Today: What to Do If You're Feeling Suicidal

 

My philosophy

I work with adults, and part of being an adult is taking charge of your life. If you have suicidal thoughts or are sometimes actively suicidal, the way forward is to empower yourself. That starts by understanding what is going on, and what you can do to help yourself.

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Sadness by John Hain from Pixabay

Q: If I have a suicidal thought, am I crazy? Or doomed to die?

A: Absolutely not! It’s surprisingly common to have thoughts like, “I wish I didn’t waken up in the mornings” or “I just want out.” For most people, it’s purely a stress reaction, the equivalent of the brain saying, “Eeeeeek! Get us out of this!”

It can also be depression lying to you. Depression is mean and it whispers nasty things. Anxiety is the same.

The main thing to consider here is that not all thoughts can be taken at face value.

So if you just have the odd thought here and there, don’t worry. Have a chat with a therapist like me, and we can sort out what’s going on.

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Q: I think about it often, though, and it’s more than a stray thought. I’d not do anything about it, probably, but should I be worried?

A: Hmmm, I’d be asking when these thoughts come. Like, is it a reaction to something? If you have a toxic boss, a difficult family, or other life circumstances, it may be that you are sad or have depression. This situation can lead to suicidal thoughts.

Or it may be depression or anxiety. These conditions don’t just feel bad—they create a false, nightmare world and convince you it’s real.

Many people living with these conditions don’t realise the world they’re seeing isn’t real. So they live for years with those nasty voices whispering at them.

If you have repeated episodes of dark thoughts, please know that you can help yourself!

This requires digging around to see what’s going on, whether it’s situational, a condition or both. That’s not something anyone can do, so you want to talk to a professional.

See a level 7 qualified person, someone with a Masters Degree in Counselling or Psychology that includes a minimum of 300 hours supervised practice.
(Yes, that includes me!)

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Q: I have repeated episodes of suicidal thoughts and sometimes I am actively suicidal. What do I do?

A: It starts with planning your support before you reach crisis point. You can kick off straight away by putting together a Suicide Safety Plan. You can Google that and download a template, or you can message me and I’ll send you one.

A Suicide Safety Plan is where you write down your resources. Here’s mine:

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Safety Plan

Feeling suicidal is the result of experiencing extreme pain.
I have a plan to reduce pain and increase coping resources.
I know that with support and time, these thoughts will pass.
When they pass, I can put energy into sorting out problems that have contributed to this episode.
For now, all I need to remember is that these feelings will not last forever.
Also, I have help and support.

• What I need to do to reduce the risk of me acting on the suicidal thoughts
• What warning signs or triggers are there that make me feel more out of control?
• What have I done in the past that helped? What ways of coping do I have?
• What I will do to help calm and soothe myself:
• What I will tell myself (as alternatives to the dark thoughts):
• What would I say to a close friend who was feeling this way?
• What could others do that would help?
• Who can I call? LIST THREE PEOPLE YOU CAN CALL WHEN YOU'RE IN DISTRESS.
• A safe place I can go to: DETAILS HERE
• If I still feel suicidal and out of control:
• I will call the national suicide line. DETAILS HERE
• I will go to the Emergency Room of a public hospital. DETAILS HERE
• If I can't get there safely, I will call emergency services.
  (e.g., 999 in the UK and Malaysia, 112 in Europe/EU, 911 in the US, Canada and Mexico)

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Second, set up a relationship with a therapist. Now, therapists typically cannot offer active suicide support because we can’t work 24/7. We’re human. Also, we have a practice to run so when you are in crisis, we can’t drop everything (other clients!).

In a crisis, you must access a service that is manned 24/7. That’s usually a suicide hotline or your nearest public hospital.

However, you can use a therapist for a few sessions to talk through your safety protocols, or you can plan for low periods and arrange to have some extra support during those times.

My clients who suffer from repeated episodes of depression/anxiety where they are actively suicidal use sessions for support. It gives you a space to get real about what’s going on without guilt, shame, or pressure to pretend you're fine. Sessions are a boost that can help you manage better when the lows hit.

If you can’t afford therapy, look at charities near you and try and set up a personal connection with a case worker there. Again, they won’t be working 24/7 so it would be used only for sessions where you can share and be supported.

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Q: I’m worried that if I tell a therapist I’m suicidal that they’ll lock me up or report me to the police.

