In a week when two celebrities, Kate Spade and Anthony Bourdain, died by suicide within days of each other, so did hundreds of other people in the U.S. One of them was named Flinn, a classmate of mine in high school.
On Flinn’s public Facebook page, an outpouring of sympathetic posts, one after the other, creates a trail of digital tears. In a long stream of posts expressing their heartbreak, people lament the pain and suffering that Flinn endured.
Nobody uses the word “suicide” or “killed himself.” Nobody says he intentionally ended his life. But he did die by suicide.
Stigma and Suicide
It’s heartbreaking – not only Flinn’s death, but also the conversation around it. There is so much stigma, fear, and pain attached to suicide that many people don’t even say the word.
I understand that families have their reasons for not disclosing when a loved one dies by suicide, and I would never pressure someone to do so. And I don’t fault others who avoid naming suicide. Instead I fault society and social conditioning for teaching us to treat suicide as unspeakable.
If we can’t acknowledge suicide when a person has died, then how can the living expect to talk openly with friends and family about their urges to end their life? It’s awfully hard to help suicidal people – and for them to ask for help – if we treat suicide as if it is a dirty word.
Avoiding Asking about Suicide
Many people are too scared to talk directly about suicide – even some therapists. I teach a class on suicide risk assessment and intervention to aspiring social workers at the University of Denver. On the first day of class, I ask them to write down one or two questions they would ask someone to determine if the person is thinking of suicide.
Some come right out with it and ask: “Are you thinking of suicide?” “Do you think of killing yourself?”
Others ask, “How has your sleep been lately?” “Are you depressed?” “What hopes do you have for the future?” Those questions will help you learn if someone’s sleeping poorly, depressed, or hopeless – not if someone’s thinking of suicide. Perhaps the conversation will lead there. Perhaps not.
Some people ask “Do you think of hurting yourself?” when they really mean, “Do you think of suicide?” “Hurt yourself” is a euphemism that some people use to avoid naming suicide. Yet there are people who intentionally hurt themselves without wanting to die. There are also people who desperately want to die and view suicide not as a means to hurt oneself, but to stop hurting. So the person’s answer to “Do you want to hurt yourself?” might not mean what you think it does. Using euphemisms for suicide also reinforces the message that suicide is unspeakable.
Fears of Asking about Suicidal Thoughts
Why don’t people ask directly about suicide? They may fear that talking directly about suicide gives others the idea (it doesn’t). Or they might consider it impolitic to name suicide, because of the stigma attached to it. Or they might be afraid of saying the wrong thing, or of angering the person, or of being unable to help, or of feeling overwhelmed by their own painful emotions.
These are all legitimate concerns. It’s scary to ask someone about suicidal thoughts. But avoiding the topic does not make the problem go away. It drives it underground, where a suicidal person may feel even more alone in the darkness.
Ways to Help Suicidal People
To truly foster open, constructive conversations about suicide — to create an environment where people can ask for help from loved ones and professionals — more people should try to name it. Only then can more suicidal people feel welcome to reveal their thoughts.
Only if we name suicide can we reach out to those we worry about and ask, “Are you thinking of suicide?” And then we can truly listen and join with the suicidal person.
There are specific techniques for asking a person about suicidal thoughts that can lessen the potential for stigma, shame, and discomfort. One way is to convey that the person is not weird or wrong to have suicidal thoughts: “Sometimes people who feel as crappy as you do have thoughts of suicide. Do you?”
Talking about Suicide
Once potential helpers can talk openly about suicide, it opens the door to potentially life-saving conversations. If you’re wondering how to respond to a suicidal person, check out my post “10 Things to Say to a Suicidal Person.” I also have a post, “10 Things Not to Say to a Suicidal Person.” Those are my own ideas, and if you have time to read the comments, you’ll see many other ideas, too.
I don’t know if these conversations occurred with my old classmate Flinn, or if they would have helped him. I remember him as someone who loved to surf in the feeble waves of Galveston and play hacky sack in between classes, but it’s been 30 years since I last saw him.
What I do know is that Flinn died in a way that many people actively avoid naming. This silence about suicide can be deafening, making it exquisitely hard to hear people who desperately need to be heard.
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Copyright 2018 by Stacey Freedenthal, PhD, LCSW. Written for SpeakingOfSuicide.. All Rights Reserved. Except where noted, photos purchased from Fotolia.com.
REVISED: October 5, 2024
Suicide well i contemplate it daily. Im a veteran whom the government has failed to help! Im still waiting for my benefits almost a decade later and im tired and dont want to go on. Im tired of excuses, and straight bull shit. I fought the war now fix ME or compensate me NOW as per our contract. I cant go another day living in this dark place.
