Suicide Prevention: If Someone Had ASSSKed Me

There were two times in my life when I was at real risk of dying by suicide. The first time, I was 19 and actually tried. The second time, I was around 42, maybe 43, and had highly lethal means available to me. The main reason I survived that time was that I had an incredibly strong reason to hold onto this life. Both times, I was isolated, at least emotionally. Recently, I got certified in the ASSSK method of suicide prevention, and I am going to use this blog entry to reflect on how that approach might have impacted me in these situations.

The ASSSK training that I attended was a one-hour online course that includes supplemental reading and a test that must be passed in order to get certified. It is referred to as a “suicide prevention gatekeeper training.” A gatekeeper is someone who is in contact with someone who may be considering ending their life. That means it could be any of us. We could all be gatekeepers at some point in our lives. Our job when we realize that someone we know is in deep pain and feeling a sense of hopelessness or helplessness is to engage that person in a sensitive and direct way and to help them connect with a professional for more extensive and knowledgeable help.

Step 1: Ask, Are You Thinking About Dying?

The training talks about the importance of connecting with the person in some sensitive way, being clear that you are not judging, asking the question directly, and actively listening to the response. I wish someone had the good sense to know that I was going through something awful inside even though I wasn’t expressing it - at least not expressing it in calm, thoughtful ways - and then to ask me if I was thinking about suicide.

This would’ve been immensely helpful for me, especially the first time, because I believe I immediately would’ve felt less alone. I had been experiencing anxiety, depression, and panic attacks due to having been molested at age 11 and feeling rejected by my mother afterward, then being sexually assaulted by a group of teenage boys when I had passed out at a party and finding out about it because a video recording of it was being passed around school, then being violently raped by an older boyfriend when I told him I didn’t feel like it that day. I remember feeling completely alone in what I was going through because it was minimized at best, and society generally sent messages that it was shameful to have problems like that. If anyone had asked me what I was going through and taken me seriously, I would’ve felt that it was at least possible that I was worth something other than a sexual object and that I might possibly be loveable.

The second time feels a little less cut and dry to me because I was more generally isolated. I had pushed so many people away, which is pretty common for addicts. I had been running away from the devastation I felt from my 11-year-old daughter’s sudden death, most significantly by drinking away the thoughts and feelings. That is never a recipe for maintaining healthy relationships.

By the time I quit drinking, there weren’t a ton of healthy people still in my life, but that is when I really needed them because everything I’d been running from came rushing at me all at once, and I was highly sensitive to new triggers. AA was helpful at first, but after I moved, I wasn’t able to find an AA group that felt similarly supportive, and the new sponsor I had seemed to rely on me to help her more than she helped me. When I did tell my remaining friends a little about what I was feeling, they got very uncomfortable, clammed up, and drifted away. My parents or my husband or people in my consulting firm could’ve asked me before I got to imminent danger, but I’m not sure I would’ve told them because I also was afraid of being forced into a 72-hour hold on a psych ward, like when I was 19.

In retrospect, that might’ve been a good thing, except for the enormous hospital bill that would’ve been added to my problems, and what I really needed at the time was help weathering the storm I was facing in my daily life, which would’ve been true whether I got hospitalized or not. Luckily, I already knew about crisis lines at that point in my life, and I called almost daily for awhile. I also walked several miles to the nearest crisis clinic on the day that I wasn’t sure I was going to be able to make it through the day with just a phone call.

Step 2: Seek More Information

This step flows naturally from the first by simply asking what’s going on, which can be very helpful in its own right. I know in both cases that it would’ve helped to talk through what was happening, at least a little, just to get the words out of my head.

Of course, it was challenging to talk about it at both of those times because 1) I didn’t believe that I would be understood and 2) I believed I would be judged or penalized in some way by expressing myself. Having had this experience, I deeply appreciate that the ASSSK method emphasizes nonjudgement and active listening. What I wrote above is and was very difficult for me to talk about, and in both situations, it was nearly impossible for me to be articulate about it when I was going through it. I remember stumbling through all my crisis calls, and I am grateful to the people that listened patiently and compassionately through what must’ve sounded like incoherent babbling at times.

I also appreciate that the method includes asking about anything that has been helpful in the past, if the person has felt like this before, and regardless of past experiences, if there are people in the person’s life that they can trust to be supportive. This can help the person in crisis to feel less hopeless and helpless if it’s possible to identify any potentially helpful steps or people to engage.

That said, it can be tricky because the level of desperation in which I found myself had me thinking that nothing and no one could help me, and just thinking about that sent me spiraling. I remember hanging up on crisis line volunteers when getting to that point but then calling right back because I didn’t feel like I could make it on my own. It was on one of those occasions that the volunteer helped me find the local crisis clinic. I suggest that we all have this information at our fingertips just in case we need it: add it to your contact list in your phone, add favorites to your web browser on your phone or tablet, and/or print out an emergency list to keep in your wallet or purse.

