For many people, particularly some Christians, the idea that a person might choose to end their life seems totally alien, and incongruous with their philosophy and beliefs.
This has led to denial that any Christians might reach a stage when death seems to be an option, and then act on it. And it means many people end up suffering in silence, as they do not feel able to talk about their feelings.
The taboo of suicide is exactly why confidential helplines have been established in many countries, to offer confidential emotional support and a listening ear for those at their point of need.
We all face pressures and challenges in our lives. How we respond to them will depend on a range of factors. For some, if we have experienced a stable and healthy family environment, our sense of security, self-worth and meaning will be firmly established. In this case it may take a significant, intense or persistent challenge to trigger a suicidal response, or a number of factors coinciding in a catastrophic way. However, if the foundation for our life, and our experiences that build upon this, are unstable, then our vulnerability to challenges increases.
We are all unique. We have different experiences, even within a single family setting. We each have our own vulnerability to the challenges of life. Something of great intensity may wash over us with no effect, yet something else that is seemingly insignificant to another person may appear catastrophic to us. When trying to understand a person's response to a situation, we have to listen to them and understand what it means to them, and why it has triggered the response it has. For some, the situation will be the `straw that breaks the camel’s back` - the final straw, following an accumulation of the `stuff of life` over a period of time. For others, it will be the challenging of the one thing that gave them a sense of meaning, stability or security in life; and when this is challenged, they feel they do not have the resources to go on.
Suicide is when a person has deliberately taken steps to end their life by one means or another. It is not where death has been the result of an accident, misadventure, or a secondary consequence of the person's action. Attempted suicide or para suicide is when a person has undertaken an action with the intent that the result should be death, but for whatever reason the person has survived the attempt. The only difference between the two is that in one the person has died, and in the other they have survived.
Surely if they survive this means they were not serious in their attempt? This is a question that is often asked, along with another frequently-heard comment: `It was only a cry for help`. We truly need to beware of making assumptions or accepting these commonly-held ideas. Over the years I have spent time with literally hundreds of people who have survived a suicide attempt, talking through what happened, how they felt, what was going through their minds at the time, and what was their intention. In almost every case the person described the situation they found themselves in, the effect it had on their thinking, feeling, and decision-making, and the clear aim that at the point of taking action they intended it to end their life. How they conceived it, described it, and put it into words varied according to the individual, but when examined carefully the outcome was the same: at that point of time, death seemed to be a real option, and action was taken with a clear intent. One person would be very matter of fact - they wanted to die. Another would describe it as wanting to sleep, but when asked about waking up they were clear that they wanted to sleep forever. Others saw it as an escape from life, themselves, circumstances, consequences of actions. Still others wanted to kill pain, whether physical, emotional, psychological or spiritual, but to do this they needed to end their life. Each had their own way of describing their thoughts, feelings and choices, but the outcome was the same: death was seen as the chosen option at the time. So what was it that drove them to this point of desperation?
For many it was connected to relationships - the end of a relationship where this was the one stable factor in their life, and the source of their meaning and security. When I first started in this work one expected this to be a predominantly female response, but over the years men too have increasingly come to rely on relationships as a source of their identity and worth, and so the number of men responding in this way to a relationship ending has significantly grown.
There are other forms of loss which can contribute to suicide: the loss of employment, status, respect, or health. Some are responding to the knowledge that something secret is about to become public; this can be particularly powerful in Christian circles or if one is in the public eye, when the sense of guilt, remorse and shame can be overpowering. Others are driven to a point of desperation by struggling with ongoing pain that has no foreseeable end, whether physical pain or illness or mental health problems. If there is no end in sight, then taking action to make it end seems rational. But the thought-process and reasoning are unique to the individual, and we cannot make assumptions regarding why they did it or what their thinking was, even if there appears to be an obvious cause.
For a few, the decision to commit suicide is carefully considered, and there is precise planning. Often this relates to their ongoing health, emotional, relationship, or psychological problems. For these individuals, the decision to take action may give them a sense of purpose, and at that time their mood may seem to the outsider to have become considerably better. But this is caused by their having a reason to prepare for action. Many a professional and relative has been caught unaware by this. The person is not being deceptive; they have found the energy to put their life in order, to prepare for death, and this energy gives the appearance of a lifting of their mood.
