Suicide Pain

Suicide pain is not discussed. But chronic pain can lead to suicide. With opioids becoming less available chronic pain sufferers are committing suicide. Pain can cause someone to believe that suicide is a way out. We need to speak about suicide pain.

Ask questions

A friend was self medicating and depressed. I asked, “Help me understand what it is like to be you.” She was taken aback. But she trusted me enough to answer “My life is complicated and so messy I can’t make sense of anything. It is hard to explain. There are no words.” I know she wanted me to understand. So I just stood and listened because I wanted to understand her perceptions, her frame. She just looked at me with a pained expression. The language we use for describing our body and emotions is very limited. What is a suicidal thought? I don’t want to be here? I don’t want to live? I want to end it all? And when/why does that thought lead to action?

Pain Processing Practice
There are ways to successfully end the pain

How you experience pain is unique

There may be a sense of overwhelm, sadness, fatigue and a desire to be done, to rest, but there does not have to be a lot of emotion. Each person is unique. My friend was so shut down, so distant from her body and emotions, she did not even notice her physical pain.

The Physical Pain of Being Suicidal

But for many people, there’s a constant pain with thoughts of suicide. When I asked if she was in pain, she looked confused. “Of course, I am in pain, I want to die.”  I asked where was the pain? She could not answer at first but then she said “My pain grows and grows it feels like it’s through my whole body. I just want to cry or scream but I can’t. I just live with it and I can’t remember living any other way. It is my everyday pain level.”

She went on to say, “When it gets bad, the pain increases exponentially every minute. I think that even the most violent ways to die would hurt less than what I’m feeling right now.” As she spoke she began to shake. Watching her I understood she needed to release this energy and I asked if I could hug her.

hug daily
Hugging is healing –

Sharing her Story

She shared with me the story of her pain and now we could begin to understand that pain cycle. With understanding, she could exit her cycle. She could change her story. But first, like everyone on the planet, she needed to feel love.

When you injure your body, you can make other decisions than simply taking pills to cover up the pain. It helps to observe and separate your thoughts about the pain from the pain itself. You use thoughts to tell yourself stories about who, what, and where you are. That story is based on your basic beliefs. It describes where you come from and where you are going. If you believe you have no way out or that you can’t go on, those concepts themselves can promote suicidal actions. Those words are from the inability to believe you have a choice.

Feeling you have No Choice

Exit your prison
You can break out of your prison

When pain is all you think about then it is hard to create distance because thoughts are how you define yourself. When your thoughts are constantly about the pain, it demonstrates you are in a pain cycle that you need to exit. Your pain is not everywhere, but it can feel that way because your thoughts touch every story you tell yourself, distorting them all.

Suicidal people are always expected to reach out for help but that rarely happens. Why? Because it’s hard to ask for help and support. Society teaches you to protect your family and friends. She did not want me to get hurt. She believed her personal pain inferno was too big and scary and she did not want me to be consumed. In her pain, she was trying to protect me. She didn’t want to burden me, even though she knew she would feel better with support. She grew up in a world where everyone had to have a stiff upper lip and asking for help brought a terrible response. Therefore she would not ask me for help. But I wanted her to live so I spent the time it took to help her deal with all her pain: physical, psychic and emotional. The Pain Processing Practice (P3) gave her the skills to deal with her pain and as that lessened her suicidal thoughts diminished.  

Soothing and Calming

Pain Processing Practice
There are life preservers

I encouraged her to soothe and calm herself, use her senses to notice beauty and to use activities to distract herself. She allowed human touch to comfort her and began to use language to create space, so she could become aware of the malleability of her pain. For example, if you say, “My neck hurts,” and it does, your focus increases the pain. When language conveys a way to remind yourself that “I am not my neck,” or “My neck is not the whole of me,” and so you realize, “I am not my pain. My pain is not in my whole body, in fact, most of my body is not in pain at all.” Most people who are suicidal, believe the only way to not think about the pain is to die. Therefore, suicide starts to look like the only way out of pain. For my friend that was her belief. She said, “When I die I will no longer be in pain.” She did not even think about the permanence of suicide. She thought she just wanted a minute, even a second of escape from the pain.

Pain Processing Practice 

With the Pain Processing Practice (P3) she implemented her own unique healing. With reduced pain, she could have new choices in life and move away from dwelling on her chronic suicidal pain to self healing with the help of her P3 toolbox, family, and friends.

just keep the person talking
Listening without even speaking helps

Helping others

In helping a person deal with suicidal thoughts, it is best to combine the approach of treating the underlying; beliefs, stories and perceptions. By reducing the pain and increasing sleep you are dealing with suicidal tendencies directly. One of the well-known prevention plans is dubbed SUPER.

