Tomás Santa Cecilia: «Suicidal behavior is a problem on a social scale»

Suicidal thoughts are one of the most attention-paid red flags in mental health. These kinds of ideas and mental images often serve as rehearsals before attempting to end the own life, and that is why for decades we have worked to offer tools to people who feel that way. way.

In this interview We spoke with the psychologist Tomás Santa Cecilia, an expert in one of the most effective intervention models with people who suffer suicidal ideation: the cognitive-behavioral.

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Interview with Tomás Santa Cecilia: therapy for suicidal thoughts

Tomás Santa Cecilia is a psychologist specializing in the cognitive-behavioral model; He offers his services as an expert in psychological intervention to individuals and companies, both in his Madrid office and also online.

What is the limit between what is considered a simple macabre exercise of imagination and suicidal thoughts?

With regard to suicidal behaviors, I have to say that the limit is in carrying out the suicidal thought, in moving from thought to action, to behavior. It is essential to make this distinction; what determines the limit is the intentionality of the action.

Importantly, suicidal thinking is one thing and suicidal behavior another. In the world, more than 1 million people commit suicide every year. In Spain, more than 3,500 people every year decide to take their own lives or what is the same, 9 people a day take their own lives.

These are the data of people who kill themselves, other data are the people who have tried and that the figure can be multiplied by 10. The same happens with people who have thought about it at some time, in the course of their lives, but who have not carried it out.

Do people who develop suicidal ideation often give notices to some of their friends or family, to try to ask for help?

This is a point of vital importance and that there is still much to be achieved, I sincerely believe that it is the great Achilles heel of suicidal behavior. Most of the people who go through this do not ask for help, and this must be one of the alarms that we have to put ourselves in the hands of a professional “I've been thinking about it for a long time, I'm going to put myself in the hands of a professional".

On the one hand, it is necessary to educate the population so that this behavior does not become "the behavior" the only option before certain problems or situations such as, for example: economic, work, love, social, family or other problems nature. For this, it is necessary to convey to society that difficulties can be addressed from very different levels and that there is no a single solution to a problem, this is the key, we have to show that there are different options from here on, things change.

On the other hand, it is necessary to promote plans for the prevention of suicidal behavior in the population aimed at detecting signs or identifying risk factors for a possible behavior suicidal such as: presence of mental disorders, social isolation, alcoholism, drug addiction, abandonment of medication, depression or, in the case of some young people, stress academic.

Due to the stigma surrounding the concept of suicide, do people who have suicidal thoughts usually recognize it from the first therapy session?

Normally yes, not clearly, but as the session progresses it manifests it. Health professionals detect if there are risk factors and we direct the person not to express it with peace of mind and confidence.

What can a psychologist do in these cases?

It is possible to work from many fronts, at a preventive level, teaching people to ask for help, not to wait for it to be the only option in the face of life's difficulties. At the institutional level from education, from the media from the institutions, the important thing is to start from the basis that suicidal behavior is a problem of non-individual social magnitude that is charged more than 3,500 every year lives.

At the most individual level, once mental illness is ruled out, the person is made to see that suicidal behavior can be a definitive and effective solution. irreversible to a temporary problem, this is one of the keys that we must transfer to people, teach them not to carry out self-injurious behaviors and that they are irreversible.

As a professional of psychology, would you say that it is complex to help people with suicidal ideation to transform the beliefs from which they interpret reality and what happens to them?

It is important to create a good bond with the professional that allows the person to gain confidence and thus allow to build a program for coping with situations, self-confidence and acquisition of strategies and tools before conflicts and difficulties.

We have to teach that there are a series of factors that predispose but do not condition how they can be: abuse sexual, school, academic or work maladjustment, parent-child conflicts or emotional breakups between others.

And as for the change in ways of relating to the environment and to others, surely it is not easy, considering that depression goes hand in hand with a lack of energy and motivation to try things new. How is this achieved through the cognitive-behavioral model?

In the specific case of depression and suicidal behavior, it must be said that not everyone who has depression will have suicidal behavior and at the same time On the contrary, not all suicidal behavior leads to a depressive state, there are cases and it is one more factor to be valued by health professionals. Health.

In this case, the complementation of therapies such as psychopharmacological or cognitive behavioral therapy have good results in the remission of this suicidal ideation.

How are the changes taking place for the better, after several weeks of therapy?

The important and decisive step is for the person to regain self-confidence, to see that there are options, that they are not alone. This allows the professional to start working efficiently and, above all, leading to healthy coping styles. As the person faces situations that were previously supposed to be unattainable or insurmountable, the rest comes rolling. It must be said that each person takes their process, her time.