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What I Told My Patient's Mom When Her Daughter 'Threatened' Suicide

Currently, I work as a psychologist in private practice. I primarily see adults and teens. Recently, one of my teen patients expressed suicidality in a pretty intense way. Scared and overwhelmed, her mother emailed me from the ER waiting room where she would spend most of the night, waiting for her daughter to either be released or admitted to the child psychiatric unit for being a potential danger to herself. My patient was sent home around 4:45 a.m. as the hospital team didn’t note any evidence that she would be a danger to herself or others in the immediate future.

My patient’s mom sent me another email the next day. She wanted to know if she should plan to participate in her daughter’s next appointment in order to talk about what happened. She wanted direction on how to handle this type of situation in the future. Also, I imagine my patient’s mom wanted to ensure her daughter felt supported after having gone through such an experience. I told her she should only plan to attend if her daughter invites her, and that I would email her after I met with my patient with any insights I might have to offer.

I kept my word and emailed my patient’s mom after our session. She agreed to allow me to share the contents of that email with other parents that might be going through something similar with their children. Here’s what I said:

I spoke with [redacted] about the recent incidents and the motivation behind her choices in the past week. I told her I would be giving you some feedback after the session. She felt OK with me sharing the following information with you: [redacted] has felt unheard for a long time. She feels that when she tries to express her thoughts and feelings to you she is generally met with opposition or some sort of explanation as to why things aren’t as she perceives them to be. She acknowledges that her behaviors were extreme the other night and states that she was acting in anger at the time.

I encourage you to talk with [redacted] about some of the things that she may have tried to express to you in the past but felt were unheard. My advice would be to validate her feelings whether you agree with them or not. One trick is to imagine that everything that she is saying is true and then respond to her feelings as such. Whatever you do, don’t try to correct her perspective. She won’t be able to change her logical [or illogical] perspective until her emotional perspective is validated and it doesn’t all happen in one conversation.

I told [redacted] that if she wants to feel heard then she has to say something (before the explosion). She agreed. So, she should be somewhat open to a conversation. If she doesn’t engage, remind her that she agreed to speak up in order to be heard during her session…

I feel the need to clarify that any threat of suicide should be taken seriously. Don’t try to decide between “attention seeking” and will to die. It could literally be a life and death decision and it should not be your burden to bear. I believe my patient’s mom did the right thing by taking her daughter to the ER and I praised her for her actions. Additionally, my patient never said (to me) that she wasn’t willing to die that night. She only admitted that her behaviors were “extreme” and that she was trying to send a message because she felt unheard. She was the second teen in seven days who told me “threats” of suicide were the only way to get people to understand the pain they feels inside. I encourage parents to take the time to validate your children’s feelings and experiences. Many times, we get caught up in whether our children are right or wrong. The truth of the matter is an emotion is never wrong. It just… is. Validating your child’s experience is not a confirmation that his or her perception of events is accurate nor is it an approval of behavior. It is simply an acknowledgment that you hear what your child is saying and it’s OK to have feelings, whatever they may be.

To see more from Dr. Jennifer Marks, visit her site.

Getty image via tommaso79

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