A: These fears are common but how realistic they are depends on where you live.

If suicide is a crime in your country, try searching anonymously or asking support forums what’s typical in your area. If they won’t say, reach out and ask about, “My friend who is sometimes down…” and see what they say. Go with your gut.

If suicide is not a crime in your country, then think about local resources. Do you know of people in your neighbourhood who have been treated badly after sharing their suicidal thoughts? If so, act as above and google discreetly before deciding who to trust.

But if you’re relying on horror stories from a film, please think again. TV often dramatizes these issues, so it's not always a reliable source.

Consider this: facilities that support actively suicidal people require a locked ward that is manned 24/7 by nurses, doctors, and case workers. It’s super expensive!

In many countries, it takes an awful lot of advocating before you can access that kind of service. Most of the time, they talk to you for some hours, give you medication and then send you home under the care of someone you trust, like a friend or relative.

If you are worried, Google and also check social media support resources and ask what the protocol in your country is for actively suicidal people. Anonymously, of course, so you’re safe.

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Q: And how do you work with suicidal clients?

A: I don’t provide crisis support or 24/7 services as I work online internationally and alone. When your crisis hits, I may be asleep or in session with another client.

If you’re in immediate danger, please contact emergency services or a suicide crisis line.

I do work with people who struggle with suicidal thoughts and want to build long-term resilience. Usually, we see a dip coming and we plan for it.

But if you’re my client and you become actively suicidal and you won’t use the safety plan
(Like, ‘I’m going to kill myself now and you can’t stop me’)
I’ll contact your emergency contact, the person you have stipulated in our agreement. This person lives close to you and can sit with you or take you to see a doctor.

I disclose the danger, (‘Kim is suicidal, please take them to see a doctor’) but I won’t tell them details of our sessions. These stay confidential!

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Q: What if I don’t have people I trust or anyone near me?

A: Then I won’t work with you. Why? Because that’s not safe, and I don’t do unsafe work.

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Final thought

If you have suicidal thoughts or are sometimes actively suicidal, please know there is a path forward. Many people recover from suicidal thinking and go on to live deeply meaningful lives.

Start by setting up your safety nets. You deserve to be happy!

Note: related post,  Suicide Counselling in Developing Nations. When a Friend or Loved One Is Suicidal: What Can You Do If There’s No Hotline, No Doctor, No System?

Stuff You May Not Like To Hear: Middle Child Syndrome Isn’t A Thing

 

How it started: Alfred Adler (1870-1937) was an Austrian medical doctor and psychotherapist who was interested in human development.  Studying his clients, he noticed that older kids in families often turned out a bit differently than middle and younger kids. He thought that these differences were due to birth order.

Alfred Adler

Why it’s wrong: Scientific studies show that birth order doesn’t affect our development. There’s no such thing as “all first borns are x” or “or middle kids are Y.”

What is going on: We’ve come a long way since Adler, especially in hard science. Today we think that our development is a complex mix of genetics, personality, health, how people treat us, our thoughts, our socio-economic status, and our life experiences.

This bio-psycho-social model acknowledges that our early years are important, and a big part of this focusses on how our parents treat us. To a child, a parent is a god. We need them to love us and our world revolves around them.

Parents are also human and constantly evolving. Therefore, the eldest child may have strict parents who hover a lot but by the time there are four kids, the parents may be tired, less involved and maybe kinder too. Or maybe it’s the other way around!

Also, it’s not just parents that matter: our wider family, friends, school, community also are hugely influential. Kids don’t grow up in isolation, they’re growing up in a complex and constantly changing world.

Why does this discredited birth order theory hang around? Most of us have no training in scientific principles; this means we can’t evaluate critically. So we read something, see it two or three times, and assume it’s true. We also love simple ideas. And we’re resistant to letting go of an idea that no longer works.

So when a mental health expert says Adler was wrong, there’s a lot of upset. Online bullying is HUGE!  Because of it, some of my colleagues are scared to say unpopular things. They shut up and go along with discredited ideas – or even pseudoscience.

I think it’s better to know that science is about constantly updating what we know. It’s unsettling but it’s also wonderful. And exciting. Also, it’s my job to help my clients be their best selves, and that won’t happen if they’re basing their decisions on discredited ideas or pseudoscience.

