Discipleship

A Biblical Perspective on COUNSELING ON SUICIDE for Caring for People

Preventing the Tragedy and Grieving Its Aftermath

• Step 1: Define the counselee's spiritual status and the circumstances that have destroyed his or her hope for living-

• Step 2: Use Scripture to show how we belong to God and that He alone is the vital answer to our souls' longings.

• Step 3: Identify and address both the difficult situations and, where applicable, the counselee's shame-filled identity-

• Step 4: Increase the counselee's hope and competence. Should suicide occur, encourage the survivors in their grief work.

Meet the Counselee. . ."Life stopped being enjoyable a long time ago. Now I've lost the hope that it will ever return to being enjoyable. The goals I'd set, The dreams I'd dreamed. . . . How foolish I was to have had them! This world destroys hope faster than I can manufacture it- But there's one thing I'm not helpless about, and that's my own life and death. I have power over that and I intend to use it."

• Define the counselee's spiritual status and the circumstances that have destroyed his or her hope for living.

• What is the counselee's spiritual condition? Unsaved? Saved? Nominal Christian or seeking maturity ?

• What is the immediate crisis that has precipitated suicidal thinking and/ or attempts?

• What coping skills have been used by your counselee during bleak times in the past? Why are those skills in danger of being overwhelmed this time?
  
• How clearly is the counselee thinking? Does the counselee ruminate over the same despairing thoughts without making progress? If so, the counselee is in extreme pain, and for his or her own protection, may need to be evaluated by a doctor for antidepressant medication.
  
• If a suicide attempt was made, how lethal was the method chosen? Was it a gun or jumping from a high place? Or, on the other hand, was it a mild overdose of an over-the-counter medication? (See "Note" on next page.) .
  
• What support does the counselee have immediately available? If tittle support is available and the signs point toward serious risk of suicide, consider having the counselee hospitalized. (See "When and How to Hospitalize a Counselee" in Step 3.)

NOTE: The questions do not imply that some attempts are to be taken less seriously than others. In fact, 12 percent of those who attempt unsuccessfully will try again and succeed within two years.' On the other hand, the meaning of the attempt may change with the lethality of the method. Generally, the less lethal the means, the more the attempt can be seen as (1) a cry for help and (2) a question about whether anyone cares enough to respond. The more lethal the means, the more hopelessness is present.

The turn toward suicide hinges on lack of hope. This lack can be chronic, part of one's internal history. Or the hopelessness can be acute, that is, due to an overwhelming external threat to one's well-being. Chronic lack of hope marks one who, deep inside, feels incompetent to handle life. Acute lack of hope, on the other hand, means that life has gotten out of control and even though the counselee might feel competent, his emotional and spiritual resources have been drained. Of course, chronic and acute lack of hope can occur simultaneously. Those who struggle with chronic hopelessness are much more vulnerable to acute hopelessness from traumatic outside events.

The potential for suicide is directly related to losing hope in one's circumstances, especially when the individual has a chronic sense of low effectiveness in mastering life.

Keep in Mind:The suicidal person has decided that life is unbearable. They feel cornered by life and see no way out. 'This counselee feels cynical about his own dreams because he no longer has any power to realize them. He or she feels impotent and hopeless- everywhere they look there is pain.

SCRIPTURAL CHARACTERS GRAPPLE WITH SUICIDE

Use Scripture to show how we belong to God and that He alone is the vital answer to our souls' longings.

• King Saul falls on his sword because he is both defeated in battle and concerned that the " uncircumcised fellows will come and run me through and abuse me" (1 Sam. 31:4).
  
• Abimelech asks his personal assistant to kill him because a woman has mortally wounded him, and he is ashamed to die at a woman's hand (Judg. 9:54).
  
• Judas, feeling remorse when Jesus is actually condemned, hangs himself (Matt. 27:5).
  
• Elijah wishes for death in 1 Kings 19:4- he is afraid (v. 3), overwhelmed (v. 4a), and alone (v. 10).
  
• Chapter 3 of Job is devoted to his insistent wish for death. Job wants to be at rest, quiet (v. 13); free from the demands of life (vv.18-19). He suffers and feels bitterness (v.20). His way is hedged in (v. 23); he is full of fear, dread, and turmoil (vv. 25-26).

