Christmas Cards or Charity? - an alternative view.

I am starting to see posts on Facebook and get messages from friends saying they are not sending Christmas cards this year. They, like many object to the cost of cards, feel perhaps it is a waste of time, money and effort and that the money is better given to charity. Very commendable!

Each time I see this I also notice the charities they are giving the Christmas card money to - usually big companies and very frequently cancer awareness, research, other huge disease or disability corporations, Macmillan or hospices. Great!

However, I would like to offer an alternative view. Some of these big companies are given so much money in legacies each year they never actually need any more. While it is admirable to give money to those who do cancer or other disease research, prevent illness or look after the terminally ill - what about those left behind? Noah's Ark - a charity in Worcester which offers counselling for children who have had parents die to help them understand and cope with their loss - has had to close recently due to lack of funding.

Likewise, surely we want life to be good for everyone - but homeless shelters close all the time because there is no money or support, leaving vulnerable children on the streets. Children's homes are obliged to have their teenagers leave them and attempt to become independent at 16 years old because they cannot get the funding to keep them until they are mature and able to care sufficiently for themselves. Many end up homeless, self-harming or committing suicide, in trouble with the police or in prison - the only place they can find safety and security.

... and individually - What about the people you usually send cards to - or might send to if you sent cards? How many are elderly, recently suffered loss or bereavement, moved away - and already feel isolated and alone and really might just be grateful to find they have been remembered - if only once a year. How many really might notice the loss of your card and evidence of both your thoughts and the feeling that they might deserve the thoughts of others.

I'm not saying don't give money to charity by any means. But I would like you to think of the smaller guys who desperately need your help and the individuals whose spirits are raised at Christmas having been remembered by you.

- Counselling Suicide Risk Online

Ok - not a cheery thought for the run up to Christmas but it is a time when people can find things really getting too much for them and unable to face this time alone, with too little money or a host of other reasons that might make the seriously drastic step of wanting to take your own life, as a means of making all the pain go away, a reality.

But what help is there? The Samaritans are a volunteer organisation for the UK and Ireland who are available 24 hours a day with confidential listeners working by telephone, text or online.

jo@samaritans.org

Outside this area it is worth contacting www.befrienders.org.

Samaritans say their phones ring every 5 seconds - so there are a lot of people in desperate circumstances who need help.

However, what about private counselling? If a client in a face to face session said they have suicidal feelings, as a counsellor you would allow them to express those feelings and support them in whatever way was appropriate. Many counsellors take details of GPs and next of kin for precisely this scenario and include in their contract the fact that this is something they will be unable to keep confidential as, morally (if not legally) they feel the need to intervene.

So what is different about working with clients online? Many websites for online counsellors will state that they cannot or will not work with clients who have thoughts of suicide. That's fine of course, we are ethically obliged to work within our level of competency. But just a couple of thoughts occur to me.

Firstly the Samaritans, while trained listeners and part of a large organisation - and truly admirable, are not qualified counsellors with degrees and extra professional development under their belts.

Secondly, why is it different to listen to someone face to face express these thoughts and feelings to hearing the same things online? In neither case are you going to immediately rush out to 'save' your client, which would be undermining them and their personal choice and control, but in both would seek to hear what they had to say, support and probably find extra support for when they were no longer talking to you. (My next blog will address assessing and responding to suicide risk)

But my main point is that, by saying you will not take a client who expresses suicidal feelings (worse - what if they are already a client? - Are you going to leave them with feelings of abandonment as you refer them rapidly to someone else?) you are denying them the opportunity to speak truthfully and from the heart. You are keeping a barrier between you that they are unable to cross if they wish to work with you.

How many of us, at any point in our lives, has not thought - 'it would be just so much easier, less painful if .... Or 'I just can't do this any more - there is no point, no hope .....'?

Then what if you came up against someone you really wanted to talk to, to help you, and they referred you elsewhere because 'they didn't work with suicide'. Is it really suicide? Is it just someone needing to say the words, try it out, see if it is a reality for themselves? Or just ask you for help.

As the BACP information sheet P7 (Reeves and Seber, 2010) points out - there is not only no evidence that asking a client if they have suicidal thoughts will put the idea into their heads, but there is a great deal of evidence to say that allowing a client the opportunity - allowing them permission and the space - to express these thoughts and feelings is an honest and respectful way of helping them to keep themselves safe. Many people feel suicidal but have no intention of acting on those feelings. However, allowing yourself to be with them in their despair in the moment allows them to reflect further on the meaning of their feelings and take control for themselves.

There is also plenty of evidence to suggest that the possible anonymity of Online Counselling allows the client to say things they would not usually say - and certainly not face to face. This is precisely then the time that, when a relationship has started to develop, the subject of suicidal thoughts might come up - and we have to be prepared to deal with that and be the empathic, honest and non judgemental ear they need us to be.