Suicidal ideation: A personal reflection

10th September marked World Suicide Prevention Day. The following personal reflection sets out my own struggles with self-harm/suicidal ideation which began at the young age of 13, leading to a serious overdose attempt in 1998 at the age of 19.

*Content warning: Please note that this article includes descriptions of self-harm and suicide attempts, please read with caution.

I will discuss how this experience shaped my early 20s and how counselling helped me at the age of 35 to make sense of these feelings. And since I will experience deep bouts of low mood, I very rarely get suicidal thoughts.

There are parts of this account that readers may find distressing, but I feel one can only get a sense of what this feels like from an honest account.

I feel I struggled in school from a social perspective or at least had a sense of inadequacy, I suppose. This is something I have only recently thought about in any great depth to understand why unbeknown to anyone else I would punch myself in the head or wrap a ligature around my neck and pull as hard as I could.

There was no danger particularly. If I had passed out I’m sure the ligature would have loosened and I would have come to. That is maybe why I consider this self-harm at this point it may have been a form of self-punishment. Because I saw myself as small, unattractive, non-athletic and generally struggled to interact with the opposite sex or someone that I found attractive.

Looking at it now, I suppose I found young romantic relationships difficult. I didn’t understand girls, and to be honest, was scared of them. I often could not recognise when a girl was interested in me. Perhaps, because of my low self-esteem would say, “Why would she be interested in us?”

To this day my wife has to point out when this is happening, although it doesn’t happen often. I look back now and think although I lost my virginity when I was 24 years old, romantic relationships were only one part of why (by the age of 19) I took an overdose that required medical intervention.

For me, suicidal ideation comes in the absence of hope. I felt I did not know who I wanted to be; there was family turmoil, no romantic relationship and in general it felt it may be easier if I was not around. Adolescence was a struggle for me looking back. I was filled with anger and resentment that my life was not going the way I wanted it to.

Leading up to the attempt that landed me in hospital, as with most stories of suicide, there had been other attempts, including taking a saw to my wrists. Fortunately, as soon as the blade hit my wrist, the pain put me off; that is why I chose to take tablets.

On the day in question, I purchased strong paracetamol and that night took all 24 of them. After about an hour I started feeling woodsy and collapsed on the floor, still conscious. I cannot explain where this came from but a voice in my head seemed to say, “What on earth are you doing? Get up!” so I phoned someone who phoned the ambulance and I was whisked away to hospital.

In 1998 I felt during my stay in hospital that I was being judged for trying to take my own life and this filled me with shame. To this day I would take issue with anyone who utters the words, “Well that was selfish” I would like to think in 2023 we know a lot more about the nature of suicide and deal with it in a more compassionate way.

After this incident, I got on with my life and eventually met my wife at 25. She has always supported me and given me the confidence to try or change things when I was feeling low. This gave me hope, but at the age of 35, I began to struggle again with low mood. This time I sought counselling and this is how it can help with suicidal ideation.

In counselling, I started to work on my feelings of low mood. Imagine a ball of knotted wool; therapy started to untie the strands and make sense of how they were connected. We discussed numerous topics and the main theme that seemed to be present was that of being unheard or unseen. This emerged after 12 sessions, which is why sometimes it can take time. Through our discussions, the counsellor reflected on what she noticed; the technique of reflecting back on what the counsellor has understood from their client helps the client think about the validity of the statement and can choose to accept it, alter it, or dismiss it.

For those experiencing suicidal ideation, the counselling space can be a vital lifeline. Here the client is the main focus and free from judgement. This helps the client feel held and safe to explore what is going on in their inner and outer worlds. That is not to say, of course, that in certain circumstances of a high-risk disclosure, the counsellor may have to take action to keep the client safe. When this will be done will either be in the client contract or explained verbally by the therapist.

As the sessions progressed, I began to understand that the reason I felt low was that I was unhappy in my career and needed a change. That is when I decided (as most counsellors/psychotherapists do) to retrain as a counsellor. Although there is some debate among the counselling approaches around using self-disclosure (some say absolutely not; some say only if it is relevant to the client’s situation), I have found on the very rare occasion that I disclose my own experiences of suicidal ideation, it has helped clients feel that I know what they are going through. Advocates of self-disclosure in therapy, argue that it shows the counsellor to be human and that we can connect with aspects of our client's experiences.

I hope that this article gives people the confidence to seek therapy, it may be one of the hardest phone calls you make in arranging that first session, but as clients report it is often seen as a worthwhile task.