I want to run my car off the road!
One of the more frustrating suicidal ideations to deal with involves the persistent, low-level ideation of running your car into a highway structure, off the road or into another vehicle.
I have often seen this ideation in older clients and often times has been with them for years or even decades. However, be aware this ideation can occur in very young people as well.
It is confounding for two major reasons.
First, the length of time and persistence of the ideation.
Second, most people who are driving have instant access to the means to carry out their suicide plan if they choose.
One of the interventions that I have found to be helpful over the years is to ask questions to determine why the client is “still here.”
This may sound morbid, but it plays a key role in “breaking the taboo.” This is a concept that we will explore later.
Start with questions like:
"Why are you still here?"
"What stopped you the last time you wanted to do this?"
"What stops you from running off the road?"
"What stops you from running your truck or car into a bridge abutment?"
etc…
If the answer comes back as …
my children,
my grandchildren,
my wife, or
any tangible relative,
…you have an “avenue for insight or change”
When this happens I often recommend the client take a small picture of the person persons they think about and tape it to the sun-visor of their car.
Then I provide instructions for the next time they have these thoughts.
“Pull down your sun-visor and look at your loved one.”
“Imagine going home to them.”
“Imagine having dinner or breakfast with them.”
“Imagine calling them and talking for a while.”
This provides immediate visual reinforcement to stay alive.
In my experience this is been relatively highly effective.
We have to remember that a very large portion of our brain, the occipital lobe, is designed to process visual data. A very large portion of this processing is designed to recognize faces.
I really do believe, in this instance, the picture is worth a thousand words.