Dear suicidal friend,

Hi I’m Sarah! I’m a Manchester psychotherapist, working worldwide via Zoom.

It feels like the pain will never end

I am sorry for your pain. I know you want to give up and I know it’s hard to keep going when you are so tired. However I would like to share with you what I have learnt from working with people like you and to let you know that change is possible.

By far the most popular content on my site is the blog article I wrote about ‘whether to tell your therapist that you’re suicidal’. It was a practical post to help people feel comfortable about talking to their therapists about how they felt and to demystify the idea that suicidal thoughts = psychiatric hospital or sectioning. It doesn’t.

I also wanted to write something more encouraging, about my experience working with suicidal clients and what I’ve learned.

Are suicidal thoughts common?

Suicidal thoughts are incredibly common.

I am not shocked when people tell they feel suicidal because nobody wants to be in constant pain.

The majority of clients I have worked with don’t really want to die. They just want the pain to stop. They have a crushing, soul destroying ache inside of them and it doesn’t seem to go away. They’ve tried running and meditating and reading books, they’ve drank and smoked and cried and screamed and it won’t leave.

Will my suicidal thoughts ever go away?

When you’ve never done something, it can be hard to imagine what doing it might be like. When you’re at the beginning of what feels like an impossible journey, it can feel like you will never get there. It can feel like a thousand failures await.

If you’ve never managed to run further than 10k, it’s easy to assume that a marathon is impossible. If you’ve run a marathon, you probably know that there are people than run ultras (50km and more). I have never run more than 10k but that doesn’t mean that it isn’t possible and that it can’t be done.

Will the pain ever end?

Although you’re in pain, and it can feel never ending, it doesn’t mean that things won’t get better.

It can be hard to imagine, but I’ve seen it happen. I’ve seen clients who drag themselves to sessions and sit downcast with their heads drooping and their shoulders hunched, learn that they are ok.

That what happened to them and how they were treated wasn’t their fault. That they are lovable, that love doesn’t require you to be perfect, that you can screw up and still be ok, that the dark times can pass, that little things can bring joy. That feelings and thoughts can shift and that you can learn to bear the unbearable and tolerate the intolerable.

Childhood trauma causes suicidal thoughts

Many carried an inherent shame that came from being mistreated. Shouted at, belittled, humiliated at school, bullied, told they were stupid, ridiculed for their sexuality, taken advantage of by those who should have known better, by those who were supposed to protect them.

Feeling alone causes suicidal thoughts

They didn’t understand that their overwhelm came from not being cared for, from having parents who were surviving and didn’t learn the skills that they didn’t know they needed, so simply couldn’t pass them on. Each emotion felt huge and insurmountable. A small break before the next tidal wave arrived. ‘Not waving but drowning’ as the poem goes.

They looked at others who seemed to be doing better and judged themselves as lesser. Not knowing that trauma keeps you stuck and locked in pain that doesn’t end. It freezes you so your brain doesn’t work and then you don’t know which way is up. Trauma is not just about wars and earthquakes. It’s a thousand cold stares, a thousand insults, a thousand silences, a thousand clipped tones, a thousand shrugs, a thousand disinterested hugs, a thousand absent kisses. Death by a thousand cuts.

Does therapy help with suicidal thoughts?

It doesn’t have to be this way, and you are not stuck like this.

Therapy can help you work out which bits are causing you pain. They can provide you with support which changes the way your brain makes connections; the more you reinforce these new pathways the more fluid and easy to navigate they become.

If you were brought up without encouragement it is not your fault that you do not know how to keep going. Although much is spoken about abuse (active hurt) and neglect (deprivation) little is spoken about the middle ground. The middle is the place where your needs were met physically but not emotionally and this can also lead to CPTSD and suicidal feelings.

You can recover from thoughts of suicide

If you have ever learned a skill, you know that learning is possible. Many of us have learned to drive, swim, speak another language or play an instrument.

These skills were not learned overnight. Persistence can be learned, tenacity can be learned. Those of you who were told you were stubborn can use this stubbornness and redirect it.

The anger that you feel for those who hurt you or let you down can be redirected and used as an energy source. You do not need to suffer or keep punishing yourself because you were hurt.

I remember during my training saying to my trainer ‘I can’t do it, it’s too hard’. He looked at me and said ‘push yourself my darling’ and I remember feeling both touched and annoyed.

Touched because I wanted the encouragement and I knew that he cared about me and believed in me and yet annoyed because I really wanted to give up in that moment.

Giving up, will not get us any closer to our goals. So take a rest and have another go when you are ready.

With best wishes,

Sarah