Saving people from suicide: An occasional letter?

by | Nov 29, 2018

Suicide: the darkest and most deluding villain. Even the psych heads can’t say exactly why it’s on the rise and what to do about it. But what if there was a solution so simple everyone missed it?

Dr. Motto was the only American to devise an experiment that dramatically reduced suicide deaths. No, his technique didn’t involve a complicated…

A savvy client brought an article to my attention: “The Best Way to Save People From Suicide,” written by Jason Cherkis. The piece appeared on HuffPost’s Highline.

The article is fascinating and powerful, so you know I had to bring it to you.

Quick heads-up before we get down to business. We’re going to be discussing suicide in a very direct manner. If you’re triggered by such discussion, please consider closing the article.

If you or someone you know are having thoughts of suicide or self-harm, dial 988 in the US. Here’s an excellent international resource.

Okay, let’s go…

“The Best Way to Save People From Suicide”

Mr. Cherkis opens his piece with a hard-hitting introduction of two of his main characters. And keep in mind, this is real life.

Amanda, a 29-year-old nurse, decided at 5:30 on a Friday morning she was going to take her life when she got home from work.

Before leaving her apartment, she emailed the following to her new therapist, Dr. Ursula Whiteside…

Not a good night last night, had a disturbing dream…Got to try and get through the day, hope I can shift my mind enough to focus. Only plan tonight is to come home and take a nap.

A very different sort of therapist

Dr. Whiteside is, well, a very different sort of therapist. For instance, she’s okay with emails from clients in between sessions – and she replies.

Now, Amanda is typically upbeat and highly expressive in her emails. Sensing something was up, Whiteside’s reply got right down to business…

If you are planning on killing yourself this evening or weekend, I need to know.

Sure as heck, Amanda got home from work, waited for darkness to fall, put on her PJs, brushed her teeth, swallowed dozens of pills, laid down on her bed, and drifted off to sleep.

After multiple unsuccessful attempts to reach her, Whiteside called the police. And some six hours after she ingested the pills, they found Amanda. Way out of it, but alive.

Jerome A. Motto, MD: The foundation

how to prevent suicide

Jerome A. Motto, MD

Midway through her undergraduate work, Whiteside transferred to the University of Washington so she could study under Dr. Marsha Linehan, the creator of dialectical behavior therapy.

DBT is a modified type of cognitive behavioral therapy, which was originally intended to treat borderline personality disorder. However, it’s been modified to treat suicidal behavior, self-injury, substance use disorders, and more.

Along her academic journey, Whiteside discovered the work of Dr. Jerome Motto, a long-ago retired psychiatrist and suicide researcher. Go figure, Linehan was into his work as well.

Those occasional letters

Dr. Motto was the only American to devise an experiment that dramatically reduced suicide deaths.

No, his technique didn’t involve a complicated, long-winded therapy manual or an exotic meds cocktail.

Very simply, Motto sent occasional letters to those at risk.

Whiteside was stunned, saying to her own therapist…

Oh my God. What if this is what we should be doing? What if it’s that simple?

So how did Motto come up with the idea? Well, he was an Army officer serving in Europe during World War II.

Throughout this difficult time, his greatest comfort came from the letters he received from a woman back in the States. Though they’d only gone out a handful of times, she wrote bundles of them.

Motto was surprised by his deep attachment to the letters, and he became driven to figure out why. I mean, they weren’t love letters – the woman just wrote about commonplace things.

Dr. Motto’s suicide research project

After the war, Motto got himself through med school, chose psychiatry, and found he was especially drawn to suicidal patients.

His belief was they were made to feel alone.

A sense of connection

Motto came upon the work of German psychoanalyst Hellmuth Kaiser, who submitted that the most disturbed patients could be helped if they felt a sense of connection, even on an unconscious level.

Motto began thinking about the comfort provided by the letters he received during the war. And he wondered if the simple act of showing his suicidal patients he was there for them, expecting nothing in return, would make them feel less isolated – less in conflict with themselves.

How it went down

Well, Motto secured a grant for a massive, long-term suicide research project. And it didn’t take him long to write the first letter.

To a suicide survivor discharged from a psychiatric facility, Motto wrote…

It has been some time since you were here at the hospital, and we hope things are going well for you. If you wish to drop us a note we would be glad to hear from you.

Enclosed was a self-addressed envelope without a stamp. That was important because Motto believed some of the recipients were so sensitive that putting a stamp on the envelope would make them feel obligated to reply – just to avoid wasting a stamp.

In all, 24 letters were mailed to each study patient over five years.

The bottom-line

Motto’s experiment was working, as patients were writing back. And then came what Motto called “the bingo letter” – a perfect encapsulation of the study’s aims.

A man living in San Francisco replied 18 months earlier with what Motto called a “kiss-off” letter. But to the most recent letter he replied in five typewritten pages. His first sentence…

You are the most persistent son-of-a-bitch I’ve ever encountered, so you must really be sincere in your interest in me.

Cutting to the chase, Motto’s work was unprecedented in the history of suicide research.

For instance, in the first two years following hospitalization, the suicide rate of the non-contact (control) group was nearly twice as high as that of the contact group.

But there was more. The work demonstrated that people who attempted suicide, and wanted zero to do with the mental health system, could still be reached.

That’s huge.

Is it that simple?

Jason Cherkis wraps-up his piece chatting with Dr. Whiteside at her Seattle bungalow.

And he met Amanda. She and Whiteside stay in touch, even though they stopped working together two years after the suicide attempt.

Regarding Whiteside, Amanda said…

I thought she was naive. Everybody else I’d worked with seemed overwhelmed and scared and frustrated…I always worried that I was too much.

Dr. Whitesides’s take on suicide? She believes people die when they feel completely alone.

Could the suicide prevention solution be found in something so simple that darned near everyone overlooked it?

Don’t know why not.

Please take the time to check out Dr. Ursula Whiteside and team’s work at Now Matters Now. You’ll find plenty of suicide and general problem resolving resources – for you and others.

Be sure to read Jason Cherkis’ “The Best Way to Save People From Suicide.” There’s a ton of info I couldn’t include here.

Looking for more Chipur mood and anxiety info and inspiration articles? Head to the titles.

Dr. Motto’s image:

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