Uncovering Reasons to Live

Mar 08, 2017

“It was the policy of the good old gentleman to make his children feel that home was the happiest place in the world; and I value this delicious home-feeling as one of the choicest gifts a parent can bestow.”

From Old Christmas
By Washington Irving (1875)

Uncovering Reasons to Live

TISA Description of the Problem: As we work with clients, both in the initial interview and in ongoing therapy, issues of suicide often raise their head. In the same token, reasons for living often come to light as well, representing important guideposts in therapeutic intervention. In the following clinical interviewing tip from Cari Myles, LCSW, we can see how a window into this sometimes life saving information can be skillfully culled, even when a client is denying suicidal ideation (which, of course, may appear later in the course of therapy).

Tip: In the following dialogue, I use a simple phrase (“What are some of the reasons you think you aren’t having such thoughts?) to explore reasons for living:

Clinician: With all of your pain, have you been having any thoughts of killing yourself?

Client: No, I really haven’t, thank God.

Clinician: What are some of the reasons you think you aren’t having such thoughts?

Client: Hmmm. I don’t really know, but I think I will be a pretty good teacher someday. And, I really don’t want to let all those kids down. And I also think I’ll be a pretty good mom.

I find that the answers to this simple question are sometimes surprising. They not infrequently provide a window into the soul.

TISA Follow-up: In this clinical interviewing tip, Cari Myles adroitly shows the power of a simple question to unlock motivators for enduring difficult times.

Tip provided by:

Cari Myles, LCSW
Madison, Wisconsin
VA system