Job reflects three common reasons that death becomes preferable to life:

• He feels overwhelmed at the demands of his life: "I can't go another step."
  
• He is wracked by enormous, unrelenting pain: "I can't take it anymore."
  
• He feels closed in, having nowhere to turn: "I can't see a way out."

Another biblical character who wished for death was Jeremiah. He wanted to die because he was constantly in a sorrowful mode: "to see trouble and sorrow and to end my days in shame" (Jer. 20:18).

Shame often varies inversely with hope in Scripture. The shamed person feels no hope that he will recover from being mocked or despised. Consequently, Bible characters cry out to God to protect them from shame and increase their hope: "Sustain me according to your promise, and I will live; do not let my hopes be dashed" (Ps. 119:116).

"Hope deferred makes the heat sick, but a longing fulfilled is a tree of life."PROV. 13:12

A longing fulfilled, a thirst quenched, a hunger satisfied - these are the signs that God responds to His children. Hope flies on these wings. The problem with longings is that we tend to confuse the trivial, the important, and the vital. Trivial longings are those for material wealth, critical acclaim, or community standing. Important longings are those for the love of a spouse, children, or friends. The only vital longing is that for intimacy with God.

God's priority is to draw us toward this vital relationship. He may even disallow the fulfillment of our trivial and important longings if that is necessary to draw us toward true closeness with Him. In Him alone will we find the vital answer to our souls' cravings: "and my God will meet all your needs according to his glorious riches in Christ Jesus" (Phil. 4:19). God reveals Himself as One who loves to meet our needs and give us hope. "Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows" (James 1: 17).

The whole of our Christian life is built on hope. God generously supplies us with reasons why we should keep on hoping when all our circumstances scream out to doubt Him and to give up on life.

• For in this hope we were saved. But hope that is seen is no hope at all. Who hopes for what he already has? But if we hope for what we do not yet have, we wait for it patiently. (Rom. 8:24-25).
  
• I pray also that the eyes of your heart may be enlightened in order that you may know the hope to which he has called you, the riches of his glorious inheritance in the saints. (Eph. 1:18)
  
• We have this hope as an anchor for the soul, firm and secure. (Heb. 6:19)
  
• Praise be to the God and Father of our Lord Jesus Christ! In his great mercy he has given us new birth into a living hope through the resurrection of Jesus Christ from the dead. . . .
  
• Therefore, prepare your minds for action; be self-controlled; set your hope fully on the grace to be given you when Jesus Christ is revealed. (1 Pet. 1:3, 13)

Scripture is filled with declarations that hope lies in God alone. Psalm 25:4-5 says,

• Show me your ways, O Lord, teach me your paths; guide me in your truth and teach me, for you are God my Savior, and my hope is in you all day long.

And, Isaiah 40:31 expands on this by saying,

• Those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint. "

Often, hope is conveyed by the idea of waiting on God: "I waited patiently for the Lord; he turned to me and heard my cry" (Ps. 40:1). A hopeful person is strongly protected against suicide. This principle is a powerful tool for the counselor.

A suicidal counselee is often one who has ingested, over the years, many messages that have made him feel inadequate or ashamed. He is, after all, saying to himself, "You never do anything right. You don't deserve to live." Further, Satan strives intently to deepen one's feelings of inadequacy and/or shame with his incessant accusations. One counselee who had into debt troubles said, "All I'm good for is to ruin my family's finances." This person, who had many gifts, had fallen prey to the lie of, "You're nothing but____________ " (Each counselee will fill in the blank of a similar statement with the most damaging self-description possible.)

Identify and address both the difficult situations and, where applicable, the counselee's shame-filled identity.

1.1 Identify the abuses and/ or deprivations affecting your counselee.

Here, you determine the level of hope the counselee feels. Suicide most commonly occurs among those who have suffered physical, emotional, or sexual abuse, or among those who experience deep deprivation of love from parents or family. What has been your counselee's background in these areas? What does your counselee feel his life is lacking? Is the lack real or exaggerated or imagined?

1.2 Identify the degree to which your counselee has a chronically low sense of competence. Here, you are determining how deep is your counselee's sense of inadequacy and/or shame. To what degree is your counselee filled with self-blame? Does the counselee focus primarily on his or her failures, real or imagined? Does he or she feel unlovable?

