How existential therapy may help people who are suicidal

ABSTRACT

Suicide is a worldwide public health issue and concerns about rising suicide rates are growing significantly in many countries. Psychotherapy is often expected to address this problem in clients. Existential therapy may be a particularly effective prevention technique to address suicide related concerns. Existential concerns common among suicidal patients include meaninglessness, isolation, freedom and responsibility. Previous work in existential therapy has given considerable attention to meaninglessness and meaning in life, but discussions on other existential concerns have been limited. This article presents a case for the relevance of existential therapy for working with people presenting with issues relating to suicidality and offers recommendations for clinicians hoping to foster discussions with clients pertaining to existential concerns.

ABSTRAKT

Suizid ist ein weltweites Problem der öffentlichen Gesundheit, und die Besorgnis über steigende Suizidraten nimmt in vielen Ländern erheblich zu. Von Psychotherapie wird oft erwartet, dass sie dieses Problem bei Klienten angeht. Existenzielle Therapie kann eine besonders wirksame Präventionstechnik sein, um suizidbedingte Bedenken anzugehen. Zu den unter Suizidpatienten verbreiteten existenziellen Sorgen gehören Sinnlosigkeit, Isolation, Freiheit und Verantwortung. Frühere Arbeiten in der Existenztherapie haben der Bedeutungslosigkeit und dem Sinn des Lebens beträchtliche Aufmerksamkeit geschenkt, aber Diskussionen über andere existenzielle Anliegen waren begrenzt. Dieser Artikel präsentiert einen Fall für die Relevanz der existenziellen Therapie für die Arbeit mit Menschen, die sich mit Problemen im Zusammenhang mit Suizidalität vorstellen, und bietet Empfehlungen für Kliniker, die hoffen, Gespräche mit Klienten über existenzielle Bedenken zu fördern.

RESUMEN

El suicidio es un problema de salud pública en todo el mundo y las preocupaciones sobre el aumento de las tasas de suicidio están creciendo significativamente en muchos países. A menudo se espera que la psicoterapia aborde este problema en los clientes. La terapia existencial puede ser una técnica de prevención particularmente efectiva para abordar las preocupaciones relacionadas con el suicidio. Las preocupaciones existenciales comunes entre los pacientes suicidas incluyen la falta de sentido, el aislamiento, la libertad y la responsabilidad. El trabajo previo en terapia existencial ha prestado considerable atención a la falta de sentido y el significado de la vida, pero las discusiones sobre otras preocupaciones existenciales han sido limitadas. Este artículo presenta un caso de la relevancia de la terapia existencial para trabajar con personas que presentan problemas relacionados con el suicidio y ofrece recomendaciones para los médicos que esperan fomentar discusiones con los clientes relacionadas con las preocupaciones existenciales.

RIASSUNTO

Il suicidio è un problema di salute pubblica mondiale e le preoccupazioni per l’aumento dei tassi di suicidio stanno crescendo in modo significativo in molti paesi. Ci si aspetta spesso che questo argomento venga abbordato con i clienti in psicoterapia. La terapia esistenziale può essere una tecnica di prevenzione particolarmente efficace per affrontare le preoccupazioni legate al suicidio. Le preoccupazioni esistenziali comuni tra i pazienti con tendenze suicide includono mancanza di significato, isolamento, libertà e responsabilità. Lavori precedenti nella terapia esistenziale hanno dato notevole attenzione alla mancanza di significato e al senso della vita, ma le discussioni sulle altre preoccupazioni esistenziali sono state limitate. Questo articolo dimostra la rilevanza che la terapia esistenziale può avere quando si lavora con persone che presentano problemi relativi al suicidio e offre raccomandazioni per i clinici che sperano di promuovere discussioni con i clienti relative a preoccupazioni esistenziali.

ABSTRAIT

Le suicide est un enjeu de santé publique mondial et le fait que le taux de suicides croît de manière significative dans beaucoup de pays rend l’affaire préoccupante. La psychothérapie est souvent censée résoudre ce problème auprès de ses clients. La thérapie existentielle peut être une technique de prévention particulièrement efficace afin de répondre aux préoccupations liées au suicide. Les préoccupations existentielles courantes chez les patients suicidaires incluent le non-sens, l’isolement, la liberté et la responsabilité. Des travaux antérieurs en thérapie existentielle ont accordé une attention considérable au non-sens et au sens de la vie, mais les discussions sur d’autres préoccupations existentielles n’ont pas été suffisamment abordées. Cet article présente un cas qui relève de la pertinence de la thérapie existentielle en cas de travail avec des personnes présentant des problèmes liés au risque du suicide et à la suicidalité. Il propose des recommandations aux cliniciens souhaitant favoriser les discussions avec leurs clients concernant lesdites préoccupations.