John Doe,
How sad and painful! I’m so sorry you’ve been let down this way. I hope you’ll keep fighting. Have you tried talking with someone at the National Suicide Prevention Lifeline, at 800-273-8255 (TALK)? They have an option for veterans. The Crisis Text Line at 741741 also might be of help. I list other resources at http://www.speakingofsuicide.com/resources/#immediatehelp.
No need to (really) talk about something if the listening parties have ALREADY concluded you’re wrong. At least that’s my take–and I gather it’s the perspective of many suicidal people. When I was in college, I spoke to a counselor about being gay. When I told him, he crossed his legs, cringing, and, despite trying not to, betrayed disgust on his face. Decades later, I remember this vividly because it’s played out over and over and over again throughout my life. For the next several sessions, my therapist tried to get me to distract myself from my natural developmental thoughts. No matter how much I, the patient, tried to reason with him that I wasn’t depressed BECAUSE my brain chemistry was abnormal, but instead because of the way others–from other students to faculty–were treating me, my therapist wanted only to talk about behavioral interventions I should be using. No mention of laws or university rules that were being broken. Not a peep about, what I would later learn about–that chronic prejudice and purposeful social exclusion can, all other things equal, cause depression and other cognitive issues.
Today, my therapist’s approach to mental health would be largely condemned. But my point is, it can be futile to talk about an issue if enough people, especially the professionals in charge of assessing and treating issues, have already made up their mind that your perspective is wrong and, therefore, indicative of YOUR needing treatment. Often enough, that’s just not the case.
Today, the big assumption is that all suicidal people are “ill.” That we haven’t reached our conclusions after a long time living with discrimination and abuse which spill over into survival–whether we’re deemed employable, despite our academic and professional qualifications; whether people want to rent to us, or how banks and mortgage managers treat us; how bosses and teammates at work interact with us; the probability we can build a protective, healthy community of support. These things, and many more, determine how much money we can make, and money is very, very important in our culture. Transexuals, for example have a hard statistical odds of lifetime chronic unemployment and poverty due, according to US government findings, to discrimination, NOT mental illness. It’s not shocking to people who actually LIVE with the lifetime pain of these kinds of discrimination that, using transexuals as an example again, this community suffers one of the highest rates of suicide.
Thankfully, some people suffering terribly can be helped. But there’s no guarantee of this. For one thing, the people who have the power to help must WANT to help. Just because someone is a law enforcement officer or a court official or a social services administrator … or a therapist doesn’t mean they care about someone’s particular issue or even agree someone’s experience constitutes “an issue.” The potential of the advice to really talk about suicide depends at least on the attitudes and openness of the person you’re talking to. And their ability to stop abuse you may be experiencing.
Just SO well-stated. It’s sickening that even search algorithms are set to return self-help pablum instead of anything related to the actual search.
A few years ago, I had to have a half page of -terms to find ANYTHING critical of positivity culture. It was out there but hidden by an algorithm and content saturation that doesn’t just drown out other voices… but redacts them. Purposely.
It’s not a struggling algorithm that turns a search for “positivity is harmful” to results completely dominated by “get rid of toxic people” and “how to be POSITIVE.” It was intentional.
Now, for a while, we have articles about toxic positivity. A nod to veritas I guess.
LOGICALLY speaking suicide is a cowardly act ; But there are situations which make you feel suicide is the only answer; But no. One cannot end a life in minutes which you have lived till now and especially where you have parents and close relatives who value you a lot ;
One such situation is non-logical issue which I encountered but I refused to give up and fought till now; I have the most non-logical, deranged brain and I could make up my logic in last 36 years that I had this brain drain . Hence, never give up life – learn to live for others
Be careful of the questions you ask
In your opening paragraph you write, ‘I describe a co-worker at a counseling hotline who explained that she would never dare ask anybody if they were having suicidal thoughts. And she thought I was a freak for doing so.’ I think your co-worker is right, though I would put it stronger, I think your question is dangerous and here’s why. Questions set frames and force people to think and check to answer. So, asking someone if they have had suicidal thoughts, forces them to do a mental search and revisit all thoughts of suicide they may have or have not had. If the client has not mentioned the word, why would you want introduce it? As a client, if you asked me that question, one thought that would now go through my mind is, ‘Wow, my psychotherapist thinks my problems are so bad that I should be thinking about committing suicide. Otherwise, why ask it.’ Nice priming of the idea of suicide!
Where a client says, ‘I’m thinking about suicide or I’m having suicidal thoughts,’ then explore the issue. If they haven’t, by asking your question you are introducing the idea and contaminating their thinking with ‘Suicide.’
Thanks for sharing your views, Alan. However, I respectfully — and strongly — disagree.
Considerable evidence demonstrates that many people with suicidal thoughts are not prone to spontaneously disclose them. This includes people who died by suicide within 24 hours of seeing a mental health professional.
Stigma, fear, and suicidal intent each can create silence. When someone with suicidal thoughts is asked directly if they are thinking of suicide, they might still hide, but in my experience as a therapist they do not. Some express relief at having been asked and being invited to unburden themselves of their secret.
