Until I started working as a counselor on a helpline, I wasn’t sure what a stranger could offer someone who was suicidal over the phone.
The people on the other end of the line shared that hesitation. They approached cautiously, unsure of who would answer, whether there would be judgment, or what this stranger, this simple voice, could do for them.
Suicide is a problem that causes a lot of shame, which prevents people from seeking help in time. Moreover, accessing professional help is an expensive affair in a country like India. Not only are the fees high, but professionals have long waiting lists and are mainly based in the big cities.
Helplines go beyond these barriers and offer an empathetic and supportive environment to those in difficulty. They offer customers something valuable that is often missing in their offline lives: Confidentiality, anonymity and unconditional support.
My training as a counseling psychologist did not prepare me to offer counseling over the phone or to address suicide remotely. With a master’s degree and some certifications in counseling psychology, I joined the helpline after a year of working face-to-face.
You can never be fully prepared
Upon joining, I was given rigorous training in many areas, including suicide prevention. I participated in multiple role-plays, although one can never be fully prepared for what awaits them on the other end of the line.
The callers to the helpline presented a variety of suicidal approaches. For some, the idea of suicide would be an occasional occurrence, while for others it would be a constant. For many callers, the helpline was a last resort before carrying out their plans.
Many Myths and misinformation Some of the most common misconceptions surrounding suicide are that suicide is seen as an act of weakness, as attention-seeking behaviour, as a mere threat or even as a sign of mental illness. People are afraid to ask directly about suicide because there is a mistaken belief that this will implant an idea in someone’s head.
People of all ages, gender identities and socioeconomic backgrounds called the helplines. We were inundated with calls at night, on special holidays like New Year’s Eve and festivals. These were the times when Loneliness and despair would be the hardest..
I gradually learned how to handle it. I had to learn that even when clients were in crisis, my job was to contain that sense of urgency. I had to learn that my job was not to fix what they were feeling, but to understand them, to help them feel more centered, to help them see options and possibilities, and to support them in accessing those options.
Callers knew there was no magic cure on the other end of the line, but they wanted someone who would listen, understand, and support them in navigating the complex terrain they found themselves in.
Reflections on what worked
Unconditional acceptance and validation: Callers are often very distressed. When people are in a negative spiral, solutions are inaccessible. Callers feel shame, self-doubt, and anger toward their lives and themselves.
Meeting people where they were with genuine empathy and acceptance helped build rapport. It gave those calling permission to feel what they felt beneath the veil of self-criticism and judgment. Often, it became a reason to wait another day.
Viewing suicide as a way of coping: People see suicide as an act of weakness. Yet it took all their strength to fight off those thoughts. After numerous calls, I came to understand that suicidal behavior was often a way of coping.
People thought this would end the pain and provide relief. They “coped” with their pain by seeing suicide as a “way out” of their situation. The empathetic paraphrase of Suicidal tendencies as a way of coping Helps regulate emotions.
Identifying resistance in despair: I was often surprised by the stories of clients’ resilience. The resilience did not always manifest itself in directly fighting a problem and overcoming it, but rather in clients who called having suicidal thoughts for months, but continuing to resist.
Or when they felt deeply hopeless but still found the courage to call a helpline. They were no longer passive recipients of the problems in their lives but active agents resisting them.
Addressing ambivalence: Ambivalence involved accepting that callers wanted to end their lives, but had reasons for continuing. This required a genuine conversation about what was causing suicidal thoughts and asking if there were reasons to continue living.
The callers gave us reasons that surprised us both. They spoke of promises made to their deceased partner, of the family they would leave behind, or of a future they imagined far from their pain, where they would be loved and cared for. These were the doors that would lead us to lands of hope and possibilities of a future where suicidal feelings would not dominate.
Building hope:Despair makes us forget that pain is temporary and can be treated. In my conversations with callers, we thanked them for reaching out to me. A person who is having suicidal thoughts often feels cornered and without options. We talked about holding on for another day, sometimes about what they did in the past when they felt this way. These actions created hope to hold on.
Support beyond psychiatry: Suicide in India is psychosocialSuicide risk arises from social situations, challenges, and systems. Pills and therapy did not always help address the distress my clients were experiencing due to job loss, financial distress, domestic violence, and discrimination.
In the case of problems arising from structural and social determinants, solutions should not come from within the person, but from outside. Interventions would involve putting people in contact with legal aid, job portals, foster homes, loan forgiveness programmes, education grants and NGOs that could offer support in accessing this practical support.
Finding a community: Callers often feel alone in their journey and fear being judged. Having someone to witness and validate our pain can be healing. Callers often find that having someone to listen to them reduces the intensity of suicidal thoughts.
As a counselor, I reassured them that they were not alone. Although it was unclear how we were going to get through the situation, I assured them that we would do it together. Identifying safe people in their lives and learning safe ways to share their feelings was critical. Grief is a human experience, but accepting it and allowing others to support you was often a transformative experience for many.
Coming back to myself: Listening to stories of pain, despair and helplessness day after day becomes tiresome over time. As therapists, we are trained to listen with empathy, putting ourselves in the client’s shoes. Some days, I would go home and not participate in any conversations with my family, because I was so exhausted from the calls.
Taking time to reflect on the impact my work had on me was important in addressing the negative effects. Regular team training, supervision, and practice were a big help. Self-care is an important component for any professional working in suicide prevention.
Every call I attended was unique. Every tale of heartbreak and recovery resonates deeply with me, even today. I often find moments in odd days and hope they are okay. Even today I carry those tales with me. Some are heavier than others and some help me get through a tough day.
If this article has raised concerns for you or someone you know, please visit https://findahelpline.com/i/iasp.
Tanuja Babre is a mental health professional, working as a consultant with mental health agencies and as a visiting professor at the Tata Institute of Social Sciences.
Originally published under Creative Commons License by 360 information™.
