Discussing suicide is challenging, yet its impact is profound and far-reaching. As a mental health nurse, I have been deeply affected by the suicides of patients, which have significantly shaped my thoughts and feelings over the years.

Working with individuals in crisis, I engage in daily conversations about suicide. Despite the frequency of these discussions, I can never become desensitized to them. I cannot, and will not, allow the people I work with to harm themselves.

In all my years of nursing, I experienced one patient death, but that was enough to leave a lasting impact. Attending Coroner’s Court was profoundly traumatic for me. Witnessing the family confront their grief, disbelief, and the painful reality of life without their loved one was heartbreaking. The loss of a future with their daughter, and the life she could have lived, serves as a poignant reminder of the enduring impact of suicide.

I frequently asked my patient about suicidal thoughts and assured her of my unwavering support if she ever needed it. Learning later that she had taken her own life was heart-wrenching. I discovered that she had been planning her suicide for several weeks but had never disclosed this to anyone. This felt like a blow to the pit of my stomach.

I could not understand how she could confide in me about her deepest thoughts, yet not reveal her struggle with suicide. Witnessing the aftermath of this experience profoundly influenced my search to understand suicide. This experience became a powerful motivator for me to continue learning and growing in my profession.

In addition, I then jump to imagine the suffering of the person experiencing suicide on their mind. When you are that person, you feel like you are drowning in psychological pain. Sadly, suicide seems like a way out to stop the pain, and thoughts of escaping unbearable suffering hijack the mind. When someone reaches that desperate point, their cognitive lens narrows. They cannot see the bigger picture or the impact their death will have on their loved ones. They are stuck in their emotional, reactive primitive mind (Limbic system). The primitive mind is always negative; it sees things from the worst possible perspective, catastrophizes, and reacts this way for survival.

This is puzzling to me because the primitive mind is about survival. So why does the person begin to look for a way out of their situation of living, by means of suicide. This is an enigma: survival mechanisms pushing someone toward self-destruction. For instance, the primitive mind, which should safeguard life, becomes entangled in a desperate search for an exit.

On the other hand, perhaps it’s because survival is not just about physical existence; it’s also about emotional survival. When emotional pain overwhelms us, the desperate search for an exit, any exit, can lead to thoughts of suicide.

Emotional information takes high priority when a person responds emotionally to a situation, hence the primitive mind becomes stimulated and the amygdala plays a major role in survival. The prefrontal cortex, which is responsible for the complex cognitive processes takes a backseat. We have all had these experiences when anger, fear of the unknown quickly overrides our rational thoughts and we overreact. This happens because the hippocampus is susceptible to stress hormones such as cortisol that inhibit cognitive functioning. For instance, the hippocampus is the memory maestro and when flooded with stress, it inhibits cognitive functioning, and we are left with raw emotions without our wise cognitive ability. Subsequently, rationality, memory, and perspective become blurred.  

Moreover, I believe that what happens is we are not meant to stay in the emotional primitive part of the brain for too long. The amygdala’s job is to sound the alarm, not to keep us perpetually on edge. It’s like activating the fire alarm and then forgetting to turn it off. When this happens we are then dealing with a crisis-driven brain. As a result of persistent stress, whether due to external circumstances, internal struggles, or both, the brain’s emergency exits start malfunctioning. The exit sign beckons too strongly, and thoughts of escape emerge.

I refer to the primitive mind as downstairs, we are not meant to live downstairs. We go downstairs when there is a threat to deal with it, but we are meant to go back upstairs to the prefrontal cortex.  Consequently, when someone faces intense emotional pain or crisis, their primitive mind, the ancient alarm system, kicks into high gear. It’s like being trapped in a survival bunker. Hence, their focus narrows to immediate threats and thoughts become obsessional. This I refer to as the mental washing machine of rumination, the spin cycle of our minds. It’s like tossing worries into a mental washing machine. Round and around they go. We replay conversations, dissect emotions, and analyse life’s plot twists. It’s as if our brain’s rinse-and-repeat button got stuck.

