Vicki L. Loyer, Ph.D., LMFT
First published in the Desert Leaf April 2020
Today it’s the Dandy Lions, 4- and 5-year-old boys and girls, lining up by the classroom door. Confidently, the line leader faces her troops and declares, “We are ready!” To which her followers echo, “We are ready.”
Ready. Hopeful. Proud. Our line leader will need to learn to internalize this experience. Mistakes and poor judgments will soon begin to compete for space in her memory and may repaint her vision of herself. “You have a purpose!” will compete with “Why am I even here?” A community of supportive others will be needed to instill hope and manage shame, possibly as early as her 10th birthday: The Centers for Disease Control and Prevention reported 517 deaths by suicide of persons 10–14 years of age in the United States in 2017.
According to the National Institute of Mental Health, the key to reducing the number of Americans who have serious thoughts of suicide (9.8 million), make plans for suicide (2.8 million), or attempt suicide (1.3 million) is to intentionally instill hope, meaning, and purpose into their lives.
While all of us experience disappointment and depression and are forced to rethink meaning in our life, sometimes the obstacles are too great, and identifying a life worth living is out of reach. Suicide is a complicated epidemic. Sometimes it is the result of mental illness, addiction, or trauma; sometimes it is a sanctioned behavior within a culture or subculture (e.g., copycat suicides); and sometimes it is caused by an increase in exposure to suicidal thoughts and behaviors.
Professors Laura Frey and Quintin Hunt reported in 2017 that 100 people are exposed to suicide for each suicide that occurs, and 25 adults attempt suicide for every one completed suicide (that ratio for adolescents is estimated to be 100–200:1). Family members are often called on as the primary unit to support a suicidal family member, yet an individual’s fight with suicidal thoughts can last for many years and causes too much emotional strain for most people. According to researcher Sanja Miklin of the University of Chicago, and her coauthors, being a family member of a suicidal person is
one of the high-risk factors for depression and suicidal ideation, attempt, and completion.
Openly speaking about suicide saves lives: those persons who believe they are a burden to their families and society are less likely to burden others by talking about their thoughts and more likely to take their lives. Those persons who are made aware of the pain and loss that other family members experience as a result of a loved one’s suicide are more likely to reach out to professionals for help. Community gatherings such as occur with community walks for suicide awareness, and support groups that include both those at high risk for suicide and loss survivors, facilitate this awareness and are effective in convincing those with suicidal ideation to choose life, according to Miklin and her colleagues.
Ane Soberg, a researcher at the Center for Psychology of Religion, in Ottestad, Norway, says that focused, healthy conversations about suicidal thoughts and behaviors help people cope with the realities of their own lives and help them create a vision of a life that reduces suicidal behaviors.
Shifting thinking from either/or (e.g., “either I am liked by all, or I am not good enough”) to both/and (e.g., “some people do not like me, and I am good enough.”) ignites new hope. This is the goal of Professor Marsha Linehan’s Dialectical Behavioral Therapy skills groups for individuals and for families. The process of creating the healing conversations around topics of life and death, hope and hopelessness, meaning, shame, religion, and suicide require detachment skills and is most successfully accomplished with persons who are less intimately involved in the suicidal person’s life. For those who are intimately involved with the suicidal person, detaching with love is possible when partnered with emotional self-care, support-group participation, and individual psychotherapy when needed.
After a suicide occurs, family members and friends generally experience complicated grief, which is more persistent and is often more incapacitating than normal grief. The opportunity to talk about their loved one, about the suicide, and the ability to make meaning of the death within the context of their own life contribute to eventual healing, according to Miklin and coauthors. Often, individual and group psychotherapy is helpful in the process of meaning-making, as is the ability to grieve as a community in environments where sharing about a loved one and the suicide is welcomed and encouraged, says Kevin Fleming, PhD.
Lives worth living are both good and contain mistakes, regrets, and dark places. Instill hope by focusing beyond disappointments. Reduce shame by refusing to define yourself or others by the wreckage of the past. Create connection by participating in community events and support groups that give voice to suicidal thinking and behaviors. As a community we create the context for Ready, Hopeful, and Proud. Be the voice that exclaims, “You have a purpose!”
If you or someone close to you is struggling with suicidal thoughts, call the suicide prevention hotline (in Tucson: 520-622-6000). If you are concerned that suicidal thoughts have progressed to a suicidal plan or other behaviors, call 911 and ask for a crisis intervention–trained officer or ask for the mobile acute crisis team, or go to your nearest hospital emergency room.