragedy is that it is the one thing that can’t be reversed or overcome. We can all feel overwhelmed and in those feelings act impulsively. Suicidal and depressive feelings are often out of our control. The best we can sometimes do is to hunker down, do our time and hang in there as best we can.

Although we do have choices, so much of our lives are dictated by the currents that we are swept along by. Perhaps if we can remind ourselves of that, we can be more forgiving of ourselves and our pain.

If you or someone you love is feeling low, please do seek support.

For immediate help with suicidal thoughts:

In an emergency, call: 999

NHS (England), call: 111

NHS Direct (Wales), call: 0845 46 47

The Samaritans 24-hour helpline, call: 116 123