IT HAPPENED TO ME: I Am A Suicide Intervention Counselor

As helpers, we have to realize that control is not the answer, either for us or for our clients. We can reach out, support, care, listen, reflect, and suggest. We cannot make a life that is unbearable bearable.
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Hilary Nunes
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As helpers, we have to realize that control is not the answer, either for us or for our clients. We can reach out, support, care, listen, reflect, and suggest. We cannot make a life that is unbearable bearable.

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I am a trained, certified suicide intervention counselor, one who spent 4 years at ContactLifeline as a volunteer. I have taken 200 suicide calls -- over 800 hours of shifts -- not including my time as a rape crisis first responder. I have been the last person to speak to someone while they lived. I have been the person who tried to keep them fighting for their lives as EMTs arrived. Most of the time, though, I was just a human being my callers didn't know, and didn't really need to know, who listened.

Before becoming a counselor, I survived my own suicide attempt. It came after years of dangerous ideation about death, freedom, love, religion, shame, worthiness, and my place in the universe. I made the choice to become a volunteer, first, because no one should ever have to face those feelings alone -- but also because I wanted more calm, reasonable dialogue available for people along that spectrum of emotion, dialogue that didn't make them feel like attention-seeking nutjobs, immature teenagers, or selfish a-holes. Because seriously, people, that is way not helpful. 

My very first call at ContactLifeline was a 190 minute suicide call with a person who suffered from post-traumatic brain injuries that inhibited some of his ability to communicate directly or clearly. (For the record, 190 minutes is A LONG TIME to be in intense, voice-only emotional contact with another human being. The vast majority of calls are under 20 minutes, and very few go as long as even one hour.)  I had a bit of a trial by fire. I was, no lie, terrified for probably the first 90 minutes.  

But then, I noticed something.

People in crisis are far from selfish. They're really forgiving. They see with relative ease what a difficult position their helpers are in, and readily acknowledge that helpers have needs, too. My very first caller taught me that it is okay to make mistakes on a suicide call, because hey there, human. What matters is how we correct those mistakes.  

During that call, I panicked. I let my emotional tie to this person who was at risk run my mouth for a second, and I said something that was not damaging, but definitely not helpful. I realized it right away, stopped and said to my caller, "I am so sorry. That thing I just said? I'm getting emotional, because I'm worried about you and I want to help so much. Can I try that again, but say it in a different way that might be helpful?"

And you know what caller's answer was? "Of course! I can't imagine how stressful this must be for you." And my caller, love of loves, said, "You're doing beautifully."  Even someone who is in emotional agony over things like the death of a child or spouse, crippling injury or illness, staggering debt or addiction, plus all of the physical, emotional, and psychological disturbances that anxiety, depression, and other forms of mental illness can impose, sees that to do the work his or her helper is doing requires a lot of energy, a good amount of training, and an ability to balance the demands of empathy with the exigencies of risk assessment and response.

My first call taught me that I don't need to know the whole story to be helpful; that what your voice and breathing and face do matters; that people will forgive you when you screw up; that you need to remind people to have a glass of water if they've been talking for a long time. I also learned that you don't need to solve a problem to be helpful; that, most of the time, the reason for the call is not the Reason For The Call; and a lot more. Finally, I learned that I'm very talented at hearing what people are not saying, and at accompanying them to a place where maybe they will start to speak the scarier truths.  

In addition to being a crisis counselor, I'm a marshmallow princess. I have all the feelings, all the time, for everyone. If I'm talking to you (over email, on the phone, in person [whoa in person], wherever/however) I am probably having at least the number and degree of feelings you are having in that moment, plus my own marshmallow biz. In seriousness, I'm highly sensitive to emotional states and stimuli. One of the excellent fringe benefits to my ASIST training through ContactLifeline was that I learned to give myself a graham cracker foundation and some chocolate goo-glue. Yeah, whatever, I'm a s'more. There's a lot to be said about how to take care of yourself while you're knees deep in taking care of others, but that is a conversation for another day.