Does he feel others' lives would be better without his presence? To what degree does she hold herself responsible for situations not fully under her control?

Once you evaluate these questions, lead the counselee in the following directions:

2.1 Christianity admits no impossible situations or ultimate deprivation. Because Christ is the way, there is always a way through hopelessness (see 2 Cor. 12:9). Not only is there, in Christ, no ultimate impossible situation or deprivation, there is ultimate resolution and/ or provision. A fallen world is not final. In a fallen world, deprivations and disappointments are numerous. But they do not gain finality by being numerous. Christ alone is final. A fallen world must give way to heaven, the place of ultimate provision.

2.2 Address shame by arguing with it. That is, offer perspectives that counter shame, especially those that emphasize your counselee's true identity in Christ. Explore with your counselee what the Scriptures say about who he or she became at salvation.

2.3 Further attack shame by exposing its hidden strategies: "What is my counselee getting out of believing shame's lies and accusations?" Example: A counselee may hang on to a shame-filled self-concept in order to avoid hope. Why? Because hope means being vulnerable. A hopeful person opens up to life, including both its joys and disappointments.

• Get a No-Suicide Agreement from Your Counselee:
  
• Put it in writing!
  
• Date it!

Most suicidal counselees are thinking in a circle: "I'm worthless" . . . "life hurts" . . . I feel more worthless" . . . "life hurts still more". . . "I feel utterly worthless," and so on. All the strategies above seek to break this circle. In addition, the following exercise may prove valuable: write words of biblically based encouragement on slips of paper. You might choose words like "beloved," "accepted," "precious," "enjoyed," and "delighted in." Come up with ten to fifteen words and place them in a bag. Have the counselee pick a word randomly from the bag at the beginning of each session. Spend five or so minutes exploring that word in Scripture.

SIGNS THAT A SUICIDE ATTEMPT MIGHT BE POSSIBLE OR IMMINIENT!!

2. A suicide threat;the more recent, the more significant (although past threats should not be discounted).

3. A method plannedfor attempting suicide.

4. Changes in behavior,such as giving away or selling treasured items, putting one's funeral affairs in order, buying life insurance "out of the blue," getting a will.

5. Situational stressorssuch as poor health, financial distress, death of a loved one, loneliness, divorce, marital stress.

6. Family indicators- that is, the presence of a depressive or dysfunctional family; or a family wherein the suicidal member has been targeted for anger and aggression in the past.

7. Emotional indicatorsthat is, depression, chronic fatigue, lassitude, futility, a feeling of impotence, or actual sexual impotence.

DANGER ,Impotence. Notice especially the depressed person who "recovers" suddenly; many depressives commit suicide, not at the bottom of their depression, but when they first start to feel better.

8. A history of mental illness.

9. A family historythat includes one or more suicides. Some counselees will feel that "suicide just runs in my family and sooner or later it has to come to that for me."

WHEN AND HOW TO HOSPITALIZE A COUNSELEE

(Refer to "Signs That a Suicide Attempt Might Be Possible or Imminent")

• You should hospitalize your counselee when signs one and two are present, along with at least one other sign. Also note whether your counselee feels little or no increase in hope.

• You should hospitalize your counselee when sign three is present, and you sense little or no increase in your counselee's the level of hope.

• Explain to your counselee why you feel hospitalization is important. Use the "why" factors above as the basis for your explanation.

• Have a family member call ahead to a hospital with a mental health program. The family member should inform the hospital personnel that your counselee has agreed to voluntarily admit himself or herself. If a family member cannot be relied on to do this, you should do it yourself.

• If your counselee will not agree to a voluntary admission, a family member will need to see a county magistrate -and declare that the counselee is a danger to himself and needs to be involuntarily admitted to a hospital. The magistrate will have a county sheriff or deputy escort the counselee to the hospital. Of course, this procedure is quite invasive, and a voluntary admission should be sought if at all possible.

Increase the counselee's hope and competence. Should suicide occur, encourage the survivors in their grief work.

