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“When is an attempt not a real act of self-destruction but merely an attention-seeking device? We may never know; however, since even attention-seekers kill themselves, it may not matter. The question we should really be asking is: Why would anyone have to get attention in such a morbid way?”
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“No matter how flat or sad his or her affect appears, the suicidally depressed adolescent is desperately trying to contain feelings of anger, rage, hatred, and violence. The suicide or the attempt represents the final self-destructive display of this rage. Where previously the rage may have been expressed in anti-social behaviors or directed at parents, school (the "system"), or a girl/boyfriend, now it has been turned inward. Not surprisingly, the suicide rate is much higher among runaways, teens in jail, and juvenile delinquents. Don't fear this anger! Allow the adolescent to express it; mobilize the anger rather than permitting it to remain festering inside, growing increasingly poisonous.”
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“It is safe to assume that, no matter how it appears, the attempt probably did not come out of the blue. Look for clues. Some possibilities include a family history of mental illness, a history of abuse, unusual or stressful family dynamics, prior diagnosis or evidence of a psychiatric disorder and/or bizarre behavior long before or in the days or weeks immediately preceding the crisis. Part of your job is to be a detective, assembling the pieces in the puzzle that is depression.”
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“The best approach is often passivity-a gentle, passive being-there that gives survivors permission to grieve, heal, and recover in their own unique way and at their own pace.”
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“Individuals who are hurting emotionally think poorly of themselves and act in ways that will cause others to think poorly of them. As this cycle is perpetuated, they become more and more isolated and convinced of their worthlessness. It is understandable, then, that persons who are depressed engage in antisocial or delinquent behavior, develop unusually hostile relationships with those closest to them, or experience progressive difficulties with peer relationships. What they are really doing is creating in the minds of others the same negative impressions they already feel about themselves.”
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“Surviving suicide is never easy, but it is possible with support, with time, compassionate direction, and, in some cases, counseling. While there are predictable responses, every case is unique. How we respond is determined genetically, culturally, and by such factors as religion, age, gender, previous experience with loss, and role models of other survivors available to us. The pattern of recovery is unpredictable. Responses such as numbness, denial, or rage, which are often thought to occur shortly after a suicide, may be absent for many months or even years. They may emerge unexpectedly years later. We are unable to identify an orderliness to the reactions of suicide. Perhaps the most important aspect of providing help to survivors is an attitude of compassionate understanding. Survivors remember the words that brought them the most comfort, as well as those spoken in haste and insensitively. In our eagerness to help we may say things that we regret later. Sensitivity to the survivor's needs and readiness to hear is crucial. Lacking such readiness, the survivor may reject all overtures, in essence saying, "Leave me alone. Unless you've experienced something like this, you don't know what I'm experiencing. Don't pretend to be an understanding, compassionate healer.”
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“The crisis must be examined from different angles. To anyone else but that boy or girl sitting across from you, the crisis may seem trivial. In his or her mind, though, it has taken on monumental proportions. "De-catastrophize" the issues where possible. Identify the most realistic and promising alternatives.”
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“Don't hurry the process. Erring on the side of caution, rather than rushing in with advice, could save a life.”
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