“Suicidal thoughts have been part of the human condition since we had frontal cortices, when we started to contemplate our worth in the world and our purpose and things… So it's not bad. It is information; it is part of our journey." ~ Dr. Sally Spencer-Thomas
Why therapists need compassionate curiosity, not fear, when talking about suicide.
This episode features a candid discussion about suicide. Please take care when engaging with the conversation.
Suicidal thoughts or suicidal ideation (SI), like the emotions that swirl around it, is a source of information. That perspective-altering declaration comes from my guest, Sally Spencer-Thomas, Ph.D. She's a brilliant, internationally recognized suicide prevention leader who lost her beloved brother to suicide. Sally urges cautious mental health professionals (and worried friends/family members tbh) to build their capacity for curiosity around suicide and SI.
"There's a whole bunch more that we could be doing," says Sally about the institutional and community-level care society provides to those with SI. "I'd felt that way before {my brother} died, that the tools we were given as psychotherapists are woefully inadequate in that they were mostly fear-based. They were really about protecting the therapist rather than actually helping the person."
Let's start with some SI basics. SI is a common aspect of the human experience which can be measured on a spectrum:
Low and chronic. These are undulating thoughts that drift in and out of immediate consciousness; a casual ebb-and-flow.
One and done. These thoughts accompany a major life event, like a break-up or financial crisis. Think: zero-to-100, then back to zero once the problem is resolved.
High and chronic. All-consuming thoughts that persist even after a client has tried everything from talk therapy to psychedelics to quiet the noise.
"We need different things for different groups and different types of conversation, but the things clinicians have been trained on, is one size fits all, and that doesn't work so well," admits Sally. In fact, a generalized approach erodes trust and ultimately fails our clients.
Clinicians have precious little time for 40-page suicide risk assessments or clinical interrogations. That’s why Sally advocates for a stop, drop, and roll approach, putting the client's needs back at the center of our efforts. "We need other things that we're offering people instead of just the safety plan, which takes a lot of energy and time to put together. How do we get them quick relief?" she asks.
Emerging models like polyvagal theory offer hope. But our ability to sit with what's uncomfortable may be our greatest source of preventative care.
GUEST CONTACT & BIO
United Suicide Survivors International
Sally Spencer-Thomas, Ph.D., is a clinical psychologist and internationally recognized suicide prevention leader. After losing her brother to suicide, she dedicated her career to advancing lived-experience-informed approaches to prevention. She is Co-Founder of United Suicide Survivors International and a leading voice in workplace suicide prevention.
MENTIONED IN THIS EPISODE
Matthew K. Nock, Ph.D. / Nock Lab
David A. Jobes, Ph. D. / The Suicide Prevention Lab
Marsha Linehan, Ph.D. / The Linehan Institute
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