Suicidal thoughts are often a topic not many want to delve into discussing. I think it’s important we do so and make sense of some of them. Suicidal behavior tends to come in a spectrum of forms, maybe you’ve heard of some of them? Active thoughts, passive thoughts, thoughts of planning, suicidal feelings, suicidal gestures, and action. This blog will be focusing primarily on passive suicidal ideation and suicidal thoughts or thoughts of death that may be a one-time experience or occur in specific situations. Suicidal thoughts, in general, are defined as thoughts of death with OR without a plan.
Passive thoughts of suicide are those that are related to thoughts of death, ending one’s life, or wanting to die, without actual planning. I think it’s important to know that even the APA states that most instances of suicidal thoughts do not progress to suicide attempts. This bolsters the claim that most suicidal ideation is fleeting and can be managed. If you’ve ever had suicidal thoughts and not wanted to actually die, and wondered why, this blog might be able to answer some questions for you. If you’re someone who has recurring suicidal thoughts and are not truly wanting to die, this also might be for you.
Active Vs Passive or Intrusive Thoughts of Suicide
It’s important to note that there is a distinction between passive/intrusive and active suicidal thoughts. Passive thoughts may involve a vague desire for escape or a fleeting notion that life would be easier if it ended, but they lack a concrete plan or intent. Active thoughts, however, involve specific plans or intentions to harm oneself. This may also involve planning oriented around ending one’s life or engaging in gestures to end one’s life. The bottom line is thoughts have become active if you have engaged in any future planning or steps have been taken towards a plan related to suicide. Understanding this difference can be crucial in assessing your emotional state and seeking appropriate support when needed.
Understanding “Calls of the Void” or The High Place Phenomenon
Have you ever had an experience where you were driving across a bridge, or standing on a high place, maybe on the end of a cliff or building, and you may have been in a normal mood, when all of a sudden you think, “what if I just drove off this bridge…” or “what if I just jumped….” Weird, right? While this can be distressing and uncomfortable, surprisingly it’s not as uncommon as you would think. Research suggests that around 50% of individuals have reported experiencing these sensations at some point in their lives. These episodes are not necessarily indicative of a desire to end one’s life but are rather intrusive thoughts that can be triggered by various factors. There’s actually a name for them – “Calls of the void,” also known as “the high place phenomenon” are brief, out-of-character, and out-of-place feelings of consideration of death. They often involve thoughts of jumping off high places or driving into oncoming traffic. While it might be tempting to dismiss them as mere curiosity, they can be indicative of a deeper mental health issue. This impulse can be terrifying, as it feels completely contradictory to the individual’s conscious desire to stay safe.
Why Might Passive Thoughts Happen?
- Intrusive Thoughts: It’s important to recognize that intrusive thoughts are a common occurrence, even among those without diagnosed mental health conditions. These thoughts can arise due to the brain’s tendency to explore different scenarios, even if they are disturbing or distressing. Your brain is an organ and it’s function is to think, as mindfulness proposes, we do not need to attach to all of the thoughts our brain presents.
- Suicide as a Perceived Solution: In some cases, individuals may experience thoughts of death or suicide because their brains see it as a solution to problems. This can be especially relevant for those who have struggled with suicidal ideation or attempts in the past. When facing overwhelming challenges or emotional distress, the idea of suicide may surface as a way to escape from pain or difficulties. It’s crucial to understand that this perception is often a result of distorted thinking, and it’s not a healthy or effective solution to life’s problems. Seeking a professional for help and support can be essential for individuals who find themselves in this mindset, as alternative coping strategies are needed. Therapists can provide support and hope, as well as coping strategies.
- Stress and Anxiety: High levels of stress and anxiety can increase the frequency and intensity of intrusive thoughts. When individuals are under significant pressure, their minds may conjure up distressing scenarios as a way to process their emotions. New stressors or changes may also cause new worries and stress that were unexpected for you.
- Underlying Mental Health Conditions: For some individuals, suicidal ideation may be a symptom of an underlying mental health condition, such as depression or anxiety and other diagnoses. Even when these conditions are managed effectively, they can still manifest in unexpected ways.
- Limited support or less engagement in pleasing activities: It is imperative for our mental health to engage in socializing and/or receiving support from others. Support can take various forms such as just having someone you trust nearby, having someone who listens to you, someone to check in on you, or even a person who assists in tasks. Pleasing activities are additionally important to our mental well-being, as they provide us small instances of joy to increase our general sense of happiness. If you are not engaging in pleasing activities, it can be difficult to pull happiness from an empty well, so to speak.
- Decrease in physical well-being/attending to health: Difficulties in managing our physical well-being can vary in cause such as injury, stress, changes in allergies, diet, medications, new health diagnoses, etc. Our bodies are connected to our brains, taking care of our bodies influences our mental health.
