Suicide Prevention Author Interview: Craig Bryan

Craig J. Bryan, PsyD, ABPP, is a board-certified clinical psychologist in cognitive behavioral psychology and is currently the executive director of the National Center for Veterans Studies and assistant professor in the department of psychology at the University of Utah.

What is the one thing above all else practitioners treating clients contemplating suicide should know?

Simple things save lives. I’ve been training clinicians for years now and I’ve come to realize that most clinicians tend to make things much more complex than they need to when working with suicidal patients. This is because most clinicians have not received extensive training in how to effectively assess suicide risk and develop treatment plans that target suicide risk. As a result, clinicians often focus on depression, anxiety, and other emotional symptoms that do not sufficiently address the underlying problems of suicide risk: emotion regulation, problem solving, and shame. Over the past few years, however, we have made considerable gains in our understanding of what works to prevent suicide, and there is consistent evidence that certain types of cognitive behavioral therapies can significant reduce the risk of suicide attempts.

What is the biggest challenge facing friends and family members of suicidal clients?

Because suicidal individuals often have difficulties communicating with others, friends and family members can become easily frustrated with them. If friends and family members personalize the patient’s suicide risk, for example by seeing their risk as reflective of their own perceived shortcomings (e.g., “I haven’t been a good enough friend”), this can create even greater interpersonal conflict and tension.

What is the most prevalent misconception about suicide and self-harm?

There are many misconceptions, and it’s hard to say if any misconception is more prevalent than another. I would say that one particularly common misconception is the perception of suicide as an “impulsive” act that occurs “on a whim” or “out of the blue.” We’re beginning to understand now that suicide isn’t quite as impulsive as we once thought, although it often appears impulsive to others. It actually seems to be the case that a good proportion of individuals who attempt suicide have thought about it previously, even if it was some time in the distant past.

What inspired you to write about this topic?

I have been interested in suicide since graduate school, but it wasn’t until I joined the military and deployed to Iraq that I was confronted with suicide in a much more personal manner than I had experienced before. Suicide is the fatal outcome of psychological injury, and the tragedy of suicide is that many of these injuries can be so easily treated. Unfortunately, many service members and veterans are unwilling to seek out these treatments because of stigma. To me, the even bigger tragedy is that when they do finally reach out for help, very few of them will receive the most effective treatments available because so few clinicians know how to do them.

What is one thing you’d say to any person contemplating suicide?

There is hope, although it may not always seem like it. Sometimes life deals us a bad hand, but we still have to play the game anyway. The good news is that even if you were dealt a bad hand, if you learn how to play the game well then you can still win.

What is your go-to online resource to recommend to suicidal clients?

What social media platform do you think best addresses suicide and self-harm?

Without a doubt the “Virtual Hope Box.” This app includes many of the concepts that have been found to be effective in treatments for preventing suicide attempts. Individuals who use it tend to rate it very positively, and find it very helpful.

By Craig Bryan