Through our work with military service members and their family members who have experienced a recent suicidal crisis, we have learned that emotions immediately preceding such crises vary significantly from person to person. During individual psychotherapy sessions, our clinicians ask patients to share their suicide stories to better understand the circumstances that resulted in the suicide-related hospitalization and which circumstances resulted most often in the decision to attempt suicide. While providing this narrative, patients report a wide range of emotions that preceded the suicidal crisis such as intense despair, extreme excitement, agitation, uncontrollable anger, numbness, or indifference, as well as debilitating feelings of inadequacy.
We believe that an important clinical strategy in working with suicidal patients is to first identify emotions that activate and shape a patient’s trajectory from suicidal thinking to suicidal behaviors. The next step is to understand the intensity of these identified emotions so that we can teach the patient to modulate these emotions more adaptively in the future. By mapping out the patient’s emotions in a stepwise fashion, the clinician is able to help the patient identify key points for early intervention strategies, such as a self-soothing technique, deep breathing exercise, or other healthy coping technique (e.g., calling a friend, engaging in strenuous exercise) to impede further escalation.