The Prefrontal Cortex: Our Rational Haven: The prefrontal cortex, the executive suite of the brain, houses reason, executive functioning, empathy, and long-term planning. The metaphor that I use to explain this to individuals is that the primitive mind is the basement, and prefrontal cortex, is the penthouse (this metaphor does not belong to me). Subsequently, it’s about supporting the individual to take the stairs back up to that comfortable penthouse, from panic mode to perspective.

I believe that it is important to understand what is going on in the mind and the body to understand suicide. Negative stress, whether triggered by loss or multiple stressors, sets off a chain reaction. It activates our ancient survival mechanisms: (fight/flight/freeze). Physiologically, negative stress can lead to oxidative stress, an imbalance between antioxidants and oxidants. These molecular can cause havoc on our cells and systems. Chronic oxidative stress messes around with methylation. Methylation is pivotal, why because, it adds or removes methyl groups from our genetic script, which can switch genes on and off. So if you have a predisposition to an illness it can switch it on. Imagine it as a genetic toggle: “Illness gene, activate!” or “Wellness gene, hibernate!”

Methylation is sensitive. It thrives on good vibes, wholesome food, stress-free days, and plenty of “me time.” But throw in oxidative stress it causes havoc with the neurotransmitter symphony and we need that. This is because methylation helps convert tryptophan (the building block for serotonin) into 5-HTP (serotonin’s precursor). Serotonin is the mood-lifter, the “I’m content with life” neurotransmitter. But wait, there’s more! Methylation also transfers dopamine, norepinephrine, and adrenaline through the brain. Moreover, methylation is the hormone regulator. For instance, it ensures that norepinephrine becomes adrenaline (for focus and attention) and even converts serotonin into melatonin, essential for sleep. Consequently as we know, when stressed sleep becomes impaired. Also methylation is detoxification, it neutralizes toxins, sweeps away free radicals, and keeps our cellular pathways tidy.

Too much stress cranks up the mental washing machine, leading to exhaustion, impaired sleep, which can progress to depression, that has been linked to inflammation in the brain. WARNING, impaired sleep exacerbates the situation, its like adding fuel to the fire. Therefore, the longer someone stays downstairs in the emotional mind it will cause the physiology changes in the mind and body, which keeps the person stressed, and the effects can sometimes lead to suicide.  However, not all people that are depressed have thoughts of suicide. Therefore, it is not the situation of feeling depressed, but how the person thinks about their situation that seems to drive suicide. For me, it is about stress, and what causes the stress, which can be anything. It is how we interpret our situation that causes the pain, our thoughts become the architect of our pain and stress tightens the grip.

WARNING, negative or chronic stress to me is the universal troublemaker, and the catalyst. It does not discriminate, it can be triggered by anything, a breakup, financial woes, physical or mental illness or even existential pondering.

Caution, we need to acknowledge that sometimes people mask there struggles and this makes it harder to spot their pain. Significant others, partners, friends, family, may be unaware of the true struggle. They see the mask, not the battle. As a result when suicide strikes, it leaves them shattered, clutching fragments of questions and guilt. Subsequently, they replay conversations, search for missed signs, and grapple with the unanswerable whys. Suicide leaves behind a void, an unfinished sentence in life’s narrative. Moreover, it is not just a personal tragedy; it ripples through hearts like shock waves.

🚨 RED ALERT: If you are grappling with suicidal thoughts, do not keep them locked away. TALK to someone, keeping it secret is RISKY. Now, let’s explore why:

Neural pathways and Repetition: Every time you think about suicide, your mind carves a neural-pathway, a mental trail etched by neurons firing together. It’s called neuroplasticity like footprints in the snow, leaving a trace. Here is the twist: Your mind does not differentiate between imagery and reality. So, when you replay those thoughts, your brain thinks it’s déjà vu, it’s been there, done that.

The Danger of Familiarity: Suicidal thoughts can become strangely familiar. If they do not scare you anymore, you are treading dangerous ground. Why? Because familiarity breeds complacency. You are less likely to seek help and more likely to succeed. It’s like walking a tightrope without a safety net.