- Normalize and Accept: Understand that these thoughts, to some degree, while distressing, are not uncommon for some, and often are fleeting. Acknowledge them without judgment, recognizing that they do not define your true intentions or desires.
- Seek Support: If these thoughts become overwhelming or persistent, consider reaching out to a mental health professional. They can help you explore the underlying causes and provide strategies to manage them.
- Mindfulness and Meditation: Practicing mindfulness techniques can help you gain better control over your thoughts and reduce their power. Mindfulness can assist you in observing your thoughts, rather than attaching to them. 5 minutes of mindfulness daily can assist in increasing self-regulation and awareness. Meditation can also be a valuable tool for calming the mind.
- Healthy Coping Mechanisms: There are various techniques you can engage in to assist in coping with distressing thoughts. Here are a few from DBT:
Take care of your mind by taking care of your body with PLEASE:
- Take Care of (P)hysical I(L)lness: Attend to your biological needs i.e. taking medications, supplements, seeing a doctor when you are ill
- Balanced (E)ating: Avoid foods that make you more emotional, try not too eat too much or too little; avoid foods that you have sensitivities to
- (A)void mood altering substances: Avoid illegal substances, use alcohol and caffeine in moderation
- Balance (S)leep: Try to get as consistent amounts of sleep per night as possible, 7-9 hours is suggested amount of sleep per night, try not to sleep to much or too little.
- Balance (E)xercise/Movement: Try to get at least 30 minutes of consistent movement with elevated heartrate per day.
Change your body chemistry with TIP:
- (T)ip your Temperature by activating “the dive response”
- You will need: cold water/icepack, a bowl or sink or plastic bag, ice cubes, 30 second timer
- Prepare your icepack or a bowl/sink/plastic bag with cold water & ice cubes
- Set your 30 second timer, take a deep inhale & hold your breath while putting the cold item on your forehead
- Hold for 30 seconds
- Exhale and follow with paced breathing for 3 minutes
- You will need: cold water/icepack, a bowl or sink or plastic bag, ice cubes, 30 second timer
- (I)ntense Exercise: Engage in any sort of movement that gets your heart rate up for approximately 10-15 minutes, or until you are tired out.
- (P)aced Breathing: Slow your breathing by taking deep breaths for 3 minutes – inhaling through your nose for at least 4 seconds, holding your breath, exhaling out of your mouth for longer than you inhaled.
- (P)aired Muscle Relaxation: From head to toe, going from muscle group by muscle group, tensing them and then releasing them. You would do this by one group individually tensing while inhaling, hold for 5 seconds, exhale and release while saying ‘relax’ in your mind. You would then move on to another group. For more information on how to implement this specific skill, please refer to the DBT skills training manual (2015) or this video.
Accumulating Positives in the Long Term
- Create long term/”Life Worth Living” Goals for your life, choose goals to work on related to the long term goals – now, brainstorm action steps to take now or in the near future, possibly review values and priorities that are workable for your life currently, take action
Accumulate Positives in the Short Term
- Engage in daily activities that bring you joy, these do not have to be grand or expensive activities. These can be as simple as doing small acts of kindness, organizing something you’ve been putting off, engage in art, watch a movie, etc.
- It is important to engage in pleasing activities consistently so that we can add to our “bank” of happiness.
Experiencing thoughts of death or suicide, even when it seems like you’re managing your mental health well, can be a bewildering and distressing experience. Remember that you are not alone, and there are resources and coping strategies available to help you navigate these feelings. By seeking support, practicing self-compassion, and adopting healthy coping mechanisms, you can better understand and manage passive thoughts, intrusive ones, or “calls of the void” while continuing your journey towards improved mental well-being.
If you find yourself experiencing more than just passive or intrusive thoughts related to self-harm or suicide, it is absolutely critical to seek immediate help. Reach out by calling 988, the National Suicide Prevention Lifeline, or visit their website at 988lifeline.org. Remember, there is no shame in seeking assistance; in fact, it is a sign of strength to ask for support when facing such challenging thoughts. Additionally, consider following up with a mental health professional who can provide you with the necessary guidance and strategies to address these thoughts effectively. Your well-being is of paramount importance. There are individuals available for assistance.
About the Author
Alyssa Eichhorn (she/her), M.A., LPCC-S, is a Licensed Professional Clinical Counselor that specializes in dialectical behavior therapy. Alyssa works with all ages in a radically genuine and nonjudgmental setting to help individuals identify more effective and balanced behaviors to create a life worth living. Alyssa provides a directive and warm approach with her clients to facilitate solutions, growth, and change where they want it. Click here to learn more about Alyssa and her therapeutic approach.
Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). Guilford Press.