Asking the Client to Speculate on His or Her “Breaking Point”

Mar 06, 2017

“Memories are just dead men making trouble.”

Gabriel Garcia Marquez
from The General In His Labyrinth

Asking the Client to Speculate on His or Her “Breaking Point”

TISA Description of the Problem: When dealing with a client’s potential for violence to self or others, one wonders how the client might respond if pushed to his or her limits. Bryan Chambliss, M.D. in the following tip, provides a direct method of “getting a read” on this possibility by directly asking the client to speculate.

Tip: I have found that the following question can be of value in getting a hint at a client’s potential for violence or suicide when I am suspicious that the client may be prone to impulsivity or is unlikely to plan ahead. I have found that the simplicity and directness of this approach is what gives it power:

“Are there any situations in which you could imagine that you would become suicidal or violent?”

TISA Follow-up: This excellent tip by Bryan has the advantage of not only being direct but of possibly uncovering some true trigger points that the client may, in reality, be exposed to in the near future. For instance, with regard to domestic violence one could envision a client who describes a stressful situation that might be likely to occur. In which case the clinician’s read on the probability of imminent violence might be raised leading to appropriate intervention.

Tip provided by:

Bryan Chambliss, M.D.
Associate Director of Residency Training
Director of Psychotherapy Training
Western Psychiatric Institute and Clinic
Pittsburgh, Pennsylvania

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