Why we don’t ask why

September 12, 2024

MANILA – September is Suicide Prevention Month. In psychotherapy class, we also just finished discussing how to manage suicide risk. My students, who major in different areas of psychology and do not necessarily plan to become practitioners, often get approached for such help whether they like it or not and so it is much better to be trained and prepared.

One could work in a private company and have to help a coworker dealing with a crisis. Schools, all too often, have to contend with mental health crises among students and staff. There is no social context or setting untouched by the risk of suicide. As much as some of my students fear such a scenario, it is important to be ready and know what to do.

There are many misconceptions surrounding suicide. I have written such articles in the past, including the myth that talking about suicide increases the risk of suicide (“Mental health month (2): Myths, misconceptions” 10/12/23).

We are making headway in clarifying that and it has become more and more acceptable for people to talk about it in a calm, straightforward manner. We now know that we must address suicide risk head-on, learn to listen with compassion and nonjudgment, and communicate openly about feelings and experiences that are unpleasant.

There is one recommendation in our guidelines on suicide risk assessment, however, that confused my students: Don’t ask “why.” As one student asked, how can we understand the suicidal thought without asking why?

“Why” is a contentious word in psychotherapy. Some therapists avoid using it altogether, fearing that it only serves to increase rationalization and intellectualization rather than allowing our clients to stay in the mode of experience.

Rationalizatio