Suicide: Understanding and Intervening – Part IV, Helping A Suicidal Person

Helping a suicidal person is a touchy subject.  Black’s booklet is addressed to people who want to help a person who is suicidal.  Black’s provides some tips to help a suicidal person:

  1. “Acknowledge the reality of [the person’s] pain.”
  2. “Help him see the connection between his pain and his felt need.” Get them to say, “Life without ___ [fill in the blank]___ will be unbearable because ___[fill in the blank]___.
  3. “Challenge constricted options and irrational thoughts.”
  4. “Explore [the person’s] perceptions of hopelessness.” How hopeless is the person feeling? Can the situation be rectified or is it hopeless?
  5. “Help the person to separate pain and need.”

Assessing risk
Black’s following guideline is a good way to assess whether a person is considering suicide:

1. Presenting problem – Assessment begins by evaluating the problem that triggered the downward spiral.  This is difficult to do if the person can’t identify any triggers.

2. Background information – Analyze the person’s life and personality to gain a better understanding of how and why he is driven to a point where he considers taking his own life.  A good warning sign: If someone says, "I can’t deal" repeatedly. "I can’t deal" really means, "I don’t have the appropriate coping skills to handle my situation."

3. Substance abuse – While a person who abuses drugs or alcohol may not be suicidal, the likelihood that a depressed person who abuses drugs or alcohol is.

4. Resources – Encourage the (potentially) suicidal individual to seek out a support network: family, friends, church, therapists, or social groups.  If a person feels needed, he is more likely to realize that his death will have a significant impact.  Perhaps he’ll think twice before making an attempt.

5. Suicidal thinking and intent

A.     "Evaluate the person’s felt experience." Use a mood scale from 1-10 to gauge how good or bad a person is feeling. (Feel free to use mine on the right.)
B.     "Determine how often the person has suicidal thoughts and how intense or compelling they are."  Frequent "passing" thoughts are no longer passing thoughts.
C.     Dry run. A person contemplating suicide might have “tried out” the way he plans on killing himself.

“Has she ever taken a few pills to see what it feels like, tied things around her neck, driven at high speed, or practiced with an unloaded gun? Dry runs help the person to resolve any ambivalence she might feel about suicide.”

If a person admits to attempting a “dry run,” the person likely is in extreme danger of following through.

6. Noble End – A person who is at the point of beautifying suicide as a glorious end to his life is completely disillusioned and should be seen as a high risk.  Watch out for talk of "No one needs me anymore" or "Everyone would be better off without me."

An addendum: A person who says "I hate myself" may be a suicidal risk, but not always.  An admission of self-hatred provides evidence that he may want to eliminate the hatred in some way.

Suicide: Understanding and Intervening – Outline

While the book had me put off, I did glean a couple of things from it, mainly things that pertain to Christians who struggle with suicidal ideation.

“The paradox is brought into full focus when a suicidal Christian wants to know if she will lose her salvation if she kills herself. The contradiction in her thinking – that the same God who has the power to condemn her eternally doesn’t have the power to help her now – seems lost on her.”

The key here for Christians is to focus on “the Way, the Truth, and the Life.” This is especially difficult to do when a person doesn’t know the next path to take, what to believe, or desperately wants die. The Biblical view of Christianity holds that a person who has trusted in Jesus Christ as his Lord and Savior and commits suicide is not condemned to hell. However, the booklet deals with issues leading up to this point and does not focus on suicide per se.

While suicide is viewed as a psychological act born out of a depressive state, the author correctly states it is “the act of a sinful heart.” All Christians must come to terms that many mental illnesses are a result of a sinful, fallen condition. Christianity rejects the teaching that “all people are inherently good.” From a Biblical standpoint, that’s a fallacy. Psalm 53:3 reminds readers, “There is none who does good, not even one.” Those who believe in God must accept that they are fallen, sinful creatures incapable of consistently doing good in and of themselves. Depressive and suicidal tendencies stem from this sinful nature.

Black quotes G.C. Berkouwer:

“One cannot find sense in the senseless and meaning in the meaningless.”

Life as a non-Christian can be senseless and meaningless because there seems to be nothing to live for other than the self. A belief in Jesus Christ as Savior gives life a brand new sense of meaning. But even a Christian can lose track of that. Again, the inability to remain focused on God stems from a sin nature.

Black uses the apostle Paul as an example of someone who overcame trials, hardships, and suffering. In II Corinthians 4:17, Paul refers to his suffering as a “light affliction, which is but for a moment.” Black outlines how Paul is able to regard trials as light, momentary afflictions:

  1. Paul lives his entire life with purpose. He endures the suffering because of the good he knows will come out of it.
  2. His life is lived for the future, for a “far more exceeding and eternal weight of glory.” (II Cor. 4:17)
  3. Paul is “strengthened” to face the challenges that God has given him through the Holy Spirit.

