Utilising narrative ideas when meeting with people experiencing suicidal thoughts By Loretta Pederson

Loretta Pederson works within a narrative practice team at Telopea Family Support (Hope Connect) in Sydney’s western suburbs. In this presentation she considers ways that we can utilise narrative ideas when meeting with people experiencing suicidal thoughts. Practitioners are invited to enter the experience of the people we meet with, in a way that is supportive and sustaining for all involved.

Loretta recently gave a longer version of this presentation through the Caspersen Therapy and Training Centre.

 

Powerpoint and document

Loretta’s powerpoint

Workers’ responses in dark times document

References

Newman, D. (2008). ‘Rescuing the said from the saying of it’: Living Documentation in Narrative Therapy. The International Journal of Narrative Therapy and Community Work, 2008, No. 3. Adelaide, Australia: Dulwich Centre Publications.

Newman, D. (2011). The Written Word and Narrative Practice. Friday Afternoons at Dulwich Centre.

O’Neill, M., and Stockell, G. (2011). Reconstructing identities and inviting preferred stories of self: Narrative practice in mental health settings and prisons. Friday Afternoons at Dulwich Centre.

O’Neill, M. (2004). ‘Researching “suicidal thoughts” and archiving young people’s insider knowledges.’ International Journal of Narrative Therapy and Community Work, 2004, No. 3. Adelaide, Australia: Dulwich Centre Publications.

O’Neill, M., and Angela, Brett & Jess (2004). ‘A conversation with Angela, Brett and Jess about suicidal thoughts, failure and resistance.’ International Journal of Narrative Therapy and Community Work, 2004, No. 3. Adelaide, Australia: Dulwich Centre Publications.

Stout, L. (2010). ‘Talking about the suicidal thoughts’: Towards an alternative framework. The International Journal of Narrative Therapy and Community Work 2010, No. 3. Adelaide, Australia: Dulwich Centre Publications.

White, M (2007). Maps of Narrative Practice. New York, NY: W.W. Norton

White, M., and Epston, D. (1990). Narrative Means to Therapeutic Ends. New York, NY: W.W. Norton

Published on August 4, 2014

This Post Has 5 Comments

  1. Mark Byrne

    Hi Loretta, I found this very helpful.

  2. Keri Murray

    Thank you Loretta for taking about this, and particularly for sharing your map of practice. I have not yet viewed the PowerPoint but hope to do so after this long weekend when I have internet access. Will your questions and format be in it? Really appreciated some different questions you ask. Cheers, Keri

    1. Loretta Pederson

      Hi Keri,
      Thanks so much. Yes there are quite a number of questions in the powerpoint about building a support team, and a few about collaboratively assessing safety, and ending the session. Also, there is more detail about possible impacts and tactics of the suicidal thoughts. I am drawing on the maps of externalising, re-authoring and re-membering, but I do think of the format I use as a map that guides my work. This is because there are certain areas I am focused on for the immediate session, and then can come back to for future sessions. I think it is possible to be de-centred but still be on the lookout for openings to building a support team, for example.

      There are more questions in Loree’s article too. Some questions I have absorbed from David Newman and Marilyn O’Neill, who I know here in Sydney. They have taught me a lot about ways of reducing isolation for people experiencing ‘dark thoughts’.

      I know you also meet with people who experience these thoughts, and that you have a lot of skills and knowledges around this. I’d be interested to know what things were similar to your work, and whether there were aspects of the ideas I presented that were different. I would love to also hear about what you do, that perhaps I have not yet tried.

      Warm wishes, Loretta

  3. Laura Gonzalez

    Dear Loretta

    First of all thank you for your questions, that makes me understand how I need to do best to explain myself, and also the limit of this excercise.

    I will describe briefly what I have done.

    First I find out if there is another negative tnought triggering the suicidal thought, so for safety reasons, will do the excercise with this earlier thought.

    I will describe the setting:

    1 Consultant describes the context and what lead to the suicidal thought…a memory of a gone person, fear, etc.

    2 I validate everythinb I hear, emotions, thoughts, scenario, and then I explain that is likely some people not only listen to their negative thoughts but, some feed them, enhance them and out of the sudden thoughts are twice as big, twice as loud and feels there is the thought and not ghemselves guiding their life.

    3 I ask them, do you want to know what I mean???….I give them a candy, and ask them to eat it, most speed up and do not even taste it, I explain this is what happens with thoughts, we do not wander what they want to say, why they are there, we just go for them and embrace them….

    4 we move on to the excercise with a negative thought (not yet the suicidal thought, this excersice might be risky ss you said and is a deeper level you might want to use only if the person masters the excercise through the therapies)

    Loretta, what do you think, if there is anything you would add or delete, please share!!

    By the way, when I do this at work, people is so happy to sense, feel and live how thoughts can be tricking and that there is an exit out of them

    Greetings from Mexico

    1. Loretta Pederson

      Hi Laura,

      Thanks for sharing your practice too. From what you describe, I imagine the people you meet with would really feel listened to and respected. I really value this highly.

      I’m not familiar with the idea you are describing. Could you tell me a bit more about it? When you are repeating the story, is it the ‘action’ of the story, with the feelings described and then also the thoughts? For example, ‘You were driving down the road, and sadness came over you and then the thoughts came: “You are nothing. You should die. Just drive off the cliff right now.” You started to cry, because you didn’t want to leave your family, but then the thoughts told you that they don’t really need you after all.’

      Then the person sits with these feelings, to experience it again and listen to it? Have I got that right, or am I off track? I can see that the person might be really able to create a fuller description of the feelings that come with negative or suicidal thoughts, when they try this exercise, and be clear about its voice. Then you are using externalising questions after the exercise to create clarity that these are tricks and tactics of the negative thoughts, not truth statements of the person’s worth. I am wondering a bit about what other ways you have of structuring safety into the session? Are there ways you assist the person to prepare for the exercise, or particular questions you have found useful after the exercise to help the person come to a point of not being so much in the experience of despair, or whatever it is they call it?

      When you ask the person to ‘listen to the negativity’, are there particular things you are asking them to listen out for? Particular questions to shape their listening? What are your hopes as the therapist in the listening to negativity?

      I guess I’m really curious that they are here, alive, in the session, so after this description you have brought forward of the negative thoughts and their impact, I might ask questions like ‘How did you get through the situation in the car, when the thoughts were so persistent in trying to convince you to die? What did you do or think to yourself to keep safe?’ Also, perhaps “What do you know about your children’s love for you, that helped you see through this statement that your family don’t need you after all?’ or ‘What do you know about your relationship with your partner that the suicidal thoughts were overlooking, or trying to make you forget?’ (depending on what we had discussed).

      What have the people you meet with said about the exercise? I’d be interested to try it myself, in the client position and see what it feels like. Thanks again for sharing your ideas. You’ve really had me thinking for the past few days, which is why it has taken me a while to respond. I certainly appreciate hearing new ideas, and trying them out. Lovely to have heard from you, Laura.

      Warmest wishes,

      Loretta

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