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The Soul of Therapy

“How Can a Spiritual Person Have Suicidal Thoughts?”

Photo Credit: Getty/roberto bucci

We all contain multitudes, and accepting the light and darkness in another can be a sign of deep trust and friendship. But acceptance doesn't mean being passive when a friend is suicidal.

Q: I have a close friend who is very spiritual, but I’m worried about how often she has thoughts of killing herself. How can a spiritual person have suicidal thoughts? She often talks about seeing the divine in herself and others. But the next time I see her she’ll be depressed and tell me she’s having suicidal thoughts. How can I best support a friend like this?

Bob Dylan just released a new song titled after one of my favorite Walt Whitman lines: “I contain multitudes.” Throughout the song, Dylan sings about both inner darkness and light. In one part he’s singing “I’ll show you my heart, but only the hateful part,” and a few lines later he’s moved on to: “I play Beethoven sonatas and Chopin preludes; I contain multitudes.”

This is the truth about human beings: We all contain multitudes. In the office where I meet patients, I keep an M.C. Escher piece depicting an intermingling of fish and birds. At the top of the frame, birds are soaring up; at the bottom, fish are diving into the deep. In the middle, the birds and fish are all mixed up together. Escher’s genius is that the fish form the birds and the birds form the fish. One of my patients felt Escher’s piece captured her multitudes so well she wanted to get a fish/bird tattoo!

Russian Nobel Prize-winning author Alexsandr Solzhenitsyn wrote: “...the line dividing good and evil cuts through the heart of every human being.” Your friend is not either a spiritual person who sees the divine in herself and others or a woman who struggles with suicidal thoughts. She is both. She contains multitudes.

Being non-judgingly accepting of one another’s multitudes is perhaps the greatest gift of deep friendship. In this case, however, nonjudgment and acceptance do not extend to allowing suicidal thoughts to become a routine, accepted part of your relationship. Some people struggle with such thoughts daily for years. Such people can be challenging to have as friends, so I encourage you to insist that she not consider confiding in you to be a replacement for being in therapy.

You don’t have to be professionally trained to ask your friend directly: “Are you having thoughts of actually going through with suicide? Do you have a plan and a timeframe? Is there anything or anyone in your life that you know would definitely keep you from killing yourself?” If you don’t get reassuring, believable answers to such questions, your role as a friend is to alert her family and support them to make sure she is evaluated in a setting that can keep her safe. Even if she is not thinking of acting on her thoughts, I hope you will ask her as often as necessary whether she is sharing these suicidal thoughts with a licensed mental health professional trained to assess suicide risk.

National Suicide Prevention Lifeline: 1-800-273-8255

For a USA Crisis Text Line, please text HOME to 741741 from anywhere in the USA, anytime, about any type of crisis.

Keep Reading: “The Complicated Grief of Suicide

Send your questions to [email protected] Questions may be edited for clarity or length. Dr. Anderson cannot respond to all letters. Sending a letter, whether answered in this column or not, does not create a doctor-patient relationship. Information in this column is for general psychoeducational purposes and is not a substitute for assessment and care provided in person by a medical or mental health professional.

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