# 133 March 2011

“The stillness of God is not apart from the dance of our every day; it is at the heart of it.”

Michael Adam
From Wandering in Eden

(continues below)

mental health professional trainings
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# 133 March 2011

Exploring Suicidal Behavior as a Form of Communication

TISA Description of the Problem: In the following excellent clinical interviewing tip provided by Jonathan Krejci, Ph.D., the clinician is given a tool for uncovering and exploring a powerful question, "What did this suicide attempt really mean?" I hope you enjoy it.

Tip: I wanted to share a question that I have found helpful to ask after a recent suicide attempt to distinguish between instrumental and communicative intent:

"Did you feel like you definitely wanted to die, or that you wanted to let other people know how bad you felt?"

If the client endorses the latter option, this can help to focus treatment on discovering healthier ways to communicate his or her pain. This question also provides a tactful and non-judgmental way to normalize suicidal "gestures".

TISA Follow-up: One of the powers of this nuanced clinical interviewing tip from Jonathan is the doorway it sensitively opens into the phenomenology of the client's inner pain, for both answers - the desire to die and the need to communicate one's angst - illuminate the inner workings of the client's soul. With this question, sometimes both the client and the clinician will unexpectedly come to discover the interesting finding, that on occasion, both processes are at work simultaneously. In any case this tip is a nice one.

Tip provided by:

Jonathan Krejci, Ph.D.
Director of Training and Research
Princeton House Behavioral Health
Princeton, NJ

TISA is a site dedicated to advancing the science and art of preventing suicide and teaching clinical interviewing