07 May Ending It All
Suicide. I am finding this a really difficult subject to write about. As I sit here typing, thinking, looking out onto my garden, I’m acutely aware of what I’m writing and feel pressure to “say the right thing” — and certainly not “say the wrong thing.” Suicide is so important to write about, to acknowledge, and to meet with stability and openness. Alongside my private practice with adults, I also work in a secondary school in North London, which means suicide is often present and spoken about (which is a good thing). It comes up frequently; these feelings need to be explored in order to understand what underpins the very difficult emotions experienced by suicidal people.
Suicide remains a significant public‑health concern across the UK, with over 7,000 deaths registered nationally in 2024 (according to the ONS). Men continue to face the highest risk, with the most affected group being men aged 50–54. Why, then, are suicide figures higher for men? I don’t know for certain, but we can wonder whether men — who are often socialised from childhood to hide vulnerability and avoid expressing distress — may come to believe that suicide is the only solution. Other contributing factors frequently include alcohol or drug misuse, social isolation, financial hardship, experiences of bullying, and histories of sexual abuse. For women, underlying issues can involve a loss of identity, difficulties with social connection, family pressures, and intense internal emotional conflicts.
Although long‑term trends show a decline since the 1980s, suicide rates have remained relatively stable in recent years, underscoring the ongoing need for prevention, support, and early intervention. It’s important to say that you can recover from these feelings. If you are experiencing suicidal thoughts or ideation, support is available; details of support are at the end of this post.
Research suggests that emotional and communication difficulties may contribute to the heightened suicide risk observed among adolescents, who are grappling with an inability to hold and manage intense feelings at a time of enormous physical, sexual, and emotional change. It is a difficult developmental stage to navigate and often brings up unprocessed emotions from earlier in life. Many young people do not want to face the reality of growing up and may try to avoid it altogether. When a young person has experienced challenges in their life, they can become more emotionally vulnerable. This is why stable relationships with adults — and access to counsellors — are so important.
How suicide shows up in therapy
When suicidal thoughts appear in therapy, they are often shrouded in shame, creating an internal “split,” as if the client has two sides: the part of the self that turns up to sessions each week, and the other, disconnected, punishing, persecutory part, intent on “killing off” the good part of the self because it feels like the only solution.
Working therapeutically with a suicidal client has its challenges. What is stirred up in the room can evoke very primitive feelings that the therapist may unconsciously want to avoid, leading them to shy away from the topic altogether. There is often a vicious undertone to this material, where the client attacks themselves repeatedly, with themes of punishment and self‑hatred that can be difficult to work with. And when clients speak about taking their life, the feelings are steeped in shame. This is why, when suicide does show up, it is crucial that the therapist can shift the narrative from solely “preventive measures” to a deeper exploration of the thought processes that might lead a person to believe there is only one final solution to their pain.
If you are experiencing difficulties, the following organisations are here to help you:
https://supportaftersuicide.org.uk/ 
