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Each week I work with teenagers at inpatient treatment centers. I facilitate groups with up to six teens where we discuss their lives. During the course of my work, I have talked with numerous teenage girls who had previously attempted suicide. Often, they had similar behaviors leading up to their suicide attempts. They also had similar ideas of what they felt and how they came to the conclusion that their lives were not worth living. Since boys and girls often have different reasons for wanting to end their lives, as well as different methods of attempting to end them, the focus of this post is on what I’ve heard expressed from teenage girls.
Often, they feel they do not measure up to the people around them. Either they feel their appearance is inferior and they start to hate the way they look, or they feel they are not good enough in some way. Other times they may have endured trauma or abuse that has become emotionally overwhelming to them. This can lead to depression, or withdrawing from social interactions in an effort to numb their feelings. This lack of feeling can prompt some teens to start cutting themselves, not to die, but to try and feel something again. They are aware that they are numb to life and are attempting to gain some sense of feeling.
The teenage girls I’ve worked with have been highly intelligent. Often, they do extremely well at school. In spite of their achievements, they often exhibit low self-esteem that puts them on a treadmill of trying to achieve their goals so they can feel better about themselves. It is when their efforts to outrun their pain don’t work that they can become overwhelmed and desperate enough to want to end their lives.
While their pain is real, they lack a perspective on what lies ahead for their lives. All they see is the present and don’t realize their circumstances are likely to change in the next few years. They often can’t see that their lives can become much more satisfying and enjoyable than they are currently. Suicide attempts tend to come from desperation and emotional overwhelm. Gaining a wider perspective of what’s possible in their lives can have a dramatically positive effect on their belief in their futures.
Teens that are cutting or engaging in other self-destructive behaviors have a need for understanding. It’s important for them to feel “someone gets it.” They need to find a way to release their feelings of despair and hopelessness so they can see a more positive future for themselves. They need to understand that “now” is not the same as “forever.”
The first thing I ask teens who have contemplated or attempted suicide is to look at their lives like it’s a movie. I tell them that if their life were a movie, they’re only 20% into it. Who leaves a movie during the first half-hour? I tell them their movie might get better. It might get much better! I have been told more than once that this analogy was helpful in developing a new, more positive perspective.
Another thing that’s important for the person communicating with the teenager is to not become emotionally overwhelmed themselves. When someone tells you they want to die, or are contemplating suicide, it’s easy to become overwhelmed and start to panic. Remember, you are being trusted and confided in. Don’t make it about you and cause them to have to take care of your feelings. Be careful you don’t become judgmental and start to lecture them. You are being trusted by a vulnerable child who is reaching out to you for help. Lecturing or criticizing may shut them down and that’s the last thing you want to do. The more you, as an adult, can stay in the conversation, without negative judgments, the more the teen can feel safe to open up and share. Then you can get them the help they need, whether it’s a conversation, therapy, or an emergency intervention.
When working with teens, I share with them that the one thing they lack is perspective. I tell them that while I may not be any smarter than they are, I do have more of a perspective about life. What age brings to the situation is the ability to look back and see that things can change. I can look back on my life and know that when it’s been difficult, it’s gotten better. My life is not the same now as it was when I was a teen, or in my 20s, or in my 30s. My life has evolved and I now have the perspective to know that the feelings that overwhelmed me at 15 are no longer weighing me down. Letting the teen know you respect their intelligence and are just trying to help them see another perspective, may give them the confidence to open up and truly shift their view of the situation. After all, most teens don’t want to die, they just want the emotional pain that’s overwhelming them to stop.
Lastly, I ask teens to look ahead to their futures and think about themselves at 30. I contend that their 30-year-old selves are going to be remarkably grateful they did not do anything rash when they were a teenager. Looking back from the perspective of their 30-year-old selves often helps teens see more possibilities for their lives as they get older.
I don’t pretend that the communications I’ve discussed here are exhaustive, or will work for everyone. I do know that these are some of the ways in which I have talked about this difficult subject with teenage girls who had previously attempted suicide. I have been told these discussions made a positive difference in their thinking. Hopefully, by more quickly recognizing when a teen has become depressed, or is starting to exhibit self-harming behaviors, the situation can be addressed in an effective way to produce the best possible outcome.