ΠΕΡΊΛΗΨΗ

Η αυτοκτονία αποτελεί ένα παγκόσμιο ζήτημα δημόσιας υγείας και οι ανησυχίες για την αύξηση των ποσοστών αυτοκτονιών αυξάνονται σημαντικά σε πολλές χώρες. Η ψυχοθεραπεία αναμένεται συχνά να αντιμετωπίσει αυτό το πρόβλημα των πελατών. Η υπαρξιακή θεραπεία μπορεί να αποτελεί μια ιδιαίτερα αποτελεσματική τεχνική πρόληψης για την αντιμετώπιση ανησυχιών που σχετίζονται με την αυτοκτονία. Οι υπαρξιακές ανησυχίες που είναι κοινές μεταξύ των αυτοκτονικών ασθενών περιλαμβάνουν την έλλειψη νοήματος, την απομόνωση, την ελευθερία και την ευθύνη. Προηγούμενες εργασίες στην υπαρξιακή θεραπεία έδωσαν μεγάλη προσοχή στην αίσθηση έλλειψης νοήματος και το νόημα στη ζωή, αλλά οι συζητήσεις για άλλες υπαρξιακές ανησυχίες ήταν περιορισμένες. Αυτό το άρθρο παρουσιάζει μια περίπτωση για τη συνάφεια της υπαρξιακής θεραπείας σχετικά με τη θεραπευτική δουλειά με άτομα που παρουσιάζουν ζητήματα που σχετίζονται με την αυτοκτονία και παρέχει συστάσεις στους θεραπευτές που ελπίζουν να ενισχύσουν συζητήσεις με πελάτες σχετικά με υπαρξιακές ανησυχίες.

KEYWORDS:

• psychotherapy
• suicide
• meaning in life
• existential therapy

SCHLÜSSELWÖRTER:

• Psychotherapie
• Suizid
• Lebenssinn
• Existenztherapie

PALABRAS CLAVE:

• psicoterapia
• suicidio
• sentido de la vida
• terapia existencial

PAROLE CHIAVE:

• Psicoterapia
• Suicidio
• Senso della vita
• Terapia esistenziale

MOTS-CLÉS:

• psychothérapie
• suicide
• le sens de la vie
• la thérapie existentielle

ΛΈΞΕΙΣ-ΚΛΕΙΔΙΆ:

• ψυχοθεραπεία
• αυτοκτονία
• νόημα ζωής
• υπαρξιακή θεραπεία

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Moslem Akbari

Moslem Akbari is Master of Clinical psychology at Islamic Azad University in IRAN. He obtained his Master in 2017 with his thesis about the effectiveness of cognitive therapy on reduction depression among people who stuttering. He is young researcher and clinical psychologist. Living in middle east and west of Iran help him to find his old interesting topic (why people think and behave in specific pattern). When he was student, he decided to change his study from natural science to clinical psychology. As Ilam and Kermansah are first and second rank of suicide in Iran, respectively, and he saw suicide is multifactorial disorder and unfortunately have multi negative outcome. So, he started his study about suicide in 2018 and wrote some papers about it. Also, he is looking for a type of psychotherapy that combines death anxiety and desire to suicide. Existential therapy is his favorite approach in psychotherapy, and he uses this approach with high-risk patients (depression, suicide and self-harm). Sleep and dream and related variables are another favorite research and not to mention low sleep quality has a positive correlation with suicide.

Mohsen Rezaeian

Mohsen Rezaeian is professor of epidemiology at Rafsanjan University of Medical Sciences, Iran. He is one of the founders of the Iranian Scientific Society for Suicide Prevention and editor-in chief of the Journal of Suicide Prevention. He is co-chair of the IASP SIG on the Development of Effective National Suicide Prevention Strategy and Practice.

Peter J Helm

Peter J. Helm is an Assistant Professor in the Department of Psychology at Montana State University. He obtained his undergraduate degree from the University of Vermont in 2012 before obtaining his Ph.D. at the University of Arizona in 2019 studying under the mentorship Dr. Jeff Greenberg. He completed a postdoctoral fellowship at the University of Missouri-Columbia before joining the faculty at Montana State University in 2022. Dr. Helm’s research focuses on understanding the underlying antecedents and consequences of subjective social disconnection (e.g., existential isolation, alienation, loneliness). These interests have led to studies on how interpersonal relationships (e.g., attachment styles and figures), social identity (e.g., gender expression and racial identity), and contemporary social issues (e.g., prejudice, bias, racism, conspiracy theories) can influence human behavior, well-being, and health. Current work includes examining how varying forms of objective and subjective isolation affect mental health, substance use, and attitudes towards psychological services in rural and agricultural communities. This work has been supported by the National Institute of Minority Health and Health Disparities (NIMHD).

Kat Becker

Kat Becker is Master of counseling psychology, is a doctoral student at the University of Denver. They provide clinical therapeutic services, are an adjunct faculty member at the University of Denver, a research assistant through the ECHO-DU program within the Center for Rural School Health Education (CRSHE) and engage in researching various topics. These topics include the lived experiences of queer individuals, existential humanistic psychotherapy, international psychology, the multicultural orientation, cancer survivorship, and philosophical underpinnings of psychotherapy. They utilize both qualitative and quantitative methodologies to explore these topics. Kat has provided therapeutic services in community mental health, hospital, and college counseling settings. Their clinical areas of interest include seeking authenticity, grief and loss, family of origin therapeutic work, complex trauma, and queer identity formation. Kat believes in the importance of integrating culture, and the mind body connection within therapeutic work. Their therapeutic approach aligns with social justice principles of providing safety, affirming those with marginalized identities, and engaging in a strengths-based, person-centered approach. Kat has been honored to be a National Board for Certificated Counselor Minority Fellow, a discussant for a symposium exploring ethical therapeutic practice in the digital era, a guest lecturer on culturally responsive safety planning and risk management, and a member of American Psychological Association Division 52.