September is the month of suicide awareness meant to bring attention to what can be one of the most concerning products of mental health conditions. A 2016 study completed by the Center for Disease Control concluded that there were 44,965 suicides in the United States in 2016, an number which had increased from 42,773 in 2014. While these number are alarming there at times seems little that we as individuals can do, which is quite the opposite. Specifically, what we as individuals can do is make an effort to ask difficult questions of those around us who we believe may be experiencing mental health symptoms. I hope this to be highlighted through a personal experience of my own, as I lost by younger brother Ryan to suicide in September, 2009.
Early in 2009 my brother Ryan, 23 years old at the time, had become increasingly distant from myself, which was difficult to notice as I had just begun the final year of graduate school and was wrapped up in my internship. Not talking for weeks at a time was normal for us, however, not speaking with our mother was lesser so. At our mother’s request I increased my efforts to find out what was going on. I had known that Ryan had become increasingly involved with the club scene and using substances typically associated with those circles. We had previously had talks about the behavior but from what I could gather the social attention that it garnered him far outweighed the alternatives. Thus, my efforts to reach out were met with some resistance, as he had relocated and changed his phone number on multiple occasions making him quite difficulty to contact.
Over the spring into the summer of that year he had picked up a new religion and had begun to speak about energy and the cosmos. None of which was all that out of place, Ryan wanted to be liked by everyone and was impressionable and had likely picked up some new ideas from some of the friends he had made around the clubs. However, his distance from our mother continued to create issues, after some investigating through friends of his I was able to get find out where he was staying. Through a few phone calls and emails I was able to convince Ryan to allow me to come visit him.
It was July when I made the trip from school to where he was staying to try speaking with him about how he was upsetting our mother and to see what all the secrecy was about. I remember arriving at the home he was renting, it was located on a street off a crossroad where 8 years prior Ryan and our father were in a traffic accident which took our father’s life, a location which I found peculiar. Upon arrival Ryan was not present, so I spent some time speaking with his girlfriend who was residing with him at the time who had some reservations about Ryan but did not seem as concerned as others around him. Ryan was late but he did show up, but the person I saw was not the person I remembered. I stood at the front door as he exited his vehicle and walked slowly and deliberately towards me, his face had a forced grin. He appeared much thinner than when I saw him last, he was typically muscular from lifting weights but looked a shell of the person he was months prior. As we spoke his reactions to joking and typical brother banter were effortful, he seemed preoccupied throughout our time together. I could tell something wasn’t right and through some less than skillful prodding I was able to find out that he was in fact feeling depressed. We talked about things we could do to help him out, seeing a counselor, get medication, he was open to discussing it but was generally non-committal. He had concerns about not having any health insurance at the time so we discussed how we could help get him some. The interaction felt from my perspective as much like two strangers meeting as it was two brothers.
There is such an unbelievable amount of discomfort related to asking someone if they are thinking about ending their life. It is not something you as a person are expected to ever have to ask. It seems much along the lines of asking someone how much money they make or who they voted for. It feels like a question that can do nothing but harm the situation. However, I had the fortune of being forced to learn how to do this in the first weeks of my internship as suicide assessment was a larger part of my role as an intern. Fighting the discomfort, I spit it out, “Ryan, have you been thinking about hurting yourself?” Eight words are what today allow me to sleep at night, they are what let me know I did my best. Eight words. There is so much fear of being rejected due to offending someone over something as simple as eight words that I can easily imagine many without the fortune of my counseling experience of being forced to ask, would have otherwise avoided uttering them. Fear that we would be rejected for caring, it seems odd to even consider when you think about it. He said no, I prodded some more, he denied any intent to harm himself. I took him at his word and he agreed to allow me help him get health insurance to get professional assistance.
It wasn’t but a month later when I received a phone call in the evening, it was a friend of Ryan’s who I had been in contact with who was keeping me updated on his well being. He was distraught, his voice shaking, barely able to release the words from his mouth that Ryan had taken his life.
Denial. Anger. Bargaining. Depression. Acceptance.
It is most definitely possible to say the perfect words and do the right things and still have something unfortunate happen. This was one of those instances. I could see that he was depressed, he admitted it, I offered help, he accepted it, I asked him if he was going to hurt himself, he denied it. Eight words are what helped me through the loss of my younger brother. I know I did everything in my power to help, it doesn’t take away the loss, but it made it possible to accept. I was not afraid, I cared and I showed it.
The lesson which I hope to impart from this personal experience is that asking the question is not the monster we can believe it to be. I would encourage you to consider the following, would you rather live as the person who was too fearful of eight words which are meant to show you care or be the person who asks and knows you did your best? Relationships can be fixed, if you ask someone, wrongly, if they are thinking about hurting themselves and they are offended, that can be repaired. Relationships, however, cannot be fixed if one person is no longer living. Next, I encourage you to think of the way you would ask someone if they are going to hurt themselves, and practice it, repeatedly. Imagine the scenario, imagine the person, the imagine asking your question. Practice it out loud, practice it until it feels as familiar as asking someone about their day. Challenging our anxiety about the question and practice are two strategies that can be helpful being able to say the words we want to say when we want to say them. And if you ever find yourself in the position I found myself in, I hope you ask.
Ronald Bristow
Licensed Clinical Professional Counselor
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