You can talk about anything in the therapy room, right? But what happens if the subject is suicide? It’s not easy to sit with a client who is telling you about their suicidal thoughts – and many of us might be apprehensive or fearful to explore with our clients their thinking and its meaning. We might even be tempted to avoid the topic entirely. Some clinicians might also work in organisations where suicide is off limits, perhaps because of an explicit policy or a tacit assumption that we should measure and manage suicide risk rather than seek to understand our clients.
In his article, Andrew Reeves invites us to consider our approach to working with suicidal clients. Andrew understands the anxiety around suicide and knows from his own experience of the long-lasting impact on the clinician if a client takes their own life. But he also believes in the power of the therapeutic relationship, as it is perhaps the only relationship that offers clients a safe space to talk about their suicidal feelings. So, Andrew asks us to be brave – to stay alongside our clients as they navigate the potentially treacherous territory between wanting to live and wanting to die.
I confess I am not a gardener. I am not even a COVID convert to planting and pruning, watering and weeding. But I am fully signed up to Sue Stuart-Smith’s ideas on the connection between tending seeds and nurturing self-belief. As Sue explains so beautifully in her article, gardening gives us both the illusion of omnipotence and the reality of fallibility. In other words, it provides us with a source of confidence and hope, so we are more equipped to bear life’s disappointments.
In my clinical work, I draw on the established techniques and theories that I learnt in my training. But I also owe it to my clients to be open to new ideas and approaches. In fact, it’s one of the joys of the job, to always be learning. And I have learnt something from Andrew Keefe’s article. Andrew is both a therapist and a personal trainer – and in an innovative fusion of the two disciplines, he brings boxing and running into the therapy room to treat trauma. Why? Well, if the body’s impulse to fight or flee was blocked at the time of the traumatic incident, boxing and running might allow a client finally to follow the instruction and recover their equilibrium.
Rebecca Fox also works with trauma – and she challenges the assumption that you cannot treat trauma in a limited number of sessions. Rebecca explains how a short-term model can create a safe space for clients, as they work through their recovery.
Healthcare workers are always under pressure. Doctors, for example, suffer higher rates of burnout and have a greater risk of suicide than the general population. Of course, the pandemic has put even more strain on the country’s healthcare staff. People in the caring professions also often find it difficult to ask for help, for fear of judgment or even retribution. The charity, Doctors in Distress, runs online, peer support groups for healthcare workers. Gavin Lashley, a BACP member, writes about his experience as a group facilitator. We also hear from Dr Chris Sanders, who joined one of the charity’s long COVID support groups, which he describes as ‘transformative’.
I hope you enjoy this issue. But if there is anything you would like us to cover in future issues, please let me know. I would also welcome emails from anyone who would like to contribute to the journal.
Naomi Caine
hcpj.editorial@bacp.co.uk