Sometimes, actively suicidal callers are manipulative or they will play games. These callers are difficult because they are at risk for suicide, and at the same time they may evoke strong countertransference. For example, a caller might tell the volunteer, "Give me 12 reasons why I should live?" Or a caller might begin to flirt with the volunteer. They may not answer suicide assessment questions. They may be unclear whether or not they took some pills already. This makes it very difficult to assess the callers suicidality or determine whether police intervention is necessary.
Why would a caller be manipulative? There is a certain level of hostility. Anger is one of the highest motivators for suicide. A suicidal person may feel powerless, and playing games with the counselor may renew that sense of power. Sometimes, the caller is experiencing identification. The caller in pain projects their pain onto their counselor. The volunteer becomes a container for that pain. The caller may stop take responsibility for their own actions.
What is helpful in these situations?
-Give the responsibility back to the caller. Ask the caller, "What are the things that keep you going?"
-Set limits. "I will not play games with you."
-Explore ambivalence. "You called suicide prevention today. A part of you still wants to live. I want to talk to that part."
-get support for yourself. Have shift partner monitor your call to provide other interventions you may not think of. After the call, talk to somebody about negative countertransference the caller may have evoked.
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