When I think of the hundreds of patients I have heard speak of suicide over the past 20 years, whether their own or that of others, and I imagine all those I will no doubt hear in the years of medical practice to come, what seems of most help is not an unwarranted optimism, or a belief that suicide can be right or that it is always wrong, but our flawed human capacity to hold mutually contradictory beliefs and voice them with conviction. When the task in hand is to convince a suicidal patient there is value and purpose in life, then thoughts of suicide are best framed as a shared enemy, a corruption of reality, a manifestation of illness – something to be reasoned away, or quelled with medication. But for the families of the dead, who sit later in the same consulting room, those metaphors of distortion and disease can be unhelpful, even hurtful, and what best replaces them are metaphors of victory and redemption, of suffering followed by release.
Needull in a haystack 