chapter  4
A Shift in Perspective
Exploring Suicidality
WithJoanne Zucchetto, Simone Jacobs, Ly Vick Johnson
Pages 25

This chapter explores the many facets of suicide – as a belief, an ideation, and a gesture. We look at how patients use the language “I’m suicidal” to say many things – some of which they are unaware. Taking a careful and direct approach with clients as safety is of the utmost importance, we explore how “wanting to die” has been a long-held belief for many patients since childhood and has allowed patients to “live another day” by giving them some control over the otherwise powerless situation of childhood abuse and neglect. The distraction that suicide provides from knowledge and feeling about abuse is also explored. We also explain how the Impulse Scale is used to help clients gain awareness of the internal processes that precede a suicidal crisis.