I suggest one addition to this step. Personally, I know that I was feeling both worthless and hopeless in both instances, so I think it would be helpful to tell that person that they matter. Dig deep to find the most heartfelt and honest reason that you mean that. I can tell anyone that I meet that they truly matter to me because their survival gives me hope for my own survival, and that whether they know it or not, there is someone out there that would be devastated and possibly at risk of taking the same action if the person ends their life. I know this to be true because I have seen it happen over and over again. Your reason may be different than mine. Whatever it is, it may be helpful for the person in crisis to hear it.

Step 3: Safety First

This step builds on the earlier conversation about what has been helpful. It aims to help the person get connected with their support system: friend, family member, counselor, faith leader, 12-step sponsor, anyone who can provide longer term support. I love how the training talks about support systems being a critical part of safety because support systems offer hope, which has been dangerously lacking for those of us who have considered suicide.

This is where I think we can all do better. People in crisis rarely behave in thoughtful, generous, healthy relationship ways - because we’re in crisis. There will be time to make amends, my friends. Safety first, please. I ask us all to step in with our healthiest, most capable way of being in the world, and show up for the person in crisis without requiring them to “deserve” our help. In the end, I believe we heal each other when we show up like this.

Luckily, I had one person each time that I could name as a helpful resource, though reluctantly. The first was my birth mother, even though she was also the source of part of my pain, and she paid for me to go through a program that ended up offering me a great deal of help as I limped forward after I got out of the hospital. The second was my husband, even though we weren’t completely solid in our relationship at the time. The person on the crisis line guided me through contacting him and letting him know what was going on with me, and he left work as soon as he could to come help me. He wasn’t equipped to provide the kind of support a counselor would have offered if I could have afforded to see one, but he sat by my side and held my hand while I cried and listened intently and lovingly whenever I was able to talk. Slowly but surely after that, I added other healing steps that led me to where I am today. While I didn’t have an extensive support system, it was enough for me to make it through those darkest of days.

Step 4: Secure Lethal Means

The best way to secure lethal means from me the first time would’ve been, first, to know that I was suffering as deeply as I was, and second, to be with me and stay with me until the threat was gone. I didn’t actually have lethal means with me, so I had to go to the store to get it. I walked 20 minutes there and back. I was serious, and I was alone. I am alive today only because my then-boyfriend happened to come over and find me unconscious…before it was too late.

The second time I was very seriously in danger of following through, I had a 9mm pistol with a loaded clip sitting next to it in my bedroom. I made myself leave my house to put space between me and it. I kneeled in the middle of my backyard, sobbed violently, and white-knuckled my phone as I spoke with the crisis line volunteer. She asked me about what I had available to me, and I told her. That was when she had me do two things: 1) contact my husband and tell him to get the guns out of the house as soon as he got home, and 2) go to the crisis clinic.

The basic idea of this step is this: put distance and time between the person in crisis and the means to follow through with the desire to die. I am living proof that this is an important step in the process because I honestly don’t know that I could’ve resisted any longer, even though my reason to live was so potent for me. That person saved my life, and I will always be grateful for that stranger and the fact that such a resource exists.

Step 5: Know How and Where to Refer

When you are wrapping up your conversation, be sure to refer, again, to trained support. Ideally, folks will be able to access counseling. It costs money, and it’s often something that people can’t afford themselves. That was true for me at both times when I needed it most.

I didn’t get appropriate counseling the first time, other than the care I received during those 72 hours in the hospital (and leaving me with a $13,000 hospital bill that I spent several years paying and cringing at the memory with each payment). The hospital really should’ve given me referrals for both counseling and financial help, if any such help existed. They did not. However, my birth mother did pay for me to access a different kind of self-help program called the Excellence Series, which did turn out to be helpful in its own way.

I didn’t get true therapeutic counseling until much later, when I finally had enough income to pay for a few sessions. Still later, when my income was high enough to afford the discounted rate of $300/hour, I was able to access a set of coaching sessions, which were ultimately transformative for me.

We need to do better than this, people. People are dying by suicide at unprecedented rates, with an average of 132 deaths by suicide per day according to the American Foundation for Suicide Prevention. It is not ok that our income levels may determine whether we live or die or generally how healthy we may be when we do survive, especially since the truth is that our networks tend to be at similar income levels. If I can’t afford to pay for my own care, chances are folks in my support system can’t either, and as we’ve said before, the few counseling sessions that may be available for free through public systems are not enough, and many of us are stuck in between…not enough income to pay for things like counseling but too much to qualify for public assistance. I’ll say it again: we need to do better.

In the meantime, there are crisis lines and crisis clinics available, and at a minimum, we should all be prepared to share this information, as I mentioned earlier in this article. It is good to share this information at this closing step as well.

Following are some resources available for free to anyone, anywhere, at any time in the United States; check online for crisis clinics and other similar resources available near you.

• Suicide & Crisis Lifeline: Call or text 988

• Crisis Text Line: Text HELLO to 741741

• The Trevor Project LGBTQ+ Crisis Hotline: Call 1-866-488-7386

• Trans Lifeline: 1-877-565-8860

• Veterans Crisis Line: 1-800-273-8255, press 1

Please, let’s all prepare ourselves to be there for the next person we find in crisis. Please, just ASSSK.