Nobody can be given the idea — or “primed” — to die by suicide. We are not “introducing” the idea. People learn of suicide at a very young age. They already know about it. And asking if they are thinking of suicide does not make someone suddenly want to kill themselves. I can assure you that of the hundreds of people I’ve asked about suicidal thoughts, not one developed them as a result of my question.
I note that you respectfully and strongly disagree with me and an intellectual argument would be a waste of time for both of us. I would ask you to indulge me in a quick experiment around questions. Below are two, do no harm, questions. All you do is, as you answer the questions, notice what processing you have to do inside to answer them.
Question 1 How do you learn?
Question 2 How easily do you learn?
To answer question one, you will have done a mental search of your learning techniques and processes that you use. For example, reading, lectures, mind-maps, flash cards, etc.
Question two will send you on a search for times in the past when you learned something easily and may even take you back to childhood learning. For example, the words to a song you like and did not set out to learn, a nursery rhyme, the route to work, etc.
Also notice that until asked those question, the chances that you were thinking about learning are millions to one.
To answer the question, ‘Are you having suicidal thoughts?’ You have to do is go inside checking your thoughts for any that you could interpret as suicidal, because the scope or frame of the question is ‘Suicidal thoughts.’ Or if you have taken the verb ‘Having’ as being ‘Right this moment,’ unless in that instant they are having a suicidal thought, their answer must be no.
By asking a specific question you are directing their thoughts and lighting up all the neuro networks in your client’s brain associated with the words in your question. The more the network lights up the strong the network grows.
Why not ask something like, ‘To help me better understand and appreciate what is going on for you, tell what thoughts you have? After each thought, if they seem stuck, simply ask ‘And what else?’ This implies there are other thoughts and takes them deeper into their thought processing.
I am not suggesting you avoid discussing suicide or suicidal thoughts. On the contrary, if the client brings them up, you have a duty to explore them with the client.
Alan Jones,
Thank you for your respectful reply and engagement. Respectfully, I believe there are two key flaws with your argument:
1. Researchers have heavily studied the question of whether asking about suicidal ideation increases suicide risk. The answer is no.
2. I hate coffee. Every time I eat at a restaurant, I am asked if I want coffee. I have been asked this thousands of times in my life. The question has never made me want coffee. That is only one, perhaps trivial, example, but it demonstrates that asking about something does not make the person want it. Everybody can draw from similar examples in their own life.
You asked, “Why not ask something like, ‘To help me better understand and appreciate what is going on for you, tell what thoughts you have?” Here’s why: The topic of suicide is so laden with stigma that many people feel too ashamed or afraid of others’ judgment to volunteer that they are having suicidal thoughts. By not asking directly about these thoughts, not only do we risk never learning this very important information, but we also collude with the forces of stigma and shame around suicide. We treat suicide as unspeakable. We also risk conveying that we ourselves can’t handle talking about suicide, when we need to be able to do so.
What’s most important is that someone with suicidal thoughts feel safe and welcome to talk about them. Avoiding the question, talking around it, and operating from the unfounded fear of causing someone to want to die by suicide — these actions (and inactions) do not help the suicidal person to overcome the forces of stigma and shame. As a result, the person may feel even more alone and hopeless than before.
As someone who has considered suicide many times, I totally disagree with you, Alan. And I dont like the way you state your opinions as claims, when in fact they ARE your opinions, and that’s fine. I just have a different view on asking someone about suicide.
I agree.
Nearly all the arguments I’ve ever read or heard against suicide make the same fundamental mistake: imposing moral perspectives on others’ life considerations and personal decisions. We did the same thing with racial minorities and non-heterosexuals and people of other religious faiths … for thousands of years. Everyone who wasn’t like us or didn’t agree with us was “wrong” even though we couldn’t produce hard evidence of their wrongness. And now we’re doing the same thing with people who have been consistently suicidal and are resolved to end their lives. These kinds of reasoning errors (assuming there are universal moral answers) sadly seem hard-baked into humanity. But we could at least refrain from insulting others by not encouraging respectful and honest conversation while we assume we already know the “right” answer (for others) to questions being discussed.
I’m all for trying to help people. But not for controlling people (in their personal lives), other than to protect other living beings from immediate harm. If we can’t give people what they need to live safely and contentedly, and these people have through many trials failed to amass these things themselves, often with professionals’ help, we ought not to have the prerogative of telling them that their personal life evaluations and choices are “wrong.” Many people won’t discuss suicide because they intuit, rightly, that the person they could speak to about it already believes that suicide is universally wrong and that speaking about it could lead to civil commitment. Physical restraint and forced treatment are the elephants in any room where suicide is being discussed. Without the law addressing this, many will continue to make and carry out their plans in secret.