While Black explains how Paul overcame his difficult trials with courageous faith, his application flies over the head of any depressed believer. The above may be encouraging to a believer who is disappointed by trials, but it is an application out of the grasp of someone who is suicidal. A more appropriate application would be King David in the Psalms, “Why are you cast down, O my soul, and why are you in turmoil within me?” (Psalm 43:5) or rather Elijah, who after a great spiritual victory, prays to God, “It is enough; now, O Lord, take away my life.” (I Kings 19:4) Perhaps even a suicidal person can relate to Job, “"Why is light given to him who is in misery, and life to the bitter in soul, who long for death, but it comes not.” (Job 3:20-21) Black overlooks believers with applicable moments of despair and opts to use the apostle Paul as example for hope. Here, the cliché is applicable: a person must go through the darkest part of the tunnel before he can see the light.

Not only did I feel as though Black throw Paul’s example in for a “See? This is how a true believer should act,” he immediately delves into how “suicide is a sinful act.” Pitting depressed people against a great apostle like Paul is just an awful reminder that they just don't “stack” up. Contrasting a suicidal person with a spiritual giant is yet another reminder as to why he needs to die, not to live. As I mentioned before, using Elijah, David, or Job would have been a more empathetic approach.

An underlying base of suicide is selfishness. Black capitalizes on this thought:

“My goal is not simply to get the person to repent over a specific act of lawbreaking (suicide), but to undermine his pattern of sinfully self-centered rationalization.”

He adds that suicide is an “expression of self-centeredness contrary to our position as creatures responsible to a Creator.” Suicidal thoughts remove God from being the primary focus of life and make people gods in their lives. Suicide seems like a noble way of dying (a form of narcissism) while it is essentially a slap in the face to God. Suicide says to God, “I don’t trust that you can help me through life so I’m taking matters into my own hands,” whether the individual is aware of God or not.

Suicide: Understanding and Intervening – Introduction

“Won’t you share a common disaster? Share with me a common disaster. Oh, a common disaster.” – Cowboy Junkies, “A Common Disaster”

SuicideI receive weekly counseling at CCEF (Christian Counseling and Education Foundation) in Glenside, Pennsylvania, The foundation has an outreach program called Resources for Changing Lives that publishes educational material on different topics. One of the small booklets I purchased was “Suicide: Understanding and Intervening (SUI)” by Jeffrey S. Black. The booklet is a tad bigger than a 3 x 5 index card and consists of 31 pages. Of all the things I read in the book, the last paragraph stood out in my mind:

“In the years I have been involved in biblical counseling, I have not completely fathomed the hopelessness and despair in a believer that makes death more attractive than life. I pray that my inability is not merely a lack of empathy for someone who struggles. I hope that it is a vision for Christ and his kingdom that keeps the true ‘meaning’ of suicide out of my reach.”

While I understand Mr. Black has years of counseling those who struggle with suicidal ideations, I can’t help but wonder: What made him qualified to write this book?

In reading SUI, I felt as though the author took an objective stance in writing this. It came across as matter-of-factual rather than empathetic or sympathetic. I read the book – in all honesty – looking for answers and some kind of sympathy. I only received a slew of answers. The book should aptly be renamed “Suicide: A Factual Guide to Intervention.” No understanding required.

The book wasn’t bad; it just felt like the author wanted to keep his distance. “Don’t get too close to the reader lest you understand what a suicidal person is experiencing!” But the lack of emotion to relate to the reader detracted from many of the positive aspects of the book.

Out of five stars, I give the book three stars. Despite the absence of emotion, the book gives great bits of information I hope to share. As a person who struggles with suicidal thoughts on a recurring basis, the book was a bit of a disappointment. I know of other counselors at the foundation who could have written a more sympathetic book than Mr. Black. But he wrote it, so it’s time to delve into it.

Suicide: Understanding and Intervening Series

Beginning next week, I’ll be unveiling a series on a booklet that I read called, "Suicide: Understanding and Intervening," by Jeffrey S. Black. According to the booklet, Mr. Black pastors Calvary Chapel in Philadelphia and is an adjunct faculty member for the Christian Counseling and Education Foundation’s School of Biblical Counseling. (Since the booklet was written in 1998, I don’t know if the previous sentence still holds true.)

The book is directed at readers who want to know how to help a suicidal person. I quote much of the book and offer some comments, but I also try to add some important pieces that I think Mr. Black overlooked. The booklet relies on the Bible to support many of its points so it is heavily Christian-themed. However, there are other interesting tips that anyone – Christian or non-Christian – can use to help those who are suicidal.

I’ll be honest: I read the book myself, and as a person who struggles with suicidal thoughts, I found it to be disappointing. This probably stems from the fact that suicidal people are not the target audience. Those who care about suicidal people are. Regardless, reading the book allowed me to gain some insight into my thought processes when I become suicidal. These thoughts aren’t evident to me when I am suicidal, but they do occur. Perhaps the coming book analysis can be a helpful tool for readers of this blog, not only for those who want to help suicidal people, but also for those who have attempted suicide and are looking for a way to thwart the process.