However, this sort of planning is the exception and not the norm. For most, suicide is an impulsive act. It is entered into with intent, but the intent is based on the impulse to take action now in response to a crisis in their life, or to pre-empt one. This is a response based on their assessment of their situation and options, but often heavily clouded by intense emotions - anger, hurt, bitterness, revenge, pain, rejection, fear or loss - perhaps reinforced with alcohol or drugs; and with an impetus of action triggered by adrenalin. The individual can become focused on their problems, their feelings, their assessment, their solution, and the need for action now. With this intensity within, they will not be satisfied until action is taken. At this point some will look for a way out of taking action, for an alternative strategy; they may call for help. If they do it is essential they are taken seriously and listened to, and are given space to allow for the internal impulse to have a chance to subside. The key is this: there is a need to direct their focus beyond the current fixed thought and action. Give them space to explore their feelings, to talk around their issues and life. Cautiously, where possible, talk about tomorrow; the future. Change their perception of the urgency of action. Offer them support today, but also reassure them of support tomorrow.
It is often said, `If they talk about suicide they will not do it.` This is not true. If a person talks about suicide, then it means that their minds are focused on it and considering it as an option, and they are genuinely at risk. Even if a person simply says hypothetically, `If I committed suicide I would use this or that method,` this means they have considered it as an idea and thought about how to do it, and if circumstances of a particular nature arose they might well act out their preconceived method.
Thankfully, for those who take action and attempt suicide, most will survive long enough for the instinctive fight for life to kick in, because it is truly difficult to do. If medication is taken, most tablets will take time to become effective. If cutting their wrists, many will stop before it becomes serious enough for them to bleed to death. With any method where there is an opportunity for thinking after the event, coupled with a sense of panic - `What have I done?`, `I need to do something` - an instinctive fight to survive kicks in, and the person is likely to seek help. Again, if and when this occurs they need to be taken seriously and listened to, and if they have done anything that is potentially dangerous they need to be referred for medical assessment.
If medication has been taken, do not take any risks. Treat it as if they have taken a potentially life-threatening cocktail of drugs. Some medications do considerable damage in small quantities, or in certain combinations. If someone is in an emotional state they may not give an accurate account of what they have taken, when, what quantity, etc. Always lean to the side of safety!
Once you have supported the person through the initial crisis and they have been given an all-clear from a medical perspective, then the key is to aim to help them find a reason and purpose to live. They need to learn to choose life. To see their life, their problems and the world around them from a different perspective, a wider perspective. To know the options so that they can begin to face the future. To know that God truly loves them, cares for them, and has a plan and purpose for them.
Do not treat them as `the suicidal person`. They are unique and individual, precious to God. Treat them with love and care, with honour and respect, but no differently to anyone else - we all have needs and face problems and at times need someone to help us through. God has called us to be his hands and feet, his voice and ears, and to show his compassion and care to the person at their time of need.
Know when to offer to help the person yourself, and when to seek professional help from a doctor (initially their GP), mental health professional or counsellor. Do not allow yourself to be overwhelmed by the pressures this can place on you. Be willing to seek help for them, but also for yourself. Do not carry this alone.
Premier Lifeline is a confidential Christian helpline offering a listening ear with emotional and spiritual support. It is open 9am to midnight daily on 020 7316 0808 or 0845 345 0707. It is one of a number of helplines offering emotional support for people at their point of need. For further information regarding a Christian response to mental health issues, please visit the Premier Mind and Soul website www.mindandsoul.info .
Jonathan Clark is Director for Premier Life at Premier Christian Radio - www.premier.org.uk - which includes Premier Mind and Soul and Premier Lifeline. Jonathan has worked in mental health since 1983 and has a special interest in working with people who attempt suicide or self harm. He has been a Pastor and is involved in the healing ministry through teaching and prayer ministry.
© Jonathan Clark 2012.