Uncovering “Passive” Suicidal Thought and Behavior

“You should never believe what people say. I stopped doing that years ago.”

Miss Marple
from the television adaptation of
Agatha Christie’s Sleeping Murder

Uncovering “Passive” Suicidal Thought and Behavior

TISA Description of the Problem: Severe self-denigration, demoralization, and death wishes may show themselves in dangerous behaviors that can lead to death, in what is sometimes called “passive suicide.” Tiffany Brown, who shared an excellent clinical interviewing tip on uncovering substance use disorders back in May 2009, finds the following technique useful in this regard.

Tip: During an initial interview, I find it useful to search for activities such as driving recklessly, purposefully not wearing seat belts, risky sexual behavior, and excessive use of alcohol and drugs as possible evidence of passive suicidal thought. Sometimes, after having asked about suicidal thought directly, if one intuits that passive suicidal thought may be active, it may be useful to directly ask as with:

“Do you ever do things that might be sort of dangerous that might be an indirect way of killing yourself like driving recklessly, not wearing your seatbelt, having risky sex or drinking heavily or drinking while you are driving?”?

TISA Follow-up: Once again Tiffany has provided an excellent tip that sometimes uncovers unexpected answers. It also may sometimes prove to be therapeutic as the client may not have realized that these behaviors are tied into their suicidal feelings. Such an added insight may help them to better understand the intensity of their pain and the need to address these potentially dangerous behaviors more seriously.

Tip provided by:

Tiffany Brown
TKBrown@bop.gov