Journeying with the depressed and suicidal: Tips for “people helpers”
TRIGGER WARNING: This story contains material on an attempted suicide that some may find distressing.
Silas Low // May 17, 2021, 1:38 pm
"The big difference between human depression and the dark night of the soul is one's holding on to the Lord rather than turning away from the One true source of strength amid the dark journey," said Dr Linda Bubud in webinar, Suffering, Depression and Suicide. Dr Bubud is dean and clinical director of the School of Counselling at Singapore Bible College. Photo by Dan Meyers on Unsplash.
Dr Linda Bubod recounted a phone call she received when she was still an intern.
“I could hear the sound of the wind. Having been raised in the mountains, I was quite familiar with that,” said Dr Bubod, who is now dean and clinical director of the School of Counselling at Singapore Bible College (SBC).
Dr Bubod was one of two speakers of online webinar, Suffering, Depression and Suicide. It was part of a series of lectures held during the annual Counselling Week of Singapore Bible College.
The caller was a former student who had gone through “overwhelming situations”.
“I asked where she was.”
On top of a building was the reply.
“I was really scared. I asked her, ‘What do you intend to do on top of the building?’
“Be present, listen carefully, love unconditionally, don’t blame. The more non-judgemental we are, the better.”
The woman replied: “I just want to jump. But I remember what you told me: That if I ever think of dying, I would call you first.
“I said, ‘Oh, I’m glad you remembered that.’”
As Dr Bubod engaged her former student in conversation, her cell phone started blinking. Her battery was low. She silently panicked and was asking those around her for the number to the landline.
But she explained calmly to the woman: “You need to go down and find a landline because my battery is low and you may not hear me anymore. So please find a landline and I promise I will listen to you.”
Dr Bubod “prayed really hard” that she would call. In her mind, the woman would either jump or look for a landline.
After an excruciating two to three minutes, the phone rang. Dr Bubod and the woman talked and met up.
Dr Bubod related the account to illustrate several important issues in diffusing a suicidal crisis. Listening and showing respect for the feelings of the suicidal person. Reinforcing the person for seeking help. Being specific in assessing the lethality. Making decisions for the person if they are very convinced about killing themselves.
After the incident, Dr Bubod said: “I went home that day so tired and hungry from the short time of anxiety.”
She called a friend for support.
“It is good to have those friends we can call to help us,” she said, highlighting the importance of self-care and having a supportive community.
Dr Bubod’s talk, like other Counselling Week lectures since they started in 2012, was free and open to the wider Christian community.
This year’s series in February was held online because of Covid restrictions. The lectures were available on YouTube for a limited time. Suffering, Depression and Suicide attracted 12,000 views from Singapore and abroad.
“There are no lone rangers in the counselling field.” – Benny Bong
The other speaker, Dr Samuel Law, is senior dean of academic affairs and associate professor of intercultural studies at SBC. He spoke on suffering and depression from a Christian perspective (check back soon for a report on his portion of the talk).
Throughout the talk, both speakers reiterated the importance of collaborating with other agencies that deal with suicide and having “connections with psychiatrists, church friends and others who can be with us in the helping profession or helping ministry” – in caring for the person and self.
“There are no lone rangers in the counselling field,” said Dr Bubod, quoting family therapist Benny Bong who also delivered lecturers during Counselling Week. Below are highlights of Dr Bubod’s talk:
Sin and depression
Dr Bubod pointed out that it is not helpful for well-meaning friends to tell others: “I think you are depressed or suffering because you have sinned or did something against the Lord.”
She explained: “That person may think ‘God is punishing me for my sin’, and this contributes to their feelings of sadness.”
That is not to say that depression is not related to sin.
It is not helpful to tell others: “I think you are depressed or suffering because you have sinned.”
“Depression is clearly related to sin when we have committed sin and are experiencing the consequences of it,” said Dr Bubod, quoting her mentor, Fred Gingrich.
