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Check In On Your Strong Friend: A Look at Survivors and Suicidality

  • Sophia Mohan
  • Oct 30, 2021
  • 6 min read

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TW: Sexual Violence, Suicide, Trauma


September marked National Suicide Awareness Month. Last month, I thought a lot about survivors.


Nearly 11 million Canadians reported that they had an experience with physical or sexual assault. Statistic wise that amounts to 37% of Canadians.


While men and women can both be survivors of sexual assault, women are almost four times more likely to be victimized.


In her book "Lucky," Journalist Alice Sebold, a survivor, described sexual assault as an act that "inhabits and destroys everything."


It is a definition I have not been able to stop thinking about.


Going through a sexual assault can have severe impacts on a survivor's mental and emotional health. Among some of the most devastating can be the development of trauma and Post-Traumatic stress disorder (PTSD).


Trauma and PTSD act as a complexity in the context of understanding or experiencing it. Like a beast with many heads, it can manifest in ways we would not expect. Moreover, our physical and psychological manifestations can be as individual as our experience of the trauma itself.


Trauma can appear in all sorts of ways. Psychologically speaking, it can show up as:


  • Disassociation

  • Flashbacks

  • Panic attacks

  • Eating disorders

  • Problematic substance use

  • Anxiety and/or Depression

  • Post-traumatic stress disorder (PTSD)


Having such a profoundly traumatizing experience can create long-term effects on the daily functioning of survivors, effects that bleed into every facet of their lives.


One of the most concerning and yet less talked about consequences of experiencing trauma and/or PTSD is suicidal ideation.



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A research study sought to examine the link between sexual assault and suicidality. Researchers worked with 67 survivors of sexual assault. Nine of those individuals cited having previously attempted suicide. Looking at the group holistically, that accounts for 14.9% of the group having attempted suicide.


The findings ultimately showed that "having a history of sexual assault was associated with an increased likelihood of a suicide attempt throughout any point in life."


Perhaps one of the most concerning findings is that for women, the likelihood of attempting suicide was increased 3 to 4 times for those who were sexually assaulted before age 16.


Depression and anxiety are commonly known to be risk factors for suicidality. Having sexual trauma needs to be considered a serious risk factor in its own right.


To put it simply, survivors are at an increased risk for suicide.


We have all heard someone say that it is essential to be kind to others because we do not know what battles they are fighting behind the scenes.


Just as I cannot look at you, and know what you are going through, we do not know what the people around us are facing unless they choose to tell us.


So allow me to further the saying:Not only is it important to be kind, but it is also our responsibility to learn how to be safe spaces for when the people we love decide to drop the curtain and show us the battles they are fighting.


Suicide is preventable, but we must know how to spot the warning signs and respond swiftly. Let's address some commonly asked questions.


Question One: What are some risk factors for suicide?


A non-exhaustive list of risk factors include:

  • A prior history of suicide attempts

  • Familial history of mental illness or suicide

  • Problematic substance use

  • Exposure to sexual abuse or violence

  • Loss (loved ones + family)

  • Depression, anxiety or other mental illnesses

  • Extreme stress

  • Social isolation


Question Two: What are some warning signs of suicide?


A non-exhaustive list of potential warning signs include:


  • Experiencing extreme emotional pain

  • Directly or indirectly talking about the desire to die or end their own lives

  • A change in their everyday routine (can be in the form of sleep routine, eating patterns, and/or daily activities)

  • Socially isolating themselves or steadily withdrawing from social circles and family

  • Giving away valued possessions/items or "sorting their affairs" (drafting up a will)



Question Three: I've recognized the warning signs, and it is an imminent situation. What should I do?


If you sense this person is in imminent danger, do not leave them alone. If you are able to, accompany them to the nearest Emergency room or phone a crisis line together. Should you know of any other close and trusted individuals in this person’s life, get in contact with them for additional support.


Question Four: What do I do in a non-imminent situation?


1. Know your resources


This is a proactive step wherein I ask you to get familiarized with your local mental health resources. Often in these situations, it is hard to know if we are doing the right thing. But a valuable thing we can do is point them in the direction of help and connect them to resources. For example, what are some local crisis lines? Where can someone go for low-cost or free mental health support or therapy?


2. Ask the person directly.


There has been a pervasive idea that if you ask someone whether they are considering suicide, you are inserting the idea in their head or increasing the chances of doing it. This is a myth. Studies have shown that asking directly does not increase the risk of suicidality. On the contrary, by asking directly, you show someone that you care for them and recognize that they are not doing well.


Some examples:


Direct Question: "I've noticed you have been really, really sad lately. Are you thinking of killing yourself?"


Indirect Question: "Do you ever wish you could go to sleep and not wake up?"


These conversations can be awkward and difficult, do not beat yourself up for feeling this way. Suicide is a taboo topic. However, here is a website that includes some excellent direct questions to ask.


3. Practice active listening


Listen to understand your loved one. Try not to interrupt. An easy way to engage in active listening is to paraphrase what the person is saying. It is best not to overdo it. But when it is done the right amount, it becomes an empathetic way of showing someone that you are giving them your full attention and making an effort to understand.


"I am hearing that you are overwhelmed by everything that you are feeling."


4. Refer them to resources


In this step, we try to get the individual connected to resources and agree to see them. You can start by asking something along the lines of:


  • Can you come with me to see a therapist?

  • Can I make you an appointment with (insert a resource here)?


When you encounter someone in a significant level of distress, suicide seems like the only option for them. Therefore, it is essential for you to consistently emphasize that suicide is not a good option and that help is available.


You can also help them create a safety plan. Here is an effective template for one.


It is also vital that you be a part of the process of getting them connected to resources. Book the appointment for the individual, and if you can, accompany them there. Offer to sit and call a crisis line with them. Follow-through will likely happen more if you are there to help make it as easy as possible.


5. Check-in. Check-in. Check-in.


Psychology researchers E. David Klonsky and Alexsis M. May write, "among those experiencing both pain and hopelessness, connectedness is a key protective factor against escalating ideation."


Connectedness is a protective factor against suicidal ideation. It is important that following your conversation with this individual, you intentionally check in with them. Make it clear that you care about them a lot and will be there for them.


Closing Thoughts


Suicide is serious, and when we know that the people we love are contemplating it, every alarm bell rings around us. The panic makes us want to handcuff them to our sides and never leave them alone, while the urgency wakes us up at night wondering, "did I do enough?"


The most important thing we can do is:

  • Ask the question directly

  • Provide a listening ear

  • Emphasize our love and care for this person and our desire for them to live

  • Ask them to promise to stay alive to get help

  • Refer them to specific resources and help book appointments and accompany them if possible

  • Check-in as much as we can


When in doubt, remember, connectedness is a protective factor. Show the person that you love them, care about them and want to support them.


Getting acquainted with these steps, further suicide training and our local resources genuinely have the potential to save a life.


The survivors in our lives deserve support, and we need to know how to support them.


Because when someone trusts us enough to show us the battles they are fighting, it is our job to be prepared to fight alongside them.



Here are some resources to get you started:



Resources for anyone in need - you deserve support:


Resources for The Indigenous Community - you deserve support:

  • First Nations & Inuit Hope for Wellness: 1-855-242-3310

  • KUU-US Aboriginal Crisis Line: 1-800-588-8717

  • Indian Residential school Survivors & Family Support Line: 1-866-925-4419

  • Native Youth Crisis Hotline: 1-877-209-1266

  • Métis Crisis Line: 1-833-638-4722

 
 
 

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