Tuesday, 13 June 2017

What to do if a friend is suicidal ?

I felt it important to write this post.  It's that ultimate baseline thing.  Your friend is suicidal, or may be.. what do I do? I've looked around online and used my knowledge and wisdom I have of my years of being a therapist so far to give my best ideas I can to support through this hugely important time.  It may be important to act and to do and say the right things.
Remember that you are not a professional.  You are just there to be you and to provide the best counselling skills you can to be able to be the buffer to hopefully ease the person through this phase and to be able to transition them out.  Think of it as potentially being like a learning of emergency CPR which you may learn to perform on someone who needs it until further support arrives.
A huge huge thing that the person needs is validation.  I can't stress this enough. 'Validation' 'validation' 'validation'.  Sometimes in therapy we refer to it as 'the value of being there'.  The very act of this is profound and is going to make a huge different to your friend and what they may do next.  They need you now more than ever. 
Here it is important to make a huge distinction between sympathy and empathy.  This validation which is required means empathy and lots of it.  In my counselling training this was displayed well as being like your friend being in a hole.  Sympathy would be the person talking from above the hole saying things like 'oh its really bad down there' 'poor you'.  Empathy is more being in the hole with the person.  They are maybe literally dying right now for someone to atleast try to understand how they feel and to feel they are not alone and that someone is with them. 
The following website https://www.helpguide.org/articles/suicide-prevention/suicide-prevention-helping-someone-who-is-suicidal.htm is a great resource and I am going to summarise from here the main points about what to do and what not to do. Funnily enough the site on the DO list says be sympathetic which I feel is an error.  Here is a summarised list of what TO DO with the words 'Be sympathetic removed and replaced with 'Be Empatic'.
'Be yourself. Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it.
Listen. Let the suicidal person unload despair, ventilate anger. No matter how negative the conversation seems, the fact that it exists is a positive sign.
Be Empathic. non-judgmental, patient, calm, accepting. Your friend or family member is doing the right thing by talking about his/her feelings.
Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important to you.
Take the person seriously. If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head, you are showing that you are concerned, that you take them seriously, and that it’s OK for them to share their pain with you.'
Stick with this list and remember you are only performing CPR and being the buffer for them to get through.  You are the emergency resource similar to the emergency act for someone choking in a restaurant.  You are not the full blown emergency services.  Keep it all as simple as you can.  VALIDATE AND BE THERE.  There is a myth that talking about suicide to them makes suicide more likely.  This is not true.  Supporting the person to talk about their feelings is the key.
Avoid any kind of moving into sympathy and somehow taking out of their frame of reference of seeing the world. Don't start saying things like 'I'd be devastated' or 'It's selfish'.  This is not validating, not empathic and not being there for them.
Do not leave your friend alone during this critical time.  You can call '111' if you feel there is immediate risk of suicide.  You could ask them if they would like you to do this.  Below is a list of numbers which can be offered as support for your friend.  Remember they just want you to be there for them during this time.  It's all about you being this prop and needed support to just get them through.
Lifeline 0800 543 354
Acute care team (ACT) 0800 653 357
A 24 hour helline from Palmeston North to Waikanae
Depression Helpline 0800 111 757
Healthline 0800 111 757.
Samartans 0800 726 666
Suicide Crisis Helpline. 0508 828 865 (0508 TAUTOKO)
Helplines for children and young people
Youthline 0800 376 633

Outline NZ (experts on LGBT matters) : 0800 688 5463

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