“‘A man reaps what he sows (Galatians 6:7), and so part of the effects of the sinful behaviour could be the feelings of sadness over what we have done. And failing to take the necessary step towards healing where we refuse help and perpetuate our own and other people’s misery.
“Depression is also the consequence of giving or losing power to others when we allow others to manage our lives. A lot of times when we don’t take personal responsibility for that, some people – who may be well-meaning, but may be very controlling or driving us nuts – may make it worse.”
Some fail to face depression because it has its “secondary rewards”. Dr Bubod has had clients say: “It’s okay to be depressed because when I am, I get the attention of their family when normally we don’t talk to each other.
“That is not necessarily healthy,” she said.
Diffusing a suicide crisis
Dr Bubod also talked about suicide.
“The goal of facing a suicide crisis is to bring the client from a point of strong dying intention into that of lesser focus on dying and hopefully out of it.
“Help the person to find importance in themselves as a child of God if the client is Christian.”
“I would like to underline that it should be done with care. As you move beyond crisis point, deal with negative thoughts,” said Dr Bubod.
“Help the person to find importance in themselves as a child of God if the client is Christian. Remember there is very poor self-esteem, so focus on redemption of identity.
“Cognitive Behaviour Therapy (renewing the mind towards a better way of perceiving life), solution-focused therapy (finding out what works ) and behaviour techniques (exercise, monitoring behaviour and going for healthy activities) will be helpful initially.”
Self-care for people helpers
“Pray hard as well and get spiritual covering from your own support group when dealing with suicidal clients,” Dr Bubod advised people helpers.
There may be times when “our best (efforts) may not be enough”.
“Please don’t take a disproportionate amount of responsibility over a suicide case.”
Looking back on the incident when she was an intern, Dr Bubod said: “I was thinking: What if she had jumped? How would I have handled it? It could have been very difficult for me.
“So the counsellor or helper can also undergo vicarious traumatisation in dealing with a suicide case. In some cases, if the person has jumped, it could also be traumatic to the counsellor.”
When grieving with a family who has lost a member through suicide, be aware of survivor guilt, said Dr Bubod.
Survivor guilt is when a person says, “What could I have done?”or “What have I done that made this person die?” Or “Maybe there are some things that I did not do. What could I have done to prevent it?”
Dr Bubod advised: “Be present, listen carefully, love unconditionally, don’t blame. The more non-judgemental we are, the better.
“Be patient in hearing the same story again and again for someone who has gone through loss especially.”
The faith factor
Drawing on her 15 years of counselling experience, Dr Bubod shared two big factors that are strongly correlated with hope.
One, the faith factor. “The big difference between human depression and the dark night of the soul is one’s holding on to the Lord rather than turning away from the One true source of strength amid the dark journey. Sufferers who do not lose their faith as a resource for coping are more likely to have more hope than those who have lost it.”
“Sufferers who do not lose their faith as a resource for coping are more likely to have more hope than those who have lost it.”
Two, the relationship factor: “We all are created for relationships. In relationships, we are empowered to thrive and grow. The absence of interconnectedness plays a major factor in recovery from and management of depression and suicidal intention. In suicide, it takes one confidant (friend, family member, caregiver) who has a nurturing effect on the depressed and suicidal person to prevent them from taking their own life.
“Jesus said: ‘Come to me all you who are weary and burdened and I will give you rest.’ (Matthew 11: 28).
“This picture ministers me a lot. No matter how difficult life is, if we could just imagine ourselves going to the Lord and being carried in His arms, I would like to think that there is hope and peace amid all that we are facing.”
Dr Bubod answered some questions raised by participants of the webinar. Here is a selection:
Are there any preventive measures for parents to prevent suicidal thoughts?
A child will not think of suicide if they have a parent who is non-judgemental and nurturing – what we call an anchor. It is someone they think of as “a person whom I can run to”. Sometimes, it could be a pastor or ministry worker.
How far should pastors be allowed to intervene when someone shares their grief or pain? How should we deal with many people who share their sadness with us?
