Once suicidal ideation (thoughts of committing suicide) is present, four basic areas must be explored in assessing suicidal potential: Once suicidal ideation (thoughts of committing suicide) is present, the risk that a person will attempt and commit suicide can be assessed by exploring four basic areas:
- Does the person have an actual plan to kill him- or herself? If the person has a plan, how specific is it? Does he or she wish to go to sleep and never wake up or perhaps simply want to die? Or, does he or she talk in terms of shooting or hanging themselves?
- How potentially lethal is the plan? In other words, if the person carries out his or her plan, how likely is it to be fatal? Overdosing on vitamin C might require some medical attention, but it’s extremely unlikely to result in death.
Does the person have access to the means to carry out his or her plan? For instance, if the plan involves a gun, does the person have access to one? If the person doesn’t have immediate access to the means to carry out the plan, how easily could he or she get it?
- How committed is the person to acting on his or her plan? To what extent does he or she seem to be determined to attempt to take his or her own life?
These questions comprise a continuum of severity and risk—the more of them that are answered in the affirmative, the higher the degree of danger for the person in question—the more likely he or she is to attempt and actually commit suicide. In counseling in general, and addiction treatment in particular, one of the most basic and important responsibilities is to help clients access a glimmer of hope where there is usually so little, and then help them build upon that hope. I’ve always believed that facilitating a client’s ability to see even a little bit of light at the end of a pitch-black tunnel was among the most valuable and therapeutic things I could do. In active addiction, the obsessive thoughts and compulsive behaviors that focus like a laser beam on accessing and using drugs precipitate an all-encompassing self-centeredness. It is a relentless, single-minded, and self-absorbed pursuit of one’s own desires and perceived needs—including the increasingly elusive “rush” reminiscent of those first using experiences. The self-centeredness is so fierce, it can preclude any meaningful consideration of the needs of others, or the potential consequences of one’s actions. It keeps people struggling with addiction mired in the depth of the emotional pain that drives one to consider taking one’s own life and fuels the rationalization that those left behind will somehow “be better off.” This self-centeredness separates the addict from others and from the world. It is characterized as a spiritual component of addiction since spirituality requires a sense of connection to that which is outside of oneself. It involves experiencing a positive connection to other people, to the world around, and to powers beyond oneself—the universe; a higher power; the god of one’s own understanding (which may or may not have anything to do with an organized religion), a feeling of belonging to a larger, greater whole. This blog post is an excerpt from Some Assembly Required – A Balanced Approach to Recovery from Addiction and Chronic Pain by By Dan Mager, MSW; Published by Central Recovery Press (CRP).