As a psychotherapist I am infrequently familiar with suicide, I experience those prior to an act, those post an attempt, and those who live on after someone has taken their own life. I am more frequently acquainted with patients for whom life has lost meaning, or that their place within life has lost value.

Consequentially, I have come to view suicide through a rational lens, although it continues to appear as the most irrational of acts.

People ask me why and how someone could have done this to them, they ask why the person did it at all, or if they will try and do it again. To question how it could be that a person felt they had enough to die for — thereby ending their own life — is to stare into the abyss, and to feel the sickening gaze of the abyss staring back. It is to face a reality that shreds at our instincts to survive. It is to question our own existence.

I would like to dispel a myth — that suicidal people are intrinsically depressed. Statistically mood disorders account for an approximated 60% of suicides, with the lay-person’s understanding of depression accounting for fewer than that number. Suicidality is not an automatic consequence of a classically defined depression diagnosis. That being said, many of the criteria necessary to meet a diagnosis of depression may be present within the lives of those who attempt suicide, but mental health diagnosis is not a straight forward thing — suffice to say that understanding suicide as a spectrum means incorporating multiple factors into the narrative.

My perspective, as a clinician, is this:

We have one mechanism of true power in our lives, to continue or to end our existence.
We do not have absolute control over our lives, but each day we either agree or disagree to exist — we either eat and take care to avoid harm, or we seek out our own demise. This is the fundamental principle of our being — that we choose to engage, or disengage, with our own existence.

There is another more philosophical conversation to be had about how we came into existence, underlining an existential crisis, but the essential basis of a crisis is that we do exist, and that we continue to exist, and that unless we (or some other force) causes that existence to cease we must find meaning in how we relate our being (our personhood) to the rest of the universe.

Frequently, media coverage of public figure suicide references a person taking medication that increased the risk of suicidality, or that a person was in recovery from addiction, or that they had been struggling to manage depression. We are presented with reasoning for their deviation from a ‘right state of mind’ — but is that enough of a combination? Is it a warning that all individuals who fit a similar pattern will harm themselves? No, of course not — there is no definitive test, even when we test for suicidal ideation within a clinical setting it is not absolute, we cannot adequately look inside the mind of a suicidal person, because they predominately do not want us to look inside. It is the secret landscape of the individual, and it is as familiarly abstract to them as a non-suicidal person watching the clouds. The substance is there, patterns and shapes come and go, impressions and projections form and fade — all governed by a wind that is out of our control. So too is suicidal ideation.

Perhaps that is the most haunting part when someone takes their life, that it underlines how we can never truly know the dimensions of another person, no matter how close we are.
We can all become strangers to each other. We can, and most certainly will, all leave each other in time.

In my work as a psychotherapist I meet people who have survived suicide attempts, I meet people who have made it through accidental overdoses, and I meet people whose lives have been impacted by the specter of suicide — they all ask the same question, why?

The answer to why is actually very simple — because at that moment, as the specific parts of the aforementioned mechanisms approached alignment — the person in question lost themselves to the abyss. There is no formula for logic in the abyss, no mirror, no perspective — just the absence of hope and reason.

A true act of suicide is absolute, it is resolute — it is not a cry for help, it is an act of power. It is the terrible side of the same coin that houses resolve and resiliency. A true act of suicide is the most private contract imaginable.

It doesn’t much matter if the act comes as a consequence of crushing depression, of perverse chemical alteration, or out of sheer desperation — it culminates in the same thing, in the loss of a life and the change of a landscape, wherein the living must come to terms with the absence of that person. We struggle with that concept, because we are at odds with their wish — suicide is a wish to be absent, to be ended — grief is the struggle between wanting that to be undone, and accepting that it is unchangeable.

I have worked with many people who have come out the other side of the abyss — they have gone through and returned to us. Some attempted suicide and failed, some were found-out before the act, and others who have visited the abyss before are able to identify markers on the road in, knowing when to ask for help — yet they all have the same adopted-perspective, a kind of fugue state wherein they are aware that something happened, but cannot effectively recall the finite mechanism of suicidality — like attempting to recall the full nuance of a dream just passed. The content is there, but the quality, the immersion has passed. It is no longer here.

That is the simplest way I can explain it — when it is real, it is real, and when it has passed, or the act has occurred, then the state has subsided; as dawn brings light and truth to the shadows, so too does returning life quiet the abyss.

I have tried and tested many answers to the question of why someone would try and kill themselves, and I keep coming back to this:

That in that moment, it seemed the most authentic choice they had.

Helping someone who is suicidal requires acknowledging the illogical reasoning of the abyss, you do not have to understand it, just admit that it is present, and take that person to a place of safety. Take that person to a professional. We are here to help. We are in hospitals, doctor’s offices, private practices, in call centers, and at first responder stations. Suicidality is entrenched in shame and stigma, it is wrapped in fear and horror — but I have found that speaking to the truth of that fear, to the reality of that horror in a way that doesn’t devalue a person’s mechanism of choice serves to open an alternative for them.

Love is not enough to stop someone from killing themselves, but radically loving someone who does wish to end their own life vs. telling them that wish is abhorrent brings illumination to the abyss, and starts to dispel the hold it can have on us. Radically loving someone means fully accepting their sovereignty, and suicidal people have already withdrawn into a sovereign state of self. There is no way to usurp them out of that role, only merge them into a larger perspective, into a grander narrative. This is the deception of the abyss, it removes all other narratives and hypnotizes an individual toward one finite script.

Radically loving a suicidal person means loaning a piece of you (without cause or question) until they are able to reconstitute themselves, not questioning if they themselves do or do not love. Radically loving someone who is suicidal is standing between them and the abyss, until they are ready to turn around and return to life.

https://suicidepreventionlifeline.org / 1–800–273–8255