Uncovering the “Turning Point” with Suicide

Mar 07, 2017

“It is absurd to have a hard and fast rule about what one should read and what one shouldn’t. More than half of modern culture depends on what one shouldn’t read.”

From the play, “The Importance of Being Ernest”
By Oscar Wilde (Victorian Man of Letters)

Uncovering the “Turning Point” with Suicide

TISA Description of the Problem: Over the years, attention has begun to swing less towards what causes suicide and more towards what prevents it – what are the person’s reasons for living. By understanding the intimate phenomenology of what keeps a person vested in life, we may find ways of enhancing these reasons or even helping the client to find new ones. It all begins with uncovering the moment of decision, which Ed Wilks chooses to call “turning points” and which he beautifully explores in the following clinical interviewing tip.

Tip: What can we learn from suicidal clients about their reported “turning points” (i.e. the point at which they suddenly decided they did not want to carry through with their attempt)? These reasons could include sensations of actual pain or fear, the belief that the experience could involve an unwanted outcome as with the following regarding an overdose,” I might just get really sick instead of dying”, or a realization that they might be of important value to others or to a greater cause. With some there may be the emergence of an instinctual drive for survival or a fear of “what happens next”. These protective reasons could be almost as limitless as there are people, and could include cognitions, emotions, biological factors and combinations of many factors. In any case, learning more about these turning points with a particular client could prove to be invaluable in treatment. Various types of questions could help to uncover this type of material such as:

“What specifically made you stop?”

or
“What were you feeling or thinking when you put the gun down?”

or
“What prompted you to decide to keep living?”

TISA Follow-up: Any of the above questions, as well as many more, could become powerful gateways for collaborative exploration and intervention. I am reminded of the types of outstanding interventions that the ASIST model uses so effectively to help clients uncover their reasons for living (see www.livingworks.net). In any case, the art of uncovering and exploring suicidal turning points, as described by Ed Wilks above, is yet another practical skill to be communicated when teaching the fine art of clinical interviewing.

Tip provided by:

Ed Wilks
E-mail: eg_wilks@yahoo.com