Family gets scared, so do healthcare professionals, and the conversation just stops. Even though that’s exactly when a conversation should start, about what it is like to live with thoughts of death.

In the framework of mental disruption we look differently at psychological suffering. Not as a collection of stand alone disorders, but as a disruption of the relationship between one’s self and what happens in their consciousness.

The Human Consciousness Is Dialogical

The human consciousness is dialogical. As a human being, you have thoughts, feelings, and desires, but you can have an opinion on these, or be sceptical about them. You can think, and at the same time notice that you are thinking. You can feel, and at the same time notice that you are feeling. There is always a connection between the person, and what happens in their consciousness.

When suffering psychologically that connection gets disrupted.

A feeling, thought, or desire can grow so big it overpowers the whole dialogue. It becomes forceful, and takes up space. It becomes isolating. The person who usually relates normally to the experience feel less and less free.

We see this in lot of forms of psychological suffering.

In compulsion a thought becomes compelling
In anxiety the fear becomes compelling
In depression the sadness becomes compelling
When hearing voices the inner voice becomes forceful
In addiction the desire becomes compulsory

And in suicidal ideation the thought of death can become forceful.

In all these situations it isn’t just about the contents of your experience. It is more about the relationship with it. The feeling there is no space left, and you become a prisoner.

The feeling of being trapped often goes hand in hand with desperation. People feel like there is no hope for the future. That everything is stuck, and that there is no other possibility.

A thought of death is not just a thought about dying. It is often an expression of deep disruption of the relationship with one’s own consciousness. The question is then not just how you get rid of that thought. The question is how do you change the relationship with that thought.

Living With Thoughts of Death

Just like people learn how to cope with hearing voices, people can learn how to cope with thoughts of death. Not by ignoring it, but by acknowledging it. By bringing it into the dialogue.

The aim isn’t always for the thought to go away. The aim is that the power shifts. That room is being created. That somebody is able to say: there is a thought of death, but it doesn’t define everything.

Why Talking About Suicide Helps

The best suicide prevention is to talk about it.

There is a persistent misunderstanding that talking about suicide is dangerous. As if you can plant the idea in someone’s head. The opposite is true. What makes suicidal thoughts dangerous is not the talking about it, but the having to deal with it on your own.

When someone with thoughts of death has no one to talk to about it, the thought retrieves itself into the inner self. And that’s where it can grow. The outer world gets smaller, the thought can develop itself into a tunnel in which only one direction is visible.

A conversation breaks this isolation. But that only works if there is a relationship. When the person opposite you stays, listens, and not just instantly tries to fix you. In this kind of relationship, you can explore the death wish together.

Exploring Thoughts of Death Together

What does the wish feel like?
How often is it there?
When does it become more forceful?
What stops you from seeing a future?
What used to give you hope in the past?

These kinds of questions aren’t a checklist. They are a way of looking at what happens on the inside. And like this, the death wish comes out of isolation. It becomes part of a shared exploration instead of a stand alone conviction.

Many people feel relief when they notice that their thoughts of death can be discussed within a relationship with another person. The thought doesn’t have to be hidden away anymore, and it doesn’t have to be carried alone either.

What also helps is to acknowledge that a thought about death is not some kind of moral failing. People think about death, that’s part of human existence. The philosopher Martin Heidegger described a person as a “Sein zum Tode”. A creature that lives with the realisation that death is inevitable.

Everybody lives towards death. And every person has some saying in the way they die. To acknowledge that doesn’t mean you encourage suicide, it means that you take someone serious, as a person.

Many people find comfort in knowing their autonomy is being respected. That it’s not instantly followed by control, panic, or moralising. That acknowledgement can open up space.

When the thought of death is no longer ‘not allowed’ and can be carried within a relationship with someone else, it often loses part of its power. And in that space, something else can appear. Something that isn’t the end. It may be small, but it’s there. A possibility to carry on.

Thoughts of death: The Danger of Silence and Taboo

When suicidal thoughts are not being discussed, more danger is often created. The thought keeps spinning around in someone’s head. It becomes stronger, more isolating, and more absolute. People get stuck in what scientists call entrapment. The feeling of being locked up, without a way out.

The same thing can happen when a healthcare provider brings up euthanasia without being prompted. Sometimes this can happen out of discomfort. The suicidal thought gets translated into a legal or medical process.

But then, the death wish turns into a fixation on euthanasia. The conversation shifts from experience to procedure. And that can make the room for exploring a relationship with the suicidal thoughts disappear. Which makes seeking help more difficult.

That’s why it’s important to stop and explore the suicidal thoughts themselves. What do they mean? Where did they come from? What are they trying to tell you?

Trauma, Psychosis, and Thoughts of Death

In many cases, thoughts of death go hand in hand with experiencing trauma, psychosis, or long term emotional disruption. Trauma can lead to feeling stuck, ashamed, and hopeless. Psychosis can disrupt the connection to your consciousness so much that thoughts and feelings become overpowering. In all of these situations, the main thing is not what someone is going through, but how they relate to it.

Recovery often means that the dialogue with these experiences slowly returns, and not that everything goes away. It means that room is created. Room to feel, to think, and to have doubts. And sometimes, despite everything, room to think about the future.

And sometimes, that recovery starts with something very simple. With someone finally being allowed to say: I sometimes wish I were dead.

And that someone sitting opposite them says: tell me about that.