When we experience conflict or dissatisfaction in our relationships, we are being called on to develop something in ourselves that is weak, hidden, or unknown ~ Jett Psaris and Marlena Lyons.
It is important to know that this is something that happens sometimes and people do go through such depths of misery. So, what does a counsellor do to tackle this delicate issue? It is important that the counsellor not be judgemental and use personal or religious beliefs to impose disdain on the client. The client has a right to be in charge of their destiny. They must be aware of all the symptoms and signs of a person feeling suicidal. Some of the important things a counsellor must do is:
Do:
Be yourself. Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it. - Assure your availability and counsel more frequently.
- Listen. Let the suicidal person unload despair, ventilate anger. No matter how negative the conversation seems, the fact that it exists is a positive sign.
- Be sympathetic, non-judgmental, patient, calm, accepting. The client is doing the right thing by talking about his/her feelings.
- Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important.
- If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head, you are showing that you are concerned, that you take them seriously, and that it’s OK for them to share their pain with you.
- Contact the person immediately when they fail to keep an appointment.
- Get help from the person’s family and friends to help provide structure.
- Make sure the person isn’t left alone for long periods of time.
- The medicines should be monitored by another and not the person who is suicidal.
- Don’t give empty reassurances. For example: Things aren’t that bad, or everyone feels this way once in a while. Statements like these will alienate the person and make him feel you are not on his side.
But don’t:
Argue with the suicidal person. Avoid saying things like: "You have so much to live for," "Your suicide will hurt your family," or “Look on the bright side.” - Act shocked, lecture on the value of life, or say that suicide is wrong.
- Promise confidentiality. Refuse to be sworn to secrecy. A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe. If you promise to keep your discussions secret, you may have to break your word.
- Offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your client.
- Blame yourself. You can’t “fix” someone’s depression. The client’s happiness, or lack thereof, is not your responsibility.
During a confirmed suicidal crisis, it is important for the counsellor to:
Be calm and supportive - Be non-judgemental
- Encourage self-disclosure
- Acknowledge suicide as a choice, but not “normalize” suicide as a choice
- Actively listen and positively reinforce self-care
- Keep the counselling process focussed in the here and now
- Avoid in depth counselling until the crisis abates
- Call upon others to assess the potential for self-harm
- Ask questions about lethality
- Remove lethal means
- Make effective crisis management decisions
It is essential for health care professionals, counsellors, psychiatrists work in collaboration and co operation to prevent a suicide. It is also clinically important to collaborate because it helps in making linkages between service centres, mental health centres and medical treatment plans. Cleary defines suicide management plans not only provide quality care but also include referral sources and ensures that no one gets lost in the system. Counselling will need to be tailored to the needs of the individual and include cognitive-behavioural therapies, psychodynamic therapies, dialectic behaviour therapies and family counselling. Therapeutic process with suicidal individuals includes promoting the resolution for the intense emotions, confronting the self destructive behaviour and encouraging personal growth. Helping develop a personal identity and self awareness are critical efforts on the part of the counsellor. Please feel free to add comments or suggestions to further assist in understanding and growth of this topic.
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