SUPER

This five-point suicide prevention plan is presented below:

1. Savoring love. The social support system of the person with suicidal thoughts must let the people concerned know about the emotional condition of that suicidal person. A suicidal individual may feel that he is alone amidst many problems that he is facing.

balancing
He can feel he is balancing ready to fall off

He may need the reassurance of the love and support of his loved ones; and these people must know that they are there to help the person feel the warmth, appreciation, assistance, and encouragement that he felt he had lost.

Under this step, the person and his family and/or social circles may organize bonding activities, such as eating meals together. Such activities will help reestablish links to empower the personal feeling of that suicidal person. Furthermore, the family or the social circle from which the person experiences alienation may undergo counseling sessions that will determine communication gaps needed to be filled in.

2. Uncovering underlying causes. It must be understood that suicide may only be the so-called tip of the iceberg. Thus, it is extremely important to determine the underlying causes for the person’s suicidal thoughts. For example, the person may be suffering from treatable mental disorders such as depression, schizophrenia, substance abuse, or borderline personality disorder. If such is the case, you must help the person avail of services from duly authorized therapists or physicians who will be able to give immediate relief to counter the suffering of that person.

change is helpful
If you keep doing what you are doing nothing changes

3. Problem-solving. For cases that may not involve other psychological illnesses such as depression, it may be helpful to take note of Shneidman’s approach in preventing suicide. Following his ten commandments, it becomes ultimately necessary to help the person seek a solution, which is outside the person’s realm of thinking.

As what Gerald Davidson, John Neale and Ana Kring explained in the article found in Abnormal Psychology: “Some Myths about Suicide,” suicidal people do not necessarily want to die. Instead, they only want to escape the negative life events they are facing.

Hence, an effective suicide prevention program must help the person understand that killing himself is not the solution. Instead, the person must be taught of a problem-solving mechanism through which he can determine various options in dealing with the problem and assess the consequences of each action that he takes. It may consist of a flowchart of things to do, with elaborations for each step so that he can take note of the fact that each decision he makes must really be a carefully thought decision.

4. Establishing contacts. It will be wise to give the person numbers of suicide service centers such as 24-hour hotlines of psychological therapy clinics that he can get in touch with whenever he feels very down or depressed.

look for support
Don’t do it alone there are lots of resources


5. Rediscovering the joy of living. Suicidal persons may have forgotten the joy of living that they would most certainly miss if they choose to die. Therefore, “rediscovery” trips will be effective in making them realize that committing suicide will deprive them of so many wonders of the world, especially those activities that the person are very interested in.

Realize your reality can change and sometimes your perceptions are clouded. There are even moments when giving up seems the easiest way. Life is twisty and your feelings can change in one minute. Your feelings can be distorted or even lie.

Your thoughts might be like a broken record saying “it’s not worth it.” Ask what is not worth it. Be specific.

When you are struggling to find something beautiful, something true. Something you treasure can show you a unique way out. It could be a hug, a message from a friend, a smell, a picture, an inspirational video or quote, anything that could become your calming and soothing tool.

National Suicide Prevention Lifeline

If you or someone you know needs help, begin by listening without judgment. And check out the resources of the National Suicide Prevention Lifeline which is a national network of local crisis centers. https://suicidepreventionlifeline.org/

Call for help now

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255. You can reach the Crisis Text Line by texting “START” to 741-741.

References

The impact of physical pain on suicidal thoughts and behaviors: Meta-analyses

Negotiating the maze: risk factors for suicidal behavior in chronic pain patients.

Chronic pain and suicide: understanding the association.

Thresholds and tolerance of physical pain in suicidal and nonsuicidal adolescents.

Suicidal intent in patients with chronic pain

Why Does Social Exclusion Hurt? The Relationship Between Social and Physical Pain.

Chronic pain and suicide risk: A comprehensive review

For more information

Suicide Prevention – SAMHSA provides suicide prevention information and other helpful resources to behavioral health professionals, the general public, and people at risk.

How You Can Play a Role in Preventing Suicide Fact Sheet

Suicide: Additional Resources – a long list by the CDC

Suicide Prevention Resource Center (SPRC)

Tool Kit for Zero Suicide

 

 

 

 

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