Time and again, my Twitter timeline contains tweets encouraging people to be active in asking questions about suicide ideation or intent. I dislike such recommendations strongly and, in this post, I want to explain why. Some people will find this post controversial.
About ten years ago I was interviewing men diagnosed with depression. There were few of them available, so when one day three men attending the outpatient clinic agreed to be interviewed, I was over the moon. I had three interviews, did them one after the other! The interviews were great, all lasted over an hour, the men were talking about extremely difficult things, all cried during the interview. All thanked me for listening.
But when I finished, I was no longer over the moon. In fact, I was in trouble. As they were offloading all their sadness and unhappiness on me, I was crumbling. All that misery was crushing me and I was quite literally unable to live with it. I needed help, and quickly. And I was quite lucky, I was conducting the interview in a hospital full of psychiatrists. One of them, the wonderful Dr Robak, sat with me and we had a long, long conversation. Somehow, the shrink was able to untangle the knot in my head. I could breathe again.
I was completely unprepared for those interviews. I was already an experienced interviewer at the time, but I had never interviewed people in such misery. I had no defences, I simply took it all on. I invited the interviewees to dump all their unhappiness on me, and they did. And I didn’t know what to do with it. But, as I said, I was lucky. I had someone to talk to. I genuinely don’t know what would happened to me if I hadn’t.
Yes, I fully realise that such experience raises all sorts of questions for the research process, but this is not what I want to write about. This a story for a different point. The point is about urging people to ask questions about others’ suicidality. In a nutshell, I want to ask this. Do all those who urge me to ask my colleagues, friends, or some other person who I think is desperate, wonder what will happen to me afterwards?
Questions are not only requests for information. They are also commitments. If I ask you if you think about committing suicide, I make a promise to listen to you. But what happens if I can’t handle it? What happens if your story crushes me? What if you dump all your misery on me and I will need to live with it? And then – what if you still kill yourself? Will I have to live with this too? Will I feel guilty that I was not successful?
Here is another story. After the experiences of 10 years ago, about 3 years ago I was doing research for my book on men’s suicide notes. And so, I was reading them, realising more and more that it was the most difficult data I had ever come across. I didn’t know the people whose farewell letters I was reading, in fact, they were anonymised, and yet, knowing that you read possibly the last words of a person before their death was too much. I quickly decided that I would read not more than 2-3 letters a day. It was just too hard. Incidentally, people around me commented on how I had changed. I became more withdrawn, sombre, despite my attempts to hide it.
Whenever I read media reports about people rescuing others, particularly when harm comes to the rescuer, experts are quick to tell the readers that the foundation of rescue activities is the safety of the rescuer. And I think there is nothing more heart-breaking when a person who selflessly attempts to rescue another, loses their life.
And so, I find it extraordinary that ‘we’ don’t think about such risks when talking about suicide and people’s suicidality. Dealing with misery, with profound desperation is difficult and one should not simply urge people to jump in with their help. No, some of us, perhaps most of us, should not ask questions about suicide, because the answers might, sooner or later, too hard for us. However well-meant the suggestions to help are, people making them will not be there when you live with your guilt or when you deal with the despair that was offloaded on you.
There is a reason why clinical psychologists and psychotherapists (there is some overlap, I know) take years to train, and have supervisors to help them also with the emotional toll of hearing about people’s distress. I know from my own experience that asking questions about misery and listening to answers can be extremely hard. And it can put you at risk. So, please, don’t tell me that I should ask ‘everybody’, if they’re suicidal. Please don’t guilt trip me after I refuse. I also don’t want to feel guilty for not asking the question you urge me to ask. This is because I also have responsibility to myself and for my own life.
And yes, I do realise the consequences. And yes, they are very difficult to accept. But my point is that in such situations, there is no choice without consequences. Let’s consider all of them.
And so, controversial as it probably is, I suggest that you think very hard before offering comment on how ‘we all’ should ask others about suicide and suicidality. No, we shouldn’t, some of us can’t handle it.