Suicide: What to do when kids say they want to kill themselves

January 22, 2010

I had already been planning on addressing suicidality in children in Privilege of Parenting when the following comment showed up:

“A friend of mine and her family are in pain.  Their 24-year old daughter died last week in an apparent suicide.  She was about to turn in her Master’s thesis, and I don’t think there were any obvious signs that she was depressed or troubled.   She was the oldest of four daughters, the youngest of whom is in elementary school.

Please send healing thoughts to this family.”

*

While I would not want to say anything about this specific situation other than I agree that we might all send some love to this family, no matter what the “facts” turn out to reveal, and to which I am not privy, I did want to address the topic of suicide in kids.

Firstly, if all children, even “grown-up” children (and I hold that adulthood actually begins at twenty-seven in many corners of American culture), are our collective children, then it serves us and those we care about to educate ourselves on how to help when things are so bleak that a person might not want to go on living.

Suicide is the third leading cause of death between 8 and 18 (after accidents and homicide), so it is a pervasive issue in our turbulent and often cruel or seemingly indifferent society.  Given that many more young people attempt suicide than complete the act, this is something that affects many more of our collective kids than we might, at first glance, realize.  Suicide prevention is an often invisible struggle—the battle to prevent the headline, to nip the horror story in the bud… it is exhausting work that takes a great toll on many compassionate volunteers who step up to do it; greater consciousness for both the “parents” of the collective who do show up to answer phones and talk people off ledges, and also for the many suffering “children” who might be contemplating self-harm at this very moment, may mean a bit more productive suffering for the group in the service of our own collective and enlightened self-interest.  In simpler words, it’s painful to think about kids wanting to hurt themselves, but if we can be conscious of it we might help avert it in some subtle degree.

In a sense, suicide is both about the wish to be free of the pain that living sometimes brings, and it is also about rage; kids who feel unsupported, unloved or inadequate may aggress against those who they anxiously depend on by attempting, or succeeding, to hurt themselves.  A common pre-suicide fantasy is that of bereft loved ones who are sorry now that this has happened crying at the funeral of the now-dead person.

It has been said that murder kills one person while suicide kills everyone.  The rage within suicide may be unconsciously held but in my clinical experience it is almost always there.

Also, if depression might be thought of as anger turned inward (a partial explanation, as neurochemicals, stressors, etc. also play a role), suicide is also self-annihilation.  While none of us know what might lie on the other side of the veil that separates the living from the dead, when those we care to help are in so much pain that they cannot stand it, we need to understand this and help be the bowl to catch and hold the dread and annihilation anxiety they cannot contain on their own.

Another way of understanding the wish to die is that a person is trying to express just how truly painful things feel at the moment.  If we can get into accurate connection with such a person, they often feel safer and no longer need to check out from the planet—neither fleeing their own feeling states nor acting out their destructive rage.  Conversely, if we minimize a suicidal person’s suffering or try to cheer them up by pointing out how smart and beautiful they are we only further their feelings of isolation and hopelessness.

While there may be cases where no obvious signs of suicide are present, let’s start with what to do when a child directly says that they wish they were dead or are going to kill themselves.

Take it seriously:  Always ere on the side of caution.  Even if your kid thinks you’re over-reacting, suicidality is a realm where we should jettison concerns about being overprotective and think worst-case scenarios.  Keep a child who expresses self-harm ideation in sight, get them talking (i.e. how would they do it?) and take measures to protect them (i.e. lock up the knives, pills, etc.).

Obviously sometimes people “just say things” and could even be joking around, but to a parent this is not funny and a child benefits from seeing that we are listening and want to keep them safe because we love and treasure them.  Even if you think a kid is just trying to get attention, by taking it seriously they will either get the help they need or learn that this is not a satisfying way to get their needs for attention met (i.e. more trouble than it’s worth if one is not in deep emotional pain).

Consult Professionals:  If in doubt about a child’s safety you can call 911.  Another option would be a suicide hotline (i.e. 1-800-Suicide).  Another would be the family doctor or a therapist if you have a relationship in place with a counselor.  As a parent, you do not have to know how to deal with suicidality on your own; you just need to reach out for appropriate help (which will further help you build your skills and abilities to not just keep kids alive, but help them heal from the feelings that would lead to self-destructive impulses in the first place).

I may be prone toward longish blog-posts, as I seek to give what support I can, however, the distillation is:  when in any doubt about your child’s risk for self harm, take it seriously and get help.

I am also aware that some readers who come across these words may be suicidal themselves.  If so, parent yourself—take it seriously and reach out for help.  I have worked with (and am personally friends with) many adult children of parents who killed themselves and I can attest to the destructive rage in the act and the torment it leaves behind.  You may be angry.  The world certainly appears to be unfair.  But there just may be people who care, people who you may not be feeling at this moment who want you to stay alive; there may also be more than just a way to stay alive, there may be a way to heal and be truly glad that you are alive.  Pain can guide us toward good feelings that last; our pain may be about our wounds, it may be about our falseness with ourselves and others.

Some self-destructive behavior can be non-verbal.  Passing out drinking, car accidents, giving things away—even a sudden elevation in mood and energy after a long sullen period of depression can indicate that the person has a secret plan to end their suffering (and thus experience a transitory boost of relief)—can all be concerning indicators. We can always call a suicide hotline, tell them our observations and concerns and get some feedback on how to play it safer rather than potentially sorry.  And keep in mind that people don’t kill themselves because someone “gave them the idea” (i.e. by asking about it); if you’re concerned, go ahead and ask.  If they say no, at least you noticed something was seriously bothering them; if they say yes, they want someone to help them so they won’t have to do it.

No one can truly and definitively stop someone from killing himself or herself if they are determined to do it, but we just might be able to do the reach out and be in this together.  Ultimately it is not about killing or not killing our ego-selves, it is about our relationships representing our fuller identity (relationships which are rather broken down at the collective level); the help is out there, let it in as an act of love for your kids, or for children you may never meet—they are the kids you once were, the kids who need to be understood and validated and respected… from there healing takes care of itself.

I have had clients realize that they didn’t really need to be in the locked ward of a psych hospital only after spending an afternoon being evaluated and checked into a psych hospital.  I’ve worked with kids who could not feel safe until they were within the locked confines of a psych hospital and who needed some time there to become more cohesive in the face of their despair and shatteredness.  Some people are able to step back from the ledge when their true pain is really heard, others have different levels of disturbance and need a safe place to begin effective treatment (i.e. proper meds, family therapy, etc.)

Suicidality is complex and longer answers would take us down several paths exploring issues such as depression, anxiety, substance abuse, emerging psychotic or bi-polar disorders, losses and traumas (such as sexual abuse) and you can search this site for posts related to those topics.

Ultimately we want to go from preventing suicide to facilitating good feelings that last.

So, let’s dedicate today to being the bowl in whatever way we can manage, sending love to heartbroken families (as suicide can devastate any one of us, sometimes unexpectedly as it is not always obvious) and to any and all of our collective children who might not much feel like being here right now—holding to an alternate truth which is that we do want them to live, grow, heal and be a loving and conscious part of our collective group (as they are part of our group whether they know it or not, and their demise always kills a part of us, whether we know it or not).

Namaste, Bruce

PS Deeply understanding our children is often a key to helping them feel both loved and safe.  To learn more about the book, Privilege of Parenting, which has entire chapters on self-esteem, depression, anxiety and oppositionality/self-harm Click Here.

Resources: http://suicidehotlines.com/

http://www.hopeline.com/

http://www.suicidepreventionlifeline.org/

http://www.metanoia.org/suicide/