Final thought about Adler. Alfred Adler was a hugely clever man and a nice one too.  He created a theory of mental health that says family, community, and social life are important for good mental health. This is the foundation of the school of individual psychology. This school of thought has changed over the century but it’s still massively useful.

Alfred Adler was also one of the few experts who wrote in simple language, so if you want to read his papers, just google them up. It’s interesting stuff.

And if you’re looking for a therapist who’ll tell you what’s still accepted theory and what’s bunk, PM me 😊

Is Mainstream Psychology Racist? Why Western Therapy May Not Work for Southeast Asians—And How to Fix It

Have you read psychology books or papers and felt frustrated – or that the information is irrelevant?

The idea that we are all the same is popular—and in some ways, it’s true. We all have hearts, lungs, and kidneys in the same place. But psychology isn’t just about biology; it’s about how we think, feel, and live—and that varies greatly across cultures.

As much psychology was developed in Europe and North America, mainstream therapy or self-help books may not work well in other places.

I’ve lived and worked in Malaysia and Indonesia for over 30 years and now run a global practice. I adapt therapy to different cultural needs and want to share how you can find a therapist who actually works for you.

"I" vs. "We" Cultures

Western cultures emphasise individualism—people see themselves as individuals first, then as part of a family or group. This fosters independence and empowerment. The downside is that is also can lead to loneliness. When needs clash, there is open conflict.

In Southeast Asia, collectivism is the norm—people see themselves as part of a family or group first. The upside is that you’re never alone. The downside is that the demand for conformity can be frustrating. Open conflict is avoided, but social pressure or bullying to enforce group norms is common.

Family Support vs. Public Safety Nets

In the West, public social safety nets are a priority—taxes fund unemployment benefits, disability support, universal healthcare, and elder care. The US is an exception, as it lacks universal healthcare. While life is expensive, it means we have a safety cushion. We can leave our jobs and move house or city if we want to. If family are toxic, we can leave and our lives are maybe difficult but not over.

In Southeast Asia, morality centres on family responsibility. Taxes are low, and government benefits are limited. If you’re unemployed or ill, your family is expected to support you. Some countries, like Malaysia and Singapore, offer minimal government aid, but most support comes from relatives, not the state. While life is cheaper, you need to build your own safety cushion.  It can be very difficult to leave a job or move. If family are toxic, it is hard to leave as the system makes it difficult to be independent.

Different Views on Mental Health

Western psychology treats mental health as a medical issue. This reduces stigma and encourages a problem-solving approach. The downside is that we can lose sight of the person; we typically try and throw pills at problems first and engaging as humans second. Part of this attitude is fuelled by mental health care being expensive compared to pills.  

In Southeast Asia, views are changing slowly but mental health is linked traditionally to weak character, evil spirits, or past life events. This fuels shame and stigma, making people avoid seeking help. Even today, admitting to mental health issues can cost you a job or promotion. Stigma has us avoiding medication, even when needed, and also because there are few psychiatrists. Traditional healing methods like prayers and rituals can offer comfort but don’t provide lasting solutions.

Hierarchy and Communication in Therapy

Western therapy is direct—clients state their issues openly, and therapists treat them as equals. This helps therapy progress quickly and efficiently.

In Southeast Asia, discussing personal problems—especially about parents, bosses, or authority figures—is difficult. Clients may withhold or misrepresent information out of shame or discomfort. Since therapists are seen as higher in hierarchy, clients may hesitate to voice concerns if therapy isn’t working.

Race and Religion in Therapy

Both the West and Southeast Asia struggle with racism, sexism, ageism, and religious discrimination. However, these issues are often hard to discuss openly, despite their impact on mental health.

How to Find the Right Therapist for You

If you’re from Southeast Asia, look for a therapist who:
✅ Respects confidentiality to help you feel safe sharing.
✅ Uses indirect communication and storytelling to foster understanding.
✅ Provides psychoeducation, so you gain practical coping skills.
✅ Focuses on solutions, rather than endless self-exploration.
✅ Considers family and social roles, not just the individual.
✅ Discusses hierarchy and its impact on your mental health.
✅ Is open to non-harmful traditional healing practices like seven-flower baths, prayer, and mindfulness.

Final Thoughts

Therapy should be adapted to fit your cultural background—not force you into a Western model. By choosing the right approach, you can make therapy work for you without feeling disconnected from your roots.