2023 Author: Malcolm Clapton | [email protected]. Last modified: 2023-05-22 06:26
Lifehacker asked psychotherapist Alexei Karachinsky how to help in a difficult situation and not make it worse.
In Russia, the suicide rate is 16.5 cases per 100,000 people. This is a lot, and on a global scale, the numbers are even higher. According to the WHO, suicide is the second leading cause of death among young people aged 15-29.
Suicides are treated with some disdain. The meme "the more suicides, the fewer suicides" did not arise from scratch: many believe that any statement of suicide is a posturing, that a person who actually thinks about suicide will make all preparations invisible to others.
The #faceofdepression flash mob showed that sometimes it is extremely difficult to find signs of suicidal behavior in a person's behavior. But there are cases when people warn about their desire to die - with words, actions, hints.
Few people understand how to act if a relative, loved one, or friend mentions suicide. With this difficult topic, we turned to the psychotherapist Alexei Karachinsky.
When a person says he wants to commit suicide, what does that mean?
- It is impossible to give exact numbers. Most people (not 51%, but the real majority) have once thought about suicide, but there is a gap between “think” and “do” - you need to make a serious decision. If a person thinks about suicide, this does not mean that he will commit it.
It is important for others to interpret what a person wants to say when voicing a desire to die: does he want to draw attention to himself or does he really want to commit suicide?
I would distinguish two types of suicide:
- Suicide to spite someone.
- Suicide due to the fact that a person is unbearable to live.
The first case, for example, if a teenager threatens to commit suicide when something is forbidden to him. In fact, he does not want to die, but this also happens. Demonstrative behavior warns about this option. For example, in my practice, there was a case when I observed a conscript soldier who showed everyone his blades and threatened to cut his veins. For the military structure, this is a problem, and he was immediately sent to receive treatment, and that was what he needed. When the company commander invited him to complete his plans, he did nothing.
Of course, such cases do not always end with a person changing his mind. Even to spite someone, some people take their own lives.
In the second case, the person does not see the meaning in life. If such people commit suicide, then most likely this is a meaningful and powerful action. If they can be saved, then there is a high risk of relapse. If a person does not want to live and does not solve his internal problems, the desire to commit suicide will return.
Often in this way a state is manifested when a person loses the meaning of life, or prolonged clinical depression. Depending on what a person is talking about suicide for, you need to act.
How to help a loved one who talks about suicide?
- In any case, a person needs support and love - this is something that everyone can give, for which one does not need to be a psychologist or psychotherapist. Love is expressed in words, in support, in actions - there is no universal advice here, because all people are different.
But the important thing to think about is this. If talking about suicide is manipulation, if in response to threats to commit suicide we give a person what he requires - attention, obedience - how much will it help him? An analogy can be drawn with raising a child. If a small child crying requires a toy in the store, and his parents buy it for him, he will learn that tears help to achieve his goal.
Many adults solve problems in the same way: when they cannot influence the situation, they begin to influence emotions.
If there is manipulation behind statements about suicide, the person will remember that he will receive attention in exchange for a threat, will learn the scheme: if I am unhappy and sick, they love me. This does not mean that you need to turn away or brush off the person, but you also need to learn to resist manipulation.
If thoughts and conversations about suicide arise in a person in depression, after an injury, in a person with emptiness in his eyes, you need to pay more attention to this, react differently. It is important for a person to feel that he is loved: if we do not feel our need, the question arises, why stay in this world at all.
Often a person comes to the idea of suicide if he does not feel the content or taste for life, and sometimes both at once. It is important to understand what the loss is, and try to make up for it: be close, share impressions, offer actions.
How to tell a person that he should visit a specialist?
- No need to say directly: "Let's go to a psychiatrist" or "Show yourself to a psychotherapist." Such advice is an attempt to impose a solution, it can generate feelings of protest. Remember how as a child, parents were forced to clean. Even if before that you wanted to put things in order in the room, after the order, such a desire disappeared.
You need to offer referral to specialists through your experience. For example, describe situations when you felt bad and ways that helped you.
When a person himself comes to the idea that he needs outside help, then this help will be more effective.
Friends often try to replace specialists, help with conversations in the kitchen and advice. But there is the concept of a "funnel of trauma" - a situation where a person with depressive thoughts affects a friend more than expected. What to do in order not to be "infected" by the unwillingness to live?
- It is advisable to understand that if you are incompetent, if you are not mentally ready for such help, then love and support alone is enough for you.
It is not always worthwhile to even ask the person about what happened.
Imagine a person got to the hospital. He is interviewed by a nurse, doctor, roommates, relatives, friends, girlfriend or boyfriend. And at some point, negative memories from constant repetition move from short-term memory to long-term memory, it is more difficult to pull a person out of negative thoughts.
Ask once. If a person wants, he will tell.
It is also important to understand what kind of support is needed: finding a solution or empathy. Sometimes you just need to listen to a person. There is no need to offer plans of salvation, it is enough to be around.
What exactly cannot be done when trying to help? What phrases should not be uttered, except "you have to go to the doctor"?
- Unfortunately, there is still a lot of ignorance in matters of mental health. In response to words about unwillingness to live, you can hear something like this: "Better get busy", "In Africa, children are starving", "Just don't worry." Girls are often advised to have a baby.
When they say that if you want you can get out of depression or want to live, then this is a mistake, because in such a state of desire, there is just no.
If you do not understand why the person has lost interest in life, then this means that you did not fall into conditions that could lead to such a state. The "Krovostok" group has a phrase that can be applied to such comments: "You were not afraid, because you were not frightened yet." I don't want anyone to feel this for myself, but it's better not to give advice that you just need to enjoy life.
Another important point: a person close to suicide has his own interpretation of reality and his own theory of why everything is going this way. This theory is false, like any personal interpretation. But to understand this and look at the problem from a different angle, you have to work on yourself with a specialist, sometimes for months. Therefore, there is no need to support these thoughts and assent in the style: "Yes, they brought you, there are enemies around." The stronger such a theory, the more difficult it is to refute it.
I advise you to carefully ask questions that would undermine this theory, not to try to destroy it "head-on". You can also share your personal experience and tell how difficult it was for you, but in fact the situation was better than it seemed.
How to offer help and not be imposed, trying to save a person at any cost?
- Tell him that he is important, that you want to help and are ready to give support, but you do not want to help by force, because the road to hell is paved with good intentions. Offer help, allow me to contact you in difficult situations. If the person refuses, agree that you will offer help and support, say, every week or once a month. This way you will limit yourself to a time frame and will not press on, but will remain available for help.