ASIST training focuses on your ability as a helper to put your on crap away and focus entirely on the needs (stated and tacit) of your client for the duration of call.  One tendency that many untrained helper-types have is to relate too closely to a client; suddenly, the contact becomes about you, the helper.  

This is damaging. When someone is in crisis so acute that she is considering ending her life, what that person needs most is to be heard by someone who is calm, compassionate, and completely focused on her. Engaged, active, reflective listening typically results in nearly instant (though almost never total) de-escalation. Opinions and advice are what helpers (me, too!) might be most inclined to provide -- but That's Not Helpful (at first).

For most listeners, the reason we instinctively reach for opinions and advice is twofold: 1) we legit want to help, but also 2) focusing on concrete responses helps distance us from a caller's intense feelings. Advice and opinion create buffers that carry us past the unpleasantness of abiding beside someone whose state of despair feels impossible to share with anyone at all ever, and into the I AM HELPING AND HAVING AN IMPACT OH HELL TO THE YES Y'ALL. Which, let's be honest, feels way better (helper-wise) in the short-term.

Don't do it.  I'm serious, f-cking don't, dudes.

Instead, how about this:

Person A: I am seriously considering ending my life. I think talking about that is a good idea, but I'm scared that this is going to become about issues and not about me, and I sort of need this to be about me for a little while.

Person B: I'm so glad that you want to talk about this, and I'm honored that you would come to me with those feelings. Please say whatever you feel. I am with you, and I am here for you.

This is essentially a summary of the first twenty minutes of every suicide call I have ever taken. And most of the work on Person B's end is not about knowing, doing, or suggesting jack. It's about convincing a perfect stranger that you are On Their Team.

As helpers, we have to realize that control is not the answer, either for us or for our clients. We can reach out, support, care, listen, reflect, and suggest. We cannot make a life that is unbearable bearable: at some point, every caller we encounter will hang up, going back to a life we cannot comprehend or inhabit.  

Instead, we are voices in the darkness that say, You are valuable, irreplaceable. That's all.  We ask someone to contract for their own safety by essentially promising us that they will live one more day in the turmoil and pain that robs them of hope, joy, and agency.  We do so in the hopes that the clouds will part, that something, anything will change.  We do so in the hopes that hearing from a person whose hand you will never hold, who will disappear into anonymity after a four hour shift, that the world will change and be different if you leave, will spark the fires of self-preservation and rebellion in the face of what seem today like insurmountable odds.

But sometimes, it doesn't. Sometimes life just ravages a person. Sometimes they face chronic pain, loss of agency, debilitating illness, irreparable loss. I understand, because it almost happened to me. And my survival was not strength of will or clarity of purpose. It was chance. It was luck. It was odds that were stacked in favor of me living.  

Which is why I hate conversations about cries for help. Look: THEY ARE CRIES. FOR HELP. Not for judgment, recrimination, blame, victimization, pity, or speculation. This cry says only, I am drowning. 

The first thing you have to do with a cry for help is hear it. This is hardest to do when we are close to someone, because we must hear them without reservation.  Even when it breaks your heart, shatters you. Even when you are impotent and small in the face of their circumstances. It's why I recommend we shy away from being an immediate responder to people we love in this particular circumstance. Because in this particular circumstance, our impulses tend too solidly towards I WILL SAVE YOU. Except, you know, I can't. And I might be so invested in this that I could hurt you (or myself) if I try.

The Suicide Prevention Lifeline fills this gap where someone who is hurting deeply can speak to someone without the baggage of a real life relationship about the feelings no one wants to discuss. If you ever need the number it's really easy: 1-800-SUICIDE.  Calling that number alerts the helper on the phone (usually) that you're at risk for self-harm, and allows them to prioritize your call.

If training to be a National Suicide Prevention Lifeline volunteer sounds like something you might feel passionate about, especially if you work closely with Veterans, the elderly, the infirm or disabled, or young children and teenagers, I will help you find a way to get certified. We need you.