Both His unchanging purposes and His unshakable covenant with us make it impossible for Him to go back on His word. Thus, "we have this hope as an anchor for the soul, firm and secure" (Heb. 6:19a). The soul is not self-anchoring. It needs something outside itself on which to fasten. Counselors should ask themselves, "To what is my counselee actually anchored?" Many depressive or suicidal counselees are anchoring to the reassurances of others that they are worthwhile. Always encourage the counselee to anchor himself or herself in Christ, the ultimate Shepherd.

"God wages war on our despair by loving us into the future and by opening us up to infinite possibilities. The person, from the believer ' s point of view, is a pilgrim, a sign of what is to come. Thus it is that we are invited to live not in the future, but from it."' Living from the future means refusing to define ourselves as less than 'hat we will be when we stand before God. Living from the future means living at the edge of glory and rejecting the attempts made by the Lord, the flesh, or the devil to cut us down.

HELP YOUR COUNSELEE DEVELOP A DEEP BELIEF IN GOD'S GRACE.

Grace simply means that God's favor always rests on His children. Under no conditions will that favor be replaced by condemnation (Rom. 8:1). How does this increase competence? Grace conveys an invitation toward freedom. Grace engenders freedom to risk, to fail, to love, to grow, even to soar (Isa. 40:31). The result? Enlarged liberty to move. More space in which to experiment with new, more godly ways of living. A liberation of laughter. A deepening of relationships. The freedom to risk confronting and forgiving. On the other hand, legalism -a denial of grace-narrows movement. It constricts one's space. There is no room to try, to fail, let alone to soar. A person's feeling of competence plummets, and this makes one more vulnerable, under the right conditions, to suicide. "In the psychological situation of suicide the interaction of a low sense of competence and external threat results in a highly constricted space of free movement. This is equivalent, of course, to a low level of hope. To a person in this situation there seems to be no course of action [left] .

WITH THE COUNSELEE'S HELP, CONSTRUCT ASSIGNMENTS THAT GRADUALLY BUILD A GREATER SENSE OF BOTH FREEDOM AND COMPETENCE.

For example, have your counselee make two lists, one entitled, "Things I've Always Wanted to Do," and, "Things I've Always Wanted to Say." With your prompting, the counselee can brainstorm as many items as he or she'd like. (When brainstorming, all ideas are worthwhile, for the time being.) Then edit each list. Which items bring the most hope to the counselee ? Which ones are more likely to happen in the near future? Which ones have to be seen as distant (but still feasible) dreams? How can each be prayed for?

The grief of those left behind after a suicide is complicated by larger amounts of anger and guilt than grief over other forms of death. Even so, working through grief from suicide usually involves the same basic elements of normal grief work: "Grief work is emancipation from the bondage to the deceased, readjustment to the environment in which the deceased is missing, and the formation of new relationships."7 Use these three elements freedom from bondage to the deceased, readjustment to the world in which the deceased is absent, and the formation of new relationships-as a three-phase structure for counseling those grieving a loss due to suicide.

PHASE ONE: freedom from bondage to the deceased. This means refusing to live as though the deceased were still around or would come back, while still honoring the memory of that person.

Those in the aftermath of suicide may develop illusory thoughts about their loved one's death; for example, "If I had been a better parent, spouse, friend, son, daughter, this wouldn't have happened." The fact is that people who kill themselves inevitably have options they haven't taken. Many are the forks in the road that lead away from suicide.

Killing one's self involves many choices, conscious and unconscious, to avoid constructive options.

The more one can get rid of illusory thinking about another's suicide, the less one will be in bondage to the deceased.

PHASE TWO: readjustment to a life without the deceased.

1. Many people feel guilty about resuming life after a loved one's suicide. They feel that, no matter how long they wait, they are somehow trivializing the death if they go on with their lives. However, putting one's life on hold simply compounds one form of death with another.
   
2. Suicide may express considerable anger at those left behind. It is an act of rage whereby "the suicidal person places his psychological skeleton in the survivor's closet." Readjusting to life after another's suicide means that the survivor must firmly refuse any responsibility for the "skeleton."

For example, a man who committed suicide after his wife confessed a sin against him was seeking to punish her endlessly. Her task was to take no responsibility for his action and to use God's path (repentance and confession), not her husband's (endless guilt and self-recrimination), to deal with her sin. She could feel great sorrow over his death without feeling that her hand had held the death instrument.

