Suicide Prevention: Staying With the Story Beneath the Pain

There are moments in the therapy room when a client’s words seem to change the temperature of the room.

“I don’t want to be here anymore.”

“I don’t have energy for any of this”.

“I don’t know if this pain will ever go away. I’m tired of fighting.”

In those moments, I have learned that my job is not to rush toward the silence. It is to stay. To listen beneath the words. To notice the exhaustion behind the hopelessness. To become curious about the story that brought them to this moment. Because sometimes, when a person says they want to die, what they are longing for is not necessarily the end of their life, but the end of a pain they can no longer imagine carrying.

I think of it like standing in a burning house. From the outside, it may seem obvious: Just get out. But when you have been surrounded by smoke for long enough, it can become difficult to see the door, trust that there is somewhere safe to go, or believe that the world outside will be any different.

As a trauma-informed therapist who further incorporates social justice perspective, I approach with holistic awareness by asking, “What happened to you? What have you survived? What does your pain need us to understand?” This does not mean ignoring risk. Suicide assessment, safety planning, crisis intervention, and access to appropriate care can save lives. But safety becomes more meaningful when it is built through collaboration rather than control; through relationship rather than shame.

It is essential to approach with willingness to understand. Because sometimes the fire is not only inside the person. For me, this issue is multifaceted and complex yet essential to address because suicide prevention is beyond what happens in the therapy room. It may be poverty that leaves someone choosing between housing and healthcare. It may be racism, homophobia, transphobia, ableism, gender-based violence, immigration stress, chronic illness, isolation, or a lack of access to culturally responsive, and anti-oppressive care. We cannot talk honestly about suicide prevention without talking about the conditions that make some lives harder to sustain than others.

How can I support someone I care about experiencing suicidal symptoms?

If someone you care about tells you they are thinking about suicide, you do not need to have the perfect words. You do not need to solve their life. Quite literally, you need to be willing to stay connected.

Start by listening. You might say, “I’m truly glad you told me. I’m here with you, and I want to understand what you’re going through.”

Try not to respond with reassurance that unintentionally dismisses their pain: “You have so much to live for,” “Things could be worse,” or “You don’t really mean that.” Even when offered with love, these responses can leave someone feeling more alone, gaslit or frustrated. 

Instead, make room for honesty. Ask directly and calmly whether they are thinking about suicide. Asking does not put the idea in someone’s head. It can communicate that you are safe enough to tell. If they say yes, stay curious about their immediate safety. Ask whether they have a plan or access to the means to carry it out. If you believe there is imminent danger, do not leave them alone. Help create distance from anything they could use to hurt themselves and connect them with immediate professional or crisis support.

You can also offer practical companionship. Sit with them while they call a therapist or crisis line (e.g. 988). Help them get to an appointment even if it’s not mental health related but also for friends meet up or picking up refills. Bring them food, snacks or a gift card. Stay on the phone. Check in the next morning and the morning after that.

And remember you are not their therapist, and you are not responsible for keeping them alive by yourself. Bring other trusted people into the circle of support when appropriate. Encourage professional help and seek support for yourself, too. Navigating this can be taxing and lead to caregiver related burnout. 

Sometimes love looks less like finding the right answer and more like saying: “You don't have to carry this moment by yourself. We can take the next step together.”

Hope does not always arrive as a bright light. Sometimes it is simply a thread we can sew like a person who answers the phone, a therapist who stays present, a meal, a safe place to sleep, a moment of connection, a reason to wait.

Suicide prevention is about holding onto that thread together until something stronger can be woven.

It is about more than keeping someone alive.

It is about helping create a life and a world in which they feel they belong.

If you or someone you know is experiencing a suicidal symptom, call or text 988 for the Suicide & Crisis Lifeline. If there is immediate danger, call 911 or go to the nearest emergency department. In the city of Chicago, you can request a Crisis Intervention Team (CIT) when calling 911 as they are trained with mental health first-aid and crisis support. 

Reminder for you or someone you care about as well:

·     You are not alone. 

·     You matter. 

·     You are enough. 

Mehak brings a warm, culturally sensitive approach to therapy, with a particular passion for supporting clients navigating identity, cultural stressors, intergenerational trauma, anxiety, depression, and family conflict. She works with individuals and couples, helping clients better understand their experiences, strengthen relationships, and build resilience. Drawing from approaches including CBT, Narrative Therapy, and EMDR, Mehak’s goal is for clients to leave therapy feeling understood, empowered, and hopeful.