Ernest Shulman is a Canadian who has lived in New York City for many years. He is a suicide researcher with a Ph.D. in social psychology from the City University of New York. His specialty is why famous people do or do not kill themselves. He is now at work on a book on the causes of suicide, titled “Thirty Famous Suicides.”

Part 1

Many methods exist for suicide prevention. A suicidal person can be placed on a locked psychiatric ward and watched. Or put on psychiatric medication to knock him/her out. Or offered counseling or psychotherapy. Or offered rewards for agreeing not to end it all (as, for example, Hemingway was given grounds privileges and later released from the Mayo Clinic in 1961 to his wife’s reluctant care after he agreed not to kill himself at the Mayo). Or physically prevented from acting self-destructively. Or simply persuaded not to.

Combinations of these methods are typically used. The person generally stays alive, at least temporarily. But an individual my not be stopped permanently if despair, hopelessness, and suffering continue unabated. My personal experience at the hot-line confirmed this knowledge.

As a hot-line counselor, I had the advantage of working with people who phoned in because they preferred to stay among the living. And they were acting to do just that: a big advantage for me. The drawback was that I had no leverage beyond the ability to listen carefully, offer emotional support (but not false reassurance), raise questions in callers’ minds, and suggesting constructive options.

With experience, I learned to do all those things. Three examples will illustrate when my efforts gained apparent success, to some degree at least. First, a young male college student called to complain about his failure to connect in any way with a female student who visited him in his room, but left unceremoniously. After establishing rapport, I decided to try a friendly confrontation: I suggested he was excessively formal and correct; he spoke in perfectly formed and grammatical sentences. He understood my point, seemed to see its relevance to his problem, but said little more and never called back. Second: an intervention with an unemployed man who had tried hard for a year to find work, but was caught in a recession with few job openings. He mentioned he had recently left his wife and children and now lived alone in a single room. He was preoccupied with despair over inability to find work. After a while, I shifted the conversation to the breakup with his family, and he responded so positively I ventured to suggest family therapy might help. He soon hung up, but a week later called in to leave a message for me, saying his wife had agreed and an appointment had now been made with a family therapist. Third: a distraught woman called, saying she had a lethal dose of pills on a table in front of her. Disabled, she was in a wheelchair. She had been engaged to a man who unilaterally decided to stop seeing her. After a long discussion of this man’s possible motives, she said it couldn’t possibly have been because of her disability. I simply said, why not? Suddenly, a light came on in her mind. She called later to leave the message for me that she had resumed all her normal activities and was no longer suicidal.

These examples all had one thing in common. The suicidal person was preoccupied with an apparent issue, and was ignoring the underlying question that had produced the suicidality. Once this deeper problem was addressed, the situation greatly improved.

Part 2: Regarding the Loved Ones of Someone Suicidal

Several things impressed me during the three years I spent (about ten hours per week) taking calls at a suicide hot-line in New York City. Most callers were NOT on the verge of suicide, but rather were contemplating it. And a few merely wanted to air some of their general problems. Some, however, were at the point of taking their lives. Such people spoke calmly and coherently, but seemed uncertain of who they actually were.

One type of interesting caller included what are referred to as third-party callers — loved ones of someone suicidal. For example, a woman phoned to ask for advice on her husband, who she believed was close to killing himself. After a little conversation, she trusted me enough to say her marital relationship wasn’t strong enough to get him to discuss his problems with her. Moreover, nothing she could say to him would have an influence. So I asked if there were anyone her husband trusted enough to open up to. She said yes, there was somebody — a close relative. Then I asked if she could approach that person, confide her worry, and ask him to try to reach her husband emotionally. Again she said yes, she would do that. I never heard about the aftermath; that’s one of the downsides of being a telephone counselor where everybody is anonymous.

Another caller was a young man who told me his younger brother was threatening to take his life. The caller didn’t seem to like his brother, but he reluctantly accepted my suggestion to go right over to visit his brother at his place.

Suicide is oten a family affair, especially with the young. For two reasons the best person to dissuade someone from ending it all is a significant other. One: many suicidal people, probably most, refuse to go for professional help. Somebody, already emotionally close, will have the best chance to convince a severely troubled individual that that person’s life is important to the loved one. Two: even if a suicidal person does go to a mental health professional, that professional probably has no training and little or no expertise in helping the suicidal.

Hot-line workers generally use a referral book so they can suggest further help, often from professionals. But callers seldom use such a referral. I felt I had to do my best on the spot, but usually did not learn about outcomes.