How Could Someone Try to Kill Themselves: Suicide Attempts and Doing the Unthinkable – from a DBT-CBT Therapy Perspective

When Emotional Mind drives and Rational Mind is left on the side of the road…

When folks are moderately, even severely depressed (say up to an 8 or an 8.5 on a scale of 1-10), they are “Big-Time in Emotional Mind” but they still have some Rational Mind going on (say 85% Emotional Mind and 15% Rational Mind).  Through the small degree of Rational Mind, they maintain some contact with reality and have some mindfulness of the big picture of their life. For instance, they still recognize they have something to live for…they still have some holds on life…and although their grip is loosening and they may be barely holding on…with at least some Rational Mind going on, they recognize the basics…like they have kids to live for…or pets…or their dying parent (examples).  However, as the depression worsens, Emotional Mind intensifies, and Rational Mind further fades…and they lose awareness of these reasons to live.

Patients in various ways have explained how this happens.  They relate that when they made that final decision to kill themselves…to enact that near fatal behavior…they weren’t  thinking…that previously they thought about their kids, their spouse, or other holds on life and they struggled to stay alive…but then, something happened and they no longer thought about these things.

One patient so well described this to me, I haven’t forgotten it.  She said that as her depression deepened, it was like she was going further and further down a well…and the deeper she went, the less she could see out.  She related that she got so far down, she was surrounded by darkness…she could no longer see nor feel…and she lost touch with the love she had for her kids and concern about what would happen to them.  She cried intensely and said that when she did what she did, thoughts of her kids did not cross her mind.  It was utterly heartbreaking, and yes, as a therapist and despite trying to hold my tears back, they rolled out of my eyes.  I stood up and hugged her as she wept and gently rocked her to help soothe her through the pain. It was one of those heart-wrenching therapy moments when I had no words to comfort her and could only pray for her self-forgiveness and healing.  She so loved her babies and could not understand how she could have tried to end her life.  With Rational Mind going on, she realized she did the unthinkable.

I believe that she became 100% (or near 100%) Emotional Mind…and Rational Mind was essentially turned off.   Without Rational Mind, she was not connected or in contact with the reality of her life and what really mattered to her.  It was like a Rational Mind black-out.   She was no longer mindful of the big picture of her life and the reasons to continue the fight.  And we always ask, “God, how could she have done that, she has kids” or “How could he have done that knowing his family would find him.”  They weren’t thinking…that part of their brain was turned off.

Based on the recovery workbook by Melanie Gordon Sheets, Ph.D. -<span


style=”color:#ff0000;”>“Out-of-Control:  A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook for Getting Control of Our Emotions and Emotion-Driven Behavior” –   Copyright 2009  – Recovery Works Publications

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