# 161 July 2013

"Where the spirit does not work with the hand there is no art."

Leonardo Da Vinci

(continues below)

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# 161 July 2013

Exploring the Morning After the Suicide Attempt

TISA Description of the Problem: We are often asked to interview clients the morning after a suicide attempt. At such moments we are doing our very best to determine the actual intent of the person to die by suicide. Michael Grin, M. D. utilizes two questions that can help with this complex inquiry.

Tip: In clinical interviewing I have found that it is often valuable to simply be direct in a sensitive fashion. In this light the following question and its logical follow-up can open the door to an honest discussion of the client's desires and his or her intent to die by a suicide. They also often open the door to the intensity of the client's pain:

1) "How did you feel when you woke up and found that you were still alive?"

2) "Were you happy or relieved that you had survived your suicide attempt?"

TISA Follow-up: As Zen monks often say, "Much that is elegant is simple." As Michael suggests above, asking the above two direct questions in a gentle fashion I believe can be quite useful. I have also found that if a client insists that they want to be discharged immediately because they are no longer suicidal (which may or may not be true), I have found it useful to ask, "What is it that is different in your life now from twelve hours ago when you attempted suicide?" Sometimes the client has answers that are suggestive of safety such as, "I did a lot of praying last night and I just don't believe suicide is the answer for me." Other times there is no good answer provided and the client may simply want to get out in order to start drinking again. In any case, these types of questions can help us to better determine potential dangerousness.

Tip provided by:

Michael Grin, M.D.

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