PHASE THREE: building new relationships. This may include deeper relationships with one's children, new friendships, or a new marriage. In any case, new relationships represent a statement that a loved one's destructive decision does not prevent the survivors' making the constructive ones.

CAUTION!!! While a counselor should provide reassurance to the suicidal counselee, that reassurance must never become a substitute for God's. After pointing the counselee toward God, the counselor must take care not to get his own needs met by the counselee's appreciation of him, should that come.

Real guilt, not the false kind, may stalk friends and family of the deceased after a suicide. Suicides do not occur in a vacuum frequently the deceased comes from a dysfunctional family or social group that greatly compounded his or her pain. The counselor must help those who carry real guilt through the following steps:

• Admit their contribution to the situation

• Confess their sin(s) to God (1 John 1:9)
  
• Stop denying whatever responsibility that is theirs for the tragedy

Suicide is a sin, just like killing another person. (EX. 20:13) That includes killing one's self. But Christ died for ALL of our sins! If a person who as trusted Him for salvation commits suicide, He will in spite of that be saved. One of the many passages that confirms this is, John 6:37-40; Romans 8: 38-39

Thus our Lord will not drive anyone away who comes to Him! Notice that He takes it a step further and declares that He will not lose any that the Father has given Him and that He will raise them up in the last day!

Homework: Many counselees feel a low sense of competence because they are afraid to change the way they relate to a key person in their lives -usually a spouse, sometimes a parent. After determining who this person is, have your counselee write out an ideal dialogue with this person. Your counselee, in the safety of a writing assignment, can express anything and everything he has wanted to say.

When the counselee brings this to the next session, discuss with him what would be scary about saying these things to this key person. Help your counselee discover how and why he may have exaggerated this person's power.

Encouragement."9 Chuck Swindoll

Anderson, s. J. When Someone Wants to Die. Downers Grove, Ill. InterVarsity Press, 1988.

Carr, G. Lloyd and Gwendolyn C. The Fierce Goodbye: Hope in the Wake of Suicide. Downers Grove, Ill.: InterVarsity Press, 1990.

Grollman, Earl A. Suicide: Prevention, Intervention, Postvention. Boston, Mass.: Beacon Press, 1988.

Hart, Archibald D. Dark Clouds Silver Linings. Colorado Springs, Colo.: Focus on the Family, 1993.

Powell, Donalyn. A Reason to Live. Minneapolis, Minn.: Bethany House, 1989.

Swindoll, Charles R. Encourage Me: Caring Words for Heavy Hearts. Grand Rapids, Mich.: Zondervan Publishing House, 1982.

For Those Who Hurt. Grand Rapids, Mich.: Zonderv'an Publishing House, 1994.

The Grace Awakening. Dallas, Tex.: Word Publishing, 1996.

NOTES

1. Maurice L. Farber, Theory of Suicide (New.' York, Funk and Wagnalls, 1968), p. 17.

2. Earl A. Grollman, Suicide' Prevention, Intervention, Postvention (Boston, Mass.. Beacon Press, 1971), p. 73.

3. Daniel J. Simundson, "Hope," The Oxford Companion to the Bible, eds. Bruce M. Metzger and Michael D. Coogan (York, N.Y.: Oxford university Press, 1993), p. 289.

4. Grollman, Suicide, pp. 72-83.

5. Alan W. Jones, Soul j1aking' The Desert Way of Spirituality (San Francisco, Calif.: Harper and Row, Publishers, 1985), p.192.

6. Faber, Theory of Suicide, p. 112

7. Eric Lindemann and Ina M. Greer, ".A Study of Grief Emotional Responses to Suicide: Pastoral Psychology, Dec. 1953, quoted in Grollman, Suicide, p. 112.

8. Grollman, Suicide, p. 4.

9. Charles R. Swindoll, Encourage ! Caring Words for Heavy Hearts (Grand Rapids, Mich.: Zondervan Publishing House, 1982), p. 9.

This article is from exerts of 'COUNSELING INSIGHTS"

From Insight for Living. Post Office Box 69000, Anaheim, California 92817-0900 .

1-800-772-888 This work is an essential pastoral companion for counseling!!!

www.intothyword.com