As a unified theme across the last three-year period from 2024 through 2026, the World Health Organization (WHO) and International Association for Suicide Prevention have been using the theme of “Changing the Narrative on Suicide”, with a global call to action asking us all to “Start the Conversation.” But how? How do you respond to your child, or a parent, a partner or a friend, when they tell you that they no longer have enough will to carry on and are increasingly thinking about ending it all? How do we start a conversation we have no idea how to have, and are woefully unprepared or trained for, and that has us feeling awkward and ill at ease?

What can I possibly say when a loved one vulnerably reaches out in a dark moment of helplessness and hopelessness? How can I help them remember they are important and loved, and that help and hope are possible? As a clinical psychologist, I have found that when our clients express intense feelings of overwhelm and thoughts of suicide, they rarely truly want to die. They just want “it” to end, whatever “it” might be for them. They are often “soul tired” and have been overthinking “it” so much that they are even more confused and do not know where to turn.

Not oblivious to the pain they might pass on to others, they often feel in the way and like a burden, and therefore believe that everyone will be better off without them being around.

People in the fugue of a suicidal episode lack clarity and vision and, like wearing dirty glasses, they are unable to see any other way out. Far from a cowardly thought, most people intensely fear death and what might lie beyond, yet they still desperately scrape together enough courage to actively start preparing a plan and choosing a method and a time to die.

Still, before it reaches that point, most people do in fact reach out to someone in sheer desperation, because they rarely truly want to die. They just want “it” to end.

All too often, when they do reach out to a trusted loved one, the trusted person has no idea what to say or how to help them navigate through the confusion. Not knowing what to say, they often simply shut the conversation down with an alienating: “No man, don’t talk like that.” Or, when we simply do not know what to say, we offer superficial, glib reassurances, like: “Don’t worry, things will look better tomorrow” or “You are strong, you just have to hold on and you will get through this.” These statements truly only make us feel better that we said something “wise,” but a person who is struggling rarely feels like they are strong or have hope for a better future, so these well-meaning statements also just alienate them further.

Other well-intended responses include statements of fear and judgments, like: “Only cowards kill themselves” or “Suicide is self-murder and you will go to hell and no one will come to your funeral.” Or, instead of offering them a compassionate ear and listening to their struggles, we personalize our solutions onto someone else (in a different situation than us) and jump straight to offering instant solutions, similar to: “You are a strong independent woman that does not need a man. Just leave him!” and “Life started when I got divorced.” Another common well-intended technique is to demonstrate “empathy” by hijacking their venting session and “relating” your story: “I know exactly how you feel! Last year when my wife cheated on me I immediately kicked her out and… [ramble on about self].” This turns the conversation around and makes us the main speaker, robbing the other person of the opportunity to vent and unpack. This also makes us, the well-meaning friend, miss the nuance of their experience, which might be different from ours.

The examples of well-intended statements above might make us feel less awkward and we might think we have been helpful, but they usually just make that person feel less heard, even less understood and even more alone.

Obviously, in a therapist’s office, we are no strangers to clients bearing their souls and expressing their struggles with life and death. During these vulnerable confessions, glib reassurances, well-meant advice and using fear and judgment rarely help. Rather, being able to freely explore these thoughts and feelings with a compassionate and non-judgmental person willing to listen to and soundboard the good, the bad and the ugly of their lives can be not only a relief, but a lifeline to someone that feels they are drowning in confusion.

So here is some advice from a therapist on how members of the general public can better hold space, help our loved ones feel more supported and heard, and offer that much-needed lifeline.

During my time working as a telephone counsellor at Lifeline Childline, I was fortunate enough to be trained in the ambiguity model that explores the very ambiguities suicidal people struggle with: their death drive versus their life drive. Why do they want to end “it” all, and what are the resources and protective factors that has kept them from ending “it” all to date?

For example, on the one hand, they could be feeling overwhelmed by finances, studies, self-esteem or perhaps unbearable loss like a job, divorce or the death of a loved one. On the other hand, perhaps they have people (or pets) who care for or depend on them, or they are still holding onto some hope, dreams or future plans. The goal is to gently guide them to, firstly, explore their pain, but then to also remember why they are still here, what they have been holding on to, and that support and help is available and possible. Sometimes all we need is a glimmer of hope and possibility.

Holding space is both a skill and an art that can be developed, and there are a few basic skills that can help you to gently help someone unpack their baggage. 

