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Facing the Spectre of Suicide

Suicide will be a national topic of conversation today, as the Samaritans conducts its annual The Big Listen campaign. While therapists well understand the transformative power of listening, expressions of suicidality can challenge our capacity to accept and sit with a client’s feelings. And, as counselling lecturer Jamie Smith reminds us, therapists aren’t immune to societal misconceptions about suicide – or the pressures of our own motivations.


This blog is being reposted to raise awareness in support of our new, free online CPD course: "Working with suicide - Essential suicide intervention and prevention strategies".


Working with suicide can be a challenging time for any therapist, regardless of level of experience, training, or qualification.

In my experience from working with clients in crisis, talking about ending one’s life may be an expression of hopelessness or despair when a client feels that all other words or actions are no longer capable of communicating their feelings. However, our personal views and feelings regarding suicide can have a significant impact on how we offer support during such encounters, and I have certainly found myself in this situation on more than one occasion, either as a trainee or since qualifying.

FREE Online Course – Working with suicide

Gain 4 hours of CPD!
Includes LIVE Q&A 27 January
With Kathy Steele, world renowned trauma expert

Most believe that the therapeutic connection can be a powerful motivator that, if nurtured, can lead to lasting change for clients. At times, the bond between client and counsellor – built on trust, understanding and mutual respect – may even transcend the barriers of ‘normal’ day-to-day relationships. Yet our faith in the significance of this relationship can become challenged when working with risk of suicide.

Whose needs are being addressed?

While on placement, I chose to work for an organisation that supports clients in suicidal crisis. Although I had an advantage in knowing that suicide would be present in the room, I can still remember going (running at times) to speak to my supervisor. I was determined to find the right ‘tool’ or ‘technique’ to allow the client to ‘turn a corner’, as I often put it. I would sit with my supervisor and offer avenues of exploration or clever techniques that I felt might have this affect with my clients. My supervisor, calmly listening, would only explore these suggestions after asking me one thing: “What’s your motivation here?” In that instant, I would be reminded that I had taken myself away from my client’s needs and begun to focus on my own – my need to control the uncontrollable.

Fears and myths

Feelings of fear or anxiety may take the form of ‘what do I do or say?’ Our core training and reliance on being fully present in the room while listening to our client’s experience can fade into the background, as we stumble upon our own uncertainties in times of client crisis. The compulsion to find the most appropriate form of action or just the right thing to say can place a barrier between the natural flow of the client/counsellor relationship, potentially adding to the pressures we may be experiencing. There could be a shift from feeling that we have a responsibility to the client, to feeling we are responsible for their safety. This shift affected me greatly when I lost a client to suicide as a trainee. Feelings of personal guilt and

professional incompetence were reinforced as I believed that I had failed. My need to control the uncontrollable was painfully challenged by the autonomy of my client’s decision.

These feelings of fear seem reasonable if we consider societal misconceptions or myths relating to suicide. This underpins the importance of reflecting on our own views, values and system of beliefs – particularly how these can impact on our confidence and competence to manage suicidal risk appropriately. A common fear or myth, for instance, is that exploring or encouraging discussion around suicidal thought can strengthen the likelihood of an individual completing suicide. However, research indicates that there is no evidence to support this. Instead, it is suggested that exploring and discussing thoughts of suicide can often be a cathartic experience, which decreases the intensity of such thoughts.

Relationship and risk

This highlights the uniqueness and value of the therapeutic relationship when exploring risk. While the outside world may be searching for the right thing to say, ‘to snap them out of it’ we can instead strive to offer support by accepting the client’s feelings in the moment, to be present with them in the darkness as they try to gain a deeper understanding of their situation. Careful contracting, with specificity on confidentiality and any limitations therein, can allow the client to explore these feelings or thoughts in a safe environment and can offer the therapist opportunity to support and vigilantly assess levels of risk as they arise.

By consistently revisiting our views and feelings surrounding suicide, maintaining appropriate levels of CPD, support through supervision or personal therapy if required, and engaging in effective and restorative self-care, we can carefully monitor our personal reactions and ensure we are offering appropriate and effective support.

FREE Online Course – Working with suicide

Gain 4 hours of CPD!
Includes LIVE Q&A 27 January
With Kathy Steele, world renowned trauma expert


Jamie Smith

Jamie Smith is an integrative counsellor registered with BACP and has worked with clients in suicidal crisis since his time as a trainee on placement and post qualification. As a lecturer in counselling and associate counsellor for Glasgow Clyde College he has a keen interest in the training of counselling students and student mental health. He is currently developing a professional development award for SQA (Scottish Qualifications Authority) in counselling children and young people.

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