From listening, you might be able to tell what the problem is and refer them to a clinical counsellor who can journey with them in the arena of grief. It’s very hard to be a pastor and counsellor at the same time. Some people would be grieving for years and you don’t expect the pastor to do that.
It is very good for a pastor to have contacts of Christian counsellors, psychiatrists and psychologists that they can refer people to.
Pastors are also candidates of burnouts and depression. Because of how they listen and listen to so many. Here’s where the issue of boundaries and the ability to identify our limitations is important.
Remember the model of Moses. Jethro said: “You cannot help all these people. Why don’t you delegate?”
As pastors, it is important to say no. If you are sick and someone calls you and says they have a problem, it is important to say that you’re currently sick but say “Can I refer you to somebody?”
That is the beauty of having people whom you can refer others to – maybe a pastoral care department or team of counsellors at church. Cell groups and discipleship groups also help, because community life is important as well.
Remember the model of Moses. Jethro said: “You cannot help all these people. Why don’t you delegate?” (Exodus 18:13-23)
What are some practical ways for caregivers to receive support?
A lot of the time, caregivers are the ones getting depressed. So let’s be proactive as caregivers and look for our own support. Call a friend. Ask someone to relieve you for one or two days so that you can go out with a friend or do something nice. Enrol in dance class or art class.
It’s important to think of how we as caregivers can take care of ourselves. That will be the way to go because we cannot expect people to say “you need to go out sometimes”. It would be nice to have friends like that. But if there are none, we will be the one to go out and seek the support that we need, ask for help.
How can we encourage someone who has depression to seek help when they don’t want to?
Create the need by making observations. For example, “My friend, I have observed that you used to be very active and go for sports. And now you don’t. What is happening?” or “You used to be so happy and jovial. But now you look down and are unusually quiet. What is happening?”
Helping someone who is depressed
Dr Bubod offered tips for caregivers (such as parents), pastors and those who have a heart for people:
Listen. Do not minimise but accept emotional expressions like crying. They may be slow; go with their pace, express concern and support. But do not rescue; if the person cries, allow the person to cry, don’t try to stop it.
Determine seriousness of the depression. If severe, find help. Does the person need hospitalisation or another form of help? Refer to a psychiatrist or a trained counsellor when necessary.
Check out possible causes. Is it physical or related to physical illness? Is it part of the grieving process or a response to loss? Is it a side effect of medication or part of the withdrawal process from alcohol or drugs? Or is it part of other psychiatric illnesses like schizophrenia? Knowing would help in terms of treatment or direction to take.
Encourage development of relationships. Do not allow the individual to withdraw and avoid others, especially if the person has suicidal ideation or intention.
Watch out for suicidal thoughts, tendencies and deterioration. Warn their family or caregivers of these.
Encourage helpful activities. Studies show that aerobics and sports help.
Gently challenge unhealthy thoughts and negative self-statements. Focus on what’s true. For example, someone may say “I am dumb” out of their very negative perception of life and perception of themselves. Say something like “I wonder if God thinks of you that way? I don’t.” Focus on positive self-statements. Appreciate small changes that occur. Be encouraging.
Help reduce their stress. Stress can be a big contribution to the depression. Encourage them to develop self-care, in as much as you also need self-care. Find gradual and healthy growth routines.
Teach adaptive social skills if they have withdrawn from people from a long time. Chances are they may lose skills on how to fellowship with others. Friendship is very important.
David Benner (author of Strategic Pastoral Counseling) has said that a lot of times, counselling is not the only way to heal; friendships, worship, spiritual direction, community can also be great healing factors.
Sometimes the faith journey of a person can also be a big healing factor.
This webinar was held as part of Singapore Bible College Counselling Week in February, and was reported with permission.
Check back soon for Part 2 of this report on the importance of understanding pain and suffering from a Christian perspective by Dr Samuel Law.
- Call 999 if there is a risk of injury, immediate threat to life or bodily harm (relatives and friends of victims can call as well).
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