The first skill is active listening, which is a skill that helps us listen more and speak less, which takes the burden off you of having to be wise or know what to say. It relies on the attitudes of curiosity, non-judgmentality and compassionate inquiry.

Active listening means listening curiously to truly understand, and it guides us to purposefully check in with the person frequently that you are, indeed, hearing and understanding them correctly. To check for correct understanding, active listening relies on careful observation and reflection of both verbal and body language.

A reflection of body language can be: “You look like you want to run away” or “I can see just how tense your divorce has made you” or “I noticed how, when you talked about your children, you smiled for the first time today…”

Few skills help to make someone feel as heard and understood as the skill of emotional reflection. This entails careful observation of and a curious reflection of people’s emotional reactions using the art of philosophical questioning: “It sounds like you are upset/devastated/embarrassed/disappointed/let down, etc.” This emotion can then be reinforced by a brief restatement or summary in your own words of what they have told you, as reassurance that you are hearing them and understanding them correctly.

Crying friend: “I don’t know how it happened or escalated so quickly but before I knew it, I lost my mind and was shouting at him”

You: “It does sound like it all happened very quickly, but I can see you really are deeply ashamed that you shouted at him and I can tell you are very upset that it happened.”

To help them elaborate even more and fully vent, a well-timed, curious philosophical question, lightly pondered, can help them engage in the conversation even more deeply.

Asking them open-ended questions (what, when, where, how or why) will help them give you more details, while other concept-check questions (like offering a 50/50 or a yes/no) can also help them continue whenever they feel stuck.

“Why have you been fighting with your wife so much lately?” [Open-ended]

“Are the children staying with you or are they staying with your wife?” [50/50]

“I am sure that it has not been easy packing up your belongings and moving out?” [Yes/No]

Another very helpful questioning technique is to mirror their words back, either verbatim or restated in your own words. This demonstrates that, not only are you listening to their words, but also that you are checking for understanding.

“Let me just check if I heard you right? Are you telling me he fired you right there and then on the spot in front of everyone?”

This can be followed by an emotional reflection or philosophical question: “I can only imagine how embarrassed/alone/angry/upset you must have felt” or an empathetic “I don’t even know how you got through it.”

These basic skills can help you to help others to vent, explore and express themselves, all the while helping you better understand the nuance of what the “it” is they have been struggling with, as well as that which they are holding onto dear life for. A deeper mutual understanding is created that promotes a feeling of safety and, often, a bit more self-worth in that at least one person valued them enough to take the time to truly be present, to try and understand them and facilitate an unburdening.

If these basic therapeutic skills are used correctly and land, they elicit a “yes set” from the person as they increasingly feel heard and understood. “Yes sets” occur when someone increasingly agrees with statements or questions, which makes them more agreeable and more open to self-disclosure or “real-talk” and, eventually, more likely to listen to suggestions of support and help-seeking options.

Perhaps the most important skill that needs to be developed is that of knowing your own personal boundaries and the limits of how you truly can help keep this person safe. “Real talk” includes being able to acknowledge that “it” is a lot, that you are not trained or qualified to really help in life and death matters and to find extra support.

Perhaps there is someone in their family you can contact for immediate support to keep them safe until it can be arranged for them to see a professional.

Often doctors or spiritual leaders are the first point of contact and can help to de-escalate the suicidality and help to contain the situation, even if just temporarily.

However, it is important to consider that neither doctors nor pastors are usually trained in suicide prevention and mental health. It is important that, besides medical and spiritual support, you find some kind of specialized mental health support, from either a psychiatrist (for psychopharmacological support), a social worker (for social intervention) or a psychologist (for psychotherapy). The match between a mental health worker and the person is also very important, so take the time to ask around, research and find someone with the right personality and training to assist.

“I want to be here for you, but this sounds like you really need more support than I can offer. I really do want to be able to help you, so I have asked around and found the numbers and websites for a psychologist. Can I make an appointment for you and come with you?”

People in the depths of a dark, depressive episode are often immobilized and struggle to even take a shower, so taking the steps to find help can seem like a mountain. This is where a loved one that is willing and able to assist can be a lifesaver. If you can, do make the appointment for them and, if you’re able to, even take them, sit with them in the reception, and wait for them to come out.

Being the change in the world that we would like to see does not require you to be wise, have all the answers or know exactly what to say when someone is struggling. Instead, all that we can learn to do much more is to offer our presence, to truly listen actively, to help our loved one unpack the confusion by asking curious philosophical questions that help them to elaborate and help us to better understand, and to help them get to a professional who is trained to help.