Supporting The Suicidal

Imagine taking care of someone who has a painful throat issue. She also has a fever, and possibly a bunch of other symptoms that neither of you are able to detect well. She has trouble speaking and can’t get out of bed. She’s stuck in your house, in your bed, and you’re afraid to leave her alone in order to get help or continue living your life.

You’re standing there, eyes glazed, wondering what you should do. Of course you’re going to consult the first 17 pages of Google results, and call all the medical experts in the country, and so much more. You’ve probably done some of this already, and told your mom about it.

Then the patient, your close friend, feebly gestures with a small twitch of her index finger. You squeeze the other hand, stare into her eyes with all your might, and tear yourself away.

You boil some water for lemon ginger tea and a hot compress, checking the ice packs as well. You heat a pot of chicken noodle soup. She must have been pointing towards her mouth for water…but maybe it was a request to visit the bathroom? You shudder just thinking about how sick she might be.

You bring over the soup, then run to fetch an eyedropper. Ever so gingerly, like you’re feeding a baby cat, you place the stew onto her tongue. You watch, observing everything, stressed about what her closed eyes and grimacing swallow entail. It’s a fraught, guesswork-filled moment.

You take the slight nod as a signal to proceed with more, pouring gently from a glass because you couldn’t find a straw. You need to make sure she’s getting what she needs without hurting her more, and the soup is hot.

After a couple hours (days) of this ministering, you have to accept that the throat pain is out of your control. It dwarfs any possible sensation you will cause with your genuine efforts. Your tiptoe-peacekeeping mentality becomes problematic; it’s more self-comfort oriented than truly helpful.

You need to verify, “Can you walk? Can you talk? Tell me how you’re feeling. What is your condition, this sickness?”

You can make this discussion as overly-communicative as you like: “I’m concerned I’ll hurt you by what I’m doing, and by talking I don’t want to bring you discomfort, but here’s what I’m noticing. I’ve been drip-dropping soup for hours, and I’m feeling overwhelmed. May we please, somehow—and it doesn’t have to be this moment—have an open conversation about how I can give you soup more sustainably? I definitely want to keep helping, and I don’t mean to diminish your sickness in any way. I’d just like to better understand what’s important here. I hope your throat, though sore, can speak to me even if it’s just a little bit. I’ll wait; thanks for your courage and trust in sharing directly and honestly what’s going on with you.”

To deal with suicidal thoughts, it’s possible to learn how to help, for example with QPR techniques and risk assessment methods, but the essential question is very simply: “Are you thinking of killing yourself?”

You have to be prepared to ask this directly. You have to talk about the situation, as difficult as it may be.

The conversation, like the soup, is perhaps momentarily discomforting. But neither will exacerbate the underlying sickness. These are necessary and helpful measures to fight the good fight together, as a team.

Don’t be pushy of course. Steer toward the pain, gently, to try understanding what’s going on and what can be done. Give them emotional breathing room, some silent space to open up.

You need to know more about their capabilities, their physical and mental state as a teammate. What can they do? What do they want to do? This information is critical for you to provide effective care, with confidence, including when to escalate beyond yourself.

It helps to be cognizant of how you approach The Hurricane:

Your friend will not be committing suicide in the next two minutes while you are patiently conversing. It’s unlikely they will be mad or sad with you at all, especially if you can just be curious together about the situation. They will mull over your questions and assertions for the next hour, or later when they’re alone, and they will eventually conclude that you are a true friend.

A true friend is willing to provide the ultimate support of performing hard emotional labor on behalf of another, to initiate communication and get through to them in a time of darkness.

A true friend listens non-judgmentally and acts as required, paying attention to the important details to negotiate a sustainable partnership structure—hours, months, or decades.

Things will get better with patience, and one day they will say to you, “Wow…thanks. I really appreciate your leadership and supportive friendship. That direct communication saved my life.”

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