The Downstairs Mind and Rational Resources: Imagine your mind as a house: Upstairs, you have the prefrontal cortex, the rational, problem-solving zone. Downstairs, it’s a different story. When suicidal thoughts dominate, you are downstairs in the dimly lit basement, cut off from your rational resources. Narrow focus takes over, and escape seems like the only way out. Remember, my friend, you are not alone. Reach out, talk, and let someone turn on the lights. Lifelines are waiting to catch you.

It is important to highlight that solution-focused hypnotherapy does not deny the pain of suicide; it acknowledges it. The goal is to balance survival instincts with rationality. To acknowledge the pain without drowning in it. Working with someone experiencing suicidal thoughts using solution-focused hypnotherapy requires a compassionate and goal-oriented approach. It is a client-centred therapy that focuses on guiding individuals toward their “preferred future.” It acknowledges the past, but primarily concentrates on the present and how the person wants their life to change moving forward. The power of solution-focused hypnotherapy lies in harnessing the trance-like state of hypnosis to calm the mind to help them with their stress and pause the mental washing machine. They can then work towards diminishing self-limiting beliefs and reinstall positive, frameworks. Therapists also use the “miracle question.”

Here’s how it works:

Step 1: The client is asked to envision their problem-free future. What would life look like if the issue no longer existed?

Step 2: Solution-focused questions further develop this picture. For example, “What would tell you things are better?”

Step 3: Together, the therapist and client set realistic, tangible steps to challenge the current problem.

Once the client is induced into a relaxed “trance” state using hypnosis techniques, positive suggestions are made. These suggestions help the client build a mental “template” in their unconscious mind, a new way of thinking about their future. The goal is to create a positive shift in thought patterns and encourage solution-focused thinking.

Empowering the Client: Solution-focused hypnotherapy empowers individuals by helping them reprogram their unconscious mind. It encourages them to respond differently to fear or distress. By viewing challenges as manageable and shifting perspective from threat to challenge, clients become more optimistic and resilient.

By helping individuals visualize the life they desire and identifying actionable steps, they empower them to move forward. It’s like untangling a knotted thread, one gentle pull at a time.

Image: The collaborative work of a therapist helping someone untangle a metaphorical mess.

As highlighted, suicidal thoughts are often a reaction to a distort reality, due to the emotional response and staying in the primitive part of the brain for far too long. Consequently, the primitive mind screams, “Escape!” But escape is not the only option and that’s why it is important to educate the person about the brain to help them gain an understanding.

Additional, by providing the brain explanation it fosters hope. It says, “You’re not stuck here forever.” And we remind them that our brains are adaptable. Resilience is not about never falling; it’s about rising after each fall.

For me solution-focused hypnotherapy helps individuals get back upstairs to the penthouse, so that they can see the bigger picture calmly and rationally. Meanwhile, it is important to state that this is undertaken at their own pace, one step at a time, but while moving up stairs, they begin to access other options to resolve their situation.  This is because they have accesses to their resources of their rational thinking mind and then they are able to consider the consequences and see a broader view.  

Training in solution-focused hypnotherapy has helped me piece together the jigsaw puzzle of these complex emotions and experiences, and it is why I am writing this post today. I love the approach so much, having worked with the effects of suicide for over 2 decades, I now feel that I too can see the bigger picture.

I often reflect on those who have taken their own lives and the loved ones they leave behind, grappling with the overwhelming shock and trauma. Imagining the immense struggle of these survivors, who must adjust to a new reality and come to terms with their grief, is heart-wrenching.

While suicide is a tragic and complex issue, it’s important to remember that support is available. If you or someone you know is struggling, don’t hesitate to seek help, no one should face this alone.

If you would want private support you can call me Tina 📞07448569443. I provide a free initial consultation, with no obligation.

Finally, I would like to emphasize that the insights shared here stem from a personal perspective. Additionally, it’s crucial to recognize that the topic, especially when delving into the intricacies of brain function, is far more intricate than we can fully capture.